Adapting health-risk communication to the specific cultural contexts of diverse populations : an assessment of malaria-treatment programs in Liberia

Drawing on theories of technical communication, rhetoric, literacy, language and culture, and medical anthropology, this dissertation explores how local culture and traditions can be incorporated into health-risk-communication-program design and implementation, including the design and dissemination of health-risk messages. In a modern world with increasing global economic partnerships, mounting health and environmental risks, and cross-cultural collaborations, those who interact with people of different cultures have “a moral obligation to take those cultures seriously, including their social organization and values” (Hahn and Inhorn 10). Paradoxically, at the same time as we must carefully adapt health, safety, and environmental-risk messages to diverse cultures and populations, we must also recognize the increasing extent to which we are all becoming part of one, vast, interrelated global village. This, too, has a significant impact on the ways in which healthcare plans should be designed, communicated, and implemented. Because communicating across diverse cultures requires a system for “bridging the gap between individual differences and negotiating individual realities” (Kim and Gudykunst 50), both administrators and beneficiaries of malaria-treatment-and-control programs (MTCPs) in Liberia were targeted to participate in this study. A total of 105 people participated in this study: 21 MTCP administrators (including designers and implementers) completed survey questionnaires on program design, implementation, and outcomes; and 84 MTCP beneficiaries (e.g., traditional leaders and young adults) were interviewed about their knowledge of malaria and methods for communicating health risks in their tribe or culture. All participants showed a tremendous sense of courage, commitment, resilience, and pragmatism, especially in light of the fact that many of them live and work under dire socioeconomic conditions (e.g., no electricity and poor communication networks). Although many MTCP beneficiaries interviewed for this study had bed nets in their homes, a majority (46.34 percent) used a combination of traditional herbal medicine and Western medicine to treat malaria. MTCP administrators who participated in this study rated the impacts of their programs on reducing malaria in Liberia as moderately successful (61.90 percent) or greatly successful (38.10 percent), and they offered a variety of insights on what they might do differently in the future to incorporate local culture and traditions into program design and implementation. Participating MTCP administrators and beneficiaries differed in their understanding of what “cultural incorporation” meant, but they agreed that using local indigenous languages to communicate health-risk messages was essential for effective health-risk communication. They also suggested that understanding the literacy practices and linguistic cultures of the local people is essential to communicating health risks across diverse cultures and populations.

U.S. utilities' experiences with the implementation of energy efficiency programs

In the U.S., many electric utility companies are offering demand-side management (DSM) programs to their customers as ways to save money and energy. However, it is challenging to compare these programs between utility companies throughout the U.S. because of the variability of state energy policies. For example, some states in the U.S. have deregulated electricity markets and others do not. In addition, utility companies within a state differ depending on ownership and size. This study examines 12 utilities’ experiences with DSM programs and compares the programs’ annual energy savings results that the selected utilities reported to the Energy Information Administration (EIA). The 2009 EIA data suggests that DSM program effectiveness is not significantly affected by electricity market deregulation or utility ownership. However, DSM programs seem to generally be more effective when administered by utilities located in states with energy savings requirements and DSM program mandates.

United States certificate programs in technical communication : a feminist-sophistic investigation

Technical communication certificates are offered by many colleges and universities as an alternative to a full undergraduate or graduate degree in the field. Despite certificates’ increasing popularity in recent years, however, surprisingly little commentary exists about them within the scholarly literature. In this work, I describe a survey of certificate and baccalaureate programs that I performed in 2008 in order to develop basic, descriptive data on programs’ age, size, and graduation rates; departmental location; curricular requirements; online offerings; and instructor status and qualifications. In performing this research, I apply recent insights from neosophistic rhetorical theory and feminist critiques of science to both articulate, and model, a feminist-sophistic methodology. I also suggest in this work that technical communication certificates can be theorized as a particularly sophistic credential for a particularly sophistic field, and I discuss the implications of neosophistic theory for certificate program design and administration.

Multidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Multidimensional preventive home visit programs aim at maintaining health and autonomy of older adults and preventing disability and subsequent nursing home admission, but results of randomized controlled trials (RCTs) have been inconsistent. Our objective was to systematically review RCTs examining the effect of home visit programs on mortality, nursing home admissions, and functional status decline. METHODS: Data sources were MEDLINE, EMBASE, Cochrane CENTRAL database, and references. Studies were reviewed to identify RCTs that compared outcome data of older participants in preventive home visit programs with control group outcome data. Publications reporting 21 trials were included. Data on study population, intervention characteristics, outcomes, and trial quality were double-extracted. We conducted random effects meta-analyses. RESULTS: Pooled effects estimates revealed statistically nonsignificant favorable, and heterogeneous effects on mortality (odds ratio [OR] 0.92, 95% confidence interval [CI], 0.80-1.05), functional status decline (OR 0.89, 95% CI, 0.77-1.03), and nursing home admission (OR 0.86, 95% CI, 0.68-1.10). A beneficial effect on mortality was seen in younger study populations (OR 0.74, 95% CI, 0.58-0.94) but not in older populations (OR 1.14, 95% CI, 0.90-1.43). Functional decline was reduced in programs including a clinical examination in the initial assessment (OR 0.64, 95% CI, 0.48-0.87) but not in other trials (OR 1.00, 95% CI, 0.88-1.14). There was no single factor explaining the heterogenous effects of trials on nursing home admissions. CONCLUSION: Multidimensional preventive home visits have the potential to reduce disability burden among older adults when based on multidimensional assessment with clinical examination. Effects on nursing home admissions are heterogeneous and likely depend on multiple factors including population factors, program characteristics, and health care setting.

Add a Dash of Rhetoric, a Pinch of Technical Communication, a Handful of Pedagogy, and Mix Well: Cookbooks and Recipes as Instructional Texts, and What Domestic Texts from 1870 to 1935 Can Teach Us About Technical Communication

Through the use of rhetoric centered on authority and risk avoidance, scientific method has co-opted knowledge, especially women's everyday and experiential knowledge in the domestic sphere. This, in turn, has produced a profound affect on technical communication in the present day. I am drawing on rhetorical theory to study cookbooks and recipes for their contributions to changes in instructional texts. Using the rhetorical lenses of metis (cunning intelligence), kairos (timing and fitness) and mneme (memory), I examine the way in which recipes and cookbooks are constructed, used and perceived. This helps me uncover lost voices in history, the voices of women who used recipes, produced cookbooks and changed the way instructions read. Beginning with the earliest cookbooks and recipes, but focusing on the pivotal temporal interval of 1870-1935, I investigate the writing and rhetorical forces shaping instruction sets and domestic discourse. By the time of scientific cooking and domestic science, everyday and experiential knowledge were being excluded to make room for scientific method and the industrial values of the public sphere. In this study, I also assess how the public sphere, via Cooperative Extension Services and other government agencies, impacted the domestic sphere, further devaluing everyday knowledge in favor of the public scientific model. I will show how the changes in the production of food, cookbooks and recipes were related to changes in technical communication. These changes had wide rippling effects on the field of technical communication. By returning to some of the tenets and traditions of everyday and experiential knowledge, technical communication scholars, practitioners and instructors today can find new ways to encounter technical communication, specifically regarding the creation of instructional texts. Bringing cookbooks, recipes and everyday knowledge into the classroom and the field engenders a new realm of epistemological possibilities.

An Active Learning Module for an Introduction to Software Engineering Course

Many schools do not begin to introduce college students to software engineering until they have had at least one semester of programming. Since software engineering is a large, complex, and abstract subject it is difficult to construct active learning exercises that build on the students’ elementary knowledge of programming and still teach basic software engineering principles. It is also the case that beginning students typically know how to construct small programs, but they have little experience with the techniques necessary to produce reliable and long-term maintainable modules. I have addressed these two concerns by defining a local standard (Montana Tech Method (MTM) Software Development Standard for Small Modules Template) that step-by-step directs students toward the construction of highly reliable small modules using well known, best-practices software engineering techniques. “Small module” is here defined as a coherent development task that can be unit tested, and can be car ried out by a single (or a pair of) software engineer(s) in at most a few weeks. The standard describes the process to be used and also provides a template for the top-level documentation. The instructional module’s sequence of mini-lectures and exercises associated with the use of this (and other) local standards are used throughout the course, which perforce covers more abstract software engineering material using traditional reading and writing assignments. The sequence of mini-lectures and hands-on assignments (many of which are done in small groups) constitutes an instructional module that can be used in any similar software engineering course.

Effects of a 6-Week Jump Training Program Combined with Two Lifting Programs

We evaluated the effects of a 6-week jump training program on 12 college basketball players using strength training programs. The Leg Press (LP) group participated in a strength program using the leg press, and the Power Clean group (PC) used the power clean exercise instead of the leg press. Both groups participated in a 6-week jump training program. Pre-program measurements recorded jump scores for one-foot take off and two-foot take offs. The LP group had an average pre-program vertical of 72.60 and 88.05 cm for the 2-foot and 1-foot take-off for an increase of about 1.7 cm. The PC group had an average post-program vertical of 76.2 cm for the 2-foot take-off for an increase of 3.6 cm, and 90.81 cm for the 1-foot take-off for an increase of about 2.75 cm. The comparison of average increases between the LP and PC groups was not significant for either the 2-foot or 1-foot take off.

Curricular Integration of Simulations in Neuroscience - Instructional and Technical Perspectives

In recent years interactive media and tools, like scientific simulations and simulation environments or dynamic data visualizations, became established methods in the neural and cognitive sciences. Hence, university teachers of neural and cognitive sciences are faced with the challenge to integrate these media into the neuroscientific curriculum. Especially simulations and dynamic visualizations offer great opportunities for teachers and learners, since they are both illustrative and explorable. However, simulations bear instructional problems: they are abstract, demand some computer skills and conceptual knowledge about what simulations intend to explain. By following two central questions this article provides an overview on possible approaches to be applied in neuroscience education and opens perspectives for their curricular integration: (i) How can complex scientific media be transformed for educational use in an efficient and (for students on all levels) comprehensible manner and (ii) by what technical infrastructure can this transformation be supported? Exemplified by educational simulations for the neurosciences and their application in courses, answers to these questions are proposed a) by introducing a specific educational simulation approach for the neurosciences b) by introducing an e-learning environment for simulations, and c) by providing examples of curricular integration on different levels which might help academic teachers to integrate newly created or existing interactive educational resources in their courses.

J-Quizmaker

Lehrvideos erfreuen sich dank aktueller Entwicklungen im Bereich der Online-Lehre (Videoplattformen, MOOCs) auf der einen Seite und einer riesigen Auswahl sowie einer einfachen Produktion und Distribution auf der anderen Seite großer Beliebtheit bei der Wissensvermittlung. Trotzdem bringen Videos einen entscheidenden Nachteil mit sich, welcher in der Natur des Datenformats liegt. So sind die Suche nach konkreten Sachverhalten in einem Video sowie die semantische Aufbereitung zur automatisierten Verknüpfung mit weiteren spezifischen Inhalten mit hohem Aufwand verbunden. Daher werden die lernerfolg-orientierte Selektion von Lehrsegmenten und ihr Arrangement zur auf Lernprozesse abgestimmten Steuerung gehemmt. Beim Betrachten des Videos werden unter Umständen bereits bekannte Sachverhalte wiederholt bzw. können nur durch aufwendiges manuelles Spulen übersprungen werden. Selbiges Problem besteht auch bei der gezielten Wiederholung von Videoabschnitten. Als Lösung dieses Problems wird eine Webapplikation vorgestellt, welche die semantische Aufbereitung von Videos hin zu adaptiven Lehrinhalten ermöglicht: mittels Integration von Selbsttestaufgaben mit definierten Folgeaktionen können auf Basis des aktuellen Nutzerwissens Videoabschnitte automatisiert übersprungen oder wiederholt und externe Inhalte verlinkt werden. Der präsentierte Ansatz basiert somit auf einer Erweiterung der behavioristischen Lerntheorie der Verzweigten Lehrprogramme nach Crowder, die auf den Lernverlauf angepasste Sequenzen von Lerneinheiten beinhaltet. Gleichzeitig werden mittels regelmäßig eingeschobener Selbsttestaufgaben Motivation sowie Aufmerksamkeit des Lernenden nach Regeln der Programmierten Unterweisung nach Skinner und Verstärkungstheorie gefördert. Durch explizite Auszeichnung zusammengehöriger Abschnitte in Videos können zusätzlich die enthaltenden Informationen maschinenlesbar gestaltet werden, sodass weitere Möglichkeiten zum Auffinden und Verknüpfen von Lerninhalten geschaffen werden.

Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening

OBJECTIVES In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries. METHODS AND FINDINGS We surveyed ART programs treating HIV-infected adults in sub-Saharan Africa, Asia and Latin America in 2012 using online questionnaires to collect program-level and patient-level data. Forty-seven sites from 26 countries participated. Patient-level data were collected on 987 adult TB patients from 40 sites (median age 34.7 years; 54% female). Sputum smear microscopy and chest radiograph were available in 47 (100%) sites, TB culture in 44 (94%), and Xpert MTB/RIF in 23 (49%). Xpert MTB/RIF was rarely available in Central Africa and South America. In sites with access to these diagnostics, microscopy was used in 745 (76%) patients diagnosed with TB, culture in 220 (24%), and chest X-ray in 688 (70%) patients. When free of charge culture was done in 27% of patients, compared to 21% when there was a fee (p = 0.033). Corresponding percentages for Xpert MTB/RIF were 26% and 15% of patients (p = 0.001). Screening practices for active disease before starting ART included symptom screening (46 sites, 98%), chest X-ray (38, 81%), sputum microscopy (37, 79%), culture (16, 34%), and Xpert MTB/RIF (5, 11%). CONCLUSIONS Mycobacterial culture was infrequently used despite its availability at most sites, while Xpert MTB/RIF was not generally available. Use of available diagnostics was higher when offered free of charge.

The Effect on Meat Quality of Integrating Pasturing Systems into Cattle Finishing Programs

The effect on meat quality of integrating pasturing systems into cattle finishing programs was observed over a two-year period. Year one consisted of 84 fall born calves and 28 spring born calves and year two consisted of 116 fall born calves. The effect of using Rumensinâ for cattle on bromegrass pasture was incorporated into year one. In year two cattle on pasture received bromegrass pasture, and one treatment group received switchgrass during the warm season. In both years there was a control group of calves that went directly to the feedlot with the remaining calves going to pasture for varying periods of time before being finished in drylot. At the conclusion of the feeding trial, cattle were processed into beef, and a ribeye steak was removed from each carcass for sensory evaluation. In year one cattle that were on pasture the longest had the lowest (P<0.05) average quality grades. In year two this trend was reversed, and cattle placed directly into drylot had the lowest (P<0.05) average quality grades. In both years cattle carcasses in all treatments averaged yield grade 2. Warner Bratzler shear force values were not affected by treatments. Sensory panel evaluations indicated tenderness was unaffected by treatments, and in year two flavor and flavor intensity were unaffected by treatments. In year one flavor intensity was lowest (P<0.05) for steaks derived from cattle that were on pasture the longest and received Rumensinâ. Inclusion of Rumensinâ for cattle on pasture did not influence yield and quality grades or affect tenderness, juiciness, and flavor. Results of this study indicate that steer calves placed on cool and warm season pastures prior to being finished in drylot, can produce carcasses with acceptable yield and quality grades and that the meat eating qualities will be largely unaffected by the inclusion of pasture.