The Iowa Homemaker vol.35, no.1

Young Loves, page 5 A Veishea trophy in the palm of your hand, Becky Matcalf, page 6 Flat tire… alone… no need for panic, Sally Young, page 8 Extra shelves – build what you need, Mary Anne Larson, page 10 What’s New – Here’s equipment to look for, Mary Vandecar, page 11 Try this amazing recipe, Barbara Culver and Mary Vandecar, page 12 “I made my hat to match”, Millie Willett, page 1

Promoting Evidence-Based Childhood Fever Management Through a Peer Education Programme Based on the Theory of Planned Behaviour

ABSTRACT Aims and Objectives This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management. Background Paediatric nurses’ inconsistent, ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests. Determinants of antipyretic administration, identified by the Theory of Planned Behavior (TPB), were belief-based attitudes and subjective norms. Design A quasi-experiment explored group effects of a Peer Education Program, based on the TPB, on factors influencing paediatric nurses’ antipyretic administration. Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months post Peer Education Program. Methods All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited. The Peer Education Program (PEP) consisted of four one-hour sessions targeting evidence-based knowledge, myths and misconceptions, normative, attitudinal and control influences over and rehearsal of evidence-based fever management. All nurses in experimental hospital targeted wards were eligible to attend. Peer education and support facilitated session information reaching those unable to attend sessions. Results Two-way univariate ANOVAs explored between subject, experimental and control group and within subject factors, pre, post and latency data. Significant interactions in normative influence (p=0.01) and intentions (p=0.01), a significant main group effect in control influence (p=0.01) and a significant main effect between audit data across time points (p=0.03) highlight PEP effectiveness in behaviour change. Normative, control and intention changes post PEP were maintained in latency data; mean temperature was not. Conclusion The PEP, based on a behaviour change theory, initiated and maintained evidence-based intentions for antipyretics use in fever management. Relevance to Clinical Practice The promotion of evidence-based change in organisational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes

ARTICULATED DIFFICULTIES OF GRADE 11 STUDENTS AT TAYTAY SENIOR HIGH SCHOOL (TSHS) IN ENGLISH PROFICIENCY

English has been the medium of instruction since the beginning of the 20th century in the Philippines during the arrival of the Americans. This has been incorporated holistically in the society through the educational system, communication, mass media, publications and social media. It is given therefore that Filipino learners are bilingual-- i.e., speaking both Filipino (the native tongue) and English as Second Language (ESL). After a century though, proficiency in the language is still a difficulty and an anxiety, especially from public school learners. In Taytay Senior High School (a public senior high school), Grade 11 students were observed of certain levels of difficulties in reading, writing, speaking and listening. In this study, the researchers probed deeper into the following: a.) the difficulties experienced by grade 11 students b.) the factors that led to such difficulties and c.) the articulated ways to help them overcome such difficulties in English proficiency. As a descriptive study, the researchers used pre-survey, survey, FGD and extensive literature review as methodologies. The survey results revealed problematic stages on vocabulary, training and knowledge, confidence and self-esteem and interest. Articulated in the FGD furthermore were issues of generation, practice/articulation, and system as factors that led to difficulties in reading writing, speaking and listening. On the other hand, Grade 11 students underscored power of mind, the use of native language and practice as methodical solutions to the problem. Further directions of this study could include elaboration of the FGD results that pertain to issues of generation, practice/articulation and system. The use of native language could also be expounded on future studies

ARTICULATED DIFFICULTIES OF GRADE 11 STUDENTS AT TAYTAY SENIOR HIGH SCHOOL (TSHS) IN ENGLISH PROFICIENCY

English has been the medium of instruction since the beginning of the 20th century in the Philippines during the arrival of the Americans. This has been incorporated holistically in the society through the educational system, communication, mass media, publications and social media. It is given therefore that Filipino learners are bilingual-- i.e., speaking both Filipino (the native tongue) and English as Second Language (ESL). After a century though, proficiency in the language is still a difficulty and an anxiety, especially from public school learners. In Taytay Senior High School (a public senior high school), Grade 11 students were observed of certain levels of difficulties in reading, writing, speaking and listening. In this study, the researchers probed deeper into the following: a.) the difficulties experienced by grade 11 students b.) the factors that led to such difficulties and c.) the articulated ways to help them overcome such difficulties in English proficiency. As a descriptive study, the researchers used pre-survey, survey, FGD and extensive literature review as methodologies. The survey results revealed problematic stages on vocabulary, training and knowledge, confidence and self-esteem and interest. Articulated in the FGD furthermore were issues of generation, practice/articulation, and system as factors that led to difficulties in reading writing, speaking and listening. On the other hand, Grade 11 students underscored power of mind, the use of native language and practice as methodical solutions to the problem. Further directions of this study could include elaboration of the FGD results that pertain to issues of generation, practice/articulation and system. The use of native language could also be expounded on future studies

Brief motivational interventions for college student drinking may not be as powerful as we think: An individual participant-level data meta-analysis

Background For over two decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), often incorporating personalized feedback (PF), and stand-alone PF interventions delivered via mail, computer, or the Web. Both narrative and meta-analytic reviews using aggregate data from published studies suggest at least short-term efficacy of BMIs, although overall effect sizes have been small. Method The present study was an individual participant-level data (IPD) meta-analysis of 17 randomized clinical trials evaluating BMIs. Unlike typical meta-analysis based on summary data, IPD meta-analysis allows for an analysis that correctly accommodates the sampling, sample characteristics, and distributions of the pooled data. In particular, highly skewed distributions with many zeroes are typical for drinking outcomes, but have not been adequately accounted for in existing studies. Data are from Project INTEGRATE, one of the largest IPD meta-analysis projects to date in alcohol intervention research, representing 6,713 individuals each with two to five repeated measures up to 12 months post-baseline. Results We used Bayesian multilevel over-dispersed Poisson hurdle models to estimate intervention effects on drinks per week and peak drinking, and Gaussian models for alcohol problems. Estimates of overall intervention effects were very small and not statistically significant for any of the outcomes. We further conducted post hoc comparisons of three intervention types (Individual MI with PF, PF only, and Group MI) vs. control. There was a small, statistically significant reduction in alcohol problems among participants who received an individual MI with PF. Short-term and long-term results were similar. Conclusions The present study questions the efficacy and magnitude of effects of BMIs for college drinking prevention and intervention and suggests a need for the development of more effective intervention strategies

Influence of lived experience on risk perception among women who received a breast cancer polygenic risk score: 'Another piece of the pie'

Polygenic risk scores (PRS) are personalized assessments of disease risk based on the cumulative effect of common low-risk genetic variants. PRS have been shown to accurately predict women's breast cancer risk and are likely to be incorporated into personalized breast cancer risk management programs. However, there are few studies investigating the individual impact of receiving a breast cancer PRS. Existing studies have not demonstrated significant changes in perceived risk or risk management behaviors after receipt of polygenic risk information. The aim of this qualitative study was to explore how women with a family history of breast cancer construct breast cancer risk perceptions after receipt of a breast cancer PRS. Unaffected women with a family history of breast cancer who had not previously received genetic counseling regarding their breast cancer risk were invited to participate in this study. In-depth, semi-structured interviews were conducted with 20 women who attended a familial cancer clinic in the Australian states of Victoria and Tasmania. Data were analyzed using an inductive thematic approach. Women's lived experience played a significant role in the construction and maintenance of their breast cancer risk perception. Women's pre-existing risk perceptions were informed by their family history and their knowledge that breast cancer is a multifactorial disease. Knowing that breast cancer is a multifactorial disease enabled most women to integrate genetic information with their pre-existing notions of risk. Women reported that the information they received was consistent with their existing notions of personal risk and screening advice. Therefore, the PRS did not lead to a change in perceived risk or risk management behaviors for most women. The results of this study provide insight into how polygenic risk information is integrated with pre-existing notions of risk, which will inform its implementation into clinical practice.</p

Project INTEGRATE: An Integrative Study of Brief Alcohol Interventions for College Students

This paper provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed two or more times from baseline up to 12 months, with varying assessment schedules across studies. This paper describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo algorithms for two-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single, intervention studies

Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits

Few genome-wide association studies (GWAS) account for environmental exposures, like smoking, potentially impacting the overall trait variance when investigating the genetic contribution to obesity-related traits. Here, we use GWAS data from 51,080 current smokers and 190,178 nonsmokers (87% European descent) to identify loci influencing BMI and central adiposity, measured as waist circumference and waist-to-hip ratio both adjusted for BMI. We identify 23 novel genetic loci, and 9 loci with convincing evidence of gene-smoking interaction (GxSMK) on obesity-related traits. We show consistent direction of effect for all identified loci and significance for 18 novel and for 5 interaction loci in an independent study sample. These loci highlight novel biological functions, including response to oxidative stress, addictive behaviour, and regulatory functions emphasizing the importance of accounting for environment in genetic analyses. Our results suggest that tobacco smoking may alter the genetic susceptibility to overall adiposity and body fat distribution

AGRICULTURAL POLICY REFORM IN THE WTO: THE ROAD AHEAD

Agricultural trade barriers and producer subsidies inflict real costs, both on the countries that use these policies and on their trade partners. Trade barriers lower demand for trade partners' products, domestic subsidies can induce an oversupply of agricultural products which depresses world prices, and export subsidies create increased competition for producers in other countries. Eliminating global agricultural policy distortions would result in an annual world welfare gain of $56 billion. High protection for agricultural commodities in the form of tariffs continues to be the major factor restricting world trade. In 2000, World Trade Organization (WTO) members continued global negotiations on agricultural policy reform. To help policymakers and others realize what is at stake in the global agricultural negotiations, this report quantifies the costs of global agricultural distortions and the potential benefits of their full elimination. It also analyzes the effects on U.S. and world agriculture if only partial reform is achieved in liberalizing tariffs, tariff-rate quotas (limits on imported goods), domestic support, and export subsidies.Agricultural and Food Policy, International Relations/Trade,