Re-thinking bilingualism : challenges of multilingualism and communication in classroom settings

Editors’ preface to the special issue of the journal.

Fear causes tears – perineal injuries in home birth settings : a Swedish interview study

Background: Perineal injury is a serious complication of vaginal delivery that has a severe impact on the quality of life of healthy women. The prevalence of perineal injuries among women who give birth in hospital has increased over the last decade, while it is lower among women who give birth at home. The aim of this study was to describe the practice of midwives in home birth settings with the focus on the occurrence of perineal injuries. Methods: Twenty midwives who had assisted home births for between one and 29 years were interviewed using an interview guide. The midwives also had experience of working in a hospital delivery ward. All the interviews were tape-recorded and transcribed. Content analysis was used. Results: The overall theme was "No rushing and tearing about", describing the midwives' focus on the natural process taking its time. The subcategories 1) preparing for the birth; 2) going along with the physiological process; 3) creating a sense of security; 4) the critical moment and 5) midwifery skills illuminate the management of labor as experienced by the midwives when assisting births at home. Conclusions: Midwives who assist women who give birth at home take many things into account in order to minimize the risk of complications during birth. Protection of the woman's perineum is an act of awareness that is not limited to the actual moment of the pushing phase but starts earlier, along with the communication between the midwife and the woman.

Non-challenging education and teacher control as factors for marginalization of students in diverse settings

This article discusses teachers’ attitudes towards immigrant students in poor settings and the effect these attitudes have on organization of education on classroom level. It draws on results from two ethnographic studies where some primary school classes in Sweden were followed with participant observation and interviews as main research methods. The article focuses on classroom activities and teachers’ attitudes towards immigrant students and students with low socio-economic status. In the article is argued for the importance of presenting students in poor settings with demanding tasks and challenging education. In these cases, intellectually undemanding tasks in combination with little room for students’ own initiatives resulted in low enthusiasm among students regarding schoolwork and accordingly low learning, while classroom work that demanded active involvement by students in combination with high level of students’ influence on what took place in classrooms resulted in high level of students’ engagement and high outcome.

Emissions Characterisation of residential pellet boilers during start-up and stop periods

In this study, gaseous emissions and particles are measured during start-up and stop periods for an over-fed boiler and an under-fed boiler. Both gaseous and particulate matter emissions are continuously measured in the laboratory. The measurement of gaseous emissions includes oxygen (O2), carbon dioxide (CO2), carbon monoxide (CO), nitrogen oxide and (NO). The emissions rates are calculated from measured emissions concentrations and flue gas flow. The behaviours of the boilers during start-up and stop periods are analysed and the emissions are characterised in terms of CO, NO, TOC and particles (PM2.5 mass and number). The duration of the characterised periods vary between two boilers due to the difference in type of ignition and combustion control. The under-fed boiler B produces higher emissions during start-up periods than the over-fed boiler A. More hydrocarbon and particles are emitted by the under-fed boiler during stop periods. Accumulated mass of CO and TOC during start-up and stop periods contribute a major portion of the total mass emitted during whole operation. However, accumulated mass of NO and PM during start-up and stop periods are not significant as the duration of emission peak is relatively short.

EMISSIONS CHARACTERISTICS OF A RESIDENTIAL PELLET BOILER AND A STOVE

Gaseous and particulate emissions from a residential pellet boiler and a stove are measured at a realistic 6-day operation sequence and during steady state operation. The aim is to characterize the emissions during each phase in order to identify when the major part of the emissions occur to enable actions for emission reduction where the savings can be highest. The characterized emissions comprised carbon monoxide (CO), nitrogen oxide (NO), total organic carbon (TOC) and particulate matter (PM 2.5). In this study, emissions were characterised by mass concentration and emissions during start-up and stop phases were also presented in accumulated mass. The influence of start-up and stop phases on the emissions, average emission factors for the boiler and stove were analysed using the measured data from a six-days test. The share of start-up and stop emissions are significant for CO and TOC contributing 95% and 89% respectively at the 20kW boiler and 82% and 89% respectively at the 12 kW stove. NO and particles emissions are shown to dominate during stationary operation.

Energy efficient and economic renovation of residential buildings with low-temperature heating and air heat recovery

With the building sector accounting for around 40% of the total energy consumption in the EU, energy efficiency in buildings is and continues to be an important issue. Great progress has been made in reducing the energy consumption in new buildings, but the large stock of existing buildings with poor energy performance is probably an even more crucial area of focus. This thesis deals with energy efficiency measures that can be suitable for renovation of existing houses, particularly low-temperature heating systems and ventilation systems with heat recovery. The energy performance, environmental impact and costs are evaluated for a range of system combinations, for small and large houses with various heating demands and for different climates in Europe. The results were derived through simulation with energy calculation tools. Low-temperature heating and air heat recovery were both found to be promising with regard to increasing energy efficiency in European houses. These solutions proved particularly effective in Northern Europe as low-temperature heating and air heat recovery have a greater impact in cold climates and on houses with high heating demands. The performance of heat pumps, both with outdoor air and exhaust air, was seen to improve with low-temperature heating. The choice between an exhaust air heat pump and a ventilation system with heat recovery is likely to depend on case specific conditions, but both choices are more cost-effective and have a lower environmental impact than systems without heat recovery. The advantage of the heat pump is that it can be used all year round, given that it produces DHW. Economic and environmental aspects of energy efficiency measures do not always harmonize. On the one hand, lower costs can sometimes mean larger environmental impact; on the other hand there can be divergence between different environmental aspects. This makes it difficult to define financial subsidies to promote energy efficiency measures.

Emissions from realistic operation of residential wood pellets heating systems

Emissions from residential combustion appliances vary significantly depending on the firing behaviours and combustion conditions, in addition to combustion technologies and fuel quality. Although wood pellet combustion in residential heating boilers is efficient, the combustion conditions during start-up and stop phases are not optimal and produce significantly high emissions such as carbon monoxide and hydrocarbon from incomplete combustion. The emissions from the start-up and stop phases of the pellet boilers are not fully taken into account in test methods for ecolabels which primarily focus on emissions during operation on full load and part load. The objective of the thesis is to investigate the emission characteristics during realistic operation of residential wood pellet boilers in order to identify when the major part of the annual emissions occur. Emissions from four residential wood pellet boilers were measured and characterized for three operating phases (start-up, steady and stop). Emissions from realistic operation of combined solar and wood pellet heating systems was continuously measured to investigate the influence of start-up and stop phases on total annual emissions. Measured emission data from the pellet devices were used to build an emission model to predict the annual emission factors from the dynamic operation of the heating system using the simulation software TRNSYS. Start-up emissions are found to vary with ignition type, supply of air and fuel, and time to complete the phase. Stop emissions are influenced by fan operation characteristics and the cleaning routine. Start-up and stop phases under realistic operation conditions contribute 80 – 95% of annual carbon monoxide (CO) emission, 60 – 90% total hydrocarbon (TOC), 10 – 20% of nitrogen oxides (NO), and 30 – 40% particles emissions. Annual emission factors from realistic operation of tested residential heating system with a top fed wood pelt boiler can be between 190 and 400 mg/MJ for the CO emissions, between 60 and 95 mg/MJ for the NO, between 6 and 25 mg/MJ for the TOC, between 30 and 116 mg/MJ for the particulate matter and between 2x10-13 /MJ and 4x10-13 /MJ for the number of particles. If the boiler has the cleaning sequence with compressed air such as in boiler B2, annual CO emission factor can be up to 550 mg/MJ. Average CO, TOC and particles emissions under realistic annual condition were greater than the limits values of two eco labels. These results highlight the importance of start-up and stop phases in annual emission factors (especially CO and TOC). Since a large or dominating part of the annual emissions in real operation arise from the start-up and stop sequences, test methods required by the ecolabels should take these emissions into account. In this way it will encourage the boiler manufacturers to minimize annual emissions. The annual emissions of residential pellet heating system can be reduced by optimizing the number of start-ups of the pellet boiler. It is possible to reduce up to 85% of the number of start-ups by optimizing the system design and its controller such as switching of the boiler pump after it stops, using two temperature sensors for boiler ON/OFF control, optimizing of the positions of the connections to the storage tank, increasing the mixing valve temperature in the boiler circuit and decreasing the pump flow rate. For 85 % reduction of start-ups, 75 % of CO and TOC emission factors were reduced while 13% increase in NO and 15 % increase in particle emissions was observed.

Assessing the physical environment of older people’s residential care facilities: development of the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM)

Background There is emerging evidence that the physical environment is important for health, quality of life and care, but there is a lack of valid instruments to assess health care environments. The Sheffield Care Environment Assessment Matrix (SCEAM), developed in the United Kingdom, provides a comprehensive assessment of the physical environment of residential care facilities for older people. This paper reports on the translation and adaptation of SCEAM for use in Swedish residential care facilities for older people, including information on its validity and reliability. Methods SCEAM was translated into Swedish and back-translated into English, and assessed for its relevance by experts using content validity index (CVI) together with qualitative data. After modification, the validity assessments were repeated and followed by test-retest and inter-rater reliability tests in six units within a Swedish residential care facility that varied in terms of their environmental characteristics. Results Translation and back translation identified linguistic and semantic related issues. The results of the first content validity analysis showed that more than one third of the items had item-CVI (I-CVI) values less than the critical value of 0.78.  After modifying the instrument, the second content validation analysis resulted in I-CVI scores above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ= 0.903 and 0.869) and inter-rater reliability (κ= 0.851 and 0.832). Conclusions Adapting an instrument to a domestic context is a complex and time-consuming process, requiring an understanding of the culture where the instrument was developed and where it is to be used. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation and adaption. This study showed preliminary validity and reliability evidence for the Swedish version (S-SCEAM) when used in a Swedish context. Further, we believe that the S-SCEAM has improved compared to the original instrument and suggest that it can be used as a foundation for future developments of the SCEAM model.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

Verdi's Settings of Shakespeare : from Play to Liberetto to Opera

As a Senior Scholar pursuing the topic, Verdi's Settings of Shakespeare: From Play to Libretto to Opera, I have endeavoured to study a project relevant to my majors, Music and English. During first semester, I carefully analysed Shakespeare's plays, Macbeth, Othello and Falstaff. The highlight of my project was in January when I travelled to New York City and spent the day working with the Metropolitan Opera Guild. I was also able to see a performance of Verdi's Othello with Jon Vickers in the lead role. During the second semester, I studied the musical aspects of the compositions. I spent time analysing musical passages and relating them to the plays and the operas. I was also able to continue my study of Italian, which I find extremely beneficial while studying Verdi's libretti. On Monday, 13th May, 1974, I gave a lecture presentation of my project. At this time, I showed slides of Metropolitan productions of the operas, presented my own rendition of five arias (in costume) and talked about comparisions between the plays and the operas. I applied for a Rotary Fellowship to take my project to Europe and am presently waiting to hear the results. If I do receive the fellowship, I am planning to spend a year studying the plays and operas in England and Italy. Afterwards, I hope to publish a paper explaining my findings. The paper is divided into six sections. The first section is an introduction which explains the period of Romanticism and its relationship to Shakespeare and Verdi. The second section is devoted to discussing the librettist for Macbeth, Francesco Piave. Following this section the opera Macbeth is discussed. Arrigo Boito, the librettist for Otello and Falstaff is discussed in the fourth section. The last two sections deal with Otello and Falstaff. I have also included a number of musical selections to better explain certain passages. My project has been invaluable to me. My Senior Scholar project has allowed me the freedom of independent study as well as a means of tying my majors together.

The impact of the 2008 economic recession on three residential property type investments: a case study of five diverse zip codes in Washington DC, USA

There has been 47 recessions in the United States of America (US) since 1790. US recessions have increasingly affected economies of other countries in the world as nations become more and more interdependent on each other. The worst economic recession so far was the “Great Depression” – an economic recession that was caused by the 1929 crash of the stock market in the US. The 2008 economic recession in the US was a result of the burst of the “housing bubble” created by predatory lending. The economic recession resulted in increased unemployment (according to NBER 8.7 million jobs were lost from Feb. 2008 to Feb. 2010); decrease in GDP by 5.1%; increase in poverty level from 12.1% (2007) to 16.0% (2008) (NBER) This dissertation is an attempt to research the impact of the 2008 economic recession on different types of residential investments: a case study of five (5) diverse neighborhoods/zip codes in Washington DC, USA The main findings were that the effect of the 2008 economic depression on the different types of residential properties was dependent on the location of the property and the demographics/socio-economic factors associated with that location.

Are cutout handles used when available in real occupational settings? Description of grips and upper extremities movements during industrial box handling

In order to achieve better postures and decrease musculoskeletal risks adequate design of hand/box couplings for manual materials handling (MMH) are still needed. No studies evaluating upper limb movement thorough direct measurements during box handling in workplace were identified in the literature. In this study we describe the types of grip and movements adopted by ten workers when handling redesigned boxes with cutout handles between different heights on industrial pallets. The new handles were used by 90% of the workers through different types of grip. Electrogoniometric measurements showed relatively safe forearm and wrist movements, although elbow inadequate range of movement was recorded. Despite the good acceptance of the cutout by workers, the new design requires extra internal space in the boxes reducing applications for this alternative of box.

Genetic similarity between staphylococcus sp isolated from human and hospital settings, and susceptibility to different antimicrobials

Foram coletadas 143 amostras de mãos de humanos e camas hospitalares, através de swabs no caldo BHI, em um hospital escola da cidade de Ribeirão Preto/SP. As amostras coletadas foram incubadas a 37ºC por 24 horas e após este período as culturas foram semeadas em placas de Petri contendo agar Staphylococcus Médium 110. As colônias típicas do gênero Staphylococcus foram colhidas e estocados a 4ºC até o momento de elaboração das provas de catalase, manitol, hemólise, DNAse e coagulase. As cepas isoladas foram analisadas através da técnica de RAPD-PCR para verificar o grau de similaridade. A sensibilidade das cepas isoladas foi testada frente a 10 diferentes antibióticos. Das 92 cepas de Staphylococcus sp isoladas, 67 (72,8%) foram identificados como Staphylococcus coagulase-negativas e 25 (27,2%) como Staphylococcus coagulase-positivas. A análise de similaridade mostrou uma grande heterogeneidade entre as cepas, entretanto foram isoladas algumas cepas com 100% de similaridade. Resistência a oxacilina foi encontrada em 39 (42%) cepas. Duas cepas de estafilococos coagulase-negativos mostraram-se resistentes a vancomicina. Onze cepas (12%) de estafilococos foram consideradas multirresistentes. Medidas de desinfecção das mãos de pessoal e dos leitos hospitalares e a racionalização do uso indiscriminado de antibióticos podem contribuir para a queda da transmissão de patógenos e diminuição da pressão de seleção, e conseqüentemente diminuindo a freqüência e letalidade das infecções nosocomiais.