A Systematic Review of Portable Electronic Technology for Health Education in Resource-limited Settings

poster abstractObjective: The objective of this study is to conduct a systematic review of the literature of how portable electronic technologies with off-line functionality are perceived and used to provide health education in resource-limited settings. Methods: Three reviewers evaluated articles and performed a bibliography search to identify studies describing health education delivered by portable electronic device in low- or middle-income countries (defined by World Bank criteria) not requiring constant internet connection. Data extracted included type of technology, method of education, improvement in provider/patient knowledge, impact on provider/patient attitude towards care, and overall health outcomes. Results: Searches yielded 6,790 titles, 5 met inclusion criteria. Four studies were qualitative, relying on surveys, interviews, questionnaires, or focus group discussions. The remaining quantitative study was a two-arm comparative study that assessed the use of internet-based versus locally loaded smartphone applications. A common educational use of mobile technology involved locally loaded, point-of-care applications used at the bedside and for self-directed learning at home. Study populations had small sample sizes (n=7-31) and were made up primarily of medical trainees or providers. Studies primarily looked at the assessment of developed educational modules on trainee health knowledge, perceptions and usability of technology, and comparisons of technologies. Overall, studies reported positive results for tablet-based health education, frequently reporting increased provider/patient knowledge, increased provider comfort level with technology, and an environment characterized by increased levels of technology-based, informal learning situations. Negative assessments included high investment costs and fear of theft of the device. Conclusions: While the research is limited, portable electronic educational resources present promising avenues to increase access to effective healthcare education in resource-limited settings, contingent on the development of culturally adapted and functional materials to be used on such devices

Tracing Nitrogen in Volcanic and Geothermal Volatiles from the Nicaraguan Volcanic Front

We report new chemical and isotopic data from 26 volcanic and geothermal gases, vapor condensates, and thermal water samples, collected along the Nicaraguan volcanic front. The samples were analyzed for chemical abundances and stable isotope compositions, with a focus on nitrogen abundances and isotope ratios. These data are used to evaluate samples for volatile contributions from magma, air, air-saturated water, and the crust. Samples devoid of crustal contamination (based upon He isotope composition) but slightly contaminated by air or air-saturated water are corrected using N2/Ar ratios in order to obtain primary magmatic values, composed of contributions from upper mantle and subducted hemipelagic sediment on the down-going plate. Using a mantle endmember with d15N= 5&and N2/He = 100 and a subducted sediment component with d15N=+7& and N2/He = 10,500, the average sediment contribution to Nicaraguan volcanic and geothermal gases was determined to be 71%. Most of the gases were dominated by sediment-derived nitrogen, but gas from Volca´n Mombacho, the southernmost sampling location, had a mantle signature (46% from subducted sediment, or 54% from the mantle) and an affinity with mantle-dominated gases discharging from Costa Rica localities to the south. High CO2/N2 exc. ratios (N2 exc. is the N2 abundance corrected for contributions from air) in the south are similar to those in Costa Rica, and reflect the predominant mantle wedge input, whereas low ratios in the north indicate contribution by altered oceanic crust and/or preferential release of nitrogen over carbon from the subducting slab. Sediment-derived nitrogen fluxes at the Nicaraguan volcanic front, estimated by three methods, are 7.8 · 108 mol N/a from 3He flux, 6.9 · 108 mol/a from SO2 flux, and 2.1 · 108 and 1.3 · 109 mol/a from CO2 fluxes calculated from 3He and SO2, respectively. These flux results are higher than previous estimates for Central America, reflecting the high sediment-derived volatile contribution and the high nitrogen content of geothermal and volcanic gases in Nicaragua. The fluxes are also similar to but higher than estimated hemipelagic nitrogen inputs at the trench, suggesting addition of N from altered oceanic basement is needed to satisfy these flux estimates. The similarity of the calculated input of N via the trench to our calculated outputs suggests that little or none of the subducted nitrogen is being recycled into the deeper mantle, and that it is, instead, returned to the surface via arc volcanism

De invloed van informatie over risico's, voordelen en bestaande attitudes op post-attitudes ten opzichte van voedselproductiemethodes

Het effect van eenzijdige versus tweezijdige informatievoorziening en bestaande attitudes op post-attitudes is onderzocht. Met name is gekeken naar de mogelijke asymmetrische invloed van positieve en negatieve informatie op post-attitudes. Daarnaast is gekeken hoe bestaande attitudes dit effect beïnvloeden. Eenzijdige informatie beïnvloedde attitudeformatie in de richting van de informatie. In tegenstelling tot de verwachting had negatieve informatie in een tweezijdige boodschap geen dominant effect op attitudeformatie. Het effect van tweezijdige informatie was afhankelijk van bestaande attitudes wanneer de informatie verschillende domeinen betrof (gezondheid en milieu), maar had geen effect wanneer de informatie eenzelfde domein betrof

Observer dependence for the phonon content of the sound field living on the effective curved space-time background of a Bose-Einstein condensate

We demonstrate that the ambiguity of the particle content for quantum fields in a generally curved space-time can be experimentally investigated in an ultracold gas of atoms forming a Bose-Einstein condensate. We explicitly evaluate the response of a suitable condensed matter detector, an ``Atomic Quantum Dot,'' which can be tuned to measure time intervals associated to different effective acoustic space-times. It is found that the detector response related to laboratory, ``adiabatic,'' and de Sitter time intervals is finite in time and nonstationary, vanishing, and thermal, respectively.Comment: 9 pages, 2 figures; references updated, as published in Physical Review

Genetically modified animals from life-science, socio-economic and ethical perspectives: examining issues in an EU policy context

The interdisciplinary EC consortium (the PEGASUS project) aimed to examine the issues raised by the development, implementation and commercialisation of genetically modified (GM) animals, and derivative foods and pharmaceutical products. The results integrated existing social (including existing public perception) environmental and economic knowledge regarding GM animals to formulate policy recommendations relevant to new developments and applications. The use of GM in farmed animals (aquatic, terrestrial and pharmaceutical) was mapped and reviewed. A foresight exercise was conducted to identity future developments. Three case studies (aquatic, terrestrial and pharmaceutical) were applied to identify the issues raised, including the potential risks and benefits of GM animals from the perspectives of the production chain (economics and agri-food sector) and the life sciences (human and animal health, environmental impact, animal welfare and sustainable production). Ethical and policy concerns were examined through application of combined ethical matrix method and policy workshops. The case studies were also used to demonstrate the utility of public engagement in the policy process. The results suggest that public perceptions, ethical issues, the competitiveness of EU animal production and risk-benefit assessments that consider human and animal health, environmental impact and sustainable production need to be considered in EU policy development. Few issues were raised with application in the pharmaceutical sector, assuming ethical and economic issues were addressed in policy, but the introduction of agricultural GM animal applications should be considered on a case-by-case basis

Tablet-based disclosure counselling for HIV-infected children, adolescents, and their caregivers: a pilot study

BACKGROUND: Overwhelmed, under-trained medical staff working in resource-limited settings need efficient resources for HIV disclosure counselling. The objective of this study was to describe providers' experiences using tablet computers for disclosure-related counselling with HIV-infected children and their caregivers in western Kenya, with additional perspectives from adolescents. METHODS: A qualitative study design was implemented at three HIV clinics in western Kenya (Bumala, Busia and Port Victoria) within the Academic Model Providing Access to Healthcare (AMPATH) partnership. Twenty-one healthcare providers involved with paediatric disclosure were recruited and enrolled in the study. Initial interviews focused on understanding current disclosure practices and barriers. Tablets containing disclosure-related resources were distributed. Resources included short narrative videos created in this context to highlight issues relevant to child HIV disclosure. RESULTS: Providers reported tablets improved disclosure, child participation, and medication adherence. All reported that reviewing materials increased their knowledge and comfort with disclosure. The most frequently used materials were the narrative videos and an animated video explaining the importance of medication adherence. Time was a major barrier for using the tablet. Clinician self-education persisted at one-year follow-up. Adolescents expressed enjoyment from viewing the tablet resources and had a better understanding of the importance of medication adherence. CONCLUSIONS: Tablet computers containing resources for disclosure are an acceptable and potentially effective resource to help providers support families with disclosure. Further work is needed to train the clinical providers in using the resources in a developmentally appropriate manner, and to develop new resources on adolescent-specific and HIV-related topics

Willingness to pay for personalised nutrition across Europe

yesPersonalised nutrition (PN) may promote public health. PN involves dietary advice based on individual characteristics of end users and can for example be based on lifestyle, blood and/or DNA profiling. Currently, PN is not refunded by most health insurance or health care plans. Improved public health is contingent on individual consumers being willing to pay for the service. Methods: A survey with a representative sample from the general population was conducted in eight European countries (N = 8233). Participants reported their will- 25 ingness to pay (WTP) for PN based on lifestyle information, lifestyle and blood information, and lifestyle and DNA information. WTP was elicited by contingent valuation with the price of a standard, non-PN advice used as reference. Results: About 30% of participants reported being willing to pay more for PN than for non-PN advice. They were on average prepared to pay about 150% of the reference price of a standard, non-personalised advice, with some differences related to socio-demographic factors. Conclusion: There is a potential market for PN 30 compared to non-PN advice, particularly among men on higher incomes. These findings raise questions to what extent personalized nutrition can be left to the market or should be incorporated into public health programsEC (FW7) funded Food4me projectThe full text will be available 12 months after publicatio

Factors influencing societal response of nanotechnology : an expert stakeholder analysis

Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured interviews with experts on nanotechnology from North West Europe were conducted using repertory grid methodology in conjunction with generalized Procrustes analysis to examine the psychological constructs underlying societal uptake of 15 key applications of nanotechnology drawn from different areas (e.g. medicine, agriculture and environment, chemical, food, military, sports, and cosmetics). Based on expert judgement, the main factors influencing societal response to different applications of nanotechnology will be the extent to which applications are perceived to be beneficial, useful, and necessary, and how 'real' and physically close to the end-user these applications are perceived to be by the publi

The interaction of a gap with a free boundary in a two dimensional dimer system

Let $\ell$ be a fixed vertical lattice line of the unit triangular lattice in the plane, and let \Cal H be the half plane to the left of $\ell$. We consider lozenge tilings of \Cal H that have a triangular gap of side-length two and in which $\ell$ is a free boundary - i.e., tiles are allowed to protrude out half-way across $\ell$. We prove that the correlation function of this gap near the free boundary has asymptotics $\frac{1}{4\pi r}$, $r\to\infty$, where $r$ is the distance from the gap to the free boundary. This parallels the electrostatic phenomenon by which the field of an electric charge near a conductor can be obtained by the method of images.Comment: 34 pages, AmS-Te

Gravity wave analogs of black holes

It is demonstrated that gravity waves of a flowing fluid in a shallow basin can be used to simulate phenomena around black holes in the laboratory. Since the speed of the gravity waves as well as their high-wavenumber dispersion (subluminal vs. superluminal) can be adjusted easily by varying the height of the fluid (and its surface tension) this scenario has certain advantages over the sonic and dielectric black hole analogs, for example, although its use in testing quantum effects is dubious. It can be used to investigate the various classical instabilities associated with black (and white) holes experimentally, including positive and negative norm mode mixing at horizons. PACS: 04.70.-s, 47.90.+a, 92.60.Dj, 04.80.-y.Comment: 14 pages RevTeX, 5 figures, section VI modifie