Search results for: Anne Jane M. Hallasgo

Authors: Kristin Lewis, Howard Steele, Anne Murphy, Miriam Steele, Karen Bonuck, Paul Meissner

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The present study examines data collected during the randomized control trial (RCT) of the Group Attachment-Based Intervention (GABI©), a trauma-informed, attachment-based intervention aimed at promoting healthy parent-child relationships that support child development. Families received treatment at Treatment Center and were randomly assigned to either the GABI condition or the treatment as usual condition, a parenting class called Systematic Training for Effective Parenting (STEP). Significant improvements in the parent-child relationship have been reported for families participating in GABI, but not in the STEP control group relying on Coding Interactive Behavior (CIB) as applied to 5-minute video-films of mothers and their toddlers in a free play context. This report considers five additional attachment-relevant 'clinical codes' that were also applied to the 5-minute free play sessions. Seventy-two parent-child dyads (38 in GABI and 34 in STEP) were compared to one another at intake and end-of-treatment, on these five-point dimensions: two-parent codes—the dissociation and ignoring; two child codes—simultaneous display of contradictory behavior and fear; and one parent-child code, i.e., role reversal. Overall, scores were low for these clinical codes; thus, a binary measure was computed contrasting no evidence with some evidence of each clinical code. Crosstab analyses indicate that child fear at end-of-treatment was significantly lower among children who participated in GABI (7% or 3 children) as compared to those whose mothers participated in STEP (29% or 10 children) Chi Sq= 6.57 (1), p < .01. Discussion focuses on the potential for GABI to reduce childhood fearfulness and so enhance the child's health.

Keywords: coding interactive behavior, clinical codes, group attachment based intervention, GABI, attachment, fear

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Authors: Isara Muangthai, Lin Sue Jane

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Electricity is vital to every country’s economy in the world. For Thailand, the electricity generation sector plays an important role in the economic system, and it is the largest source of CO2 emissions. The aim of this paper is to use the decomposition analysis to investigate the key factors contributing to the changes of CO2 emissions from the electricity sector. The decomposition analysis has been widely used to identify and assess the contributors to the changes in emission trends. Our study adopted the Divisia index decomposition to identify the key factors affecting the evolution of CO2 emissions from Thailand’s thermal power sector during 2000-2011. The change of CO2 emissions were decomposed into five factors, including: Emission coefficient, heat rate, fuel intensity, electricity intensity, and economic growth. Results have shown that CO2 emission in Thailand’s thermal power sector increased 29,173 thousand tons during 2000-2011. Economic growth was found to be the primary factor for increasing CO2 emissions, while the electricity intensity played a dominant role in decreasing CO2 emissions. The increasing effect of economic growth was up to 55,924 million tons of CO2 emissions because the growth and development of the economy relied on a large electricity supply. On the other hand, the shifting of fuel structure towards a lower-carbon content resulted in CO2 emission decline. Since the CO2 emissions released from Thailand’s electricity generation are rapidly increasing, the Thailand government will be required to implement a CO2 reduction plan in the future. In order to cope with the impact of CO2 emissions related to the power sector and to achieve sustainable development, this study suggests that Thailand’s government should focus on restructuring the fuel supply in power generation towards low carbon fuels by promoting the use of renewable energy for electricity, improving the efficiency of electricity use by reducing electricity transmission and the distribution of line losses, implementing energy conservation strategies by enhancing the purchase of energy-saving products, substituting the new power plant technology in the old power plants, promoting a shift of economic structure towards less energy-intensive services and orienting Thailand’s power industry towards low carbon electricity generation.

Keywords: co2 emission, decomposition analysis, electricity generation, energy consumption

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Authors: Milan N. A. Van Der Kuil, Anne M. A. Visser-Meily, Andrea W. M. Evers, Ineke J. M. Van Der Ham

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Navigation ability is essential for autonomy and mobility in daily life. In patients with acquired brain injury, navigation impairment is frequently impaired; however, in this study, we tested the effectiveness of a serious gaming training protocol as a tool for cognitive rehabilitation to reduce navigation impairment. In total, 38 patients with acquired brain injury and subjective navigation complaints completed the experiment, with a partially blind, randomized control trial design. An objective navigation test was used to construct a strengths and weaknesses profile for each patient. Subsequently, patients received personalized compensation training that matched their strengths and weaknesses by addressing an egocentric or allocentric strategy or a strategy aimed at minimizing the use of landmarks. Participants in the experimental condition received psychoeducation and a home-based rehabilitation game with a series of exercises (e.g., map reading, place finding, and turn memorization). The exercises were developed to stimulate the adoption of more beneficial strategies, according to the compensatory approach. Self-reported navigation ability (wayfinding questionnaire), participation level, and objective navigation performance were measured before and after 1 and 4 weeks after completing the six-week training program. Results indicate that the experimental group significantly improved in subjective navigation ability both 1 and 4 weeks after completion of the training, in comparison to the score before training and the scores of the control group. Similarly, goal attainment showed a significant increase after the first and fourth week after training. Objective navigation performance was not affected by the training. This navigation training protocol provides an effective solution to address navigation impairment after acquired brain injury, with clear improvements in subjective performance and goal attainment of the participants. The outcomes of the training should be re-examined after implementation in a clinical setting.

Keywords: spatial navigation, cognitive rehabilitation, serious gaming, acquired brain injury

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Authors: Kalina Alina Aidarovna, Khayrullina Yulia Sergeevna

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The question of forming quality housing and living environment remains a vexed problem in the current situation of high-rise apartment building in big cities of Russia. At this start up stage of the modern so-called "mass housing" market it needs to identify key quality characteristics on a different scale from apartments to the district. This paper describes the methodology of qualitative assessment of modern mass housing construction, made on the basis of the ITMO university in cooperation with the institute of spatial planning "Urbanika," based on the case study of St. Petersburg’s residential mass housing built in 2011-2014. The methodology of the study of housing and living environment goes back to the native and foreign urbanists of 60s - 80s, such Jane Jacobs, Jan Gehl, Oscar Newman, Krasheninnikov, as well as Sommer, Stools, Kohnen and Sherrod, Krasilnikova, Sychev, Zhdanov, Tinyaeva considering spatial features of living environment in a wide range of its characteristics (environmental control, territorial and personalization, privacy, etc.). Assessment is carrying out on the proposed system of criteria developed for each residential environment scale-district, quarter, courtyard, building surrounding grounds, houses, and flats. Thus the objects of study are planning unit of residential development areas (residential area, neighborhood, quarter) residential units areas (living artist, a house), and households (apartments) consisting of residential units. As a product of identified methodology, after the results of case studies of more than 700 residential complexes in St. Petersburg, we intend the creation of affordable online resource that would allow conducting a detailed qualitative evaluation or comparative characteristics of residential complexes for all participants of the construction market-developers, designers, realtors and buyers. Thereby the main objective of the rating may be achieved to improve knowledge, requirements, and demand for quality housing and living environment among the major stakeholders of the construction market.

Keywords: methodology of living environment, qualitative assessment of mass housing, scale-district, vexed problem

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Authors: Paolo Boscaro, Vasile Hulea, François Fajula, Francis Luck, Anne Galarneau

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TiO2 based monoliths with hierarchical macropores and mesopores have been synthesized following a novel one pot sol-gel synthesis method. Taking advantage of spinodal separation that occurs between titanium isopropoxide and an acidic solution in presence of polyethylene oxide polymer, monoliths with homogeneous interconnected macropres of 3 μm in diameter and mesopores of ca. 6 nm (surface area 150 m2/g) are obtained. Furthermore, these monoliths present some carbon and nitrogen (as shown by XPS and elemental analysis), which considerably reduce titanium oxide energy gap and enable light to be absorbed up to 700 nm wavelength. XRD shows that anatase is the dominant phase with a small amount of brookite. Enhanced light absorption and high porosity of the monoliths are responsible for a remarkable photocatalytic activity. Wastewater treatment has been performed in closed reactor under sunlight using orange G dye as target molecule. Glass reactors guarantee that most of UV radiations (to almost 300 nm) of solar spectrum are excluded. TiO2 nanoparticles P25 (usually used in photocatalysis under UV) and un-doped TiO2 monoliths with similar porosity were used as comparison. C,N-doped TiO2 monolith allowed a complete colorant degradation in less than 1 hour, whereas 10 h are necessary for 40% colorant degradation with P25 and un-doped monolith. Experiment performed in the dark shows that only 3% of molecules have been adsorbed in the C,N-doped TiO2 monolith within 1 hour. The much higher efficiency of C,N-doped TiO2 monolith in comparison to P25 and un-doped monolith, proves that doping TiO2 is an essential issue and that nitrogen and carbon are effective dopants. Monoliths offer multiples advantages in respect to nanometric powders: sample can be easily removed from batch (no needs to filter or to centrifuge). Moreover flow reactions can be set up with cylindrical or flat monoliths by simple sheathing or by locking them with O-rings.

Keywords: C-N doped, sunlight photocatalytic activity, TiO2 monolith, visible absorbance

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Authors: Anne N. Heirman, Song Duimel, Rob van Son, Lisette van der Molen, Richard Dirven, Gyorgi B. Halmos, Julia van Weert, Michiel W.M. van den Brekel

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Objectives: Treatments for head-neck cancer are drastic and often significantly impact the quality of life and appearance of patients. Shared decision-making (SDM) beholds a collaboration between patient and doctor in which the most suitable treatment can be chosen by integrating patient preferences, values, and medical information. SDM has a lot of advantages that would be useful in making difficult treatment choices. The objective of this study was to determine the current level of SDM among patients and head-and-neck surgeons. Methods: Consultations of patients with a non-cutaneous head-and-neck malignancy facing a treatment decision were selected and included. If given informed consent, the consultation was recorded with an audio recorder, and the patient and surgeon filled in a questionnaire immediately after the consultation. The SDM level of the consultation was scored objectively by independent observers who judged audio recordings of the consultation using the OPTION5-scale, ranging from 0% (no SDM) to 100% (optimum SDM), as well as subjectively by patients (using the SDM-Q-9 and Control preference scale) and clinicians (SDM-Q-Doc, modified control preference scale) percentages. Preliminary results: Five head-neck surgeons have each at least seven recorded conversations with different patients. One of them was trained in SDM. The other four had no experience with SDM. Most patients were male (74%), and oropharyngeal carcinoma was the most common diagnosis (41%), followed by oral cancer (33%). Five patients received palliative treatment of which two patients were not treated recording guidelines. At this moment, all recordings are scored by the two independent observers. Analysis of the results will follow soon. Conclusion: The current study will determine to what extent there is a discrepancy between the objective and subjective level of shared decision-making (SDM) during a doctor-patient consultation in Head-and-Neck surgery. The results of the analysis will follow shortly.

Keywords: head-and-neck oncology, patient involvement, physician-patient relations, shared decision making

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Authors: Sera Ratu, Jane Chivers, Jessica Botfield

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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.

Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools

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Authors: Franco Miguel Nodado, Adrienne Marie Bugayong Janagap, Allen Claire Arances, Kirsten Anne Gerez, Frances Catherine Rosario, Charise Alvyne Samaniego, Matt Andrew Secular, Rommel Gestuveo, Marilyn Sumayo, Joseph Arbizo, Philip Ian Padilla

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COVID-19 pandemic adversely affected the delivery of health care services, but its impacts on Maternal, Newborn, Child Health and Nutrition (MNCHN) programs in rural municipalities in the Philippines remains understudied. Thus, this study explored the effects of the pandemic on MNCHN indicators in the municipalities of Miagao, Iloilo and Sibunag, Guimaras. A cross-sectional design was employed to compare the MNCHN indicators before and during the pandemic, and between Miagao and Sibunag. Key informant interviews (KII) were performed to identify the factors affecting access to MNCHN programs. During the pandemic, Miagao had a significant increase in positive outcomes of eight out of ten maternal health indicators, while Sibunag showed a significant decrease in six indicators. For child health and nutrition, Miagao obtained significant improvements in five of seven indicators, while Sibunag showed a significant increase in positive outcomes for six. KII data showed that the primary concern of mothers in Miagao is accessibility, while mothers in Sibunag raised concerns on accessibility, availability, and affordability of these MNCHN services. Miagao MHO employed various strategies such as telemedicine, activation of barangay health workers, and decentralization of health services to Barangay Health Centers, which can explain the improvements in MNCHN indicators. Sibunag also decentralized its health services, but its limited resources might have led them to prioritize child health and nutrition services. The findings suggest that the impacts of the COVID-19 pandemic on MNCHN depend on local health measures employed by the municipality, while telemedicine is a very useful tool in mitigating the negative effects of disrupted health services.

Keywords: maternal, child, COVID-19, Miagao, Sibunag, nutrition

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Authors: Nathalie Elia, Samer Aouad, Jane Estephane, Christophe Poupin, Bilal Nsouli, Edmond Abi Aad

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Carbon dioxide is one of the main contributors to greenhouse effect and hence to climate change. As a result, the methanation reaction CO2(g) + 4H2(g) →CH4(g) + 2H2O (ΔH°298 = -165 kJ/mol), also known as Sabatier reaction, has received great interest as a process for the valorization of the greenhouse gas CO2 into methane which is a hydrogen-carrier gas. The methanation of CO2 is an exothermic reaction favored at low temperature and high pressure. However, this reaction requires a high energy input to activate the very stable CO2 molecule, and exhibits serious kinetic limitations. Consequently, the development of active and stable catalysts is essential to overcome these difficulties. Catalytic methanation of CO2 has been studied using catalysts containing Rh, Pd, Ru, Co and Ni on various supports. Among them, the Ni-based catalysts have been extensively investigated under various conditions for their comparable methanation activity with highly improved cost-efficiency. The addition of promoters are common strategies to increase the performance and stability of Ni catalysts. In this work, a small amount of Ru was used as a promoter for Ni catalysts supported on ceria and tested in the CO2 methanation reaction. The nickel loading was 5 wt. % and ruthenium loading is 0.5wt. %. The catalysts were prepared by successive impregnation method using Ni(NO3)2.6H2O and Ru(NO)(NO3)3 as precursors. The calcined support was impregnated with Ni(NO3)2.6H2O, dried, calcined at 600°C for 4h, and afterward, was impregnated with Ru(NO)(NO3)3. The resulting solid was dried and calcined at 600°C for 4 h. Supported monometallic catalysts were prepared likewise. The prepared solids Ru(0.5%)/CeO2, Ni(5%)/CeO2 and Ru(0.5%)-Ni(5%)/CeO2 were then reduced prior to the catalytic test under a flow of 50% H2/Ar (50 ml/min) for 4h at 500°C. Finally, their catalytic performances were evaluated in the CO2 methanation reaction, in the temperature range of 100–350°C by using a gaseous mixture of CO2 (10%) and H2 (40%) in Ar balanced at a total flow rate of 100 mL/min. The effect of pressure on the CO2 methanation was studied by varying the pressure between 1 and 10 bar. The various catalysts showed negligible CO2 conversion at temperatures lower than 250°C. The conversion of CO2 increases with increasing reaction temperature. The addition of Ru as promoter to Ni/CeO2 improved the CO2 methanation. It was shown that the CO2 conversion increases from 15 to 70% at 350°C and 1 bar. The effect of pressure on CO2 conversion was also studied. Increasing the pressure from 1 to 5 bar increases the CO2 conversion from 70% to 87%, while increasing the pressure from 5 to 10 bar increases the CO2 conversion from 87% to 91%. Ru–Ni catalysts showed excellent catalytic performance in the methanation of carbon dioxide with respect to Ni catalysts. Therefore the addition of Ru onto Ni catalysts improved remarkably the catalytic activity of Ni catalysts. It was also found that the pressure plays an important role in improving the CO2 methanation.

Keywords: CO2, methanation, nickel, ruthenium

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Authors: Sipho Mbatha, Anne Mastament-Mason

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South African manufacturing global competitiveness was ranked 22nd (out of 38 countries), dropped to 24th in 2013 and is expected to drop further to 25th by 2018. These impacts negatively on the industrialisation project of South Africa. For industrialization to be achieved through labour intensive industries like the Apparel Manufacturing Industries of South Africa (AMISA), South Africa needs to identify and respond to factors negatively impacting on the development of competitive advantage This paper applied factor conditions from Porter’s Diamond Model (1990) to understand the various challenges facing the AMISA. Factor conditions highlighted in Porter’s model are grouped into two groups namely, basic and advance factors. Two AMISA associations representing over 10 000 employees were interviewed. The largest Clothing, Textiles and Leather (CTL) apparel retail group was also interviewed with a government department implementing the industrialisation policy were interviewed The paper points out that while AMISA have basic factor conditions necessary for competitive advantage in the clothing and textiles industries, Advance factor coordination has proven to be a challenging task for the AMISA, Higher Education Institutions (HEIs) and government. Poor infrastructural maintenance has contributed to high manufacturing costs and poor quick response as a result of lack of advanced technologies. The use of Porter’s Factor Conditions as a tool to analyse the sector’s competitive advantage challenges and opportunities has increased knowledge regarding factors that limit the AMISA’s competitiveness. It is therefore argued that other studies on Porter’s Diamond model factors like Demand conditions, Firm strategy, structure and rivalry and Related and supporting industries can be used to analyse the situation of the AMISA for the purposes of improving competitive advantage.

Keywords: compliance rule, apparel manufacturing industry, factor conditions, advance skills and South African industrial policy

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Authors: Sherelle Lou Sumera Icutan, Sheila P. Cayabyab, Mary Jane Laruan, Paulo V. Cenas, Agustina R. Tactay

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This study critically analyzed the recent theses and dissertations of the Basic Education Curriculum (BEC) teachers who finished their graduate programs in selected higher educational institutions in Region I and CAR to be able to come up with a unified result from the varied results of the analyzed research works. All theses and dissertations completed by the educators/teachers/school personnel in the secondary and elementary public and private schools in Region 1 and CAR from AY 2003–2004 to AY 2007–2008 were classified first–as to work or non-work related; second–as to the different aspects of the curriculum: implementation, content, instructional materials, assessment instruments, learning, teaching, and others; third–as to being eligible for meta-analysis or not. Only studies found eligible for meta-analysis were subjected to the procedure. Aside from documentary analysis, the statistical treatments used in meta-analysis include the standardized effect size, Pearson’s correlation (r), the chi-square test of homogeneity and the inverse of the Fisher transformation. This study found out that the BEC-teachers usually probe on work-related researchers with topics that are focused on the learning performances of the students and on factors related to teaching. The development of instructional materials and assessment of implemented programs are also equally explored. However, there are only few researches on content and assessment instrument. Research findings on the areas of learning and teaching are the only aspects that are meta-analyzable. The research findings across studies in Region I and CAR of BEC teachers that focused on similar variables correlated to teaching do not vary significantly. On the contrary, research findings across studies in Region I and CAR that focused on variables correlated to learning performance significantly vary. Within each region, variations on the findings of research works related to learning performance that considered similar variables still exist. The combined finding on the effect size or relationship of the variables that are correlated to learning performance are low which means that effect is small but definite while the combined findings on the relationship of the variables correlated to teaching are slight or almost negligible.

Keywords: meta-analysis, BEC teachers, work-related research,

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Authors: Anne N. Heirman, Lisette van der Molen, Richard Dirven, Gyorgi B. Halmos, Michiel W.M. van den Brekel

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Background: Due to the rising incidence of oropharyngeal squamous cell cancer (OPSCC), many patients are challenged with choosing between transoral(robotic) surgery and radiotherapy, with equal survival and oncological outcomes. Also, functional outcomes are of little difference over the years. With this study, the wants and needs of patients and caregivers are identified to develop a comprehensible patient decision aid (PDA). Methods: The development of this PDA is based on the International Patient Decision Aid Standards criteria. In phase 1, relevant literature was reviewed and compared to current counseling papers. We interviewed ten post-treatment patients and ten doctors from four head and neck centers in the Netherlands, which were transcribed verbatim and analyzed. With these results, the first draft of the PDA was developed. Phase 2 beholds testing the first draft for comprehensibility and usability. Phase 3 beholds testing for feasibility. After this phase, the final version of the PDA was developed. Results: All doctors and patients agreed a PDA was needed. Phase 1 showed that 50% of patients felt well-informed after standard care and 35% missed information about treatment possibilities. Side effects and functional outcomes were rated as the most important for decision-making. With this information, the first version was developed. Doctors and patients stated (phase 2) that they were satisfied with the comprehensibility and usability, but there was too much text. The PDA underwent text reduction revisions and got more graphics. After revisions, all doctors found the PDA feasible and would contribute to regular counseling. Patients were satisfied with the results and wished they would have seen it before their treatment. Conclusion: Decision-making for OPSCC should focus on differences in side-effects and functional outcomes. Patients and doctors found the PDA to be of great value. Future research will explore the benefits of the PDA in clinical practice.

Keywords: head-and-neck oncology, oropharyngeal cancer, patient decision aid, development, shared decision making

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Authors: Yara Saleh, Sebastien Antherieu, Romain Dusautoir, Jules Sotty, Laurent Alleman, Ludivine Canivet, Esperanza Perdrix, Pierre Dubot, Anne Platel, Fabrice Nesslany, Guillaume Garcon, Jean-Marc Lo-Guidice

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Air pollution is one of the leading causes of premature death worldwide. Among air pollutants, particulate matter (PM) is a major health risk factor, through the induction of cardiopulmonary diseases and lung cancers. They are composed of coarse, fine and ultrafine particles (PM10, PM2.5, and PM0.1 respectively). Ultrafine particles are emerging unregulated pollutants that might have greater toxicity than larger particles, since they are more abundant and consequently have higher surface area per unit of mass. Our project aims to develop a relevant in vivo model of sub-chronic exposure to atmospheric particles in order to elucidate the specific respiratory impact of ultrafine particles compared to fine particulate matter. Quasi-ultrafine (PM0.18) and fine (PM2.5) particles have been collected in the urban industrial zone of Dunkirk in north France during a 7-month campaign, and submitted to physico-chemical characterization. BALB/c mice were then exposed intranasally to 10µg of PM0.18 or PM2.5 3 times a week. After 1 or 3-month exposure, broncho alveolar lavages (BAL) were performed and lung tissues were harvested for histological and transcriptomic analyses. The physico-chemical study of the collected particles shows that there is no major difference in elemental and surface chemical composition between PM0.18 and PM2.5. Furthermore, the results of the cytological analyses carried out show that both types of particulate fractions can be internalized in lung cells. However, the cell count in BAL and preliminary transcriptomic data suggest that PM0.18 could be more reactive and induce a stronger lung inflammation in exposed mice than PM2.5. Complementary studies are in progress to confirm these first data and to identify the metabolic pathways more specifically associated with the toxicity of ultrafine particles.

Keywords: environmental pollution, lung affect, mice, ultrafine particles

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Authors: Anne Lehner, Mostafa Salari Rad, Jeremy Ginges

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Many of life’s privileges (and burdens) are thrust on us at birth. Someone born white or male in the United States is also born with a set of advantages over someone born non-white or female. One aspect of privileges conferred by birth is that they are so entrenched in social institutions and social norms that until they are robustly challenged, they can be seen as a moral good. While American society increasingly confronts privileges based on gender and race, other types of privileges, like one's nationality, see less attention. The nationality one is born into can have enormous effects on one’s personal life, work opportunities, and health outcomes. Yet, we predicted that although most Americans would regard it as absurd to think that white people have a right to protect their privileges and 'way of life', they would regard it as obvious that Americans have a right to protect the American way of life and associated privileges. In a preregistered study we presented 300 Americans randomly with one out of three 'privilege scales' in order to assess their agreement with certain statements. The domains for the privilege scales were nationality, race, and gender. Next, all participants completed the switched-at-birth task assessing ones tendency to essentialize nationality. We found that Americans are more approving of privilege based on nationality than of privilege based on gender and race. In addition, we found an interaction of condition with ideology, showing that conservatives are in general more approving of the privilege of any kind than liberals are, and they especially approve of privilege based on nationality. For the switched-at-birth task, we found that both, liberals as well as conservatives are equally willing to grant the child 100% American nationality. Whether or not one chose 100% is unrelated to the expressed approval of privilege based on nationality. One might hesitate to fully grant the child 100% American nationality in the task, yet disapprove of privilege based on nationality. This shows that as much as we see beholders of privilege being oblivious to their statuses within other social categories, like gender or race, we seem to detect the same blindness for the privilege based on nationality. Liberals showing relatively fewer support for privilege based on nationality compared to conservatives still refused to acknowledge the child as having become 100% American and thereby denying the privileges it potentially bestows upon them.

Keywords: thought experiment, anti-immigrant attitudes, privilege of nationality, immigration, moral circles, psychology

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Authors: Ivan M. Taremwa, Scholastic Ashaba, Harriet O. Adrama, Carlrona Ayebazibwe, Daniel Omoding, Imelda Kemeza, Jane Yatuha, Thadeus Turuho, Noni E. MacDonald, Robert Hilliard

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Background: The burden of malaria in Uganda remains unacceptably high, especially among children and pregnant women. To prevent malaria related complications, household possession and use of Insecticide Treated mosquito Nets (ITNs) has become a common practice in the country. Despite the availability of ITNs, the number of malaria cases has not gone down. We sought to explore knowledge, attitude, and behaviour towards the use of ITNs as a nightly malaria prevention strategy among pregnant women and children under five years of age in rural southwest Uganda. Materials and Methods: This was a community based, descriptive cross-sectional study, in which households with children under 5 years, and/or pregnant women were enrolled. We used a structured questionnaire to collect data on participants’ understanding of the causes, signs and symptoms of malaria; use of ITNs to prevent malaria; attitudes and behaviours towards the use of ITNs. We also conducted key informant interviews (KIIs) to get in-depth understanding of responses from the participants. We analysed quantitative data using STATA version 12. Qualitative findings from the KIIs were transcribed and translated, and manually analysed using thematic content analysis. Results: Of the 369 households enrolled, 98.6% (N=363) households had children under five. Most participants (41.2%, N=152) were in the 21-30 years of age category (mean age; 32.2). 98.6% (N=362) of the respondents considered ITNs a key malaria prevention strategy. The ITN possession rate was 84.0% (N=310), of these, 67.0% (N=205) consistently used them. 39% of the respondents did not have a positive attitude towards ITNs, as they considered more the perceived effects of ITNs. Conclusions: Although 84.0% of the respondents possessed ITNs, many were not consistently using them. There is need to engage all stakeholders (including cultural leaders, community health workers, religious leaders and the government) in the malaria prevention campaigns using ITNs through: a) government’s concerted effort to ensure universal access of good quality ITNs, b) end-user directed education to correct false beliefs and misinformation, c) telling the ITN success stories to improve on the usage.

Keywords: ITNs use, malaria, pregnant women, rural Uganda

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Authors: Sarah Nasser, Anne Moreau, Alain Hedoux, Romain Jeantet, Guillaume Delaplace

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Background: Spray dryed powders containing some caseins are commonly produced in dairy industry. It is widely admitted that the structure of casein evolves during powder storage, inducing a loss of solubility. However few studies evaluate accurately the destabilization mechanisms at molecular and mesoscopic level, in particular for Native Phospho Casein powder (NPC). Consequently, at the state of the art, it is very difficult to assess which secondary structure change or crosslinks initiate insolubility during storage. To address this issue, controlled ageing conditions have been applied to a NPC powder (which was obtained by spray drying a concentrate containing a higher content of casein (90%), whey protein (8%) and lactose (few %)). Evolution of structure and loss of solubility, with the effects of temperature and time of storage were systematically reported. Methods: FTIR spectroscopy, Raman and Circular Dichroism were used to monitor changes of secondary structure in dry powder and in solution after rehydration. Besides, proteomic tools and electrophoresis have been performed after varying storage conditions for evaluating aggregation and post translational modifications, like lactosylation or phosphorylation. Finally, Tof Sims and MEB were used to follow in parallel evolution of structure in surface and skin formation due to storage. Results + conclusion: These results highlight the important role of storage temperature in the stability of NPC. It is shown that this is not lactosylation at the heart of formation of aggregates, as advanced in others publications This is almost the rise of multitude post translational modifications (chemical cross link), added to disulphide bridges (physical cross link) wich contribute to the destabilisation of structure and aggregation of casein. A relative quantification of each kind of cross link, source of aggregates, is proposed. In addition, it has been proved that migration of lipids and formation of skin in surface during the ageing also explains the evolution of structure casein and thus the alterations of functional properties of NPC powder.

Keywords: casein, cross link, powder, storage

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Authors: Burdin Louise, Brulez Anne-Catherine, Mazurcyk Radoslaw, Leclercq Jean-louis, Benayoun Stéphane

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By using a biomimetic approach, an investigation was conducted to determine the connections between morphology and wetting. The interest is focused on the Morpho peleides butterfly. This butterfly is already well-known among researchers for its brilliant iridescent color and has inspired numerous innovations. The intricate structure of its wings is responsible for such color. However, this multiscale structure exhibits a multitude of other features, such as hydrophobicity. Given the limited research on the wetting properties of Morpho butterfly, a detailed analysis of its wetting behavior is proposed. Multiscale surface topographies of the Morpho peleides butterfly were analyzed using scanning electron microscope and atomic force microscopy. To understand the relationship between morphology and wettability, a goniometer was employed to measured static and dynamic contact angle. Since several studies have consistently demonstrated that superhydrophobic surfaces can effectively delay freezing, icing delay time the Morpho’s wings was also measured. The results revealed contact angles close to 136°, indicating a high degree of hydrophobicity. Moreover, sliding angles (SA) were measured in different directions, including along and against the rolling-outward direction. The findings suggest anisotropic wetting. Specifically, when the wing was tilted along the rolling outward direction (i.e., away from the insect’s body) SA was about 7°. While, when the wing was tilted against the rolling outward direction, SA was about 29°. This phenomenon is directly linked to the butterfly’s survival strategy. To investigate the exclusive morphological impact on anti-icing properties, PDMS replicas of the Morpho butterfly were obtained. When compared to flat PDMS and microscale textured PDMS, Morpho replications exhibited a longer freezing time. Therefore, this could be a source of inspiration for designing superhydrophobic surfaces with anti-icing applications or functional surfaces with controlled wettability.

Keywords: biomimetic, anisotropic wetting, anti-icing, multiscale roughness

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Authors: Linda Jane Wells

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In 1914 Topsy Smith, a woman of the First Nations Arabana tribe arrived in Alice Springs with her seven children and a herd of goats. They had come in from the goldfields at Arltunga where they had been living, and Topsy’s husband, Welsh-born Bill Smith, had recently died. Sergeant Stott, the local policeman and sub-protector of Aborigines for the region, erected a tin shed for Topsy and the children to live in, which became known as the Bungalow for half-castes. Over the years that followed many more children of mixed descent were removed from their families and brought to live at the Bungalow until, a decade later, sixty children were growing up there, cared for predominantly by Topsy Smith; Ida Standley who was the first, white schoolteacher for the town; and Sergeant Stott. The story of the Bungalow is pivotal to the foundations of social relations in the town of Alice Springs and beyond. At the same time, it is little known, recognised or understood locally, let alone more broadly. This is typical of the dominant historic narratives that have emerged out of the Australian colonial project and led to ‘the Great Australian Silence.’ The term was coined by Australian anthropologist WEH Stanner in his 1968 Boyer Lectures, in reference to the omission of the Aboriginal experience from the dominant narratives of the nation’s history. In his lecture, he attributed this silence to something that may have begun as a simple forgetting of other possible views which turned, under habit and over time, into something like a cult of forgetfulness practised on a national scale. This doctoral project, underpinned by a methodology of practice-led research, engages a bricolage of methods including archival research, ethnography, and oral histories to research the bungalow and the context in which it operated. Techniques of fictocriticism, speculative biography, autoethnography, and archival poetics are then engaged to write the research outcomes into a post-colonial, multi-genre work of creative non-fiction that speaks into the silences in the archives. The overall intent of this doctoral work is to explore and demonstrate how techniques of creative non-fiction can be used to rewrite narratives of Australian colonial history that resonate beyond the academy, thus contributing to the bank of post-colonial stories and working towards a more just, honest and inclusive national ‘memory’ and identity.

Keywords: Australian history, collective memory, creative non-fiction, postcolonialism

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Authors: Vivienne Cloude C. Bersabe, Nuelle Anne Castro, Christy P. Gonzales, Nathalie Ann D. Ocbo, Araceli Chuwaley C. Padcayan, Michelle Gaile Lianne S. Peralta, Cecile A. Perez, Eiden Mae A. Roque, Frances Bea S. Sabaten, Korina Louise A. Saculles, Jada Kristen O. Taska, Jose Reinhard C. Laoingco, Don Leonardo N. Dacumos

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The rationale of the study: Since discussion about sexuality is considered taboo in the Filipino culture, provision of quality holistic care often lacks sexuality aspect. This research was conducted to highlight the need for nurses to incorporate sexuality in their care of older adults. Research Objectives: To measure the levels of older adults’ sexual desire, sexual behavior, and sexual intimacy and relate them to sex, living arrangement, educational level, and presence of chronic illness, whether with or without treatment. Methods: This study is of quantitative descriptive design that utilized purposive sampling. 400 older adults of Baguio City participated. The study used a 30 point researcher-made questionnaire, one-on-one interview and focused group discussion to gather data. Data were treated using weighted mean, t-test, F-test, and Scheffe's test. Results and Conclusions: The overall findings revealed that Filipino older adults have a low level of sexuality expressed by the participants’ sexual desire, behavior, and intimacy. Males have significantly higher level of sexual desire, behavior, and intimacy. Living arrangement does not seem to influence the level of sexuality in all its 3 facets. Sexual desire was significantly higher among those with tertiary education and without chronic illness. Recommendation: It is recommended that nurses carry out their assessment of clients to include the exploration of their sexuality especially the older adults. A similar study may be done to explore other variables like demographic location, i.e., rural or urban setting; socio-cultural factors; and functional performance status. It is also recommended that a similar study may be done exploring the different facets of sexuality among homosexual older persons.

Keywords: geriatrics, older adults, Philippines, sexuality

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Authors: Anne Tan, Kok-Sing Tang, Audrey Cooke

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Play has always been a prominent pedagogy in early childhood. However, there is growing evidence of success in students’ learning using explicit instruction, especially in literacy in the early years. There is also limited research using explicit instruction in early childhood mathematics, and play is usually prominently mentioned. This proposed research aims to investigate the possibilities and benefits of integrating guided play with explicit instruction in early childhood mathematics education. While play has traditionally been a prominent pedagogy in early childhood, there is growing evidence of success in student learning through explicit instruction, particularly in literacy. However, limited research exists on the integration of explicit instruction in early childhood mathematics, where play remains prominently mentioned. This study utilises a multiple case study methodology to gather data and provide immediate opportunities for curriculum improvement. The research will commence with semi-structured interviews to gain insights into educators' background knowledge. Highly structured observations will be conducted to record the frequency and manner in which guided play is integrated with specific elements of explicit instruction during mathematics teaching in early childhood. To enhance the observations, video recordings will be made using cameras with video settings and Microsoft Teams meeting recordings. In addition to interviews and observations, educators will maintain journals and use the Microsoft Teams platform for self-reflection on the integration of guided play and explicit instruction in their classroom practices and experiences. The study participants will include educators with early childhood degrees and students in years one and two. The primary goal of this research is to inform the benefits of integrating two high-impact pedagogies, guided play, and explicit instruction, for enhancing student learning outcomes in mathematics education. By exploring the integration of these pedagogical approaches, this study aims to contribute to the development of effective instructional strategies in early childhood mathematics education.

Keywords: early childhood, early childhood mathematics, early childhood numbers, guided play, play-based learning, explicit instruction

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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Background: A mixed method systematic review was undertaken in order to explore issues related to the experiences of health care providers and parents in the care of children with palliative care needs. The aims of this systematic review were to identify existing evidence about the experiences of communication in the care of children with palliative care needs, to appraise the research conducted in this area and to identify gaps in the literature in order to recommend for future related studies. Method: A mixed method systematic review of research on the experience of communication in the care of children with palliative care needs, conducted with parents and health professionals was undertaken. The electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period of 2000-2016. Inclusion was limited to studies of communication experience in the care of children with palliative care needs. Result: Thirty-eight studies were found. The studies were conducted in a variety of countries: Uganda, Jordan, USA, UK, Taiwan, Turkey, Ireland, Poland, Brazil, Australia, Switzerland, Sweden, Netherland, Lebanon, Spain, Greece, and China. The current review shows that parents tend to protect their children when they are discussing their illnesses with them, particularly where they have a life-threatening or life-limiting condition. The approach of parents towards the discussion of sensitive issues concerning death with their children is significantly affected by the cultural background of the families. Conservative cultures encourage collusion behaviours which tend to keep children unaware of the incurable nature of the disease. The major communication challenges reported by health professionals are facing difficulties in judging how much information should be given to parents, responding to difficult questions, conflicts with families and inadequate skills to support grieving families. Conclusion: It is probably significant for the future studies to consider the change of parent-child communication experience over time in order to understand how the parents could change their interaction styles with their children according to the different stages of their children’s disease. Moreover, further studies are required to investigate the experience of communication of parents of children with non-malignant life-threatening and life-limiting illnesses.

Keywords: children with life-threatening or life- limiting illnesses, end of life, experience of communication, healthcare care providers, paediatric palliative care

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Authors: Md. Rakeb-Ul Islam, Daniel J. Schmidt, Jane M. Hughes

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Population connectivity plays an important role in the conservation and recovery of declining species. It affects genetic diversity, adaptive potential and resilience of species in nature. Loss of genetic variation can affect populations by limiting their ability to persist in stressful environmental conditions. Generally, freshwater fishes show higher levels of genetic structuring and subdivision among populations than those inhabiting estuarine or marine environments due to the presence of artificial (e.g. dams) and natural (e.g. mountain ranges) barriers to dispersal in freshwater ecosystems. The Australian smelt (Retropinnidae: Retropinna spp.) is a common freshwater fish species which is widely distributed throughout coastal and inland drainages in South - eastern Australia. These fish are found in a number of habitats from headwaters to lowland sites. They form large shoals in the mid to upper water column and inhabit deep slow – flowing pools as well as shallow fast flowing riffle-runs. Previously, Australian smelt consisted of two described taxa (Retropinna semoni and Retropinna tasmanica), but recently a complex of five or more species has been recognized based on an analysis of allozyme variation. In many area, they spend their entire life cycle within freshwater. Although most populations of the species are thought to be non-diadromous, it is still unclear whether individuals within coastal populations of Australian Retropinna exhibit diadromous migrations or whether fish collected from marine/estuarine environments are vagrants that have strayed out of the freshwater reaches. In this current study, the population structure and genetic differentiation of Australian smelt fish were investigated among eight rivers of South-East Queensland (SEQ), Australia. 11 microsatellite loci were used to examine genetic variation within and among populations. Genetic diversity was very high. Number of alleles ranged from three to twenty. Expected heterozygosity averaged across loci ranged from 0.572 to 0.852. There was a high degree of genetic differentiation among rivers (FST = 0.23), although low levels of genetic differentiation among populations within rivers. These extremely high levels of genetic differentiation suggest that the all smelt in SEQ complete their life history within freshwater, or, if they go to the estuary, they do not migrate to sea. This hypothesis is being tested further with a micro-chemical analysis of their otoliths.

Keywords: diadromous, genetic diversity, microsatellite, otolith

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Authors: Vanessa De Carvalho, Chad MacPherson, Julien Tremblay, Julie Champagne, Stephanie-Anne Girard

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Background: The interactions between bacteria and fungi in the human vaginal microbiome are fundamental to the concept of health and disease. The means by which the microbiota and mycobiota interact is still poorly understood and further studies are necessary to properly characterize this complex ecosystem. The aim of this study was to select a DNA extraction method capable of recovering high qualities of fungal and bacterial DNA from a single vaginal swab. Methods: 11 female volunteers ( ≥ 20 to < 55 years old) self-collected vaginal swabs in triplicates. Three commercial extraction kits: Masterpure Yeast Purification kit (Epicenter), PureLink™ Microbiome DNA Purification kit (Invitrogen), and Quick-DNA™ Fecal/Soil Microbe Miniprep kit (Zymo) were evaluated on the ability to recover fungal and bacterial DNA simultaneously. The extraction kits were compared on the basis of recovery, yield, purity, and the community richness of bacterial (16S rRNA - V3-V4 region) and fungal (ITS1) microbiota composition by Illumina MiSeq amplicon sequencing. Results: Recovery of bacterial DNA was achieved with all three kits while fungal DNA was only consistently recovered with Masterpure Yeast Purification kit (yield and purity). Overall, all kits displayed similar microbiota profiles for the top 20 OTUs; however, Quick-DNA™ Fecal/Soil Microbe Miniprep kit (Zymo) showed more species richness than the other two kits. Conclusion: In the present study, Masterpure Yeast purification kit proved to be a good candidate for purification of high quality fungal and bacterial DNA simultaneously. These findings have potential benefits that could be applied in future vaginal microbiome research. Whilst the use of a single extraction method would lessen the burden of multiple swab sampling, decrease laboratory workload and off-set costs associated with multiple DNA extractions, thoughtful consideration must be taken when selecting an extraction kit depending on the desired downstream application.

Keywords: bacterial vaginosis, DNA extraction, microbiota, mycobiota, vagina, vulvovaginal candidiasis, women’s health

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Authors: Mamatha Hosapatna, Anne D. Souza, Vrinda Hari Ankolekar, Antony Sylvan D. Souza

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Introduction: The lower extremity of the femur is characterized by an anterior groove in which patella is held during motion. This groove separates the two lips of the trochlea (medial and lateral), prolongation of the two condyles. In humans, the lateral trochlear lip is more developed than the medial one, creating an asymmetric groove that is also specific to the human body. Because of femoral obliquity, contraction of quadriceps leads to a lateral dislocation stress on the patella, and the more elevated lateral side of the patellar groove helps the patella stays in its correct place, acting as a wall against lateral dislocation. This specific shape fits an oblique femur. It is known that femoral obliquity is not genetically determined but comes with orthostatism and biped walking. Material and Methodology: To measure the various dimensions of the Femoropatellar groove (FPG) and femoral condyle using digital image analyser. 37 dried adult femora (22 right,15 left) were used for the study. End on images of the lower end of the femur was taken. Various dimensions of the Femoropatellar groove and FP angle were measured using image J software. Results were analyzed statistically. Results: Maximum of the altitude of medial condyle of the right femur is 4.98± 0.35 cm and of the left femur is 5.20±.16 cm. Maximum altitude of lateral condyle is 5.44±0.4 and 5.50±0.14 on the right and left side respectively. Medial length of the groove is 1.30±0.38 cm on the right side and on the left side is 1.88±0.16 cm. The lateral length of the groove on the right side is 1.900±.16 cm and left side is 1.88±0.16 cm. Femoropatellar angle is 136.38◦±2.59 on the right side and on the left side it is 142.38◦±7.0 Angle and dimensions of the femoropatellar groove on the medial and lateral sides were measured. Asymmetry in the patellar groove was observed. The lateral lip was found to be wider and bigger which correlated with the previous studies. An asymmetrical patellar groove with a protruding lateral side associated with an oblique femur is a specific mark of bipedal locomotion. Conclusion: Dimensions of FPG are important in maintaining the stability of patella and also in knee replacement surgeries. The implants used in to replace the patellofemoral compartment consist of a metal groove to fit on the femoral end and a plastic disc that attaches to the undersurface of the patella. The location and configuration of the patellofemoral groove of the distal femur are clinically significant in the mechanics and pathomechanics of the patellofemoral articulation.

Keywords: femoral patellar groove, femoro patellar angle, lateral condyle, medial condyle

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Authors: Sharon Milberger, Jane Turner, Denise White-Perkins

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Michigan shares the overall U.S. national need for more highly qualified professionals who have knowledge and experience in the use of evidence-based practices to meet the special health care needs of children, adolescents, and adults with neurodevelopmental disabilities including autism spectrum disorder (DD/ASD). The Michigan Leadership Education in Neurodevelopmental Disabilities (MI-LEND) program is a consortium of six universities that spans the state of Michigan and serves more than 181,800 undergraduate, graduate, and professional students. The purpose of the MI LEND program is to improve the health of infants, children and adolescents with disabilities in Michigan by training individuals from different disciplines to assume leadership roles in their respective fields and work across disciplines. The MI-LEND program integrates “L.I.F.E.” perspectives into all training components. L.I.F.E. is an acronym for Leadership, Interdisciplinary, Family-Centered and Equity perspectives. This paper will describe how L.I.F.E. perspectives are embedded into all aspects of the MI-LEND training program including the application process, didactic training, community and clinical experiences, discussions, journaling and projects. Specific curriculum components will be described including content from a training module dedicated to Equity. Upon completion of the Equity module, trainees are expected to be able to: 1) Use a population health framework to identify key social determinants impacting families and children; 2) Explain how addressing bias and providing culturally appropriate linguistic care/services can influence patient/client health and wellbeing; and 3) Describe the impact of policy and structural/institutional factors influencing care and services for children with DD/ASD and their families. Each trainee completes two self-assessments: the Cultural and Linguistic Competence Health Practitioner Assessment and the other assessing social attitudes/implicit bias. Trainees also conduct interviews with a family with a child with DD/ASD. In addition, interdisciplinary Equity-related group activities are incorporated into face-to-face training sessions. Each MI-LEND trainee has multiple ongoing opportunities for self-reflection through discussion and journaling and completion of a L.I.F.E. project as a culminating component of the program. The poster will also discuss the challenges related to teaching and measuring successful outcomes related to diversity/equity perspectives.

Keywords: disability, diversity, equity, training

Procedia PDF Downloads 134

Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.

Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid

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Authors: Anne Y. Faxer, Ellen Olausson, Jens Hagman, Ana Magazinius, Jenny J. Stier, Tommy Fransson, Oscar Enerback

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While electric vehicles (both battery electric vehicles and plug-in hybrids) have been on the market for around 6 years, they are still far from mainstream and the knowledge of them is still low among the public. This is likely one of the reasons that Sweden, having one of the highest penetrations of electric vehicles in Europe, still has a long way to go in reaching a fossil free vehicle fleet. Car dealerships are an important medium that connects consumers to vehicles, but somehow, their role in introducing electric vehicles has not yet been thoroughly studied. Research from other domains shows that salespeople can affect customer decisions in their choice of products. The aim of this study is to explore the role of car dealerships when it comes to promoting electric vehicles. The long-term goal is to understand how they could be a key in the effort of achieving a mass introduction of electric vehicles in Sweden. By emulating the customer’s experience, this study investigates the interaction between car salespeople and customers, particularly examining whether they present electric vehicles as viable options. Covert participatory observations were conducted for data collection from four different brands at in total twelve car dealers. The observers worked in pairs and played the role of a customer with needs that could be matched by an electric vehicle. The data was summarized in observation protocols and analyzed using thematic coding. The result shows that only one of twelve salespeople offered an electric vehicle as the first option. When environmental factors were brought up by the observers, the salespeople followed up with lower fuel consumption internal combustion engine vehicles rather than suggesting an electric vehicle. All salespeople possessed at least basic knowledge about electric vehicles but their interest of selling them were low in most cases. One of the reasons could be that the price of electric vehicles is usually higher. This could be inferred from the finding that salespeople tend to have a strong focus on price and economy in their dialogues with customers, regardless which type of car they were selling. In conclusion, the study suggests that car salespeople have the potential to help the market to achieve mass introduction of electric vehicles; however, their potential needs to be exploited further. To encourage salespeople to prioritize electric vehicles in the sales process, right incentives need to be in place.

Keywords: car dealerships, covert participatory observation, customer perspective , electric vehicle, market penetration

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Authors: Emily Jin, Harry Sharples, Anne Weist

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Introduction: NICE Evidence Search Student Champion Scheme is a peer-assisted learning scheme that aims to improve the routine use of evidence-based information by future health and social care staff. The focus is on the NICE evidence search portal that provides selected information from more than 800 reliable health, social care, and medicines sources, including up-to-date guidelines and information for the public. This paper aims to evaluate the effectiveness of the scheme when implemented in Liverpool School of Medicine and to understand the experiences of those attending. Methods: Twelve student champions were recruited and trained in February 2020 as peer tutors during a workshop facilitated by NICE. Cascade sessions were then organised and delivered on an optional basis for students, in small groups of < 10 to approximately 70 attendees. Surveys were acquired immediately before and 8-12 weeks after cascade sessions (n=47 and 45 respectively). Data from these surveys facilitated the analysis of the scheme. Results: Surveys demonstrated 74% of all attendees frequently searched for health and social care information online as a part of their studies. However, only 15% of attendees reported having prior formal training on searching for health information, despite receiving such training earlier on in the curriculum. After attending cascade sessions, students reported a 58% increase in confidence when searching for information using evidence search, from a pre-session a baseline of 36%. Conclusion: NICE Evidence Search Student Champion Scheme provided clear benefits for attending students, increasing confidence in searching for peer-reviewed, mainly secondary sources of health information. The lack of reported training represents the unmet need that the champion scheme satisfies, and this likely benefits student champions as well as attendees. Increasing confidence in searching for healthcare information online may support future evidence-based decision-making.

Keywords: evidence-based medicine, NICE, medical education, medical school, peer-assisted learning

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Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

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Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

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Authors: Ashleigh Beales, Anne Whitworth, Jade Cartwright

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Background: While significant benefits of lexical retrieval intervention are evident within the Primary Progressive Aphasia (PPA) and Alzheimer’s disease (AD) literature, an understanding of the mechanisms that underlie change or improvement is limited. Change mechanisms have been explored in the non-progressive post-stroke literature that may offer insight into how interventions affect change with progressive language disorders. The potential influences of cognitive factors may also play a role here, interacting with the aims of intervention. Exploring how such processes have been applied is likely to grow our understanding of how interventions have, or have not, been effective, and how and why generalisation is likely, or not, to occur. Aims: This review of the literature aimed to (1) investigate the proposed mechanisms of change which underpin lexical interventions, mapping the PPA and AD lexical retrieval literature to theoretical accounts of mechanisms that underlie change within the broader intervention literature, (2) identify whether and which nonlinguistic cognitive functions have been engaged in intervention with these populations and any proposed influence, and (3) explore evidence of linguistic generalisation, with particular reference to change mechanisms employed in interventions. Main contribution: A search of Medline, PsycINFO, and CINAHL identified 36 articles that reported data for individuals with PPA or AD following lexical retrieval intervention. A review of the mechanisms of change identified 10 studies that used stimulation, 21 studies utilised relearning, three studies drew on reorganisation, and two studies used cognitive-relay. Significant treatment gains, predominantly based on linguistic performance measures, were reported for all client groups for each of the proposed mechanisms. Reorganisation and cognitive-relay change mechanisms were only targeted in PPA. Eighteen studies incorporated nonlinguistic cognitive functions in intervention; these were limited to autobiographical memory (16 studies), episodic memory (three studies), or both (one study). Linguistic generalisation outcomes were inconsistently reported in PPA and AD studies. Conclusion: This review highlights that individuals with PPA and AD may benefit from lexical retrieval intervention, irrespective of the mechanism of change. Thorough application of a theory of intervention is required to gain a greater understanding of the change mechanisms, as well as the interplay of nonlinguistic cognitive functions.

Keywords: Alzheimer's disease, lexical retrieval, mechanisms of change, primary progressive aphasia

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