A Review of the Research on Childminding: Understanding Children's Experiences in Home-Based Childcare Settings

This paper offers a discussion of the literature of an under-developed area of early years research—the exploration of childminding or home-based childcare and the contribution which this form of provision makes for children and families. Despite growing interest in childminding at the policy level and some international research on understanding home-based childcare settings and practices, there remains a relative dearth of studies conceptualising and reviewing the extant literature. This paper addresses this gap by presenting the findings of a comprehensive database search for literature and a review of published international work from 1990 to 2013. It offers a conceptual analysis of the notion of “home-based childcare”, with a focus on understanding caregivers’ practices, and the key issues and debates that characterise the field. The paper argues that home-based childcare not only offers a specialist type of service as family support, especially for vulnerable families, but that it provides a form of pedagogical approach to children’s developmental and educational outcomes that is distinct from any other types of early years care

Structural Reliability of the Tampico Bridge under Wind Loading

A highway bridge located in Tampico, on the east coast of Mexico, is analyzed to determine its structural reliability against wind loading. The inherent variabilities of the random wind force and of the mechanical properties of steel constitute the aleatory uncertainty; this contributes to the probability of failure of the steel girder. The idealization of the loading and of the bridge structure, and the analysis of the structural response to wind loading, contribute to additional uncertainty of the epistemic type, which leads to a range of possible (or distribution of) failure probabilities. The design with the minimum expected life-cycle cost is the optimal design. However, for this optimal design, the 90% value (or the mean plus one standard deviation value) of the corresponding failure probability or safety index may be selected for a risk-aversive design. The proposed criteria constitute a new approach to make conservative decisions and involve the epistemic uncertainty on the bridge design and assessment proces

Sanitation and hygiene in Kibera Slums, Nairobi : women´s concerns and nurses promotional tools

The purpose of the study was to review the relevant literature of sanitation and hygiene regarding women in poor urban centres and explore ways on empowering women on sanitation and hygiene. The aim of the study was to describe the typical concerns for women regarding sanitation and hygiene in Kibera as well as providing women with practical suggestions to improve Hygiene and Sanitation in slums. The data collection method involved reviewing relevant literature which consisted research materials from poor urban centres and developing countries. In addition, United Nations publications and educational books for research were referred to. The findings suggest that there are seven sanitation and hygiene concerns that women experience: Toileting, water, poverty, problems caused by poor sanitation, communicable diseases, insecurity and gender inequality. Nurses need to promote hygiene and sanitation practices by advocating, educating, campaigning and participating in designing community projects that affect sanitation and hygiene. Furthermore, nurses need to work within communities, churches, and schools. As a conclusion, the findings of this study give idea on designing a poster for the community health care nurses who are working with women living in under privileged environments.Tämän kirjallisuuskatsauksen tarkoituksena oli käydä läpi asiaankuuluvaa kirjallisuuta koskien puhtaanapitoa ja hygieniaa naisten näkökulmasta köyhissä kaupunkilaiskeskustoissa. Lisäksi tarkoituksena oli tutkia naisten voimallistamisen keinoja puhtaanapidossa ja hygieniassa. Kirjallisuuskatsauksen pyrkimyksenä oli selvittää naisten tyypillisiä huolenaiheita puhtaanapitoon ja hygieniaan liittyen Kiberassa. Samalla kirjallisuuskatsauksen päämääränä oli tarjota käytännöllisiä neuvoja hygienian ja puhtaanapidon kehittämiseen slummialueilla. Aineisto kerättiin käymällä läpi asiaankuuluvaa kirjallisuutta, joka koostui sekä köyhissä kaupunkilaiskeskustoissa tehdyistä tutkimuksista että kehitysmaatutkimuksista. Lisäksi kirjallisuuskatsauksessa viitattiin Yhdistyneiden Kansakuntien julkaisuihin ja kasvatukselliseen kirjallisuuteen. Tutkimustulokset osoittavat, että naisten huolenaiheet näissä ympäristöissä puhtaanapitoa ja hygieniaa koskien voidaan jakaa seitsämään osaan: käymäläkulttuuriin, vesiongelmiin, köyhyyteen, vaillinaisen puhtaanapidon aiheuttamiin ongelmiin, tartuntatauteihin, turvattomuuteen ja sukupuolten väliseen epätasa-arvoon. Sairaanhoitajien tulisi edistää hygienia- ja puhtaanapitokäytäntöjä puoltamalla paikallisia yhteisöjä, opettamalla, järjestämällä kampanjoita ja osallistumalla yhteisöjen projektinsuunnitteluun näiden asioiden taholta. Olisi suotuisaa, että sairaanhoitajat toimisivat paikallisten yhteisöjen, kirkkojen ja koulujen sisällä. Tämä kirjallisuuskatsaus tarjoaa idean julistemallille, jonka tarkoituksena olisi yhteisön omien sairaanhoitajien kautta toimia tämän ongelman lieventämiseksi naisille epäsuosiollisissa ympäristöissä

Defining the content of an online sexual health intervention: the MenSS Website

BACKGROUND: Health promotion and risk reduction are essential components of sexual health care. However, it can be difficult to prioritize these within busy clinical services. Digital interventions may provide a new method for supporting these. OBJECTIVE: The MenSS (Men's Safer Sex) website is an interactive digital intervention developed by a multidisciplinary team, which aims to improve condom use in men who have sex with women (MSW). This paper describes the content of this intervention, and the rationale for it. METHODS: Content was informed by a literature review regarding men's barriers to condom use, workshops with experts in sexual health and technology (N=16) and interviews with men in sexual health clinics (N=20). Data from these sources were analyzed thematically, and synthesized using the Behavior Change Wheel framework. RESULTS: The MenSS intervention is a website optimized for delivery via tablet computer within a clinic waiting room setting. Key targets identified were condom use skills, beliefs about pleasure and knowledge about risk. Content was developed using behavior change techniques, and interactive website features provided feedback tailored for individual users. CONCLUSIONS: This paper provides a detailed description of an evidence-based interactive digital intervention for sexual health, including how behavior change techniques were translated into practice within the design of the MenSS website. Triangulation between a targeted literature review, expert workshops, and interviews with men ensured that a range of potential influences on condom use were captured

Kegiatan Pengabdian Masyarakat Pemberdayaan Masyarakat dalam Upaya Peningkatan Kesadaran untuk mengurangi risiko Penyakit Kronis di Wilayah Tengger

Suku Tengger merupakan salah satu suku yang berada di wilayah kerja Puskesmas Sukapura yang masih mempertahankan tradisi leluhur seperti perayaan adat. Pada saat perayaan tersebut, masyarakat Tengger menyajikan makanan bersantan dan tinggi lemak. Hal itu diindikasi sebagai salah satu penyebab penyakit kronis yang menyerang usia pralansia dan lansia seperti hipertensi, diabetes melitus, dan obesitas. Berdasarkan data dari puskesmas setempat, diketahui angka tersebut cukup tinggi sehingga tujuan dari kegiatan pengabdian masyarakat ini adalah untuk melakukan deteksi dini, pemeriksaan serta melakukan penyuluhan kepada warga setempat tentang masalah penyakit kronis. Kegiatan yang dilakukan antara lain analisis masalah dengan pihak puskesmas serta melakukan kerja sama, kemudian melaksanakan kegiatan berupa pemeriksaan kesehatan serta penyuluhan. Pemeriksaan dilakukan selama tiga hari untuk melakukan screening untuk memeriksa hipertensi, kadar gula darah, dan obesitas. Pasien yang ditemukan pada kondisi kronis dirujuk ke puskesmas setempat untuk dilakukan pemeriksaan lebih lanjut dan diberikan edukasi untuk melakukan pemeriksaan rutin. Kegiatan KIE (komunikasi, informasi, dan edukasi) tetap dilakukan pada masyarakat. Hasil dari kegiatan pengabdian masyarakat disusun dan dilaporkan pada pemerintah setempat

The metastable Q 3Δ2^3\Delta_2 state of ThO: A new resource for the ACME electron EDM search

The best upper limit for the electron electric dipole moment was recently set by the ACME collaboration. This experiment measures an electron spin-precession in a cold beam of ThO molecules in their metastable $H~(^3\Delta_1)$ state. Improvement in the statistical and systematic uncertainties is possible with more efficient use of molecules from the source and better magnetometry in the experiment, respectively. Here, we report measurements of several relevant properties of the long-lived $Q~(^3\Delta_2)$ state of ThO, and show that this state is a very useful resource for both these purposes. The $Q$ state lifetime is long enough that its decay during the time of flight in the ACME beam experiment is negligible. The large electric dipole moment measured for the $Q$ state, giving rise to a large linear Stark shift, is ideal for an electrostatic lens that increases the fraction of molecules detected downstream. The measured magnetic moment of the $Q$ state is also large enough to be used as a sensitive co-magnetometer in ACME. Finally, we show that the $Q$ state has a large transition dipole moment to the $C~(^1\Pi_1)$ state, which allows for efficient population transfer between the ground state $X~(^1\Sigma^+)$ and the $Q$ state via $X-C-Q$ Stimulated Raman Adiabatic Passage (STIRAP). We demonstrate $90\,$% STIRAP transfer efficiency. In the course of these measurements, we also determine the magnetic moment of $C$ state, the $X\rightarrow C$ transition dipole moment, and branching ratios of decays from the $C$ state.Comment: 21 pages, 6 figures, 5 pages appendice

Evidence-based decision support for pediatric rheumatology reduces diagnostic errors.

BACKGROUND: The number of trained specialists world-wide is insufficient to serve all children with pediatric rheumatologic disorders, even in the countries with robust medical resources. We evaluated the potential of diagnostic decision support software (DDSS) to alleviate this shortage by assessing the ability of such software to improve the diagnostic accuracy of non-specialists. METHODS: Using vignettes of actual clinical cases, clinician testers generated a differential diagnosis before and after using diagnostic decision support software. The evaluation used the SimulConsult® DDSS tool, based on Bayesian pattern matching with temporal onset of each finding in each disease. The tool covered 5405 diseases (averaging 22 findings per disease). Rheumatology content in the database was developed using both primary references and textbooks. The frequency, timing, age of onset and age of disappearance of findings, as well as their incidence, treatability, and heritability were taken into account in order to guide diagnostic decision making. These capabilities allowed key information such as pertinent negatives and evolution over time to be used in the computations. Efficacy was measured by comparing whether the correct condition was included in the differential diagnosis generated by clinicians before using the software ( unaided ), versus after use of the DDSS ( aided ). RESULTS: The 26 clinicians demonstrated a significant reduction in diagnostic errors following introduction of the software, from 28% errors while unaided to 15% using decision support (p \u3c 0.0001). Improvement was greatest for emergency medicine physicians (p = 0.013) and clinicians in practice for less than 10 years (p = 0.012). This error reduction occurred despite the fact that testers employed an open book approach to generate their initial lists of potential diagnoses, spending an average of 8.6 min using printed and electronic sources of medical information before using the diagnostic software. CONCLUSIONS: These findings suggest that decision support can reduce diagnostic errors and improve use of relevant information by generalists. Such assistance could potentially help relieve the shortage of experts in pediatric rheumatology and similarly underserved specialties by improving generalists\u27 ability to evaluate and diagnose patients presenting with musculoskeletal complaints. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02205086

Responses to environmental enrichment differ with sex and genotype in a transgenic mouse model of Huntington's disease.

BACKGROUND: Environmental enrichment (EE) in laboratory animals improves neurological function and motor/cognitive performance, and is proposed as a strategy for treating neurodegenerative diseases. EE has been investigated in the R6/2 mouse model of Huntington's disease (HD), where increased social interaction, sensory stimulation, exploration, and physical activity improved survival. We have also shown previously that HD patients and R6/2 mice have disrupted circadian rhythms, treatment of which may improve cognition, general health, and survival. METHODOLOGY/PRINCIPAL FINDINGS: We examined the effects of EE on the behavioral phenotype and circadian activity of R6/2 mice. Our mice are typically housed in an "enriched" environment, so the EE that the mice received was in addition to these enhanced housing conditions. Mice were either kept in their home cages or exposed daily to the EE (a large playground box containing running wheels and other toys). The "home cage" and "playground" groups were subdivided into "handling" (stimulated throughout the experimental period) and "no-handling" groups. All mice were assessed for survival, body weight, and cognitive performance in the Morris water maze (MWM). Mice in the playground groups were more active throughout the enrichment period than home cage mice. Furthermore, R6/2 mice in the EE/no-handling groups had better survival than those in the home cage/no-handling groups. Sex differences were seen in response to EE. Handling was detrimental to R6/2 female mice, but EE increased the body weight of male R6/2 and WT mice in the handling group. EE combined with handling significantly improved MWM performance in female, but not male, R6/2 mice. CONCLUSIONS/SIGNIFICANCE: We show that even when mice are living in an enriched home cage, further EE had beneficial effects. However, the improvements in cognition and survival vary with sex and genotype. These results indicate that EE may improve the quality of life of HD patients, but we suggest that EE as a therapy should be tailored to individuals