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During the COVID-19 pandemic, public health guidance (e.g., regarding the use ofnon-medical masks) changed over time. Although many revisions were a result ofgains in scientific understanding, we nonetheless hypothesized that makingchanges in guidance salient would negatively affect evaluations of experts andhealth-protective intentions. In Study 1 (N = 300), wedemonstrate that describing COVID-19 guidance in terms of inconsistency (versusconsistency) leads people to perceive scientists and public health authoritiesless favorably (e.g., as less expert). For participants in Canada(n = 190), though not the U.S. (n = 110),making guidance change salient also reduced intentions to download a contacttracing app. In Study 2 (N = 1399), we show that a briefforewarning intervention mitigates detrimental effects of changes in guidance.In the absence of forewarning, emphasizing inconsistency harmed judgments ofpublic health authorities and reduced health-protective intentions, butforewarning eliminated this effect.
We study the pairwise interactions of drops in an applied uniform DC electric field within the framework of the leaky dielectric model. We develop three-dimensional numerical simulations using the boundary integral method and an analytical theory assuming small drop deformations. We apply the simulations and the theory to explore the electrohydrodynamic interactions between two identical drops with arbitrary orientation of their line of centres relative to the applied field direction. Our results show a complex dynamics depending on the conductivities and permittivities of the drops and suspending fluids, and the initial drop pair alignment with the applied electric field.
Iceberg calving and basal melting are the two primary mass loss processes from the Antarctic ice sheet, accounting for approximately equal amounts of mass loss. Basal melting under ice shelves has been increasingly well constrained in recent work, but changes in iceberg calving rates remain poorly quantified. Here we examine the processes that precede iceberg calving, and focus on initiation and propagation of ice-shelf rifts. Using satellite imagery from the Moderate Resolution Imaging Spectroradiometer (MODIS) and the Multi-angle Imaging Spectroradiometer (MISR), we monitored five active rifts on the Amery Ice Shelf, Antarctica, from 2002 to 2014. We found a strong seasonal component: propagation rates were highest during (austral) summer and nearly zero during winter. We found substantial variability in summer propagation rates, but found no evidence that the variability was correlated with large-scale environmental drivers, such as atmospheric temperature, winds or sea-ice concentration. We did find a positive correlation between large propagation events and the arrival of tsunamis in the region. The variability appears to be related to visible structural boundaries within the ice shelf, e.g. suture zones or crevasse fields. This suggests that a complete understanding of rift propagation and iceberg calving needs to consider local heterogeneities within an ice shelf.
It is important that health professionals and support staff are prepared for disasters to safeguard themselves and the community during disasters. There has been a significantly heightened focus on disasters since the terrorist attacks of September 11, 2001 in New York (USA); however, despite this, it is evident that health professionals and support staff may not be adequately prepared for disasters.
Report
An integrative literature review was performed based on a keyword search of the major health databases for primary research evaluating preparedness of health professionals and support staff. The literature was quality appraised using a mixed-methods appraisal tool (MMAT), and a thematic analysis was completed to identify current knowledge and gaps.
Discussion
The main themes identified were: health professionals and support staff may not be fully prepared for disasters; the most effective content and methods for disaster preparedness is unknown; and the willingness of health professionals and support staff to attend work and perform during disasters needs further evaluation. Gaps were identified to guide further research and the creation of new knowledge to best prepare for disasters. These included the need for: high-quality research to evaluate the best content and methods of disaster preparedness; inclusion of the multi-disciplinary health care team as participants; preparation for internal disasters; the development of validated competencies for preparedness; validated tools for measurement; and the importance of performance in actual disasters to evaluate preparation.
Conclusion
The literature identified that all types of disaster preparedness activities lead to improvements in knowledge, skills, or attitude preparedness for disasters. Most studies focused on external disasters and the preparedness of medical, nursing, public health, or paramedic professionals. There needs to be a greater focus on the whole health care team, including allied health professionals and support staff, for both internal and external disasters. Evaluation during real disasters and the use of validated competencies and tools to deliver and evaluate disaster preparedness will enhance knowledge of best practice preparedness. However, of the 36 research articles included in this review, only five were rated at 100% using the MMAT. Due to methodological weakness of the research reviewed, the findings cannot be generalized, nor can the most effective method be determined.
GowingJR, WalkerKN, ElmerSL, CummingsEA. Disaster Preparedness among Health Professionals and Support Staff: What is Effective? An Integrative Literature Review. Prehosp Disaster Med. 2017;32(3):321–328.
The scale of foot problems in the population is high, and highest in older people. Whilst podiatry is solely concerned with the foot, other professions with a broader remit are also involved in foot care, as not only the foot may be at risk but also there may be serious systemic sequelae. Foot problems can be usefully viewed from a functional, hierarchical perspective. The interventions required are suggested by considering problems according to this hierarchy. Many approaches exist for the management of foot conditions from educated self-care to surgery. In managing such conditions, multi-disciplinary approaches are required. Podiatry has developed considerably over the years, has a growing research base, an extensive scope of practice and anticipated developments. The profession can develop further, particularly in its preventative role, in terms of professional autonomy and in further increasing its evidence base.
In this paper I want to raise an extremely ancient philosophical problem: the problem of the nature of philosophy itself. But I do not want to answer this question in the abstract, since it is never asked in the abstract. ‘What is philosophy?’ always means ‘What is philosophy for us here and now?’ It is with philosophy ‘here and now’ that I am concerned. Now this ‘here and now’ can be defined in many different ways; the definition I have chosen, with some arbitrariness, is taken over from Heidegger and Ellul. Philosophy ‘here and now’, as I shall read this, means ‘philosophy in a technological age’. The question I want to raise, therefore, can be formulated as the question whether philosophy is possible in a technological age and, if so, under what conditions.
Self-knowledge is a permanent and necessary aim for man. By ‘self-knowledge’ I mean the knowledge of oneself as a human being; the understanding of what it is to be a human being; the grasp of human nature as such. There are many sides to this knowledge: the sciences and social sciences, the arts, history, reflexion on day-to-day experience. Philosophy has traditionally been seen as a road that can lead towards self-knowledge. What I propose here is an essay in the philosophy of self-knowledge. It is a study of one aspect of human nature among others, namely human embodiment.
In the absence of a compelling model of moral functioning, the field of moral development has been languishing and is in critical need of resuscitation. Although in recent years some important conceptual insights have been advanced, corresponding empirical paradigms have been in short supply; and so the most promising theories remain largely unsubstantiated and without practical “legs.” As a further consequence, moral educators have had few viable frameworks on which to base intervention efforts. This vacuity is primarily attributable to the once inordinate interest in moral rationality, an interest that initially gave spark to the field and fanned its flames for a time, but is an enterprise now reduced to a few smoldering embers.
This focus on moral cognition arose through the magisterial contributions of Piaget (1932/1977) and Kohlberg (1969) who heralded the cognitive revolution within psychology. These structural-developmental theorists forcefully advocated the notion that the fundamental core of moral functioning entailed processes of deliberative moral judgment. Their models embraced the formalist assumptions of the philosophical mindset of the Enlightenment Era, which conceptualized human nature dualistically, pitting rationality against personality. Moral rationality was hoisted onto a pedestal, regarded as not only necessary to define the moral quality of situations, but also as imbued with sufficient oomph to motivate moral action. In striking contrast, however, emotions, personal desires, and other aspects of personality were tossed into the garbage “bag of virtues” (Kohlberg, 1981, p. 78), regarded as potentially contaminating influences that the moral agent must eschew in order to adhere to the purer dictates of reason.
General practitioner activity is increasingly under pressure to monitor its performance. The involvement of service users in the development and assessment of services is said to be a key feature of this process. This article reports on the acceptability among general practitioners of a patient-completed post-consultation measure of outcome (the Patient Enablement Instrument; PEI), and its use in conjunction with two further indicators of quality, namely time spent in consultation and patients reporting knowing the doctor well. The survey was conducted using focus groups and the administration of a postal questionnaire among a group of general practices that had participated and received feedback from a large quantitative study testing these measures. The focus group study provided useful insights into general practitioners' perceptions of patient assessment of their performance and their concerns surrounding the measurement of general practice activity. The general practitioners' perceptions of the measures under the study were enmeshed within these concerns overall. The PEI was seen as being generally acceptable as a measure of patient assessment of care, and the methods of data collection were acceptable for routine use in general practice. General practitioners who performed better in terms of their feedback scores generally approved more of the proposed measures. However, these general practitioners were not comfortable with the concept of assessment of the clinical interaction by patients, and were anxious to link such assessment explicitly with clinical (disease-related) outcome. Doctors who performed ‘better’ were no more likely than those who performed less well to advocate more use of patient assessment, or to believe that patient assessment of consultations is a reliable quality indicator. These concerns need to be addressed if patients' assessments of their care are to be taken seriously.
This study is concerned with the development of a modified sol-gel synthesis of Fe2O3 xerogels that would allow the design and control of the interfacial area between the oxidant iron oxide matrix and the metal reducing agent, thus optimizing the energetic yield of these highly energetic reactions. The modification consisted in the addition of a new class of di-functional template molecules, such as diamines or di-acids, as gelation agents. pH profile measurements indicated that the mechanism of reaction of propylene oxide and of succinic acid as the gelation agents was fundamentally different. Propylene oxide acts as a proton scavenger, reducing the hydrated iron species to Fe2O3, thus reducing the concentration of protons in the reaction mixture leading to an increase in pH. When succinic acid is used as the gelation agent, a decrease in pH versus time during the reaction indicates the formation of carboxylate ions, thus creating reactive molecules that are capable of stabilizing the Fe2O3 clusters during the growth process. Infrared spectra of the products in both reactions support presence of carboxylate groups in the Fe2O3 xerogels. X-ray diffraction analyses revealed low levels of crystallinity in both products, and the presence of different phases of Fe2O3.
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