Digital Picture Books for Young Dual Language Learners: Effects of Reading in the Second Language

Reading picture books in the first language (L1) before rereading them in the second language (L2) is assumed to be beneficial for young dual language learners (DLLs). This pilot study examined how sharing digital picture books in L1 or L2 at home before reading them in L2 in kindergarten affected L2 book-specific vocabulary learning and story comprehension. Participants were 14 three- and four-year-old children who spoke Polish at home and learned Norwegian as their second language. Even when DLLs were less advanced in L2, reading first in L1 was not advantageous for L2 vocabulary learning. Characteristics of caregiver–child interactions during the reading of digital picture books in L2 may explain why home reading in L2 was more beneficial than reading in L1 for less proficient young L2 learners.publishedVersio

Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer.

BackgroundIn 2007, we reported a summary of data comparing diabetic foot complications to cancer. The purpose of this brief report was to refresh this with the best available data as they currently exist. Since that time, more reports have emerged both on cancer mortality and mortality associated with diabetic foot ulcer (DFU), Charcot arthropathy, and diabetes-associated lower extremity amputation.MethodsWe collected data reporting 5-year mortality from studies published following 2007 and calculated a pooled mean. We evaluated data from DFU, Charcot arthropathy and lower extremity amputation. We dichotomized high and low amputation as proximal and distal to the ankle, respectively. This was compared with cancer mortality as reported by the American Cancer Society and the National Cancer Institute.ResultsFive year mortality for Charcot, DFU, minor and major amputations were 29.0, 30.5, 46.2 and 56.6%, respectively. This is compared to 9.0% for breast cancer and 80.0% for lung cancer. 5 year pooled mortality for all reported cancer was 31.0%. Direct costs of care for diabetes in general was $237 billion in 2017. This is compared to$80 billion for cancer in 2015. As up to one-third of the direct costs of care for diabetes may be attributed to the lower extremity, these are also readily comparable.ConclusionDiabetic lower extremity complications remain enormously burdensome. Most notably, DFU and LEA appear to be more than just a marker of poor health. They are independent risk factors associated with premature death. While advances continue to improve outcomes of care for people with DFU and amputation, efforts should be directed at primary prevention as well as those for patients in diabetic foot ulcer remission to maximize ulcer-free, hospital-free and activity-rich days

Pedagogical principles and methods underpinning education of health and social care practitioners on experiences and needs of older LGBT+ people: findings from a systematic review

There is a growing awareness of the need for LGBT + competency training to ensure that the health and social care services offered to older LGBT + people is affirmative and gender sensitive. To conduct a synthesis of the literature that describes the pedagogical principles, curriculum content and methods (teaching and assessment) used to educate health and social care practitioners on the experiences and needs of older LGBT + people. Systematic thematic review of literature. MEDLINE, CINAHL, PsycINFO, EMBASE, Web of Science, Social Sciences Index, ERIC. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined peer-reviewed papers published in English, prior to April 2018 that addressed pedagogical and curriculum issues on the inclusion of needs and experiences of older LGBT + people. The combined searches yielded 2214 papers of which 17 papers were eligible for inclusion, 10 discussion papers and 7 evaluation studies. Analysis identified the following themes: i) Acknowledging the wider historical context of older LGBT + people's lives; ii) Recognising that older LGBT + people are not a homogenous group; iii) Incorporating a multitude of theories and models from different perspectives; iv) Alerting practitioners to the health issues and disparities facing older LGBT + people; v) Including content that supports inclusive care for older LGBT + people; vi) Addressing barriers to older LGBT + people accessing health care; vii) Interactive activities are the preferred pedagogical strategy; viii) Involving older LGBT + people in curriculum development is a core principle; and ix) Mandatory education is not always the solution. As the field matures there is a need for more exploration of curriculum principles, assessment strategies and strategies to overcome barriers to the inclusion of issues experienced by older LGBT + people within curricula. [Abstract copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

BEING ME: Project report on best practices in learning and education to support LGBT ageing care and wellbeing

This report is based on our experiences of using a collaborative approach to identifying best practices for those involved in professional, vocational and community-based education and learning, in order to facilitate improved support for Lesbian, Gay, Bisexual and Transgender (LGBT) older people in health and social care. The best practices discussed here on learning and teaching, emerged from cross national collaboration and intercultural dialogue with a variety of stakeholders, including older LGBT people, educators, practitioners and learners using the World Café method. As one of the workstreams within the BEING ME European Project funded by EU Erasmus Plus (https://www.beingme.eu/), we aimed to promote and support the social inclusion of LGBT older people through positive interaction with educational institutions that prepare future professionals to work with older people. The best practices described here include a) identifying pedagogic approaches (the method and practice of teaching) b) generating examples of tailored educational resources c) recommendations on how to improve the knowledge and capabilities of future care professionals in the area of LGBT affirmative practices. Through a process of learning and exchange during two World Cafés, these areas were able to be more clearly articulated and should be read in conjunction with the BEING ME ‘Best Practice principles’ (https://beingme.eu/public/application/downloads/resources/being-me-best-practice-principles-20190212.pdf) which underpin good practice in the area of LGBT ageing care. Giving specific attention to identify ways of enhancing the skills, knowledge and capabilities of practitioners through education, should place them in a better position to develop a culture of support, openness and respect for LGBT identities which in turn are essential to LGBT older people's inclusiveness in care environments. The Best Practices Report provides the foundation for the development of the BEING ME educators online ‘toolkit’ aimed at both formal and informal learning settings and to a range of disciplines professions and vocations in health and social care

Learning to deliver LGBT+ aged care: exploring and documenting best practices in professional and vocational education through the World Café method

Substantial evidence on the adverse impact of ageing on lesbian, gay, bisexual and transgender (LGBT+) populations through the lack of inclusive care services has highlighted the need for education and training of the health and social care workforce to enhance their skills, knowledge and capabilities in this area. We describe a cross-national collaboration across four European Union countries called BEING ME. This collaboration examined the current pedagogic environment within professional, vocational and community-based education to identify what is most valuable for addressing these needs. The World Café method enabled a process of structured learning and knowledge exchange between stakeholders resulting in: (a) identification of best practices in pedagogies, (b) generation of tailored co-produced educational resources, and (c) recommendations on how to improve the knowledge and capabilities of future care professionals in the area of LGBT+ affirmative practices. Combined with themes from the post-Café evaluation, our findings suggest that underpinning professional and vocational education with a person-in-environment perspective facilitates going some way to acknowledging the historical context of older LGBT+ people's lives. Addressing the unique needs of sub-populations within LGBT+ communities and setting these in the context of holistic and person-centred care may better enable the meeting of their unique diverse needs for ageing. Recommendations are made for learning and teaching strategies to support improved LGBT+ aged care

What has finite element analysis taught us about diabetic foot disease and its management?:a systematic review

Over the past two decades finite element (FE) analysis has become a popular tool for researchers seeking to simulate the biomechanics of the healthy and diabetic foot. The primary aims of these simulations have been to improve our understanding of the foot's complicated mechanical loading in health and disease and to inform interventions designed to prevent plantar ulceration, a major complication of diabetes. This article provides a systematic review and summary of the findings from FE analysis-based computational simulations of the diabetic foot.A systematic literature search was carried out and 31 relevant articles were identified covering three primary themes: methodological aspects relevant to modelling the diabetic foot; investigations of the pathomechanics of the diabetic foot; and simulation-based design of interventions to reduce ulceration risk.Methodological studies illustrated appropriate use of FE analysis for simulation of foot mechanics, incorporating nonlinear tissue mechanics, contact and rigid body movements. FE studies of pathomechanics have provided estimates of internal soft tissue stresses, and suggest that such stresses may often be considerably larger than those measured at the plantar surface and are proportionally greater in the diabetic foot compared to controls. FE analysis allowed evaluation of insole performance and development of new insole designs, footwear and corrective surgery to effectively provide intervention strategies. The technique also presents the opportunity to simulate the effect of changes associated with the diabetic foot on non-mechanical factors such as blood supply to local tissues.While significant advancement in diabetic foot research has been made possible by the use of FE analysis, translational utility of this powerful tool for routine clinical care at the patient level requires adoption of cost-effective (both in terms of labour and computation) and reliable approaches with clear clinical validity for decision making

Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes: a systematic review

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