Addressing Cultural Pluralism from an Evangelical Christian Perspective

The complex issues surrounding cultural pluralism are rapidly turning the public square into a battlefield that divides our country. As Charles Haynes summarized, “At issue for this nation, as for much of the world, is the simple but profound question that runs through modern experience: How will we live with our deepest differences?” (Haynes, 1994). At a time when many citizens of our diverse nation have become disillusioned with the motto e pluribus unum, the Christian higher education community deals with issues involving race, ethnicity, and gender through a variety of responses ranging from isolationism to unqualified inclusion. Evangelical institutions of higher learning are not new to the discussion of multiculturalism. They have rather a rich history of commitment to living out Christ’s commandment to love one’s neighbor as oneself (Mk 12:31) regarding each other through the unity of faith in Christ (Gal 3:28). This paper addresses the historical context for understanding cultural pluralism together with the scriptural and religious imperatives for engaging Christian and secular audiences on this issue. It identifies several of the issues surrounding cultural pluralism faced by evangelicals today, while also developing criteria for celebrating and confronting pluralism. Finally, it articulates strategies for pursuing common ground in the public arena and discusses implications for Christian higher education in addressing cultural pluralism within and beyond the college classroom

What predicts the richness of seeder and resprouter species in fire-prone Cape fynbos: Rainfall reliability of vegetation density?

In ecosystems subject to regular canopy fires, woody species have evolved two general strategies of post-fire regeneration. Seeder species are killed by fire and populations regenerate solely by post-fire recruitment from a seed bank. Resprouter species survive fire and regenerate by vegetative regrowth from protected organs. Interestingly, the abundance of these strategies varies along environmental gradients and across regions. Two main hypotheses have been proposed to explain this spatial variation: the gap dependence and the environmental-variability hypotheses. The gap-dependence model predicts that seeders are favoured in sparse vegetation (vegetation gaps allowing effective post-fire recruitment of seedlings), while resprouters are favoured in densely vegetated sites (seedlings being outcompeted by the rapid crown regrowth of resprouters). The environmental-variability model predicts that seeders would prevail in reliable rainfall areas, whereas resprouters would be favoured in areas under highly variable rainfall that are prone to severe dry events (leading to high post-fire seedling mortality). We tested these two models using distribution data, captured at the scale of quarter-degree cells, for seeder and resprouter species of two speciose shrub genera (Aspalathus and Erica) common in fire-prone fynbos ecosystems of the mediterranean-climate part of the Cape Floristic Region. Contrary to the predictions of the gap-dependence model, species number of both resprouters and seeders increased with values of the Normalized Difference Vegetation Index (a widely used surrogate for vegetation density), with a more marked increase for seeders. The predictions of the environmental-variability hypothesis, by contrast, were not refuted by this study. Seeder and resprouter species of both genera showed highest richness in environments with high rainfall reliability. However, with decreasing reliability, seeder numbers dropped more quickly than those of resprouters. We conclude that the environmental-variability model is better able to explain the abundance of woody seeder and resprouter species in Southern Hemisphere fire-prone shrublands (fynbos and kwongan) than the gap-dependence model

Novel robotic assistive technologies: choosing appropriate training for healthcare professionals

One of the key challenges for the training of healthcare professionals (HCPs) is to maintain a good understanding and knowledge of new assistive technologies (ATs) that are currently on the market [1]. Indeed, at present, available training on ATs is limited and does not meet the practice-related needs of HCPs. It is in this context that the ADAPT European project aims to develop a new AT training programme for healthcare professionals, which will also introduce them to the project’s new AT developments - a smart powered wheelchair and a virtual reality wheelchair-driving simulator. The program consists of six multimodal units; five delivered via e-learning and one through a blended method of e-learning and face-to-face sessions. The development of the content is guided by findings from an earlier literature review and an online survey of AT training needs for HCP’s, both undertaken by the ADAPT cross-national research team, comprised of UK and French experts. The level of technical difficulty increases with successive units in order to train all HCPs to use innovative ATs more widely in their practice. A Learning Management System enables the dissemination of the e-learning AT program. Preliminary results from participant unit-specific evaluations available at this stage are overall positive and encouraging

Taking stock: protocol for evaluating a family planning supply chain intervention in Senegal.

BACKGROUND: In Senegal, only 12% of women of reproductive age in union (WRAU) were using contraceptives and another 29% had an unmet need for contraceptives in 2010-11. One potential barrier to accessing contraceptives is the lack of stock availability in health facilities where women seek them. Multiple supply chain interventions have been piloted in low- and middle-income countries with the aim of improving contraceptive availability in health facilities. However, there is limited evidence on the effect of these interventions on contraceptive availability in facilities, and in turn on family planning use in the population. This evaluation protocol pertains to a supply chain intervention using performance-based contracting for contraceptive distribution that was introduced throughout Senegal between 2012 and 2015. METHODS: This multi-disciplinary research project will include quantitative, qualitative and economic evaluations. Trained researchers in the different disciplines will implement the studies separately but alongside each other, sharing findings throughout the project to inform each other's data collection. A non-randomised study with stepped-wedge design will be used to estimate the effect of the intervention on contraceptive stock availability in health facilities, and on the modern contraceptive prevalence rate among women in Senegal, compared to the current pull-based distribution model used for other commodities. Secondary data from annual Service Provision Assessments and Demographic and Health Surveys will be used for this study. Data on stock availability and monthly family planning consultations over a 4-year period will be collected from 200 health facilities in five regions to perform time series analyses. A process evaluation will be conducted to understand the extent to which the intervention was implemented as originally designed, the acceptability of third-party logisticians within the health system and potential unintended consequences. These will be assessed using monthly indicator data from the implementer and multiple ethnographic methods, including in-depth interviews with key informants and stakeholders at all levels of the distribution system, observations of third-party logisticians and clinic diaries. An economic evaluation will estimate the cost of the intervention, as well as its cost-effectiveness compared to the current supply chain model. DISCUSSION: Given the very limited evidence base, there is an important need for a comprehensive standardised approach to evaluating supply chain management, and distribution specifically. This evaluation will help address this evidence gap by providing rigorous evidence on whether private performance-based contracting for distribution of contraceptives can contribute to improving access to family planning in low- and middle-income countries

Characterization of Three Carbon- and Nitrogen-Rich Particles from Comet 81P/WILD

Comets may sample the early solar system s complement of volatile-forming elements - including C and N - more fully and reliably than do the terrestrial planets or asteroids. Until recently, all elemental analyses of unambiguously cometary material were carried out remotely. The return of the Stardust mission makes it possible to analyze documented material from P81/Wild 2 in the laboratory Wild 2 particles fragmented when they stopped in the aerogel collectors. We have studied three fragments thought to be rich in C and N by using several techniques: FTIR to characterize organic matter; synchrotron-induced x-ray fluorescence (SXRF) to determine Fe and certain element/Fe ratios; SEM to image sample morphology and to detect semiquantitatively Mg, Al, Si, Ca, and Fe; and nuclear reaction analysis (NRA) to measure C, N, O, and Si

Impact of Low-Level-Viremia on HIV-1 Drug-Resistance Evolution among Antiretroviral Treated-Patients

to determine the emergence and evolution of DRAM during LLV in HIV-1-infected patients while receiving antiretroviral therapy (ART).Retrospective analysis of patients presenting a LLV episode defined as pVL between 40 and 500 c/mL on at least 3 occasions during a 6-month period or longer while on the same ART. Resistance genotypic testing was performed at the onset and at the end of LLV period. Emerging DRAM was defined during LLV if never detected on baseline genotype or before.48 patients including 4 naive and 44 pretreated (median 9 years) presented a LLV episode with a median duration of 11 months. Current ART included 2NRTI (94%), ritonavir-boosted PI (94%), NNRTI (23%), and/or raltegravir (19%). Median pVL during LLV was 134 c/mL. Successful resistance testing at both onset and end of the LLV episode were obtained for 37 patients (77%), among who 11 (30%) acquired at least 1 DRAM during the LLV period: for NRTI in 6, for NNRTI in 1, for PI in 4, and for raltegravir in 2. During the LLV period, number of drugs with genotypic resistance increased from a median of 4.5 to 6 drugs. Duration and pVL level of LLV episode, duration of previous ART, current and nadir CD4 count, number of baseline DRAM and GSS were not identified as predictive factors of resistance acquisition during LLV, probably due to limited number of patients.Persistent LLV episodes below 500 c/ml while receiving ART is associated with emerging DRAM for all drug classes and a decreasing in further therapeutic options, suggesting to earlier consider resistance monitoring and ART optimization in this setting

Clinical use of HIV integrase inhibitors : a systematic review and meta-analysis

Background: Optimal regimen choice of antiretroviral therapy is essential to achieve long-term clinical success. Integrase inhibitors have swiftly been adopted as part of current antiretroviral regimens. The purpose of this study was to review the evidence for integrase inhibitor use in clinical settings. Methods: MEDLINE and Web-of-Science were screened from April 2006 until November 2012, as were hand-searched scientific meeting proceedings. Multiple reviewers independently screened 1323 citations in duplicate to identify randomized controlled trials, nonrandomized controlled trials and cohort studies on integrase inhibitor use in clinical practice. Independent, duplicate data extraction and quality assessment were conducted. Results: 48 unique studies were included on the use of integrase inhibitors in antiretroviral therapy-naive patients and treatment-experienced patients with either virological failure or switching to integrase inhibitors while virologically suppressed. On the selected studies with comparable outcome measures and indication (n = 16), a meta-analysis was performed based on modified intention-to-treat (mITT), on-treatment (OT) and as-treated (AT) virological outcome data. In therapy-naive patients, favorable odds ratios (OR) for integrase inhibitor-based regimens were observed, (mITT OR 0.71, 95% CI 0.59-0.86). However, integrase inhibitors combined with protease inhibitors only did not result in a significant better virological outcome. Evidence further supported integrase inhibitor use following virological failure (mITT OR 0.27; 95% CI 0.11-0.66), but switching to integrase inhibitors from a high genetic barrier drug during successful treatment was not supported (mITT OR 1.43; 95% CI 0.89-2.31). Integrase inhibitor-based regimens result in similar immunological responses compared to other regimens. A low genetic barrier to drug-resistance development was observed for raltegravir and elvitegravir, but not for dolutegravir. Conclusion: In first-line therapy, integrase inhibitors are superior to other regimens. Integrase inhibitor use after virological failure is supported as well by the meta-analysis. Careful use is however warranted when replacing a high genetic barrier drug in treatment-experienced patients switching successful treatment