How embarrassing is that? Purchasing sensitive products and the potential for self-service

Consumers might feel uncomfortable or embarrassed when buying products that are inconsistent with the desire to project a positive self-image to others [3], [5], [7], [16]. Embarrassment and shame are key elements in the relationship between sales assistant and consumer [7] and may affect the likelihood of engagement with a service provider [10]. We explored the circumstances under which embarrassing retail experiences occur, with a view to identify the potential for self-service solutions to alleviate these experiences

Measuring State Compliance with the Right to Education Using Indicators: a Case Study of Colombia’s Obligations Under the ICESCR

The right to education is often referred to as a “multiplier right” because its enjoyment enhances other human rights. It is enumerated in several international instruments, but it is codified in greatest detail in the International Covenant on Economic, Social and Cultural Rights (ICESCR). Despite its importance, the right to education has received limited attention from scholars, practitioners, and international and regional human rights bodies as compared to other economic, social and cultural rights (ECSRs). In this Article, we propose a methodology that utilizes indicators to measure treaty compliance with the right to education. Indicators are essential to measuring compliance with ECSRs because indicators are, in many cases, the only way to evaluate whether or not a State is progressively realizing its obligations to fulfill ESCRs. Human rights scholars, professionals and intergovernmental organizations have been increasingly interested in using indicators to measure and enforce a State’s compliance with its obligations under international human rights treaties. However, there have been few attempts to develop a comprehensive methodology that uses human rights indicators closely tied to treaty language to measure a State’s compliance with the right to education. Furthermore, there are no studies of which we are aware that analyze a specific country’s treaty compliance using indicators. This Article’s proposed framework is used to evaluate Colombia’s compliance with its obligations relating to the right to education under the ICESCR. In particular, the methodology that we propose to develop a suitable framework for measuring State party fulfillment of the right to education under the ICESCR calls for: 1) analyzing the specific language of the ICESCR that pertains to ensuring the right; 2) defining the concept and scope of obligations of the right in order to identify indicators for measurement; 3) identifying appropriate indicators to measure State compliance; 4) setting benchmarks to measure progressive realization; and 5) clearly identifying what constitutes a violation of the right to education in order to improve future State party compliance with its obligations under the ICESCR. This methodology can be used by States in reports and by NGOs in shadow reports submitted to the Committee on Economic, Social and Cultural Rights (CESCR), the committee that monitors compliance with the ICESCR. From our case study of Colombia, we conclude that, although Colombia has made strides in improving educational access, it is not in compliance with its many of its obligations relating to the right to education under the ICESCR

Enhancing Enforcement of Economic, Social, and Cultural Rights Using Indicators: A Focus on the Right to Education in the ICESCR

Nearly fifteen years ago, Audrey Chapman emphasized the importance of ascertaining violations of the International Covenant on Economic, Social and Cultural Rights (ICESCR) as a means to enhance its enforcement. Today, this violations approach is even more salient given the recent adoption of the Optional Protocol to the ICESCR. This article focuses on the right to education in the ICESCR to illustrate how indicators can be employed to ascertain treaty compliance and violations. Indicators are important to enforcing economic, social, and cultural rights because they assist in measuring progressive realization. The methodology that we propose calls for: 1) analyzing the specific language of the treaty that pertains to the right in question; 2) defining the concept and scope of the right; 3) identifying appropriate indicators that correlate with state obligations; 4) setting benchmarks to measure progressive realization; and 5) clearly identifying violations of the right in question

Understanding Banking via WeChat Diaries

This paper describes the development and refinement of an existing chat application, China’s WeChat, as a remote diary tool, which researchers can employ to acquire a deeper understanding on their consumers whilst overcoming major geographical and time zone constraints. This research was part of a project to understand the experiences of Chinese consumers related to finance and banking. A diary study was conducted through WeChat and phone interviews to understand how consumers conduct their everyday financial transactions. The research illustrated the need to adapt approaches to diary participants, such as utilising a chat agent or avatar to elicit richer data, and demonstrated the utility of a feedback loop, which reassured and reminded participants to post regularly, in turn encouraging posts with more depth. The relationships built over the course of the diary study were also imperative to the success of follow-up semi-structured phone interviews, as trust and familiarity between researchers and participants enabled more intimate conversations. Novel use of the application worked well in gaining a deeper appreciation of the experiences of selected consumers. The paper adds to the growing literature on the use and adaptation of chat applications as a substitute for conventional mobile diary tools, and concludes with a list of key considerations for further applications in a similar research context

Enhancing Enforcement of Economic, Social and Cultural Rights Using Indicators: A Focus on the Right to Education in the ICESCR

Nearly fifteen years ago, Audrey R. Chapman emphasized the importance of ascertaining violations of the International Covenant on Economic, Social and Cultural Rights (ICESCR) as a means to enhance its enforcement. Today, the violations approach is even more salient given the recent adoption of the ICESCR’s Optional Protocol, a powerful tool to hold States parties accountable for violations. Indicators are essential tools for assessing violations of economic, social and cultural rights (ESCRs) because they are often the best way to measure progressive realization. Proposed guidelines on using indicators give guidance on the content of States parties reports to treaty monitoring bodies, but none creates a framework to assess violations of a specific right in a particular treaty. This article fills this void by providing a framework to assess State compliance that integrates indicators into the project of ascertaining specific violations of economic, social and cultural rights under the ICESCR. The methodology that we propose calls for: 1) analyzing the specific language of the treaty that pertains to the right in question; 2) defining the concept and scope of the right; 3) identifying appropriate indicators that correlate with State obligations; 4) setting benchmarks to measure progressive realization; and 5) clearly identifying violations of the right in question. We illustrate our approach by focusing on the right to education in the ICESCR. In addition to assessing right to education violations, this methodology can be employed to develop frameworks for ascertaining violations of other ESCRs as well

Comparative epidemiology and factors associated with major healthcare-associated methicillin-resistant Staphylococcus aureus clones among interconnected acute-, intermediate- and long-term healthcare facilities in Singapore

Funding: Bioinformatics and Computational Biology analyses were supported by the University of St Andrews Bioinformatics Unit that is funded by a Wellcome Trust ISSF award (grant 097831/Z/11/Z). M.T.G.H is supported by the Scottish Infection Research Network and Chief Scientist Office through the Scottish Healthcare Associated Infection Prevention Institute consortium funding (CSO Reference: SIRN10).Objectives Methicillin-resistant Staphylococcus aureus(MRSA) has spread across countries and healthcare settings, with different ecological niches for different clones. It is crucial to understand the comparative epidemiology of MRSA clones between healthcare settings, and independent factors associated with colonization of specific clones. Methods We conducted annual cross-sectional surveillance studies in a network comprising an acute-care hospital and six closely-affiliated intermediate- and long-term care facilities in Singapore, in June-July, 2014-2016. 5,394 patients contributed 16,045 nasal, axillary and groin samples for culture and MRSA isolates for whole genome sequencing. Multivariable multilevel multinomial regression models were constructed to assess for independent factors associated with MRSA colonization. Results MRSA clonal complex(CC) 22 was more prevalent in the acute-care hospital(n=256/493; 51.9%) and intermediate-care(n=348/634; 54.9%) than long-term care(n=88/351; 25.1%) facilities, with clones besides CC22 and CC45 being more prevalent in long-term care facilities(n=144/351; 41.0%) (P<0.001). Groin colonization with CC45 was 6 times that of nasal colonization(aOR 6.21, 95%CI 4.26-9.01). Prior MRSA carriage was associated with increased odds of current MRSA colonization in all settings, with a stronger association with CC22(aOR 6.45, 95%CI 3.85-10.87) than CC45(aOR 4.15, 95%CI 2.26-7.58). Conclusions Colonization of MRSA clones differed between anatomic sites and across healthcare settings. With CC22 having a predilection for the nares and CC45 the groin, MRSA screening should include both sites. Prior MRSA carriage is a risk factor for colonization with predominant MRSA clones in the acute-care hospital and intermediate- and long-term care facilities. Contact precautions for prior MRSA-carriers on admission to any healthcare facility could prevent intra- and inter-institutional MRSA transmission.PostprintPeer reviewe

Nivolumab in Advanced Hepatocellular Carcinoma: Safety Profile and Select Treatment-Related Adverse Events From the CheckMate 040 Study.

BACKGROUND: CheckMate 040 assessed the efficacy and safety of nivolumab in patients with advanced hepatocellular carcinoma (HCC). Understanding the safety profile of nivolumab is needed to support the management of treatment-related adverse events (TRAEs). This analysis assessed the safety of nivolumab monotherapy in the phase I/II, open-label CheckMate 040 study. MATERIALS AND METHODS: Select TRAEs (sTRAEs; TRAEs with potential immunologic etiology requiring more frequent monitoring) occurring between first dose and 30 days after last dose were analyzed in patients in the dose-escalation and -expansion phases. Time to onset (TTO), time to resolution (TTR), and recurrence of sTRAEs were assessed, and the outcome of treatment with immune-modulating medication (IMM) was evaluated. RESULTS: The analysis included 262 patients. The most common sTRAE was skin (35.5%), followed by gastrointestinal (14.5%) and hepatic (14.1%) events; the majority were grade 1/2, with 10.7% of patients experiencing grade 3/4 events. One patient had grade 5 pneumonitis. Median (range) TTO ranged from 3.6 (0.1-59.9) weeks for skin sTRAEs to 47.6 (47.1-48.0) weeks for renal sTRAEs. Overall, 68% of sTRAEs resolved, with median (range) TTR ranging from 3.7 (0.1-123.3+) weeks for gastrointestinal sTRAEs to 28.4 (0.1-79.1) weeks for endocrine sTRAEs. Most gastrointestinal and all hepatic events resolved with treatment in accordance with established toxicity management algorithms. In 57 patients (40%), sTRAEs were managed with IMM. Reoccurrence of sTRAEs was uncommon following rechallenge with nivolumab. CONCLUSION: Nivolumab demonstrated a manageable safety profile in this analysis of patients with advanced HCC. A majority of sTRAEs resolved with treatment. IMPLICATIONS FOR PRACTICE: Nivolumab is a viable treatment option for patients with previously treated advanced hepatocellular carcinoma as it has demonstrated durable tumor responses and promising survival. Nivolumab has a manageable safety profile. The most common select treatment-related adverse events (sTRAEs) in this analysis were skin related (35%). Gastrointestinal and hepatic sTRAEs were observed in approximately 14% of patients. The majority of sTRAEs resolved (68%). Safety events are easier to manage if addressed early. Patient education on signs and symptoms to watch out for and the importance of early reporting and consultation should be emphasized

A Sustainable Campus for the Future: Proposals for Sarah Lawrence College

The combined version of A Sustainable Campus for the Future: Proposals for Sarah Lawrence College comes from a joint project between the students in Economics of the Ecological Crisis and Global Change Biology in Spring 2016, taught by Nicholas Reksten and Michelle Hersh, respectively.https://digitalcommons.slc.edu/undergrad_sustainproject/1009/thumbnail.jp

Nivolumab in Advanced Hepatocellular Carcinoma: Safety Profile and Select Treatment-Related Adverse Events From the CheckMate 040 Study

Background. CheckMate 040 assessed the efficacy and safety of nivolumab in patients with advanced hepatocellular carcinoma (HCC). Understanding the safety profile of nivolumab is needed to support the management of treatment-related adverse events (TRAEs). This analysis assessed the safety of nivolumab monotherapy in the phase I/II, open-label CheckMate 040 study. Materials and Methods. Select TRAEs (sTRAEs; TRAEs with potential immunologic etiology requiring more frequent monitoring) occurring between first dose and 30 days after last dose were analyzed in patients in the dose-escalation and -expansion phases. Time to onset (TTO), time to resolution (TTR), and recurrence of sTRAEs were assessed, and the outcome of treatment with immune-modulating medication (IMM) was evaluated. Results. The analysis included 262 patients. The most common sTRAE was skin (35.5%), followed by gastrointestinal (14.5%) and hepatic (14.1%) events; the majority were grade 1/2, with 10.7% of patients experiencing grade 3/4 events. One patient had grade 5 pneumonitis. Median (range) TTO ranged from 3.6 (0.1–59.9) weeks for skin sTRAEs to 47.6 (47.1–48.0) weeks for renal sTRAEs. Overall, 68% of sTRAEs resolved, with median (range) TTR ranging from 3.7 (0.1–123.3+) weeks for gastrointestinal sTRAEs to 28.4 (0.1–79.1) weeks for endocrine sTRAEs. Most gastrointestinal and all hepatic events resolved with treatment in accordance with established toxicity management algorithms. In 57 patients (40%), sTRAEs were managed with IMM. Reoccurrence of sTRAEs was uncommon following rechallenge with nivolumab. Conclusion. Nivolumab demonstrated a manageable safety profile in this analysis of patients with advanced HCC. A majority of sTRAEs resolved with treatment

MRSA transmission dynamics among interconnected acute, intermediate-term, and long-term healthcare facilities in Singapore

This work was supported by the Ministry of Health, Singapore (Communicable Diseases–Public Health Research Grant), the Wellcome Trust (Institutional Strategic Support Fund award [grant 097831/Z/11/Z] to the University of St Andrews Bioinformatics Unit), and the Scottish Infection Research Network and Chief Scientist Office (Scottish Healthcare Associated Infection Prevention Institute consortium funding [Chief Scientist Office reference SIRN10] to K. P. and M. T. G. H.).Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common healthcare-associated multidrug-resistant organism. Despite the interconnectedness between acute care hospitals (ACHs) and intermediate- and long-term care facilities (ILTCFs), the transmission dynamics of MRSA between healthcare settings is not well understood. Methods: We conducted a cross-sectional study in a network comprising an ACH and 5 closely affiliated ILTCFs in Singapore. A total of 1700 inpatients were screened for MRSA over a 6-week period in 2014. MRSA isolates underwent whole-genome sequencing, with a pairwise single-nucleotide polymorphism (Hamming distance) cutoff of 60 core genome single-nucleotide polymorphisms used to define recent transmission clusters (clades) for the 3 major clones. Results: MRSA prevalence was significantly higher in intermediate-term (29.9%) and long-term (20.4%) care facilities than in the ACH (11.8%) (P < .001). The predominant clones were sequence type [ST] 22 (n = 183; 47.8%), ST45 (n = 129; 33.7%), and ST239 (n = 26; 6.8%), with greater diversity of STs in ILTCFs relative to the ACH. A large proportion of the clades in ST22 (14 of 21 clades; 67%) and ST45 (7 of 13; 54%) included inpatients from the ACH and ILTCFs. The most frequent source of the interfacility transmissions was the ACH (n = 28 transmission events; 36.4%). Conclusions: MRSA transmission dynamics between the ACH and ILTCFs were complex. The greater diversity of STs in ILTCFs suggests that the ecosystem in such settings might be more conducive for intrafacility transmission events. ST22 and ST45 have successfully established themselves in ILTCFs. The importance of interconnected infection prevention and control measures and strategies cannot be overemphasized.PostprintPeer reviewe