Lifelong Learning: A Debate Regarding the Appropriateness of Adult Education Faculty\u27s Participation in Teacher Preparation Programs

The academic study of adult education remains in a precarious position in schools of education because adult education is often viewed as neither necessary nor integral to the colleges\u27 main mission: usually the preparation of beginning teachers

Reaching absent and refusing individuals during home-based HIV testing through self-testing-at what cost?

Introduction: In the HOSENG trial (NCT03598686), the secondary distribution of oral self-tests for persons absent or refusing to test during a home-based HIV testing campaign in rural Lesotho resulted in an increase in testing coverage of 21% compared to a testing campaign without secondary distribution. This study aims to determine the per patient costs of both HOSENG trial arms. Method: We conducted a micro-costing study to estimate the cost of home-based HIV testing with (HOSENG intervention arm) and without (HOSENG control arm) secondary self-test distribution from a provider's perspective. A mixture of top-down and bottom-up costing was used. We estimated both the financial and economic per patient costs of each possible testing cascade scenario. The costs were adjusted to 2018 US$. Results: The overall provider cost for delivering the home-based HIV testing with secondary distribution was US$36,481 among the 4,174 persons enumerated and 3,094 eligible for testing in the intervention villages compared to US$28,620 for 3,642 persons enumerated and 2,727 eligible for testing in the control. The cost per person eligible for testing was US$11.79 in the intervention vs. US$10.50 in the control. This difference was mainly driven by the cost of distributed oral self-tests. The cost per person tested was, however, lower in intervention villages (US$15.70 vs. US$22.15) due to the higher testing coverage achieved through self-test distribution. The cost per person confirmed new HIV+ was US$889.79 in the intervention and US$753.17 in the control. Conclusion: During home-based HIV testing in Lesotho, the secondary distribution of self-tests for persons absent or refusing to test during the visit reduced the costs per person tested and thus presents a promising add-on for such campaigns. Trial Registration:https://ClinicalTrials.gov/, identifier: NCT03598686

Influence of crack history on the stable tearing behavior of a thin-sheet material with multiple cracks

Fracture tests were conducted on 2.3mm thick, 305mm wide sheets of 2024-T3 aluminum alloy with from one to five collinear cracks. The cracks were introduced (crack history) into the specimens by three methods: saw cutting, fatigue precracking at a low stress range, and fatigue precracking at a high stress range. For the single crack tests, the initial crack history influenced the stress required for the onset of stable crack growth and the first 10mm of crack growth. The effect on failure stress was about 4 percent or less. For the multiple crack tests, the initial crack history was shown to cause differences of more than 20 percent in the link-up stress and 13 percent in failure stress. An elastic-plastic finite element analysis employing the CTOA fracture criterion was used to predict the fracture behavior of the single and multiple crack tests. The numerical predictions were within 7 percent of the observed link-up and failure stress in all the tests

Stable tearing behavior of a thin-sheet material with multiple cracks

Fracture tests were conducted on 2.3mm thick, 305mm wide sheets of 2024-T3 aluminum alloy with 1-5 collinear cracks. The cracks were introduced (crack history) into the specimens by three methods: (1) saw cutting; (2) fatigue precracking at a low stress range; and (3) fatigue precracking at a high stress range. For the single crack tests, the initial crack history influenced the stress required for the onset of stable crack growth and the first 10mm of crack growth. The effect on failure stress was about 4 percent or less. For the multiple crack tests, the initial crack history was shown to cause differences of more than 20 percent in the link-up stress and 13 percent in failure stress. An elastic-plastic finite element analysis employing the Crack Tip Opening Angle (CTOA) fracture criterion was used to predict the fracture behavior of the single and multiple crack tests. The numerical predictions were within 7 percent of the observed link-up and failure stress in all the tests

Response to ranibizumab therapy in neovascular AMD - an evaluation of good and bad responders

Background: Treatment of neovascular age-related macular degeneration (AMD) with Lucentis® shows a broad spectrum regarding the course of visual acuity (VA). While some patients show a good response (increase in VA), others disclose much less promising results. Patients and Methods: A retrospective data analysis of all eyes treated for neovascular AMD at the University Hospital of Zurich, Switzerland for at least 12 months was carried out. The courses of VA between the 90th (good responders, GR) and the 10th (bad responders, BR) percentiles were compared at 3, 12 and 24 months from baseline. An analysis regarding demographic data, lesion type and size as well as injection frequency and visits was done and predictive factors for GR and BR were evaluated. Results: Marked differences in the course of VA between GR (n = 30) and BR (n = 30) are already observed 3 months from baseline. In GR the gains in VA after 3, 12 and 24 were 15.7 ± 9 letters ETDRS, 25.3 ± 7 and 14.0 ± 14. BR showed a deterioration of 8.3 ± 11 letters ETDRS after 3, 22.1 ± 8 after 12 and 23.6 ± 13 after 24 months. The gender distribution was equal with a higher percentage of female patients (64 % in BR and 66 % in GR). The baseline VA was statistically significantly lower in GR (45.7 ± 10 vs. 55.4 ± 11, p < 0.05) than in BR. No other significant differences in baseline data were found, and no predictor for group membership could be identified. Conclusions: Only the course of VA in the first three months seems to be of value for an estimation of the response to treatment. In the future the response to treatment in the early phase may influence the treatment algorithm and the injection frequency

"If it is left, it becomes easy for me to get tested": use of oral self-tests and community health workers to maximize the potential of home-based HIV testing among adolescents in Lesoth

Home-based HIV testing fails to reach high coverage among adolescents and young adults (AYA), mainly because they are often absent during the day of home-based testing. ADORE (ADolescent ORal tEsting) is a mixed-method nested study among AYA in rural Lesotho, measuring the effect of home-based secondary distribution of oral HIV self-tests (HIVST) on coverage, as well as exploring how AYA perceive this HIV self-testing model.; ADORE study was nested in a cluster-randomized trial. In intervention village-clusters, oral HIVST were left for household members who were absent or declined testing during a testing campaign. One present household member was trained on HIVST use. Distributed HIVST were followed up by village health workers (VHW). In control clusters no self-tests were distributed. The quantitative outcome was testing coverage among AYA (age 12 to 24) within 120 days, defined as a confirmed HIV test result or known status, using adjusted random-effects logistic regression on the intention-to-treat population. Qualitatively, we conducted in-depth interviews among both AYA who used and did not use the distributed HIVST.; From July 2018 to December 2018, 49 and 57 villages with 1471 and 1620 consenting households and 1236 and 1445 AYA in the control and intervention arm, respectively, were enrolled. On the day of the home-visit, a testing coverage of 37% (461/1236) and 41% (596/1445) in the control and the intervention arm, respectively, were achieved. During the 120 days follow-up period, an additional 23 and 490 AYA in control and intervention clusters, respectively, knew their status. This resulted in a testing coverage of 484/1236 (39%) in the control versus 1086/1445 (75%) in the intervention arm (aOR 8.80 [95% CI 5.81 to 13.32]; p < 0.001). 21 interviews were performed. Personal assistance after the secondary distribution emerged as a key theme and VHWs were generally seen as a trusted cadre.; Secondary distribution of HIVST for AYA absent or refusing to test during home-based testing in Lesotho resulted in an absolute 36% increase in coverage. Distribution should, however, go along with clear instructions on the use of the HIVST and a possibility to easily access more personal support

Formation of Structure in Snowfields: Penitentes, Suncups, and Dirt Cones

Penitentes and suncups are structures formed as snow melts, typically high in the mountains. When the snow is dirty, dirt cones and other structures can form instead. Building on previous field observations and experiments, this work presents a theory of ablation morphologies, and the role of surface dirt in determining the structures formed. The glaciological literature indicates that sunlight, heating from air, and dirt all play a role in the formation of structure on an ablating snow surface. The present work formulates a mathematical model for the formation of ablation morphologies as a function of measurable parameters. The dependence of ablation morphologies on weather conditions and initial dirt thickness are studied, focusing on the initial growth of perturbations away from a flat surface. We derive a single-parameter expression for the melting rate as a function of dirt thickness, which agrees well with a set of measurements by Driedger. An interesting result is the prediction of a dirt-induced travelling instability for a range of parameters.Comment: 28 pages, 13 figure

Metal on metal hip resurfacing versus uncemented custom total hip replacement - early results

<p>Abstract</p> <p>Introduction</p> <p>There is no current consensus on the most appropriate prosthesis for treating symptomatic osteoarthritis (OA) of the hip in young, active patients. Modern metal on metal hip resurfacing arthroplasty (HR) has gained popularity as it is theoretically more stable, bone conserving and easier to revise than total hip arthroplasty. Early results of metal on metal resurfacing have been encouraging. We have compared two well matched cohorts of patients with regard to function, pain relief and patient satisfaction.</p> <p>Methods</p> <p>This prospective study compares 2 cohorts of young, active patients treated with hip resurfacing (137 patients, 141 hips) and custom uncemented (CADCAM) stems (134 patients, 141 hips). All procedures were performed by a single surgeon. Outcome measures included Oxford, WOMAC and Harris hip scores as well as an activity score. Statistical analysis was performed using the unpaired student's t-test.</p> <p>Results</p> <p>One hundred and thirty four and 137 patients were included in the hip replacement and resurfacing groups respectively. The mean age of these patients was 54.6 years. The mean duration of follow up for the hip resurfacing group was 19.2 months compared to 13.4 months for the total hip replacement group.</p> <p>Pre operative oxford, Harris and WOMAC scores in the THA group were 41.1, 46.4 and 50.9 respectively while the post operative scores were 14.8, 95.8 and 5.0. In the HR group, pre- operative scores were 37.0, 54.1 and 45.9 respectively compared to 15.0, 96.8 and 6.1 post operatively. The degree of improvement was similar in both groups.</p> <p>Conclusion</p> <p>There was no significant clinical difference between the patients treated with hip resurfacing and total hip arthroplasty in the short term.</p