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Faced with limited resources, nurse educators are challenged with transforming nursing education while preparing enough qualified nurses to meet future demand; therefore, innovative approaches to teaching are needed. In this article, we describe the development of an innovative teaching activity. Baby Boy Jones is a Web-delivered, case-based learning activity focused on neonatal infection. It was created using e-learning authoring software and delivered through a learning management system.

Background and Purpose: No scales measure self-efficacy in women with Type 2 diabetes. A scale was developed and tested. Methods: Items generated, content validity index (CVI) assessed by experts, the 2-part Diabetes Self-Efficacy Scale (DSLF-I and DSLF-II) was piloted with 62 women, administered to 208 women, and then readministered to 30 women to determine initial reliability. Factor analysis was conducted for construct validity. Discriminant, convergent, and predictive validity was examined. Results: The CVI index was 98%. Cronbach's alphas were 0.88 (DSLF-I) and 0.82 (DSLF-II; pilot) and 0.87 and 0.86, respectively (main study); test-retest correlation was .60 (DSLF-I) and .69 (DSLF-II). There were 3 factors that emerged: diabetes knowledge of self-care activity, diabetes diet self-care, and diabetes medication self-care. Conclusions: The Diabetes Self-Efficacy Scale demonstrates good initial reliability and validity.Keywords: instrument development; self-efficacy; diabetes mellitus Type 2; reliability; validity; factor analysisDiabetes mellitus affects 8.3% of the population in the United States, or 25.8 million people. More than 7 million people are estimated to be undiagnosed and unaware they have the disease (Center for Disease Control and Prevention [CDC], 2011). Approximately 90%-95% of persons with diabetes have Type 2 diabetes mellitus (T2DM). The San Antonio Heart Study revealed a rising incidence of T2DM, with age, ethnicity, and neighborhood as significant predictors of T2DM (Burke et al., 1999).Although T2DM affects all ethnic and gender groups, there is a disparate effect. For example, African Americans are 1.6 times more likely to have diabetes than Whites and are more likely to go undiagnosed American Diabetes Association (ADA, 2005a). Complications from T2DM are also more prevalent in minority populations (Carter, Pugh, & Monterosa, 1996). In addition, diabetic women, compared to diabetic men, have a significantly higher prevalence of cardiovascular disease and suffer greater adverse outcomes (D'Arrigo, 1999; Gu, Cowie, & Harris, 1999; Howard et al., 1998; Smitherman & Reis, 1997). Further, Sowers (1998) reported that the gender protectiveness for coronary heart disease (CHD) declines in women between the ages of 50 and 59 years, and that the loss of gender protectiveness increases the risk ratio for CHD to 3.5 for women with diabetes compared to 2.4 for men with diabetes (p. 618). Koerbel and Korytkowski (2003) stated that women with diabetes not only have greater risk for cardiovascular disease but they also suffer greater adverse outcomes. They cite several factors, which increase this risk in women: poorer glycemic control, elevated blood pressure and lipids, central obesity, increased depression and lower socioeconomic status. These factors contribute to increased morbidity and health care costs for women with diabetes. These data support the need for more research into prevention, detection, and cost-effective methods to effectively manage T2DM and prevent its complications in women.Maintenance of health and prevention of diabetic complications require significant changes in lifestyle management and adherence to a therapeutic diabetic regimen. Behavior change and adherence are not only difficult but are also often inadequate to maintain recommended glycemic control (Anderson, Fitzgerald, & Oh, 1993; Skelly, Marshall, Haughey, Davis, & Dunford, 1995). The importance of participation in diabetic self-care behavior in achieving glycemic control has been demonstrated by the Diabetes Control and Complications Trial Research Group (1993) for individuals with Type 1 diabetes mellitus (T1DM) and by the United Kingdom Prospective Diabetes Study Group (1998) for individuals with T2DM. This goal is accomplished through a therapeutic alliance among clients, family, and health care providers to promote self-care behaviors and therapeutic modalities (ADA, 2005b). Self-care behaviors include a combination of changing or modifying eating habits, maintaining weight or achieving weight loss, participating in a physical exercise program, self-monitoring of blood glucose, and/or taking oral or injectable medication. …

Explaining the Male Contribution to Household Labor: Does Peers’ Behavior Matter?

The paper has the aim of reflect on the current situation of the Lake Chad Basin, characterized by the increasing Humanitarian Situation , determined not more only from the water crisis, but from the progressive presence of terrorist militias of the fundamentalist group Boko Haram. Indeed, today, environmental and social degradation of forests, increasingly advanced, the increasing salinization of soils, the proliferation of aquatic vegetation, the high concentration of population around the lake and wetlands exacerbate exploitation of resources and stir up the anarchist social conflicts. Scholars therefore speak of climate refugees, who face not only climate change, but also international terrorism . In the realization of the paper we will use the Human Development Index ( HDI ), the Human Poverty Index ( HPI ) and the Global Hunger Index referring to countries bordering Lake Chad, in order to better understand the phenomena under investigation

Page EXECUTIVE SUMMARY iii 1. INTRODUCTION 1 2. PREVENTION 2 3. PROTECTION 4 4. PROSECUTION 8 5. CONCLUSION 10 APPENDICES Appendix 1 : Status of Commonwealth Members Ratifications and Accessions...

This study examined incidental receptive and productive vocabulary gains within conversation class interactions. Sixteen Mexican learners of English attended four videotaped conversation lessons where 40 target words were incorporated into different types of exposure. Stimulated recall interviews with students highlighted the effect of cognates, learners’ access to passive vocabulary, and use of their vocabulary knowledge in learning related words. Posttests revealed a correlation between frequency of exposure and receptive/productive gains. Mean scores showed that students most often learned task-essential words, followed by words mentioned with synonyms, and last, those mentioned without an explanation. A two-way ANCOVA revealed main effects for cognates, and a statistical interaction between cognate status and types of exposure to target words, and a moderate effect of frequency of mention on receptive knowledge. Results provide implications for ESL teachers who consider incidental learning of vocabulary within their conversation lessons.

Introduction The purpose of this study was to examine attitudes and behaviors associated with parenthood and pregnancy among adolescents in the juvenile justice system. Method A cross-sectional survey of attitudes and behaviors about parenthood was conducted with 300 adolescents residing in three juvenile detention centers. Results Data revealed high rates of risky behaviors that resulted in parenthood/pregnancy and generally positive attitudes about being an adolescent parent. Positive attitudes about parenthood (P = .000) and lower self-efficacy to not have sex (P = .021) were significantly correlated with having been pregnant or having fathered a child. Logistic regression showed positive attitudes about parenthood and the combination of drinking and driving together were significant predictors of pregnancy (P ≤ .05). Discussion Pediatric nurse practitioners working with adolescents in the juvenile justice system who routinely provide prevention counseling and implement health promotion programs must take into account the reality that many adolescents in this population are or will become parents and do not consider pregnancy as an outcome to be necessarily avoided. Moving beyond primary and secondary prevention strategies to implement programs to prevent second pregnancies and enhance parenting skills will provide needed health benefits to these adolescent parents.

Daishowa Paper Manufacturing Co., Ltd. owns five mills, namely, Suzukawa, Yoshinaga, Imaizumi, Fuji, in Shizuoka prefecture and Shiraoi in Hokkaido.Shiraoi mill, located at Shiraoi-cho in South Hokkaido, has started its operation since 1960, now it is the largest and newest mill in our company.The mill is about 40 kliometers far to the north east of Muroran Port, from which imported wood chips (Douglas fir, Eucalyptus) and 70% of its products are transported.Paper & paperboard mill has 6 paper machines (daily capacity 1, 230 tons), 3 paperboard machines (daily capacity 320 tons), 2 off coaters (daily capacity 16 tons) and its products are newsprint, printing and writing paper, diazo sensitive paperstock, business form paper, coated paper, linerboard, coated white board and others.Pulp mill has 2 KP continuous digesters, 5 KP batch digesters, 3 BKP plants, 3 grinders, RGP plant, A-CGP plant, DIP plant and 2 pulpers for old corrugated containers pulping. The mill area is about 1, 340, 000m2 and the employees are about 1, 200.

Wondering recently in London how to present this enormous subject to an enlightened but very mixed audience, I strolled out into St James’s and then through Green and Hyde Parks. The grass was still short and the trees were bare, but here and there fine clumps of daffodils and flashes of crocuses were in full bloom, and the ‘lakes’ were alive with all manner of waterfowl. In quiet corners I met more blackbirds than one generally sees in a long walk in the country—not to mention the hordes of pigeons and sparrows. Some early-flowering Prunus trees added a delicate tinge of pink. The entire prospect was delightful in early spring, though almost entirely artificial: not at all typical of the biosphere, but an impressive display of what man has created—and can do even better—when the will, knowledge, and money, are available. Given these last three prerequisites, it is also a portent of what we may expect to see more and more of in future, as human population burgeons and great cities multiply, extend, and ultimately coalesce.

I had seriously thought of beginning this global account of freshwater supplies and pollution with a porcine analogue to the human population explosion. Projection of the latest fifteen-year period for which figures are available, indicating a pig population doubling-time of about twenty years up to 1967–68, suggests that the global balance in numbers between pigs and men will shift in favour of pigs by the year 2060 (cf. United Nations, 1970). Each pig being more or less equivalent to two humans in terms of food consumption and physiological waste production, a still more meaningful shift in these terms will take place approximately one pig doubling-time earlier, namely about the year 2040. These facts prepare the ground for a question posed at the end of this paper—namely, are we really solving our problems today? They also help to establish a proposition pertaining to human populations that, for some reason or other, seems acceptable only when applied to some animal other than man, namely: that the world population explosion of pigs will persist on its seemingly inevitable course only as long as humans want to have more and more pigs around them. In a like manner, the world population explosion of humans will persist on its seemingly inevitable course only as long as humans want to have more and more humans around.

Fruit and vegetable consumption may protect against sarcopenia but there are no studies on this topic from low- and middle-income countries (LMICs). Thus, we assessed this association among older adults from six LMICs. Community-based cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. The sample consisted of 14,585 individuals aged &ge, 65 years (mean (SD) age 72.6 (11.4) years, 55% females). Adjusted analyses showed that overall, compared to the lowest quintile (Q1), the highest quintile (Q5) of fruit consumption was associated with a 40% lower odds for sarcopenia (OR = 0.60, 95% CI = 0.42-0.84) but this association was largely driven by the strong association among females (e.g., Q5 vs. Q1 OR = 0.42, 95% CI = 0.24&minus, 0.73), with no significant associations found among males. Vegetable consumption was not significantly associated with sarcopenia. Future studies of longitudinal design may shed light on whether increasing fruit consumption among older females in LMICs may reduce risk for sarcopenia.

Partial migration, when only part of the population migrates seasonally while the other part remains resident on the shared range, is the most common form of migration in ungulates. Migration is often defined by spatial separation of seasonal ranges and consequently, classification of individuals as migrants or residents is usually only based on geographic criteria. However, the underlying mechanism for migration is hypothesized to be movement in response to spatiotemporal resource variability and thus, migrants are assumed to travel an “ecological distance” (ED) or shift their realized ecological niches. While ecological and geographic distances should be related, their relationship may depend on landscape heterogeneity. Here, we tested the utility of ecological niche theory to both classify migratory individuals and to understand the underlying ecological factors for migratory behavior. We developed an integrative approach combining measures in geographic and ecological niche space and used this to classify and explain migratory behavior of 71 annual roe deer (Capreolus capreolus) movement trajectories in five European study areas. First, to assess the utility of the ED concept for classifying migratory behavior, we tested whether roe deer sought the same ecological conditions year-round or moved to different ecological conditions by measuring the annual ED travelled and the seasonal niche overlap using multivariate statistics. Comparing methods to classify migrants and residents based on geographic and ecological niche space, we found that migratory roe deer switched between seasons both in geographic and in ecological dimensions. Second, we tested which seasonal ecological factors separated resident from migrant niches using discriminant analysis and which broad-scale determinants (e.g., spatiotemporal forage variation and population density) predicted migration probability using generalized linear models. Our results indicated that factors describing forage and topographic variability discriminated seasonal migrant from resident niches. Determinants for predicting migration probability included the temporal variation (seasonality) and also the spatial variability of forage patches. Last, we also found suggestive evidence for a positive relationship between population density and migration probability. By applying the ecological niche concept to the study of partial migration in ungulates, our work underlines that partial migration is a form of behavioral plasticity. Key words: behavioral plasticity; Capreolus capreolus; ecological distance; large herbivores; niche switching; Normalized Difference Vegetation Index; partial migration; realized niche; spatiotemporal variation; ungulates

The instruments language teachers employ to assess student learning are rarely studied and they constitute a significant source of input of how learning and teaching are conceived. The aim of this research is to analyze 205 assessment instruments created by English teachers. This is an exploratory case study, in which the assessment principles of Authenticity, Validity, Fairness, Reliability and Practicality were analyzed within the context of the assessment instruments. The 205 assessment instruments were analyzed by using an analytic rubric, which considered the language assessment principles as criteria. Through the different analyses, it is possible to conclude that traditional assessment was favoured over authentic assessment and four different clusters reveal that language assessment principles manifest in different degrees in each type of instrument. Interestingly, although language learning is mainly about how people try to communicate with others, teachers are still stressing the assessment of grammar and vocabulary knowledge instead of helping students develop the skill of foreign language communication through key authentic assessment, self-assessment and peer-assessment techniques and procedures. Resumo Os instrumentos que os professores de línguas utilizam para avaliar a aprendizagem dos alunos raramente são estudados e são uma fonte significativa de informações sobre como a aprendizagem e o ensino são concebidos. O objetivo da pesquisa é analisar 205 instrumentos de avaliação fornecidos por professores de inglês. Este é um estudo de caso exploratório, onde os princípios de avaliação da linguagem analisados foram Autenticidade, Validade, Equidade, Confiabilidade e Praticidade. Estes 205 instrumentos de avaliação foram analisados através da utilização de uma rubrica analítica, que considerou os princípios da avaliação linguística como critérios. Por meio das diferentes análises foi possível concluir que a avaliação tradicional é favorecida sobre a avaliação autêntica e quatro agrupamentos diferentes revelam que os princípios de avaliação da linguagem manifestam-se em diferentes graus em cada tipo de instrumento. Curiosamente, embora a aprendizagem de línguas seja principalmente sobre como as pessoas tentam se comunicar com outras, os professores ainda estão enfatizando a avaliação do conhecimento de gramática e vocabulário em vez de ajudar os alunos a desenvolver a habilidade de comunicação em língua estrangeira por meio de técnicas e procedimentos autênticos de avaliação, autoavaliação e coavaliação. Resumen Los instrumentos que el profesorado de idiomas emplea para evaluar el aprendizaje son raramente estudiados, y ellos constituyen una fuente significativa de input sobre la forma como se concibe el aprendizaje y la Enseñanza. El propósito de la investigación es analizar 205 instrumentos de evaluación proporcionados por profesores de inglés. Este es un estudio de casos exploratorio, en el cual los principios de evaluación del idioma analizados fueron Autenticidad, Validez, Equidad, Confiabilidad y Practicabilidad. Estos 205 instrumentos de evaluación fueron analizados mediante el uso de una rúbrica analítica, la cual consideró los principios de evaluación del idioma como criterios. Mediante los diferentes análisis presentados en este estudio, es posible concluir que la evaluación tradicional es preferida sobre la evaluación auténtica; además, cuatro diferentes grupos revelan que los principios de evaluación del idioma se manifiestan en diferentes grados en cada tipo de instrumento de evaluación. Interesantemente, aunque el aprendizaje de la lengua consiste principalmente en cómo las personas se comunican con otros, el profesorado aún enfatiza la evaluación de la gramática y el vocabulario en vez de ayudar al estudiantado a desarrollar la habilidad de comunicación en una lengua extranjera mediante técnicas y procedimientos de evaluación auténtica, auto-evaluación y co-evaluación.

[EN]Background: The urban environment may influence neurodevelopment from conception onwards, but there is no evaluation of the impact of multiple groups of exposures simultaneously. We investigated the association between early-life urban environment and cognitive and motor function in children. Methods: We used data from 5403 mother-child pairs from four population-based birth-cohorts (UK, France, Spain, and Greece). We estimated thirteen urban home exposures during pregnancy and childhood, including: built environment, natural spaces, and air pollution. Verbal, non-verbal, gross motor, and fine motor functions were assessed using validated tests at five years old. We ran adjusted multi-exposure models using the Deletion-Substitution-Addition algorithm. Results: Higher greenness exposure within 300 m during pregnancy was associated with higher verbal abilities (1.5 points (95% confidence interval 0.4, 2.7) per 0.20 unit increase in greenness). Higher connectivity density within 100 m and land use diversity during pregnancy were related to lower verbal abilities. Childhood exposure to PM2.5 mediated 74% of the association between greenness during childhood and verbal abilities. Higher exposure to PM2.5 during pregnancy was related to lower fine motor function (-1.2 points (-2.1, -0.4) per 3.2 mu g/m3 increase in PM2.5). No associations were found with non-verbal abilities and gross motor function. Discussion: This study suggests that built environment, greenness, and air pollution may impact child cognitive and motor function at five years old. This study adds evidence that well-designed urban planning may benefit children's cognitive and motor development. Acknowledgements We are grateful to all the participating children, parents, practi-tioners and researchers in the four countries who took part in this study. This work was supported by funding from the European Community's Seventh Framework Programme [FP7/2007-206 n 308333; the HELIX project] . This INMA cohort was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 incl. FEDER funds, FIS PI06/0867, FIS-PI09/00090, FIS and FIS-PI18/01142 incl. FEDER funds, FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/1213, PI07/0314, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, PI16/00118 and PI17/00663; FIS-FSE: 17/00260; Miguel Servet-FEDER CP11/00178, CP15/00025, CPII16/00051, and CPII18/00018) , from UE (FP7-ENV-2011 cod 282957, HEALTH.2010.2.4.5-1, and H2020 n 824989) , Generalitat de Catalunya-CIRIT 1999SGR 00241, Fundacio La marato de TV3 (090430) , Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, and UGP-15-249) , Alicia Koplowitz Foundation 2017, CIBERESP, Department of Health of the Basque Government (2013111089, 2009111069, 2013111089, 2015111065 and 2018111086) , Provincial Government of Gipuzkoa (DFG06/002, DFG08/001, DFG15/221 and DFG 89/17) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu , Legazpi, Azkoitia y Azpeitia y Beasain) . We acknowledge support from the Spanish Ministry of Science and Inno-vation and the State Research Agency through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX2018-000806-S) , and support from the Generalitat de Catalunya through the CERCA Program. The work was also supported by MICINN [MTM2015-68140-R] and Centro Nacional de Genotipado-CEGEN-PRB2-ISCIII (Spain) . The Rhea project was financially supported by European projects, and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011-2014; "Rhea Plus": Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012-15) . This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Collaboration for Applied Health Research and Care (CLAHRC) for Yorkshire and Humber (UK) . The EDEN study was supported by Foundation for medical research (FRM) , National Agency for Research (ANR) , National Institute for Research inPublic health (IRESP: TGIR cohorte sante 2008 program) , French Min-istry of Health (DGS) , French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A) , and Human Nutrition Na-tional Research Programs, Paris-Sud University, Nestle, French National Institute for Population Health Surveillance (InVS) , French National Institute for Health Education (INPES) , the European Union FP7 pro-grams (ESCAPE, ENRIECO, Medall projects) , Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD) ) , French Agency for Environmental Health Safety and French National Agency for Food Security (now ANSES) , Mutuelle Generale de l'Education Nationale a complementary health insurance (MGEN) , French-speaking association for the study of diabetes and metabolism (ALFEDIAM) . Core support for Born in Bradford is also provided by the Wellcome Trust (WT101597MA, UK) . Born in Bradford (BiB) is only possible because of the enthusiasm and commitment of the children and parents in BiB. We are grateful to all the participants, health professionals, schools and researchers who have made BiB happen. BiB receives funding from the ESRC/MRC, the Wellcome Trust (WT101597MA) and the National Institute for Health Research York-shire and Humber ARC (reference: NIHR20016) . M. Mon-Williams was supported by a Fellowship from the Alan Turing Institute. Additional funding from the National Institute of Environmental Health Science supported Dr Chatzi (R01ES030691, R01ES029944, R01ES030364, R21ES029681, and P30ES007048) . The views expressed are those of the authors, and not necessarily those of the NHS or the NIHR. None of the funders were involved in designing the study, collecting the data, analyzing or interpreting the data, deciding to submit the article for publication, or the writing of the report. Data sharing statement The HELIX data warehouse has been established as an accessible resource for collaborative research involving researchers external to the project. Access to HELIX data is based on approval by the HELIX Project Executive Committee and by the individual cohorts. Further details on the content of the data warehouse (data catalogue) and procedures for external access are described on the project website (http:// www.proj-ecthelix.eu/index.php/es/data-inventory) .

International audience; Disease modeling techniques summarize the possible trajectories of progression from multimodal and longitudinal data. These techniques often assume that individuals form a homogeneous cluster, thus ignoring possible disease subtypes within the population. We extend a non-linear mixed-effect model used for disease course mapping with a mixture framework. We jointly estimate model parameters and subtypes with a tempered version of a stochastic approximation of the Expectation Maximisation algorithm. We show that our model recovers the ground truth parameters from synthetic data, in contrast to the naive solution consisting in post hoc clustering of individual parameters from a one-class model. Applications to Alzheimer's disease data allows the unsupervised identification of disease subtypes associated with distinct relationship between cognitive decline and progression of imaging and biological biomarkers.

In credit markets, screening algorithms discriminate between good-type and bad-type borrowers. This is their raison d’être. However, by doing so, they also often discriminate between individuals sharing a protected attribute (e.g. gender, age, race) and the rest of the population. In this paper, we show how to test (1) whether there exists a statistical significant difference in terms of rejection rates or interest rates, called lack of fairness, between protected and unprotected groups and (2) whether this difference is only due to credit worthiness. When condition (2) is not met, the screening algorithm does not comply with the fair-lending principle and can be qualified as illegal. Our framework provides guidance on how algorithmic fairness can be monitored by lenders, controlled by their regulators, and improved for the benefit of protected groups.