Descriptive Anatomy and Three-Dimensional Reconstruction of the Skull of the Early Tetrapod Acanthostega gunnari Jarvik, 1952

The early tetrapod Acanthostega gunnari is an iconic fossil taxon exhibiting skeletal morphology reflecting the transition of vertebrates from water onto land. Computed tomography data of two Acanthostega skulls was segmented using visualization software to digitally separate bone from matrix and individual bones of the skull from each other. A revised description of cranial and lower jaw anatomy in this taxon based on CT data includes new details of sutural morphology, the previously undescribed quadrate and articular bones, and the mandibular symphysis. Sutural morphology is used to infer loading regime in the skull during feeding, and suggests Acanthostega used its anterior jaws to initially seize prey while smaller posterior teeth were used to restrain struggling prey during ingestion. Novel methods were used to repair and retrodeform the skull, resulting in a three-dimensional digital reconstruction that features a longer postorbital region and more strongly hooked anterior lower jaw than previous attempts while supporting the presence of a midline gap between the nasals and median rostrals

Mobile professional voluntarism and international development : killing me softly?

This book explores the impact that professional volunteers have on the low resource countries they choose to spend time in. Whilst individual volunteering may be of immediate benefit to individual patients, this intervention may have detrimental effects on local health systems; distorting labour markets, accentuating dependencies and creating opportunities for corruption. Improved volunteer deployment may avoid these risks and present opportunities for sustainable systems change. The empirical research presented in this book stems from a specific volunteering intervention funded by the Tropical Health Education Trust and focused on improving maternal and newborn health in Uganda. However, important opportunities exist for policy transfer to other contexts

The ethics of educational healthcare placements in low and middle income countries : first do no harm?

This book examines the current state of elective placements of medical undergraduate students in developing countries and their impact on health care education at home. Drawing from a recent case study of volunteer deployment in Uganda, the authors provide an in-depth evaluation of the impacts on the students themselves and the learning outcomes associated with placements in low resource settings, as well as the impacts that these forms of student mobility have on the host settings. In addition to reviewing the existing literature on elective placements, the authors outline a potential model for the future development of ethical elective placements. As the book concurs with an increasing international demand for elective placements, it will be of immediate interest to universities, intermediary organizations, students as consumers, and hosting organisations in low-resource settings

Healthcare, frugal innovation, and professional voluntarism : a cost-benefit analysis

This book investigates what international placements of healthcare employees in low resource settings add to the UK workforce and the efficacy of its national health system. The authors present empirical data collected from a volunteer deployment project in Uganda focused on reducing maternal and new-born mortality and discuss the learning and experiential outcomes for UK health care professionals acting as long term volunteers in low resource settings. They also develop a model for structured placement that offers optimal learning and experiential outcomes and minimizes risk, while shedding new light on the role that international placements play as part of continuing professional development both in the UK and in other sending countries

Optimising student learning on international placements in low income settings

This paper challenges the assumption that student visits to low resource settings inevitably promote the acquisition of cultural competence. Much of the literature and marketing rhetoric advocating the expansion of such ‘exposures’ lists numerous positive outcomes with an emphasis on ‘cultural learning’. With important exceptions, the concept of cultural learning remains uncontested, nestling in the fluffy haze of an inherently benevolent multi-culturalism. The emphasis in current research is on ‘learning’ or ‘competency’ at the expense of definitional clarity around the concept of culture itself. This results in a tendency to overemphasise (and essentialise) difference rather than commonality and conflates cultural learning with narrow (stereotypical) concepts of race, ethnicity and religion. The paper discusses the experiences of students undertaking placements in Uganda through Knowledge For Change, a UK charity hosting the Ethical Educational Placements project, to identify and critique this dimension of ‘learning’. Using an action-research approach combining observational research with qualitative interviews and surveys the paper uncovers the nuance of cultural learning. In important respects the behaviour that students are witnessing and attributing to culture is connected more to the specific organisational contexts that they are placed in and the patient groups they ‘serve’ than any connection to an homogenous ‘national’ culture. Poverty and gender inequality, amongst many other forms of structural inequality, result in ‘othering’ behaviour on the part of health workers towards patients that is a fundamental characteristic of public health organisations in residualised welfare systems. In this complex environment, cultural learning is not so much about celebrating difference. It is more about understanding social context and accepting that you don’t and can’t possibly know a person’s situation; and with that in mind you should treat everyone with the same degree of humility and respect. Adopting and practising ‘epistemic humility’ (Hanson et al 2011; Ahmed, Ackers-Johnson & Ackers 2017) is crucial to meaningful learning in any context. Further, a lack of understanding of the broader structural processes perpetuates inequalities between the Global North and South (Husih, 2012; Ahmed, Ackers-Johnson & Ackers, 2017) and impedes knowledge acquisition, particularly cultural learning. Moreover, hubris – or Western students’ assumptions of superiority over host health care workers (Bauer, 2017; Elit et al, 2011, Ahmed, Ackers-Johnson & Ackers, 2017) – may act as a further obstacle to cultural learning. Cultural learning is as much about learning about ourselves and what it feels like to be ‘othered’ as it is learning about others. International placements in LMICs create critical opportunities for relevant student learning. But achieving this and guarding against the risks of ‘mis-learning’ requires the level of cultural brokerage provided by ‘More Knowledgeable Others’ that we take for granted with clinical learning

Opportunities and challenges for improving antimicrobial stewardship in low and middle income countries ; lessons learnt from the maternal sepsis intervention in Western Uganda

This paper presents findings from an action-research intervention designed to identify ways of improving antimicrobial stewardship in a Ugandan Regional Referral Hospital. Building on an existing health partnership and extensive action-research on maternal health, it focused on maternal sepsis. Sepsis is one of the main causes of maternal mortality in Uganda and Surgical Site Infection, a major contributing factor. Post-natal wards also consume the largest volume of antibiotics. The findings from the Maternal Sepsis Intervention demonstrate the potential for remarkable changes in health worker behaviour through multi-disciplinary engagement. Nurses and midwives create the connective tissue linking pharmacy, laboratory scientists and junior doctors to support an evidence-based response to prescribing. These multi-disciplinary ‘huddles’ form a necessary, but insufficient, grounding for active clinical pharmacy. The impact on antimicrobial stewardship and maternal mortality and morbidity is ultimately limited by very poor and inconsistent access to antibiotics and supplies. Insufficient and predictable stock-outs undermine behaviour change frustrating health workers’ ability to exercise their knowledge and skill for the benefit of their patients. This escalates healthcare costs and contributes to Anti-Microbial Resistance

Unusual Formation of Point-Defect Complexes in the Ultrawide-Band-Gap Semiconductor β-Ga2 O3

Understanding the unique properties of ultra-wide band gap semiconductors requires detailed information about the exact nature of point defects and their role in determining the properties. Here, we report the first direct microscopic observation of an unusual formation of point defect complexes within the atomic-scale structure of β-Ga2O3 using high resolution scanning transmission electron microscopy (STEM). Each complex involves one cation interstitial atom paired with two cation vacancies. These divacancy-interstitial complexes correlate directly with structures obtained by density functional theory, which predicts them to be compensating acceptors in β-Ga2O3. This prediction is confirmed by a comparison between STEM data and deep level optical spectroscopy results, which reveals that these complexes correspond to a deep trap within the band gap, and that the development of the complexes is facilitated by Sn doping through increased vacancy concentration. These findings provide new insight on this emerging material's unique response to the incorporation of impurities that can critically influence their properties

Microbial contamination and efficacy of disinfection procedures of companion robots in care homes

Contains fulltext : 221797.pdf (publisher's version ) (Open Access)Background: Paro and other robot animals can improve wellbeing for older adults and people with dementia, through reducing depression, agitation and medication use. However, nursing and care staff we contacted expressed infection control concerns. Little related research has been published. We assessed (i) how microbiologically contaminated robot animals become during use by older people within a care home and (ii) efficacy of a cleaning procedure. Methods: This study had two stages. In stage one we assessed microbial load on eight robot animals after interaction with four care home residents, and again following cleaning by a researcher. Robot animals provided a range of shell-types, including fur, soft plastic, and solid plastic. Stage two involved a similar process with two robot animals, but a care staff member conducted cleaning. The cleaning process involved spraying with anti-bacterial product, brushing fur-type shells, followed by vigorous top-to-tail cleaning with anti-bacterial wipes on all shell types. Two samples were taken from each of eight robots in stage one and two robots in stage two (20 samples total). Samples were collected using contact plate stamping and evaluated using aerobic colony count and identification (gram stain, colony morphology, coagulase agglutination). Colony counts were measured by colony forming units per square centimetre (CFU/cm2). Results: Most robots acquired microbial loads well above an acceptable threshold of 2.5 CFU/cm2 following use. The bacteria identified were micrococcus species, coagulase negative staphylococcus, diptheriods, aerobic spore bearers, and staphylococcus aureus, all of which carry risk for human health. For all devices the CFU/cm2 reduced to well within accepted limits following cleaning by both researcher and care staff member. Conclusions: Companion robots will acquire significant levels of bacteria during normal use. The simple cleaning procedure detailed in this study reduced microbial load to acceptable levels in controlled experiments. Further work is needed in the field and to check the impact on the transmission of viruses.17 p

PENGGUNAAN MODEL PEMBELAJARAN INKUIRI TERBIMBING UNTUK MENINGKATKAN HASIL BELAJAR PESERTA DIDIK

Penelitian ini dilatar belakangi oleh rendahnya sikap rasa ingin tahu dan hasil belajar peserta didik pada Subtema Makananku Sehat dan Bergizi yang pencapaiannya hanya 35% peserta didik yang tuntas memenuhi nilai KKM. Selain itu pendidik masih menggunakan metode atau model pembelajaran yang bersifat teacher centered, yaitu model ceramah.Pelaksanaan yang dilakukan peneiti yaitu dua siklus dan setiap siklus terdiri dari 3 pembelajaran.Model Pembelajaran yang digunakan peneliti yaitu inkuiri terbimbing, pengertian dari inkuiri terbimbing merupakan model pembelajaran yang memberikan kesempatan kepada peserta didik untuk aktif terlibat dalam proses pembelajaran dengan melakukan penyelidikan dan pemecahan masalah secara mandiri namum tetap dengan bimbingan pendidik agar peserta didik lebih mudah dalam memahami konsep pelajaran. Subjek penelitian ini adalah siswakelas IV D SDN Leuwipanjang dengan jumlah peserta didik sebanyak 35 orang. Instrument pembelajaran yang digunakan adalah berupa tes, lembar observasi (observasi pendidik dan observasi peserta didik), LKPD (Lembar Kerja Peserta Didik) dan lembar angket. Hasil penelitian dengan menggunakan model pembelajaran inkuiri terbimbing ditunjukan dengan perencanaan setiap siklusnya yang mengalami perbaikan berdasarkan hasil refleksi di siklus sebelumnya. Pelaksanaan pembelajaran dengan menggunakan model pembelajaran inkuiri terbimbing dapat dilihat dari aktivitas pendidik dan peserta didik pada setiap siklusnya yang mengalami peningkatan. Pencapaian hasil belajar afektif mencapai 44% pada siklus II mencapai 80% dan kognitif peserta didik pada siklus I mencapai rata-rata 35% Siklus II ketuntasan 80%. Adapun hasil belajar psikomotor peserta didik di siklus I mencapai ketuntasan 36%. Siklus II mencapai mencapai ketuntasan 88%. Ambatan yang dilami oleh peneiti yaitu alokasi waktu dan pengelolaan kelas, Upaya yang dilakukan peneliti adalah mengatur pelaksannaan pembelajaran sesuai dengan rencana yang kita persiapkan dengan baik dan mengatur suasana kelas dengan menyenangkan yaitu membuat media pembelajaran yang baik sehingga daapat menarik minat belajar peserta didik. Kata Kunci : Inkuiri Terbimbing, rasa ingin tahu, hasil belajar peserta didik, hambatan pelaksanaan, upaya peningkata

Digit-only sauropod pes trackways from China - evidence of swimming or a preservational phenomenon?

For more than 70 years unusual sauropod trackways have played a pivotal role in debates about the swimming ability of sauropods. Most claims that sauropods could swim have been based on manus-only or manus-dominated trackways. However none of these incomplete trackways has been entirely convincing, and most have proved to be taphonomic artifacts, either undertracks or the result of differential depth of penetration of manus and pes tracks, but otherwise showed the typical pattern of normal walking trackways. Here we report an assemblage of unusual sauropod tracks from the Lower Cretaceous Hekou Group of Gansu Province, northern China, characterized by the preservation of only the pes claw traces, that we interpret as having been left by walking, not buoyant or swimming, individuals. They are interpreted as the result of animals moving on a soft mud-silt substrate, projecting their claws deeply to register their traces on an underlying sand layer where they gained more grip during progression. Other sauropod walking trackways on the same surface with both pes and manus traces preserved, were probably left earlier on relatively firm substrates that predated the deposition of soft mud and silt . Presently, there is no convincing evidence of swimming sauropods from their trackways, which is not to say that sauropods did not swim at all