Are stress and mixed urinary incontinence associated with impaired executive control in community-dwelling older women?

Objectives: To assess whether stress or mixed urinary incontinence (UI) is associated with deficits in executive functioning among community-dwelling women. Design: An observational study comparing the performance, using multivariate analyses of variance (MANOVAs) and Bonferroni post hoc test, of continent women and women with stress or mixed UI during executive control tasks. Setting: The research center of the Institut universitaire de gériatrie de Montréal. Participants: One hundred and fifty-five community-dwelling women aged 60 and older participated in the study. Measurements: Based on the Urogenital Distress Inventory (UDI), participants were split into three groups: 35 continent women, 43 women with stress UI, and 78 women with mixed UI. Participants completed a battery of neuropsychological tests and a computerized dual-task test. Results: Women with mixed UI showed poorer performances than continent and stress UI women in executive control functions. Deficits were specific to tests involving switching and sharing/dividing attention between two tasks. Conclusion: Results of this study suggest that mixed UI can be associated with executive control deficits in community-dwelling older women. Future intervention studies in the treatment of UI should take the higher risk of an executive control deficit in women with UI under consideration.

Clean Cookstoves and Health in Samlout, Cambodia

This paper discusses results from a study of the use of cleaner cooking solutions and general health status of people in rural areas from the Battambang province of Cambodia. Data collection included 372 demographic, health and socio-economic surveys with households living in 6 villages in the Samlout district, general health examinations, and measurements of stove use and household concentrations of PM 2.5. The data reveal that health in this population is a major concern, with a very high prevalence of reported abdominal pain, nausea, chronic cough, chest pains, and fever during examinations.  At the household level, we find that clean stove ownership is significantly correlated with the educational status of household head and socio-economic status of a household. Respondents from households with clean stoves appear less likely (though not statistically significantly so) to report household individuals having health problems such as occasional cough, high blood pressure and tuberculosis. Concentrations of PM2.5 are positively correlated with prevalence of occasional cough, high blood pressure and tuberculosis. Based on these results, we advise field testing and evaluation of targeted health interventions in these villages to address the numerous concerns of the local population, including exploring the potential role of clean stoves.

Early detection of delirium in older medical inpatients: prodrome, predictors and motor subtyping

Background Delirium is highly prevalent, especially in older patients. It independently leads to adverse outcomes, but remains under-detected, particularly hypoactive forms. Although early identification and intervention is important, delirium prevention is key to improving outcomes. The delirium prodrome concept has been mooted for decades, but remains poorly characterised. Greater understanding of this prodrome would promote prompt identification of delirium-prone patients, and facilitate improved strategies for delirium prevention and management. Methods Medical inpatients of ≥70 years were screened for prevalent delirium using the Revised Delirium Rating Scale (DRS--‐R98). Those without prevalent delirium were assessed daily for delirium development, prodromal features and motor subtype. Survival analysis models identified which prodromal features predicted the emergence of incident delirium in the cohort in the first week of admission. The Delirium Motor Subtype Scale-4 was used to ascertain motor subtype. Results Of 555 patients approached, 191 patients were included in the prospective study. The median age was 80 (IQR 10) and 101 (52.9%) were male. Sixty-one patients developed incident delirium within a week of admission. Several prodromal features predicted delirium emergence in the cohort. Firstly, using a novel Prodromal Checklist based on the existing literature, and controlling for confounders, seven predictive behavioural features were identified in the prodromal period (for example, increasing confusion; and being easily distractible). Additionally, using serial cognitive tests and the DRS-R98 daily, multiple cognitive and other core delirium features were detected in the prodrome (for example inattention; and sleep-wake cycle disturbance). Examining longitudinal motor subtypes in delirium cases, subtypes were found to be predominantly stable over time, the most prevalent being hypoactive subtype (62.3%). Discussion This thesis explored multiple aspects of delirium in older medical inpatients, with particular focus on the characterisation of the delirium prodrome. These findings should help to inform future delirium educational programmes, and detection and prevention strategies.

Are stress and mixed urinary incontinence associated with impaired executive control in community-dwelling older women?

Objectives: To assess whether stress or mixed urinary incontinence (UI) is associated with deficits in executive functioning among community-dwelling women. Design: An observational study comparing the performance, using multivariate analyses of variance (MANOVAs) and Bonferroni post hoc test, of continent women and women with stress or mixed UI during executive control tasks. Setting: The research center of the Institut universitaire de gériatrie de Montréal. Participants: One hundred and fifty-five community-dwelling women aged 60 and older participated in the study. Measurements: Based on the Urogenital Distress Inventory (UDI), participants were split into three groups: 35 continent women, 43 women with stress UI, and 78 women with mixed UI. Participants completed a battery of neuropsychological tests and a computerized dual-task test. Results: Women with mixed UI showed poorer performances than continent and stress UI women in executive control functions. Deficits were specific to tests involving switching and sharing/dividing attention between two tasks. Conclusion: Results of this study suggest that mixed UI can be associated with executive control deficits in community-dwelling older women. Future intervention studies in the treatment of UI should take the higher risk of an executive control deficit in women with UI under consideration.

(Table 1) Temperature and foraminiferal Mg/Ca ratios of samples off Japan

We studied Mg/Ca in high-Mg, shallow-water benthic foraminifera in culture and in samples from natural environments, in order to evaluate the expression of latitudinal and seasonal temperature variability in Mg/Ca in their tests. We cultured Planoglabratella opercularis (d'Orbigny) and Quinqueloculina yabei Asano under controlled temperature (10°-25°C) and salinity (30-38) conditions. Both species show a linear correlation between Mg/Ca and temperature, but they differ in temperature sensitivity. Salinity does not significantly influence Mg/Ca. In the samples collected in nature, Mg/Ca and seawater temperatures are positively correlated, but there are more complexities than in the records for cultured specimens due to such factors as seasonal fluctuations in temperature. We conclude that Mg/Ca ratios in monospecific benthic foraminiferal samples may be used as a reliable temperature proxy, if the lifetime of the species is taken into account.

An Investigation into the Failure to Implement a Universal School Lunch Program during WWII and Postwar Reconstruction in Canada: The Case of Ontario

The purpose of this research is to investigate the various social, political and economic factors that contributed to Canada’s failure to implement a universal school lunch program during the 1940s. Although Canada developed several other social welfare programs in the post-war period, it remains one of the only industrialized nations that does not provide hot meals to children in elementary or secondary schools. Data from the province of Ontario, a major site of postwar reconstruction and policy-making, has been taken up to inform the broader national discourse on school lunches from the 1940s. National, Ontario provincial and City of Toronto archival records were collected and analyzed according to common themes, in order to identify key barriers that constrained government support of a hot meal program. Archival records were identified using key words, and were limited to materials created between 1930-1952. Analysis suggests that sufficient need for a hot meal program had not been established during the 1940s. Despite misleading nutrition messages, rates of malnutrition and nutrient-related disease were at an all-time low, and many Ontario school boards did not appear to have the necessary infrastructure required to supply all pupils with hot meals. The Canadian government had already employed significant resources to improve existing social security programs by coupling them with health education. This strategy reflected a shift in understanding malnutrition as a knowledge-based problem, as opposed to income-based. This understanding was further reinforced through the moralized dissemination of nutrition information, which placed blame on women for improperly raising their children. Ultimately, the strong uptake of nutrition as a public health issue in Ontario may have limited prospective responses to solutions already utilized in the public health domain, and directed favour away from a universal school lunch program for Canada.

Supporting Metacognitive Development in Early Science Education: Exploring Elementary Teachers' Beliefs and Practices in Metacognition

Metacognition is the understanding and control of cognitive processes. Students with high levels of metacognition achieve greater academic success. The purpose of this mixed-methods study was to examine elementary teachers’ beliefs about metacognition and integration of metacognitive practices in science. Forty-four teachers were recruited through professional networks to complete a questionnaire containing open-ended questions (n = 44) and Likert-type items (n = 41). Five respondents were selected to complete semi-structured interviews informed by the questionnaire. The selected interview participants had a minimum of three years teaching experience and demonstrated a conceptual understanding of metacognition. Statistical tests (Pearson correlation, t-tests, and multiple regression) on quantitative data and thematic analysis of qualitative data indicated that teachers largely understood metacognition but had some gaps in their understanding. Participants’ reported actions (teaching practices) and beliefs differed according to their years of experience but not gender. Hierarchical multiple regression demonstrated that the first block of gender and experience was not a significant predictor of teachers' metacognitive actions, although experience was a significant predictor by itself. Experience was not a significant predictor once teachers' beliefs were added. The majority of participants indicated that metacognition was indeed appropriate for elementary students. Participants consistently reiterated that students’ metacognition developed with practice, but required explicit instruction. A lack of consensus remained around the domain specificity of metacognition. More specifically, the majority of questionnaire respondents indicated that metacognitive strategies could not be used across subject domains, whereas all interviewees indicated that they used strategies across subjects. Metacognition was integrated frequently into Ontario elementary classrooms; however, metacognition was integrated less frequently in science lessons. Lastly, participants used a variety of techniques to integrate metacognition into their classrooms. Implications for practice include the need for more professional development aimed at integrating metacognition into science lessons at both the Primary and Junior levels. Further, teachers could benefit from additional clarification on the three main components of metacognition and the need to integrate all three to successfully develop students’ metacognition.

AN INVESTIGATION ON ROUTINE FOLLOW-UP CARE FOR HEAD AND NECK CANCER

BACKGROUND: Follow-up care aims to provide surveillance with early detection of recurring cancers and to address treatment complications and other health issues in survivorship. It is assumed that follow-up care fulfills these aims, however little evidence supports routine surveillance detecting curable disease early enough to improve survival. Cancer survivors are a diverse patient population, suggesting that a single follow-up regimen may not meet all patients’ follow-up needs. Little is known about what effective follow-up care should include for head and neck cancer patients in a Canadian setting. Identification of subgroups of patients with specific needs and current practices would allow for hypotheses to be generated for enhancing follow-up care. OBJECTIVES: 1a) To describe the follow-up needs and preferences of head and neck cancer patients, 1b) to identify which patient characteristics predict needs and preferences, 1c) to evaluate how needs and preferences change over time, 2a) to describe follow-up care practices by physician visits and imaging tests, and 2b) to identify factors associated to the delivered follow-up care. METHODS: 1) 175 patients who completed treatment between 2012 and 2013 in Kingston and London, Ontario were recruited to participate in a prospective survey study on patients’ needs and preferences in follow-up care. Bivariate and multivariate analyses were employed to describe patient survey responses and to identify patient characteristics that predicted needs and preferences. 2) A retrospective cohort study of 3975 patients on routine follow-up from 2007 to 2015 was carried out using data linkages across registry and administrative databases to describe follow-up practices in Ontario by visits and tests. Multivariate regression analyses assessed factors related to follow-up care. RESULTS: 1) Patients’ needs and preferences were wide-ranging with several characteristics predicting needs and preferences (ORECOG=2.69 and ORAnxiety=1.13). Needs and preferences declined as patients transitioned into their second year of follow-up (p<0.05). 2) Wide variation in practices was found, with marked differences compared to existing consensus guidelines. Multiple factors were associated with follow-up practices (RRTumor site=0.73 and RRLHIN=1.47). CONCLUSIONS: Patient characteristics can be used to personalize care and guidelines are not informing practice. Future research should evaluate individualized approaches to follow-up care.

Digital anthropology and educational eGames: learning through behavioural patterns in digital, game-based contexts

The selected publications are focused on the relations between users, eGames and the educational context, and how they interact together, so that both learning and user performance are improved through feedback provision. A key part of this analysis is the identification of behavioural, anthropological patterns, so that users can be clustered based on their actions, and the steps taken in the system (e.g. social network, online community, or virtual campus). In doing so, we can analyse large data sets of information made by a broad user sample,which will provide more accurate statistical reports and readings. Furthermore, this research is focused on how users can be clustered based on individual and group behaviour, so that a personalized support through feedback is provided, and the personal learning process is improved as well as the group interaction. We take inputs from every person and from the group they belong to, cluster the contributions, find behavioural patterns and provide personalized feedback to the individual and the group, based on personal and group findings. And we do all this in the context of educational games integrated in learning communities and learning management systems. To carry out this research we design a set of research questions along the 10-year published work presented in this thesis. We ask if the users can be clustered together based on the inputs provided by them and their groups; if and how these data are useful to improve the learner performance and the group interaction; if and how feedback becomes a useful tool for such pedagogical goal; if and how eGames become a powerful context to deploy the pedagogical methodology and the various research methods and activities that make use of that feedback to encourage learning and interaction; if and how a game design and a learning design must be defined and implemented to achieve these objectives, and to facilitate the productive authoring and integration of eGames in pedagogical contexts and frameworks. We conclude that educational games are a resourceful tool to provide a user experience towards a better personalized learning performance and an enhance group interaction along the way. To do so, eGames, while integrated in an educational context, must follow a specific set of user and technical requirements, so that the playful context supports the pedagogical model underneath. We also conclude that, while playing, users can be clustered based on their personal behaviour and interaction with others, thanks to the pattern identification. Based on this information, a set of recommendations are provided Digital Anthropology and educational eGames 6 /216 to the user and the group in the form of personalized feedback, timely managed for an optimum impact on learning performance and group interaction level. In this research, Digital Anthropology is introduced as a concept at a late stage to provide a backbone across various academic fields including: Social Science, Cognitive Science, Behavioural Science, Educational games and, of course, Technology-enhance learning. Although just recently described as an evolution of traditional anthropology, this approach to digital behaviour and social structure facilitates the understanding amongst fields and a comprehensive view towards a combined approach. This research takes forward the already existing work and published research onusers and eGames for learning, and turns the focus onto the next step — the clustering of users based on their behaviour and offering proper, personalized feedback to the user based on that clustering, rather than just on isolated inputs from every user. Indeed, this pattern recognition in the described context of eGames in educational contexts, and towards the presented aim of personalized counselling to the user and the group through feedback, is something that has not been accomplished before.

Sorting Test, Tower Test, and BRIEF-SR do not predict school performance of healthy adolescents in preuniversity education

Executive functions (EF) such as self-monitoring, planning, and organizing are known to develop through childhood and adolescence. They are of potential importance for learning and school performance. Earlier research into the relation between EF and school performance did not provide clear results possibly because confounding factors such as educational track, boy-girl differences, and parental education were not taken into account. The present study therefore investigated the relation between executive function tests and school performance in a highly controlled sample of 173 healthy adolescents aged 12–18. Only students in the pre-university educational track were used and the performance of boys was compared to that of girls. Results showed that there was no relation between the report marks obtained and the performance on executive function tests, notably the Sorting Test and the Tower Test of the Delis-Kaplan Executive Functions System (D-KEFS). Likewise, no relation was found between the report marks and the scores on the Behavior Rating Inventory of Executive Function—Self-Report Version (BRIEF-SR) after these were controlled for grade, sex, and level of parental education. The findings indicate that executive functioning as measured with widely used instruments such as the BRIEF-SR does not predict school performance of adolescents in preuniversity education any better than a student's grade, sex, and level of parental education.

Worries and possibilities in active citizenship : Three Swedish educational contexts

This article examines how the concept of active citizenship has been given a neo-liberal character by examining practice in three different educational contexts in Sweden. The concept of active citizenship has become influential in educational policy and practice throughout the European Union. The aim of this article is to highlight concerns at how this concept has come to be re-shaped by neo-liberal principles in Swedish education. The analysis highlights three themes, based on voice, ethical awareness and complexity and mutuality of lived experience, and argues that they provide the basis for a shift away from the present neo-liberal colouring of the concept.

The Design and Development of Educational Immersive Environments: From Theory to Classroom Deployment

Computer game technology is poised to make a significant impact on the way our youngsters will learn. Our youngsters are ‘Digital Natives’, immersed in digital technologies, especially computer games. They expect to utilize these technologies in learning contexts. This expectation, and our response as educators, may change classroom practice and inform curriculum developments. This chapter approaches these issues ‘head on’. Starting from a review of the current educational issues, an evaluation of educational theory and instructional design principles, a new theoretical approach to the construction of “Educational Immersive Environments” (EIEs) is proposed. Elements of this approach are applied to development of an EIE to support Literacy Education in UK Primary Schools. An evaluation of a trial within a UK Primary School is discussed. Conclusions from both the theoretical development and the evaluation suggest how future teacher-practitioners may embrace both the technology and our approach to develop their own learning resources.

It is just not fair: the Endangered Species Act in the United States and Ontario

The United States and the Canadian province of Ontario have enacted endangered species laws that regulate private land. The rationale for this is that the vast majority of endangered species in the two countries rely on private lands for survival. However, from a landowner perspective the law is deemed unfair. This paper presents analysis from 141 interviews with landowners in three U.S. states and Ontario. In recognition of distributive justice claims, both the U.S. government and the Ontario government have enacted programs aimed at increasing financial incentives for participation and compliance with the law. However, the law is still perceived as unfair. The central argument of this paper is that future amendments and new policies for endangered species should confront two other forms of environmental justice: procedural justice and justice-as-recognition. Landowners in both countries expressed not only concerns about compensation, but also a deep desire to be included in the protection and recovery process, as well as to be recognized by government and society as good stewards of the land. The paper concludes by stating that future policy amendments need to address justice-as-recognition if endangered species conservation on private lands is to be considered fair by landowners.

Avaliação ecotoxicológica de efluentes industriais utilizando Danio rerio Hamilton-Buchanan, 1822 (TELEOSTEI, CYPRINIDAE)

The industrial effluents are one of the main sources of water pollution. For an appropriate characterization and control of their discharges, the most efficient strategy is the integrated use of chemical, physical and ecotoxicological analyses. The aims of this study were to asses the efficiency of the treatment plant of a textile industry performing acute toxicity tests and physical-chemical analyses of the effluents before and after the treatment, besides evaluate the toxicity of the effluents of the Treatment System of Liquids Effluents (Sistema de Tratamento de Efluentes Líquidos - SITEL) of Distrito Industrial de Natal (DIN) and some of their physical-chemical variables. The species used in the ecotoxicological tests was the fish Danio rerio. The results showed that the treatment plant reduced significantly (around 50%) the toxicity of the raw textile effluent in only three of the seven tests but, in general, it promoted the reduction of the physical-chemical parameters analyzed. The toxicity and the physical-chemical factors of the effluents of SITEL of DIN varied among the tests and show the importance of monitoring their discharges in the Potengi river, one of the most important rivers of the Rio Grande do Norte state

Spatial and temporal measurements using polyoxometalate, enzymatic and biofilm layers on a CMOS 0.35 μm 64 X 64-pixel I.S.F.E.T. array sensor

This thesis presents the achievements and scientific work conducted using a previously designed and fabricated 64 x 64-pixel ion camera with the use of a 0.35 μm CMOS technology. We used an array of Ion Sensitive Field Effect Transistors (ISFETs) to monitor and measure chemical and biochemical reactions in real time. The area of our observation was a 4.2 x 4.3 mm silicon chip while the actual ISFET array covered an area of 715.8 x 715.8 μm consisting of 4096 ISFET pixels in total with a 1 μm separation space among them. The ion sensitive layer, the locus where all reactions took place was a silicon nitride layer, the final top layer of the austriamicrosystems 0.35 μm CMOS technology used. Our final measurements presented an average sensitivity of 30 mV/pH. With the addition of extra layers we were able to monitor a 65 mV voltage difference during our experiments with glucose and hexokinase, whereas a difference of 85 mV was detected for a similar glucose reaction mentioned in literature, and a 55 mV voltage difference while performing photosynthesis experiments with a biofilm made from cyanobacteria, whereas a voltage difference of 33.7 mV was detected as presented in literature for a similar cyanobacterial species using voltamemtric methods for detection. To monitor our experiments PXIe-6358 measurement cards were used and measurements were controlled by LabVIEW software. The chip was packaged and encapsulated using a PGA-100 chip carrier and a two-component commercial epoxy. Printed circuit board (PCB) has also been previously designed to provide interface between the chip and the measurement cards.