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Although fostering values is promoted within environmental and sustainability education (ESE) and a shift in values is seen as essential for a sustainable future, recent international findings indicate that this aspect of ESE is being neglected. Previous research has shown there to be common ground between ESE and the field of character education (CE), a form of values education. Bringing together these two strands of theory and practice has the potential to be fruitful in terms of strengthening current, and introducing new, practices in both fields, particularly through drawing on existing evidence-based strategies within CE to inform ESE. While there has been some work in this regard, this has been almost exclusively theoretical and there has been little research regarding the practice of such integration. This paper details an instrumental case study exploring an existing case of where ESE and CE come together in practice. A study was conducted at a Scottish, independent, all-ages, holistic education-oriented school, exploring how ESE is carried out. Data were gathered via teacher interviews, school observations, field notes and document analysis. Thematic analysis revealed four themes: the school as a sustainable organism; holistic learning; fostering a connectedness with nature; and nurturing the whole person. The data were then analysed from a CE perspective revealing multiple points of ESE-CE intersection, e.g. school climate/ethos, role-modelling and service-learning. The findings reveal commonalities between ESE and CE and provide examples of integrated ESE-CE practice, demonstrating potential for collaboration or shared ESE-CE practice. Avenues for further research are suggested.

An adequate response to the environmental and sustainability issues we now face cannot be limited to single perspectives, disciplines, or ways of knowing, and instead requires an interdisciplinary approach. Despite the connections between the fields of citizenship-, character- and sustainability education, they have thus far run parallel to each other, without any substantial convergence. This paper focuses on the conceptual and historical reasons for this lack of integration, exploring the tensions among them perceived by many scholars and practitioners, such as an individual vs. a social vs. a global focus, a deliberative vs. fact based pedagogic approach, and an individual vs. socio-political educational context. The paper ends by exploring different ways in which these three fields of education might be integrated.

Although fostering values is promoted within sustainability education (SE), many educators appear concerned or conflicted about how, or whether, to approach values education. An interdisciplinary research project sought to draw on insights from character education (CE) in order to explore the problem. Using the Delphi technique, 12 CE and SE experts were gathered, via email, to explore their perceptions regarding the feasibility of integrating theoretical/practical insights from the CE and SE fields. Experts rated their agreement and made comments on 41 statements. Fourteen statements reached 'consensus'. Thematic analysis revealed experts' agreement on an ethical base of SE providing practical application of CE; a perceived tension between democracy, pluralism and normativity; reservations about the individual nature of CE; the need for CE, and SE, to more actively foster awareness of self as part of nature; a desire for holistic and interdisciplinary education; concern regarding exam-driven education and agreement on the need to re-examine the purpose of education. The findings reveal common ground between the two fields, as well as indicating where differences could be bridged and misunderstandings addressed, suggesting avenues for future collaboration and potential integration -- possibilities that it would be fruitful to pursue through further interdisciplinary research.

This article argues that the dominant sustainable development approach fails to acknowledge the interconnectedness and interrelatedness of social and environmental issues, and that sustainability requires a "transformational" approach, involving a fundamental change in how humans relate to each other and to nature. The authors propose that virtue ethics, grounded in Aristotle's "Nicomachean Ethics," provides a framework with which to tackle such a transformation; to redress the human-nature relationship and help foster a more ecological perspective; to facilitate a more holistic and integrative view of sustainability; and to explore questions of how to live and flourish within a more sustainable world. Beginning with an overview of virtue ethics and critique of current approaches in environmental virtue ethics, this article proposes a new virtue, "harmony with nature," that addresses the interconnectedness of our relationship with nature. This is followed by a proposal for the re-visioning of human flourishing as being necessarily situated within nature. The article concludes with some of the implications of a virtue ethics approach to sustainability, and the new virtue, for both sustainability education and moral education.

The most effective means of preventing seasonal influenza is through strain‐specific vaccination. In this study, we investigated the efficacy, effectiveness and safety of cell‐based trivalent and quadrivalent influenza vaccines. A systematic literature search was conducted in electronic databases and grey literature sources up to 7 February 2020. Randomised controlled trials (RCTs) and non‐randomised studies of interventions (NRSIs) were eligible for inclusion. Two reviewers independently screened, extracted data and assessed the risk of bias of included studies. Certainty of evidence for key outcomes was assessed using the GRADE methodology. The search returned 28,846 records, of which 868 full‐text articles were assessed for relevance. Of these, 19 studies met the inclusion criteria. No relative efficacy data were identified for the direct comparison of cell‐based vaccines compared with traditional vaccines (egg‐based). Efficacy data were available comparing cell‐based trivalent influenza vaccines with placebo in adults (aged 18–49 years). Overall vaccine efficacy was 70% against any influenza subtype (95% CI 61%–77%, two RCTS), 82% against influenza A(H1N1) (95% CI 71%–89%, 2 RCTs), 72% against influenza A(H3N2) (95% CI 39%–87%, 2 RCTs) and 52% against influenza B (95% CI 30%–68%, 2 RCTs). Limited and heterogeneous data were presented for effectiveness when compared with no vaccination. One NRSI compared cell‐based trivalent and quadrivalent vaccination with traditional trivalent and quadrivalent vaccination, finding a small but significant difference in favour of cell‐based vaccines for influenza‐related hospitalisation, hospital encounters and physician office visits. The safety profile of cell‐based trivalent vaccines was comparable to traditional trivalent influenza vaccines. Compared with placebo, cell‐based trivalent influenza vaccines have demonstrated greater efficacy in adults aged 18–49 years. Overall cell‐based vaccines are well‐tolerated in adults, however, evidence regarding the effectiveness of these vaccines compared with traditional seasonal influenza vaccines is limited. [ABSTRACT FROM AUTHOR]

The most effective means of preventing seasonal influenza is through vaccination. In this systematic review, we investigated the efficacy, effectiveness and safety of recombinant haemagglutinin (HA) seasonal influenza vaccines to prevent laboratory‐confirmed influenza. A systematic literature search was conducted in electronic databases and grey literature sources up to 7 February 2020. Randomised controlled trials and non‐randomised studies of interventions were eligible for inclusion. The search returned 28,846 records, of which 10 studies on recombinant HA influenza vaccine met our inclusion criteria. One study found that the quadrivalent recombinant HA influenza vaccine had higher relative vaccine efficacy (rVE) in preventing laboratory‐confirmed influenza during the 2014–15 season compared with traditional quadrivalent vaccination in adults aged ≥50 years (rVE = 30%, 95% CI 10%–47%, moderate‐certainty evidence). In a subgroup analysis, higher rVE was reported for influenza A (rVE = 36%, 95% CI 14% to 53%), but not for B (non‐significant). Another study reported higher efficacy for the trivalent recombinant HA vaccine compared with placebo (VE = 45%, 95% CI 19–63, 1 RCT, low‐certainty evidence) in adults aged 18–55 years. With the exception of a higher rate of chills (RR = 1.33, 95% CI 1.03–1.72), the safety profile of recombinant HA vaccines was comparable to that of traditional influenza vaccines. The evidence base for the efficacy and effectiveness of recombinant HA influenza vaccines is limited at present, although one study found that the quadrivalent recombinant HA influenza vaccine had higher rVE compared with traditional quadrivalent vaccination in adults aged ≥50 years. [ABSTRACT FROM AUTHOR]

This review sought to assess the efficacy, effectiveness and safety of high‐dose inactivated influenza vaccines (HD‐IIV) for the prevention of laboratory‐confirmed influenza in individuals aged 18 years or older. A systematic literature search was conducted in electronic databases and grey literature sources up to 7 February 2020. Randomised controlled trials (RCTs) and non‐randomised studies of interventions (NRSIs) were included. The search returned 28,846 records, of which 36 studies were included. HD‐IIV was shown to have higher relative vaccine efficacy in preventing influenza compared with standard‐dose influenza vaccines (SD‐IIV3) in older adults (Vaccine effectiveness (VE) = 24%, 95% CI 10–37, one RCT). One NRSI demonstrated significant effect for HD‐IIV3 against influenza B (VE = 89%, 95% CI 47–100), but not for influenza A(H3N2) (VE = 22%, 95% CI −82 to 66) when compared with no vaccination in older adults. HD‐IIV3 showed significant relative effect compared with SD‐IIV3 for influenza‐related hospitalisation (VE = 11.8%, 95% CI 6.4–17.0, two NRSIs), influenza‐ or pneumonia‐related hospitalisation (VE = 13.7%, 95% CI 9.5–17.7, three NRSIs), influenza‐related hospital encounters (VE = 13.1%, 95% CI 8.4–17.7, five NRSIs), and influenza‐related office visits (VE = 3.5%, 95% CI 1.5–5.5, two NRSIs). For safety, HD‐IIV were associated with significantly higher rates of local and systemic adverse events compared with SD‐IIV (combined local reactions, pain at injection site, swelling, induration, headache, chills and malaise). From limited data, compared with SD‐IIV, HD‐IIV were found to be more effective in the prevention of laboratory‐confirmed influenza, for a range of proxy outcome measures, and associated with more adverse events. [ABSTRACT FROM AUTHOR]

The most effective means of preventing seasonal influenza is through vaccination. In this systematic review, we investigated the efficacy, effectiveness and safety of MF59® adjuvanted trivalent and quadrivalent influenza vaccines to prevent laboratory‐confirmed influenza. A systematic literature search was conducted in electronic databases and grey literature sources up to 7 February 2020. Randomised controlled trials and non‐randomised studies of interventions (NRSIs) were eligible for inclusion. The search returned 28,846 records, of which 48 studies on MF59® adjuvanted vaccines met our inclusion criteria. No efficacy trials were identified. In terms of vaccine effectiveness (VE), MF59® adjuvanted trivalent influenza vaccines were effective in preventing laboratory‐confirmed influenza in older adults (aged ≥65 years) compared with no vaccination (VE = 45%, 95% confidence interval (CI) 23%–61%, 5 NRSIs across 3 influenza seasons). By subtype, significant effect was found for influenza A(H1N1) (VE = 61%, 95% CI 44%–73%) and B (VE = 29%, 95% CI 5%–46%), but not for A(H3N2). In terms of relative VE, there was no significant difference comparing MF59® adjuvanted trivalent vaccines with either non‐adjuvanted trivalent or quadrivalent vaccines. Compared with traditional trivalent influenza vaccines, MF59® adjuvanted trivalent influenza vaccines were associated with a greater number of local adverse events (RR = 1.90, 95% CI 1.50–2.39) and systemic reactions (RR = 1.18, 95% CI 1.02–1.38). In conclusion, MF59® adjuvanted trivalent influenza vaccines were found to be more effective than 'no vaccination'. Based on limited data, there was no significant difference comparing the effectiveness of MF59® adjuvanted vaccines with their non‐adjuvanted counterparts. [ABSTRACT FROM AUTHOR]

Although fostering values is promoted within environmental and sustainability education (ESE) and a shift in values is seen as essential for a sustainable future, recent international findings indicate that this aspect of ESE is being neglected. Previous research has shown there to be common ground between ESE and the field of character education (CE), a form of values education. Bringing together these two strands of theory and practice has the potential to be fruitful in terms of strengthening current, and introducing new, practices in both fields, particularly through drawing on existing evidence‐based strategies within CE to inform ESE. While there has been some work in this regard, this has been almost exclusively theoretical and there has been little research regarding the practice of such integration. This paper details an instrumental case study exploring an existing case of where ESE and CE come together in practice. A study was conducted at a Scottish, independent, all‐ages, holistic education‐oriented school, exploring how ESE is carried out. Data were gathered via teacher interviews, school observations, field notes and document analysis. Thematic analysis revealed four themes: the school as a sustainable organism; holistic learning; fostering a connectedness with nature; and nurturing the whole person. The data were then analysed from a CE perspective revealing multiple points of ESE–CE intersection, e.g. school climate/ethos, role‐modelling and service‐learning. The findings reveal commonalities between ESE and CE and provide examples of integrated ESE–CE practice, demonstrating potential for collaboration or shared ESE–CE practice. Avenues for further research are suggested. [ABSTRACT FROM AUTHOR]

Examines the high school experiences of lesbian and gay students through questionnaires completed by 34 students. Most (73.5%) reported receiving support regarding sexual orientation issues from someone at school, and 41.2% reported that information about gay, lesbian, and bisexual issues was available from school staff. However, 35.3% reported a previous suicide attempt. (SLD)

Background: Approximately 60% of antibiotics issued in primary care are for acute respiratory tract infections (RTIs), which are largely self-limiting and do not require antibiotics. Point-of-care testing (POCT) devices that measure C-reactive protein (CRP)-a biomarker for infection-can be used to guide prescribing decisions.Objective: We evaluated the cost-effectiveness and budget impact of a national CRP POCT program to guide antibiotic prescribing for acute RTIs in primary care in Ireland.Methods: We compared CRP POCT with and without enhanced communication skills training of general practitioners against usual care. A probabilistic decision tree was used to investigate cost-effectiveness from the perspective of the healthcare system. The model considered outcomes for the Irish population over a 5-year time horizon. Inputs were synthesized from published studies. Cost-effectiveness was estimated using an incremental cost per prescription avoided.Results: CRP POCT with and without communication training were more costly but more effective than usual care over 5 years. CRP POCT alone was dominated, while the combined intervention had a cost per prescription avoided of €111 (95% CI: €45-243) versus usual care. The budget impact was costly over 5 years, but potential budget savings were available depending on the implementation scenario. The findings were largely robust to sensitivity analyses.Conclusions: CRP POCT reduces antibiotic prescribing, but increases healthcare costs. The most cost-effective program of CRP POCT includes enhanced communication skills training. Further research on the impact of CRP POCT beyond 5 years is warranted, as well as the potential impact on antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Most studies of Chronic Fatigue Syndrome (CFS) have been based on patients recruited from primary or tertiary care settings. Patients from such settings might not be typical of patients in the general population. The present investigation involved examining individuals with CFS from a community-based study. A random sample of 18,675 respondents in Chicago were first interviewed by telephone. A group of individuals with chronic fatigue accompanied by at least four Fukuda et al. (1994) symptoms associated with CFS were given medical and psychiatric examinations. From this sample, a physician review group diagnosed individuals with CFS. Those diagnosed with CFS were subclassified based on frequency of symptoms. Important differences emerged on measures of sociodemographics and disability. The implications of these findings and others are discussed. KEYWORDS. Chronic health conditions, epidemiology, chronic fatigue syndrome, subtypes

This study critically examines Molefi Asante's development of Afrocentricity through a rhetorical analysis of his philosophy as found in the texts Afrocentricity and The Afrocentric Idea. Using Burke's theory of dramatism by way of Conrad's three phase approach, this study employed statistical analysis (which consisted of cluster analysis and identification), representational analysis, and pentadic analysis. This study identified three key terms based on their frequency in the text: Afrocentricity, Afrology, and Ideology/Reality. The pentadic analysis found that the ratio of scene/purpose was the most significant of all the ratios in Asante's discourse. The scene (Eurocentricity in scholarship) stands for the situation to which all parts of the pentad respond. The purpose of Afrocentricity is thus to challenge the Eurocentric tradition without replacing it with another tradition; and to develop a perspective that speaks about the multiplicity of culture and experience that Eurocentrism historically has failed to consider. This study illuminated Asante's motives in the development of Afrocentricity through the use of identification with his audience. The theme of the narrative that drives Asante's discourse is that the multiplicity of the human condition requires alternative modes of inquiry. The analysis was grounded in the text; therefore, the interpretations were based on the language and vocabulary of Asante's own writings., One of the many current challenges posed to scholarship is that of the historicity of scholarship itself. One manifestation of this challenge can be seen in critical researcher's contention that [...]

Chronic Fatigue Syndrome's principal symptoms are severe and include prolonged fatigue and a number of other minor symptoms. Behavioral data collected methods were used in a case study to show some of the benefits that can be derived from monitoring symptoms hourly and daily. Using time series regression, several statistically significant correlates of fatigue were found both within days and between days. Perceived energy, physical exertion, and mental exertion were significantly related to fatigue in both analyses. Collection of such data may help resolve a number of theoretical and methodological problems in research on the Chronic Fatigue Syndrome.

The present study investigated relations between lesbians' disclosure of their sexual orientation and psychological adjustment. The 499 participants responded to a questionnaire assessing level of self-disclosure, sources of social support, forms of socializing, self-description of sexual orientation, and length of self-identification as a lesbian. The more widely a woman disclosed her sexual orientation the less anxiety, more positive affectivity, and greater self-esteem she reported. Degree of disclosure to family, gay and lesbian friends, straight friends, and co-workers was related to overall level of social support, with those who more widely disclosed reporting greater levels of support. Participants who more widely disclosed their sexual orientation were less likely to engage in anonymous socializing, had a larger percentage of lesbian friends, and were more involved in the gay and lesbian community. Path analyses revealed a mediating effect of social reactions (both initial and current) on the relation between identity development and self-disclosure.