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The second Health Inequalities Module in the European Social Survey (ESS):Methodology and research opportunities
No full textThe European Social Survey (ESS) is a pan-European social survey that has mapped and explained stability and change in the attitudes, beliefs, and behaviour patterns of European populations since 2002. In 2013/14, the ESS introduced a rotating module on health and its social determinants. With this Health Inequalities module, the ESS contributed substantially to social epidemiological research and inquiry into social inequalities in health and it became a vital data source for public health research, advancing knowledge of why social inequalities in health exist in Europe and how they vary between countries and welfare states. With the second rotating Health Inequalities module in 2023/24, the ESS enables new research opportunities, primarily by generating robust and cross-national comparative data on stability and change of social inequalities in health in times of various economic, demographic, public health, and political developments. The aims of the current paper are threefold.First, we summarize key insights on health inequalities in Europe provided by data from the first ESS Health Inequalities Module. Second, we describe the methodology of the second ESS Health Inequalities Module. Third, we point to future research opportunities and offer some critical reflections. By describing in detail the analytical opportunities that the two ESS Health Inequalities Modules provide, we aim to increase engagement with the survey from a wide range of health-focused disciplines including anthropology, geography, health economics, psychology and sociology
Green Chemistry Avant La Lettre: The Pine Institute and Resin Chemistry in Aquitaine (1900–1970)
No full textBy Marcin Krasnodębski. Pp. xxxi + 346, illus., index. World Scientific Publishing: Singapore. 2024. £120.00 (hardcover), £95.00 (ebook). ISBN: 978-981-12-5285-3 (hardcover), 978-981-12-5286-0 (ebook)
Cross-Border Regional Labour Market Analysis - Case study Region Zeeland/Brabant - Eastern Flanders, Antwerps (Belgium-Netherlands)
No full textAuthors' response:A personalized approach is essential for enhancing the clinical relevance of exercise prehabilitation
No full textAcceptability and feasibility of a mobile electronic medical record system for community-based antiretroviral therapy in Lilongwe, Malawi:A rapid qualitative analysis
No full textBackground Mobile health (mHealth) is reshaping healthcare delivery, especially in HIV management. The World Health Organization advocates for mHealth to provide healthcare workers (HCWs) with real-time data, enhancing client care. However, in Malawi's Lighthouse Trust antiretroviral therapy (ART) clinic, the nurse-led community-based ART (NCAP) program faces hurdles with data management due to lack of access to electronic medical records systems (EMRS) in the community setting. EMRS are not typically available in differentiated service delivery settings where reliable power and internet are often unavailable. We used human-centered design (HCD) processes to create a mobile EMRS prototype, the Community-based ART Retention and Suppression (CARES) app. CARES aims to simplify workflow for HCWs and improve client care. As part of prototype testing, we explore CARES' feasibility and acceptability from the perspective of NCAP HCWs.Methods We conducted in-depth interviews among 15 NCAP HCWs. We used a rapid qualitative analysis approach guided by the Technology Acceptance Models (TAM1 and TAM2). The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ).Results HCWs demonstrated high perceived usefulness for the CARES app to improve healthcare delivery and data management, both of which could facilitate continued and effective use. However, challenges such as app performance, data integration, and system navigation were significant barriers to ease of use, reducing acceptance and current feasibility of scale-up. Despite challenges, HCWs remained optimistic about CARES' potential to enhance NCAP clinical decision-making and data flow in future, likely reflecting organizational expectations for CARES optimization. Beyond the TAM framework, additional themes of consistent staff engagement and considerations for sustainability were identified as critical factors for long-term success. HCWs emphasized the need for continuous training and stakeholder engagement, improved infrastructure, data security protections, and establishing the CARES app and EMRS integration to facilitate CARES' sustained expansion.Conclusion The study findings underscore the importance of HCD for mHealth buy-in. As HCWs were invested in CARES success, they remained optimistic that the app could enhance NCAP services if user experience and app performance improved. Incorporation of HCW feedback could help deliver the promise of CARES, current and future
Defining Reablement in the Dutch Context A Modified Delphi Study
No full textIntroduction: For the past decade, the Netherlands has been developing and implementing reablement programs to promote independence and to empower older adults' autonomy. However, a key challenge remains the lack of clarity around the definition of reablement and its relations to usual care practices. Existing international definitions lack specificity to account for contextual differences, such as variations in healthcare systems and cultural norms. An operational definition is needed that not only fits the Dutch health and social care system and incorporates context-specific elements. This study extends the original conceptual definition by integrating these elements, offering clearer, more practical guidance for real-world application. Materials and methods: A modified Delphi study was performed to develop a definition of reablement that fits the Dutch health and social care system, extending beyond conceptual understanding. The study comprised three expert rounds and three Delphi survey rounds. Results: A total of 139 participants from Dutch health and social care, education, research, and representatives of clients and informal caregivers, participated. They evaluated statements in four sections: the target group, aims, type of care or support, and characteristics of reablement programs. Key discussions during the expert rounds focused mainly on 1) the target group, emphasizing the importance of involving individuals and their families, and 2) the characteristics of reablement, such as coordinating roles, team composition, and size. Input from the Delphi surveys and expert rounds led to the development of an operational definition for the Dutch context, agreed upon by 81% of stakeholders. Conclusion: The Delphi methodology proved valuable in identifying context-specific elements and incorporating expert perspectives, creating a culturally and contextually sensitive definition. This definition distinguishes itself from the international version by offering practical guidance on areas of application and interventions, with a focus on promoting social participation, well-being, and the involvement of the individual's social network
Excuses, excuses:moral agency and the professional identity of AI developers
No full textArtificial intelligence developers, machine learning engineers, and data scientists occupy a contradictory role in the modern marketplace. While they are central to the business and science of AI, they are marginalized as moral agents. Consequently, the marketplace has cultivated environments in which developers can be unthinking in their own roles and responsibilities, while at the same time tasking them with creating "thinking machines." The central aim of this article is to show that this state of affairs is morally unjustifiable. To accomplish this, we draw from Arthur Isak Applbaum's work on adversary roles and Alasdair MacIntyre's framework for professional moral agency to establish the context dependencies for a "good" AI developer. We then draw from available studies that have engaged developers in questions about their moral agency and place them in conversation with Dennis Thompson and Helen Nissenbaum about the excuses associated with "the problem of many hands," a concept that has beguiled accountability in the AI community for decades. We then return to MacIntyre's framework to provide evidence from the same set of studies that AI developers do understand themselves as being responsible for more than just the role, yet they lack a robust community to whom they can submit their choices for ethical scrutiny and work environments that are often non-conducive to their moral actualization. We conclude with specific recommendations for bringing developers' moral agency more fully into the discourse about AI ethics
Development of a novel anti-CEACAM5 VHH for SPECT imaging and potential cancer therapy applications
No full textPurpose: In this study, we investigated the utility of a novel developed anti-CEACAM5 VHH for cancer diagnosis and its potential of being a targeting-moiety of VHH-drug conjugates for cancer therapy. Methods: Anti-CEACAM5 VHH (6B11) affinity and specific cellular binding was confirmed by ELISA, FACS and immunofluorescence in cancer cell lines with varying CEACAM5 expression levels. Intracellular penetration ability within tumor spheroids was tested with Oregon Green 488 labeled 6B11 (OG488-6B11). Biodistribution and binding specificity of 99mTc-radiolabeled 6B11 was tested in A549 CEACAM5 overexpressing (A549-CEA5-OV) and knockout (A549-CEA5-KO) tumor-bearing mice upon SPECT/CT imaging, γ-counting and autoradiography. The therapeutic efficacy of 6B11 and 6F8 (anti-CEACAM5 VHH with lower binding affinity) was tested by viability, wound healing and adhesion assays. To verify the potential of VHHs as a warhead for VHH-drug conjugation, an internalization assay with OG488 labeled VHH was performed. Result: 6B11 demonstrated high binding affinity (EC 50 0.5nM) and cellular binding. OG488-6B11 penetrated tumor spheroids completely at 24 h, while a conventional antibody was only visible at the spheroid periphery. SPECT imaging indicated higher uptake (p < 0.05) in A549-CEA5-OV tumors, resulting in increased tumor-to-blood ratios especially at 4 (2.0016 ± 1.1893, p = 0.035) and 24 (2.9371 ± 2.0683, p = 0.003) hpi compared to A549-CEA5-KO tumors at 4 (0.5640 ± 0.3576) and 24 (0.8051 ± 0.4351) hpi. 99mTc-6B11 was predominantly renally cleared. Autoradiography and immunohistochemistry confirmed these uptake patterns. 6B11 nor 6F8 did exhibit significant anti-cancer therapeutic efficacy in vitro. OG488-6B11 was effectively internalized and accumulated in cells in a time-dependent manner, to end up in the lysosomes. Conclusion: The anti-CEACAM5 VHH 6B11 is a good candidate for SPECT-based cancer diagnosis and can be potentially used as targeting moiety in the development of VHH-based drug conjugates for cancer treatments.</p
Longitudinal development of career adaptability in pre-service teachers:the impact of internship experiences and emotion regulation strategies
No full textIndividuals with high career adaptability tend to navigate career transitions more smoothly. To address the challenges associated with pre-service teachers transitioning from students to teachers, it is essential to explore the development of their career adaptability. This study aims to investigate the growth of four dimensions of career adaptability in pre-service teachers-career concern, career control, career curiosity, and career confidence-over a semester, as well as how internship experiences and emotion regulation strategies (specifically cognitive reappraisal and expressive suppression) influence this growth. Three surveys were conducted over the semester, involving 779, 683, and 448 pre-service teachers, respectively, who completed questionnaires assessing career adaptability three times and emotion regulation strategies once. The results of the latent growth model showed significant increases in career concern, control, and curiosity over time, whereas career confidence exhibited a gradual decline. Both internship experiences and emotion regulation strategies predicted different aspects of career adaptability. The findings provide empirical evidence for optimizing teacher education programs, ultimately aiming to enhance the overall career adaptability of pre-service teachers
Smallholder farming, fertilizer use, and the polycrisis period:Cross-country evidence from longitudinal surveys in Sub-Saharan Africa?
No full textSmallholder agriculture continues to be the main source of livelihood for a large portion of Sub-Saharan Africa's population. In recent years, compounding crises and shocks have threatened this livelihood basis. How did smallholder farmers in Sub-Saharan Africa fare throughout this period? What measures did they take to cope with the repeated disruption to their farming activities? We address this knowledge gap using nationally representative, cross-country comparable longitudinal microdata collected from over 16,000 agricultural households in six Sub-Saharan African countries between 2018 and 2024. While overall fertilizer adoption remained relatively stable, we find considerable cross-country heterogeneity and poorer households to be more likely to have discontinued fertilizer use. At the intensive margin, 47% of farmers could not access their desired quantity of fertilizer. On average, these farmers used less than half as much inorganic fertilizer as they desired with affordability being the main constraint. Households adopted a range of coping strategies, some of which may compromise productivity and heighten future vulnerability