The estimation of pectin and a study of the constitution of pectin

Publication authorized May 1, 1925.Digitized 2007 AES.Includes bibliographical references (pages 38-39)

An interactive health communication application for supporting parents managing childhood long-term conditions: outcomes of a randomized controlled feasibility trial

Background: Families living with chronic or long-term conditions such as chronic kidney disease (CKD), stages 3-5, face multiple challenges and respond to these challenges in various ways. Some families adapt well while others struggle, and family response to a condition is closely related to outcome. With families and professionals, we developed a novel condition-specific interactive health communication app to improve parents’ management ability—the online parent information and support (OPIS) program. OPIS consists of a comprehensive mix of clinical caregiving and psychosocial information and support. Objective: The purpose of this study was to (1) assess feasibility of a future full-scale randomized controlled trial (RCT) of OPIS in terms of recruitment and retention, data collection procedures, and psychometric performance of the study measures in the target population, and (2) investigate trends in change in outcome measures in a small-scale RCT in parents of children with CKD stages 3-5. Methods: Parents were recruited from a pediatric nephrology clinic and randomly assigned to one of two treatment groups: usual support for home-based clinical caregiving (control) or usual support plus password-protected access to OPIS for 20 weeks (intervention). Both groups completed study measures at study entry and exit. We assessed feasibility descriptively in terms of recruitment and retention rates overall; assessed recruitment, retention, and uptake of the intervention between groups; and compared family condition management, empowerment to deliver care, and fathers’ involvement between groups. Results: We recruited 55 parents of 39 children (42% of eligible families). Of those, about three-quarters of intervention group parents (19/26, 73%) and control group parents (22/29, 76%) were retained through completion of 20-week data collection. The overall retention rate was 41/55 (75%). The 41 parents completing the trial were asked to respond to the same 10 questionnaire scales at both baseline and 20 weeks later; 10 scores were missing at baseline and nine were missing at 20 weeks. Site user statistics provided evidence that all intervention group parents accessed OPIS. Analysis found that intervention group parents showed a greater improvement in perceived competence to manage their child’s condition compared to control group parents: adjusted mean Family Management Measure (FaMM) Condition Management Ability Scale intervention group 44.5 versus control group 41.9, difference 2.6, 95% CI -1.6 to 6.7. Differences between the groups in the FaMM Family Life Difficulty Scale (39.9 vs 36.3, difference 3.7, 95% CI -4.9 to 12.2) appeared to agree with a qualitative observation that OPIS helped parents achieve understanding and maintain awareness of the impact of their child’s condition. Conclusions: A full-scale RCT of the effectiveness of OPIS is feasible. OPIS has the potential to beneficially affect self-reported outcomes, including parents’ perceived competence to manage home-based clinical care for children with CKD stage 3-5. Our design and methodology can be transferred to the management of other childhood conditions. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 84283190; http://www.controlled-trials.com/ISRCTN84283190 (Archived by WebCite at http://www.webcitation.org/6TuPdrXTF)

Facing the Issue of Cultural Sensitivity with Female Patients who have Undergone Circumcision: A Survey ofNursing Students’ Knowledge and Perceptions Concerning the Practice of Circumcision

With an influx of refugees coming to the United States, the need to be culturally sensitive has become increasingly important. Health care workers are now being exposed to what was once a relatively unknown issue in the Western world: the controversial practice of female circumcision. The aim of this research was twofold: to determine the degree of knowledge nursing students have concerning female circumcision, and to ascertain if participating in an educational seminar on the practice of female circumcision might have an effect on how nursing students care for patients who have been circumcised. Data was collected from 25 nursing students who were enrolled in an upper-level nursing course. Seventy-six percent of the students had little or no knowledge of the practice. Data from this study may be considered for future curriculum development

Emerging communities of child-healthcare practice in the management of long-term conditions such as chronic kidney disease: Qualitative study of parents' accounts

Background: Parents of children and young people with long-term conditions who need to deliver clinical care to their child at home with remote support from hospital-based professionals, often search the internet for care-giving information. However, there is little evidence that the information available online was developed and evaluated with parents or that it acknowledges the communities of practice that exist as parents and healthcare professionals share responsibility for condition management. Methods. The data reported here are part of a wider study that developed and tested a condition-specific, online parent information and support application with children and young people with chronic-kidney disease, parents and professionals. Semi-structured interviews were conducted with 19 fathers and 24 mothers who had recently tested the novel application. Data were analysed using Framework Analysis and the Communities of Practice concept. Results: Evolving communities of child-healthcare practice were identified comprising three components and several sub components: (1) Experiencing (parents making sense of clinical tasks) through Normalising care, Normalising illness, Acceptance & action, Gaining strength from the affected child and Building relationships to formalise a routine; (2) Doing (Parents executing tasks according to their individual skills) illustrated by Developing coping strategies, Importance of parents' efficacy of care and Fear of the child's health failing; and (3) Belonging/Becoming (Parents defining task and group members' worth and creating a personal identity within the community) consisting of Information sharing, Negotiation with health professionals and Achieving expertise in care. Parents also recalled factors affecting the development of their respective communities of healthcare practice; these included Service transition, Poor parent social life, Psycho-social affects, Family chronic illness, Difficulty in learning new procedures, Shielding and avoidance, and Language and cultural barriers. Health care professionals will benefit from using the communities of child-healthcare practice model when they support parents of children with chronic kidney disease. Conclusions: Understanding some of the factors that may influence the development of communities of child-healthcare practice will help professionals to tailor information and support for parents learning to manage their child's healthcare. Our results are potentially transferrable to professionals managing the care of children and young people with other long-term conditions. © 2014 Carolan et al.; licensee BioMed Central Ltd

Teach for All: A Narrativa das “Soluções Compartilhadas” e a Expansão Global da Reforma da Educação

Teach For All is a global network of state-based organizations that translate Teach For America’s market model of school reform into moral projects of nation-building abroad. Referring to this challenge as one of “scaling” the organization, its leaders elaborate a theory of change that hinges on replicability: in order to effect a global education revolution, Teach For All must reproduce inspiring instances of change in classrooms around the world. In service of this goal, the organization marshals an impressive archive of transformational stories. Each supports its “shared problems, shared solutions” philosophy and attains status as evidence, suggesting that Teach For All’s brand of transformative teaching can eradicate educational inequity despite the contingencies of place. Teach For All’s use of stories to “sell” this brand of reform is itself nothing new. But what is so peculiar about Teach For All’s project is that tales of individual conversion – of situated transformation – come to serve as sites for scalability. By exploring stories as technologies of scale, tracing the ways in which they travel the globe and operate on different audiences, and interrogating the work they do within Teach For All’s ideological apparatus, this article explores the relationship between storytelling “shared solutions” and scaling global reform, and the generic subject that such a relationship produces.Teach For All es una red global de organizaciones nacionales que traducen el modelo de reforma educativa en base al mercado propuesto por Teach For America en proyectos morales de construcción de la nación. Al referirse a este desafío como uno de llevar la organización a “escala”,  sus líderes elaboran una teoría de cambio basada en la replicabilidad: para lograr una revolución educativa global, Teach For All debe reproducir instancias inspiradoras de cambio a nivel aula alrededor del mundo. Para cumplir este objetivo, la organización ha compilado un archivo impresionante de historias transformacionales. En cada una de ellas subyace la filosofía de “problemas comunes, soluciones comunes,” lo cual las transforma en evidencia, sugiriendo que el modelo propuesto por Teach For All es capaz de erradicar la desigualdad educativa más allá de las contingencias locales. El uso de historias por parte de Teach For All para “vender” este tipo de reforma no es nada nuevo en sí mismo. Pero lo que es peculiar es que estas historias de conversión individual –transformación situada- se tornan sitios de llevado a escala. Al explorar las historias como tecnologías de escala, siguiendo las formas en las que viajan alrededor del mundo y operan sobre diferentes audiencias, e interrogando el trabajo que realizan dentro del aparato ideológico de Teach For All, este artículo investiga la relación entre la narración de “soluciones comunes” y llevado a escala de la reforma global, y el sujeto genérico que esta relación produce. Teach For All é uma rede global de organizações baseadas em estados nacionais que traduzem o modelo mercadorial de reforma escolar do Teach For America em projetos morais da construção de nações em outros países. Referindo-se a este desafio como uma da “escalabilidade” da organização, seus líderes elaboram uma teoria de mudança que depende-se na replicabilidade: para efetuar uma revolução global na educação, Teach For All tem que reproduzir casos inspiradoras de mudança em salas de aula no mundo todo. No serviço deste objetivo, a organização faz uso de um arquivo impressivo de histórias transformacionais. Cada história apoia a filosofia de “problemas compartilhados, soluções compartilhadas” e atinge uma condição de ser considerada evidência, sugerindo que o ensino transformacional e único de Teach For All possa erradicar inequidade educacional apesar das contigências locais. O uso de histórias por Teach For All para "vender" esta marca de reforma não é nada novo em si. Mas o que é particular sobre o projeto de Teach For All é que estes contos de conversão individual--de transformação localizada--vêm a servir como locais de escalabilidade. Ao examinar histórias como tecnologias de escala, delineando as maneiras em que viagem pelo mundo e operam-se em audiências diferentes, interrogando o trabalho que fazem dentro do aparelho ideológico de Teach For All, este artigo documenta a relação entre histórias de "soluções compartilhadas" e a escalada de reforma global, e o sujeito genêrico que é produzido nesta relação.

Colostrum Management on German Dairy Farms : Current State and Potential for Improvements

Calf rearing is the fundament of any dairy farm. In consequence, colostrum management is an important part of calf rearing because calves are passively immunized through colostrum uptake. Therefore, colostrum management is of particular importance for healthy calves and long lasting performances of cows and should be optimized. However, high mortality and morbidity rates of 3.0–15.0% in German calf rearing indicate that colostrum management has enormous potential for improvement. The objective of this thesis was to identify potential strategies for enhancement and to underscore the significance of optimized colostrum management on German dairy farms. The thesis offers a comprehensive account of colostrum management and its implications for calf development. Study 1 looked at indirect and direct methods of measuring colostrum quality. Direct methods are not easily applicable in practice, so farmers have to resort to indirect methods such as colostrometers and refractometers. Indirect methods allow conclusions about the concentration of Ig in colostrum, which can be used to assess the quality of the colostrum. In addition, the parameters influencing the Ig concentration were investigated in Study 1. Many parameters can be considered and positively influenced by the farmer. In particular, yield, parity and temporal aspects serve as key factors. Newer aspects such as dry period, seasonal influences and genetics are becoming increasingly important, but their impact on Ig concentrations has not been sufficiently investigated. Furthermore, there is a particular need for research in the area of data management. To gain an overview of colostrum management practices on German dairy farms, a 33 question online survey focusing on frozen colostrum storage was developed (Study 2). The survey highlighted areas where a more targeted knowledge transfer can improve colostrum management. In addition, there appeared to be a lack of “Standard Operating Procedures” for employees on the practical implementation of colostrum management. Particular attention should be paid to the regular determination and documentation of Ig concentrations. The added value of stored colostrum should also be emphasized, especially for smaller farms. Based on the two studies, the three areas of work organization, knowledge transfer, and data management were placed in the context of improved colostrum management. The objective was to identify the most important future tasks and implementation challenges to achieve adequate colostrum management of German dairy farms.Die Kälberaufzucht ist die Basis eines jeden Milchviehbetriebes. Insbesondere das Kolostrummanagement ist ein wichtiger Bestandteil der Erstversorgung, da die Kälber über das Kolostrum eine passive Immunisierung erfahren. Hohe Mortalitäts und Morbiditätsraten in der deutschen Kälberaufzucht von 3.0–15.0 % zeigen jedoch, dass das Kolostrummanagement ein enormes Optimierungspotenzial aufweist. Ziel dieser Dissertation war es, Verbesserungsstrategien aufzuzeigen und die Bedeutung eines optimierten Kolostrummanagements in deutschen Milchviehbetrieben hervorzuheben. Die Arbeit bietet eine umfassende Darstellung des Kolostrummanagements und seiner Auswirkungen auf die Kälberentwicklung. Studie 1 beschäftigte sich mit indirekten und direkten Messmethoden zur Erfassung der Kolostrumqualität. Direkte Messmethoden sind in der Praxis nicht ohne weiteres anwendbar, daher müssen die Landwirte meist auf indirekte Methoden mittels Kolostrometer oder Refraktometer zurückgreifen. Indirekte Methoden lassen Rückschlüsse auf die Ig Konzentration im Kolostrum zu, wodurch die Qualität des Kolostrums beurteilt werden kann. Weiterhin wurden in Studie 1 die Einflussfaktoren auf die Ig Konzentration untersucht. Es gab zahlreiche Einflussfaktoren, die jedoch vom Landwirt berücksichtigt und positiv beeinflusst werden können. Insbesondere die Kolostrummenge, Laktation und zeitliche Aspekte spielen eine wesentliche Rolle. Neuere Aspekte wie Trockenstehzeit, saisonale Einflüsse und Genetik gewinnen an Bedeutung, ihr Einfluss auf die Ig Konzentration ist aber noch nicht ausreichend untersucht. Außerdem besteht vor allem im Bereich des Datenmanagements Entwicklungsbedarf. Um einen Überblick über die Praxis des Kolostrummanagements in deutschen Milchviehbetrieben zu erhalten, wurde eine Online Umfrage mit 33 Fragen entwickelt (Studie 2), die sich auf gefrorene Kolostrumreserven konzentrierte. Die Umfrage zeigte Bereiche auf, in denen ein gezielterer Wissenstransfer das Kolostrummanagement verbessern kann. Darüber hinaus schien es an konkreten, umsetzbaren Anweisungen (sog. Standard Operating Procedures) für das Personal zur praktischen Umsetzung des Kolostrummanagements zu mangeln. Dabei sollte vor allem auf die regelmäßige Bestimmung und Dokumentation der Ig Konzentrationen Wert gelegt werden. Auch der Mehrwert von gelagertem Kolostrum im Vergleich zu einem höheren Arbeitsaufwand sollte insbesondere in kleineren Betrieben hervorgehoben werden. Auf Basis der beiden Studien werden die drei Bereiche Arbeitsorganisation, Wissenstransfer und Datenmanagement in den Kontext eines verbesserten Kolostrummanagements gestellt. Um das Kolostrummanagement in deutschen Milchviehbetrieben zu verbessern, war es das Ziel, die wichtigsten zukünftigen Aufgaben und Herausforderungen bei der Umsetzung zu identifizieren

Through the lens of the adolescent : a survey of at-risk behaviors

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