The extent of tablet computer use in New Zealand's early childhood education services: Results from a national survey and a collective case study

In 2017, New Zealand’s revised curriculum for early childhood education, Te Whāriki, expanded reference to the use of technology for teaching and learning to include digital media and related devices. This article reports findings from a doctoral study about tablet computer use among New Zealand’s four major early childhood service types: education and care centres, home-based services, kindergartens, and playcentres. Data were gathered in 2017, initially through a national survey, followed by a collective case study. Seven services participated in the collective case study which was designed to explain the results of the survey. Descriptive statistics and inferential statistics were used to analyse survey data while cross-case analysis was used to identify themes from the responses from each service in the collective case study. The results are presented according to two categories of respondents, services who classified themselves as non-users and services who were using tablet computers for teaching and learning at the time of the survey. The national survey results revealed that more than half of the services did not use tablets. Non-users’ reasons for not using tablet computers are discussed considering findings from both quantitative and qualitative phases of the study. Services who used tablets did so for a variety of reasons, including for documentation and assessment, to support children’s learning and teaching work. Qualitative data regarding policies or guidelines for staff about the use of and access to digital media, teachers’ and educators’ learning for how to use touchscreen tablets for teaching and learning, as well as services’ preferences on the facilitation of children’s tablet use are also presented. An important issue uncovered in this study was the use of personal tablets within ECE services. Among non-users, teachers and educators from more than half of home-based services and playcentres used their personally owned tablet computers, raising concerns about cybersafety and screen time. Many user services did not have formal guidelines or policies regarding tablet use. The data suggest that some services relied on the use of teachers’ and educators’ personally owned tablets. Implications arising from the findings of this study are explored, including the relevance of using digital technology for supporting distance learning and learning at home as a result of the global Covid-19 pandemic

The extent of tablet computer use in New Zealand's early childhood education services: Results from a national survey and a collective case study

In 2017, New Zealand’s revised curriculum for early childhood education, Te Whāriki, expanded reference to the use of technology for teaching and learning to include digital media and related devices. This article reports findings from a doctoral study about tablet computer use among New Zealand’s four major early childhood service types: education and care centres, home-based services, kindergartens, and playcentres. Data were gathered in 2017, initially through a national survey, followed by a collective case study. Seven services participated in the collective case study which was designed to explain the results of the survey. Descriptive statistics and inferential statistics were used to analyse survey data while cross-case analysis was used to identify themes from the responses from each service in the collective case study. The results are presented according to two categories of respondents, services who classified themselves as non-users and services who were using tablet computers for teaching and learning at the time of the survey. The national survey results revealed that more than half of the services did not use tablets. Non-users’ reasons for not using tablet computers are discussed considering findings from both quantitative and qualitative phases of the study. Services who used tablets did so for a variety of reasons, including for documentation and assessment, to support children’s learning and teaching work. Qualitative data regarding policies or guidelines for staff about the use of and access to digital media, teachers’ and educators’ learning for how to use touchscreen tablets for teaching and learning, as well as services’ preferences on the facilitation of children’s tablet use are also presented. An important issue uncovered in this study was the use of personal tablets within ECE services. Among non-users, teachers and educators from more than half of home-based services and playcentres used their personally owned tablet computers, raising concerns about cybersafety and screen time. Many user services did not have formal guidelines or policies regarding tablet use. The data suggest that some services relied on the use of teachers’ and educators’ personally owned tablets. Implications arising from the findings of this study are explored, including the relevance of using digital technology for supporting distance learning and learning at home as a result of the global Covid-19 pandemic

Developing a Research Agenda for Cardiovascular Disease Prevention in High-Risk Rural Communities

The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas

Blood brothers & southern men : engaging with alcohol advertising in Aotearoa : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University

The aim of this project is to develop a robust methodological translation of the insights of 'culturalist' theoretical positions in communications studies as an alternative through which to approach contemporary media research. The focus is on engagements with alcohol advertising. In Aotearoa/New Zealand, as internationally, there is a significant body of publicly-funded research examining how alcohol advertising affects audiences. However, this thesis contends that important questions need to be asked about the adequacy of these (dominantly positivist) investigations. A review of local research identifies that in theoretical and methodological terms the majority of these studies are riddled with tensions and contradictions. In addition, when located within the context of wider developments in contemporary communication studies, an important epistemological gap is highlighted as requiring attention and debate. Comparison of this local review with international studies highlights similar concerns, particularly around 'effects' driven research, the adequacy of dominant positivist models, and the need to examine epistemological alternatives that can encompass meta, meso, and micro forms of enquiry. A discursive-theoretical approach is then argued as an epistemological alternative that is highly congruent with contemporary communication studies, which, if more robustly translated through methodology and method, could provide a very solid 'culturalist' alternative framework for media research. Taking a contrastive, multi-voiced, context-based approach, the present research focuses on connections, divergences, or disjunctions between different participants' interpretations of, and responses to, themes, ideas and positions they perceive as existing in the ad-texts, and themes and ideas on offer about alcohol in the wider social context. Using a methodology I describe as 'Discursive Sonar', this research highlights the socially located, interpretative complexity of advertising engagements. By unpacking that complexity, this project identifies how, and why, media engagements vary for different participants (including that of the reflexively engaged participant researcher). By locating the interactions between participants and ad-texts within the context of wider struggles over meanings around alcohol in Aotearoa/New Zealand the research shows ways in which both ad-texts and participants reflect, employ, and debate those wider struggles. I contrasted and compared individual participant interactions with the content and themes they identify in response to the ad-texts, with what producers intended those texts to communicate, and also with the views of the other participants. Through these analyses key textual 'mechanisms' become apparent as determining why and how engagements can be closely shared or variable between people and groups. Focusing on diversity and variance in engagements highlights cultural shifts around how alcohol is understood in Aotearoa/New Zealand, as well as significant alterations in views between the generations involved in the project. Focusing on commonalities across engagements identifies how 'interpretative communities' can be produced through textual responses, which are in turn engendered in response to commonly held constructs such as gender and age. This project succeeds in two ways. As well succeeding in significantly developing existing 'operationalisation' of discursive theory, it also constructs a viable discursive framework through which to approach media research. It is suggested that further development of this alternative might move us beyond the barriers of abstraction and effects in media research to examine the ways in which media and other dominant discursive forms interact, and are interacted with, to shape choices in our social worlds

Protocol for a trial-based economic evaluation analysis of a complex digital health intervention including a computerised decision support tool: the iFraP intervention

BackgroundDigital health interventions (DHI) are associated with significant promise. In recent years, the need to assess the value of these healthcare technologies has motivated a debate regarding the suitability of existing economic evaluation methods in the context of DHI evaluation. Some have argued that robust economic evaluation methods may not be capable of capturing relevant DHI’s characteristics. Others consider that assessing the value of DHI might not be feasible.This protocol paper challenges that view. More specifically, it describes early Health Technology Assessments (HTA) methods to rigorously assess the value for money of a complex intervention including a digital decision support tool i.e., Improving uptake of Fracture Prevention drug treatments (iFraP) as a tracer intervention. iFraP is a complex intervention consisting of a computerised decision support tool, a clinician training package, and information resources to facilitate shared decision-making, increase informed medicine initiation and reduce levels of medicine discontinuation. iFraP’s development was motivated by a view that good quality shared decision-making conversations have the potential to improve levels of osteoporosis medicine uptake.MethodsAn early economic evaluation of the iFraP intervention was designed to identify, measure, and evaluate the costs and health benefits of iFraP compared to usual practice in Fracture Liaison Services (FLSs). A within-trial cost-effectiveness from the perspective of the National Health Service and Personal Social Service in England will be conducted using patient’s self-reported health related quality of life (HRQoL) and resource use from the iFraP randomised controlled trial. Microanalysis will be used to estimate iFraP’s intervention cost. Finally, Bayesian Value of Information analysis will allow us to estimate an upper bound for the potential health benefits gained from reducing uncertainty on the impact of the iFraP intervention to support uptake and adherence with osteoporosis medicines.Trial registrationISRCTN10606407 - https://doi.org/10.1186/ISRCTN1060640

Tenofovir disoproxil fumarate versus adefovir dipivoxil for chronic hepatitis B

Background: Tenofovir disoproxil fumarate (DF) is a nucleotide analogue and a potent inhibitor of human immunodeficiency virus type 1 reverse transcriptase and hepatitis B virus (HBV) polymerase. Methods: In two double-blind, phase 3 studies, we randomly assigned patients with hepatitis B e antigen (HBeAg)-negative or HBeAg-positive chronic HBV infection to receive tenofovir DF or adefovir dipivoxil (ratio, 2:1) once daily for 48 weeks. The primary efficacy end point was a plasma HBV DNA level of less than 400 copies per milliliter (69 IU per milliliter) and histologic improvement (i.e., a reduction in the Knodell necroinflammation score of 2 or more points without worsening fibrosis) at week 48. Secondary end points included viral suppression (i.e., an HBV DNA level of <400 copies per milliliter), histologic improvement, serologic response, normalization of alanine aminotransferase levels, and development of resistance mutations. Results: At week 48, in both studies, a significantly higher proportion of patients receiving tenofovir DF than of those receiving adefovir dipivoxil had reached the primary end point (P<0.001). Viral suppression occurred in more HBeAg-negative patients receiving tenofovir DF than patients receiving adefovir dipivoxil (93% vs. 63%, P<0.001) and in more HBeAg-positive patients receiving tenofovir DF than patients receiving adefovir dipivoxil (76% vs. 13%, P<0.001). Significantly more HBeAg-positive patients treated with tenofovir DF than those treated with adefovir dipivoxil had normalized alanine aminotransferase levels (68% vs. 54%, P = 0.03) and loss of hepatitis B surface antigen (3% vs. 0%, P = 0.02). At week 48, amino acid substitutions within HBV DNA polymerase associated with phenotypic resistance to tenofovir DF or other drugs to treat HBV infection had not developed in any of the patients. Tenofovir DF produced a similar HBV DNA response in patients who had previously received lamivudine and in those who had not. The safety profile was similar for the two treatments in both studies. Conclusions: Among patients with chronic HBV infection, tenofovir DF at a daily dose of 300 mg had superior antiviral efficacy with a similar safety profile as compared with adefovir dipivoxil at a daily dose of 10 mg through week 48. (ClinicalTrials.gov numbers, NCT00116805 and NCT00117676.). Copyrigh

A person-centred consultation intervention to improve shared decision-making about, and uptake of, osteoporosis medicines (iFraP): a pragmatic, parallel-group, individual randomised controlled trial protocol

BackgroundGood quality shared decision-making (SDM) conversations involve people with, or at risk of osteoporosis and clinicians collaborating to decide, where appropriate, which evidence-based medicines best fit the person’s life, beliefs, and values. We developed the improving uptake of Fracture Prevention drug treatments (iFraP) intervention comprising a computerised Decision Support Tool (DST), clinician training package and information resources, for use in UK Fracture Liaison Service consultations.Two primary objectives to determine (1) the effect of the iFraP intervention on patient-reported ease in decision-making about osteoporosis medicines, and (2) cost-effectiveness of iFraP intervention compared to usual NHS care. Secondary objectives are to determine the iFraP intervention effect on patient reported outcome and experience measures, clinical effectiveness (osteoporosis medicine adherence), and to explore intervention acceptability, mechanisms, and processes underlying observed effects, and intervention implementation.MethodsThe iFraP trial is a pragmatic, parallel-group, individual randomised controlled trial in patients referred to a Fracture Liaison Service, with nested mixed methods process evaluation and health economic analysis. Participants aged ≥50 years (n=380) are randomised (1:1 ratio) to one of two arms: (1) iFraP intervention (iFraP-i) or (2) comparator usual NHS care (iFraP-u) and are followed up at 2-weeks and 3-months. The primary outcome is ease of decision-making assessed 2 weeks after the consultation using the Decisional Conflict Scale (DCS). The primary objectives will be addressed by comparing the mean DCS score in each trial arm (using analysis of covariance) for patients given an osteoporosis medicine recommendation, alongside a within-trial cost-effectiveness and value of information (VoI) analysis. Process evaluation data collection includes consultation recordings, semi-structured interviews, and DST analytics.DiscussionThe iFraP trial will answer important questions about the effectiveness of the new ‘iFraP’ osteoporosis DST, coupled with clinician training, on SDM and informed initiation of osteoporosis medicines.Trial registration: ISRCTN10606407, 21/11/2022 https://doi.org/10.1186/ISRCTN1060640

Developing a Research Agenda for Cardiovascular Disease Prevention in High-Risk Rural Communities

The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas

Inhibition of azoxymethane-induced preneoplastic lesions in the rat colon by a cooked stearic acid complexed high-amylose cornstarch

This study evaluated a novel stearic acid complexed high-amylose cornstarch (SAC) for the prevention of preneoplastic lesions in the colon of azoxymethane (AOM)-treated Fisher 344 rats fed resistant starches at 50-55% of the diet for 8 weeks. Uncooked SAC (r-SAC) diet was compared with raw normal-cornstarch diet (r-CS) or raw high-amylose cornstarch diet (r-HA), and water-boiled CS (w-CS) was compared with w-HA and w-SAC, respectively. w-SAC markedly reduced mucin-depleted foci (MDF) numbers compared with w-HA or w-CS. r-HA significantly decreased aberrant crypt foci (ACF) numbers compared with r-CS or r-SAC. Increased cecum weight and decreased cecum pH were observed in the SAC or HA groups. The highest amounts of total or individual short-chain fatty acids (SCFAs) in cecum and of butyrate or propionate in feces were observed in the AOM-treated w-SAC group. This study revealed the effectiveness of a novel resistant starch in inhibiting colonic preneoplastic lesions and the importance of high-moisture cooking on the suppression of colon carcinogenesis by this resistant starch