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Abstract Background Vaccine hesitancy exists on a continuum ranging between complete adherence and complete refusal due to doubts or concerns within a heterogeneous group of individuals. Despite widespread acknowledgement of the contextual factors influencing attitudes and beliefs shaping COVID-19 vaccine hesitancy, qualitative research with equity-deserving groups, accounting for unique lived experiences, remains a gap in the literature. We aim to identify and begin to understand and document the unique contextual factors shaping hesitancy by equity-deserving groups as it relates to relationships with government and health authorities. Methods Participants were recruited and interviewed between Aug-Dec 2021. Semi-structured interviews using a convergent interviewing technique were conducted with individuals from the general population, as well as individuals who identify as First Nations, Métis, or Inuit, members of the LGBT2SQ + community, low-income Canadians, Black Canadians, and newcomers. Interviews were audio recorded and transcribed by a team of researchers. Memos were written following interviews and used to complement the thematic analysis of the interview data. Themes are presented in the results section. Results The rationale for hesitancy among equity-deserving groups is consistent with literature documenting hesitancy in the general population. Contextual factors surrounding equity-deserving groups’ attitudes and beliefs, however, are unique and relate to a history of oppression, discrimination, and genocide. We identified factors unique to subgroups; for example, religious or fatalistic beliefs among participant who identify as FNMI, fear associated with lack of testing and speed of vaccines’ production among participants who identify as FNMI, Black, and LGBT2SQ + , distrust of the healthcare system for LGBT2SQ + and Black Canadians, and distrust of the government and opposition to vaccine mandates for participating who identify as LGBT2SQ + , low-income, FNMI, or Black Canadian. Newcomers stood out as very trusting of the government and accepting of COVID-19 vaccination. Conclusions While our data on vaccine hesitancy largely mirror concerns reported in the vast body of literature citing rationale for COVID-19 hesitancy in high-income countries, the contextual factors identified in our work point to the need for wider systemic change. Our results may be used to support efforts, beyond tailored promotion campaigns, to support the confident acceptance of vaccines for COVID-19 and the acceptance of novel vaccines as future infectious diseases emerge.

Abstract Background Clinical placement is recognised as essential for nursing students’ development of clinical competence. However, difficulties in providing supportive clinical learning environments are a well-known challenge in nursing education. In Norway, the use of nurse educators in joint university and clinical roles has been recommended as an initiative to strengthen the clinical learning environment and enhance the educational quality. In this study we use the term practice education facilitator in a generic sense for these roles. The aim of this study was to explore how practice education facilitators can contribute to strengthen the clinical learning environments for nursing students. Methods This study has a qualitative explorative design with a purposive sample of practice education facilitators affiliated to three different universities located in southeast, mid-, and northern Norway. Individual in-depth interviews with 12 participants were conducted during spring 2021. Results A thematic analysis resulted in four themes: “coherence between theory and practice”; “student support and guidance during placement”; “supporting the supervisors to support the students” and “factors influencing the practice education facilitators’ performance in their role”. The participants experienced that the practice education facilitator role contributed to strengthened clinical learning environments. However, their performance in the role was found to be contingent upon factors such as time allocated for the role, personal and professional attributes of the post holder, and a common understanding within the organisations regarding practice learning and role remits for the practice education facilitator. Conclusions Findings indicate that the practice education facilitator role can be a valuable resource for clinical supervisors and nursing students in clinical placement. Moreover, nurse educators who are familiar with the clinical area, and who are insiders in both settings, are ideally placed to contribute to bridge the theory-practice gap. The benefits of using these roles, however, were influenced by personal attributes of the post holder, time allocated for the role and the number of practice education facilitators positions, and management anchorage. Thus, to achieve the full potential of these roles, efforts to reduce these barriers should be considered.

Abstract Aim The aim was to illuminate how nurses experience person‐centred care planning using video conferencing upon hospital discharge of frail older persons. Design Care planning via video conferencing requires collaboration, communication and information transfer between involved parties, both with regard to preparing and conducting meetings. Participation of involved parties is required to achieve a collaborative effort, but the responsibilities and roles of the involved professions are unclear, despite the existence of regulations. Method A qualitative content analysis was conducted based on 11 individual semi‐structured interviews with nurses from hospitals, municipalities and primary care in Sweden. Results This study provides valuable insights into challenges associated with care planning via video conferencing. The meeting format, that is video conferencing, is perceived as a barrier that makes the interaction challenging. Shortcomings in video technology make a person‐centred approach difficult. The person‐centred approach is also difficult for nurses to maintain when the older person or relatives are not involved in the planning.

Organized patterns of system-wide neural activity adapt fluently within the brain to adjust behavioral performance to environmental demands. In major depressive disorder (MD), markedly different co-activation patterns across the brain emerge from a rather similar structural substrate. Despite the application of advanced methods to describe the functional architecture, e.g., between intrinsic brain networks (IBNs), the underlying mechanisms mediating these differences remain elusive. Here we propose a novel complementary approach for quantifying the functional relations between IBNs based on the Kuramoto model. We directly estimate the Kuramoto coupling parameters (K) from IBN time courses derived from empirical fMRI data in 24 MD patients and 24 healthy controls. We find a large pattern with a significant number of Ks depending on the disease severity score Hamilton D, as assessed by permutation testing. We successfully reproduced the dependency in an independent test data set of 44 MD patients and 37 healthy controls. Comparing the results to functional connectivity from partial correlations (FC), to phase synchrony (PS) as well as to first order auto-regressive measures (AR) between the same IBNs did not show similar correlations. In subsequent validation experiments with artificial data we find that a ground truth of parametric dependencies on artificial regressors can be recovered. The results indicate that the calculation of Ks can be a useful addition to standard methods of quantifying the brain's functional architecture.

Two survey instruments were used to gather information from speech-language pathologists (SLPs) and university personnel (UP) regarding their perceptions of the adequacy of SLP training for providing early intervention (EI) services. In the SLP survey, respondents were asked to rate their perceptions of training adequacy in specific EI Knowledge and Skill Acquisition (KASA) areas. UP were also surveyed regarding their perceptions of the adequacy of their programs' academic preparation in EI. Results from 189 SLPs employed in EI settings indicated that less than 50% agreed that their academic preparation in the majority of EI knowledge and skill areas was adequate. However, with the exception of service coordination and linguistic diversity, the majority of UP (90%-100%) perceived that their graduate programs provided students with adequate training for serving EI populations. Implications of respondents' differing perspectives will be discussed.

Purpose: The purpose of this study was to investigate the relationship between oral language, literacy skills, age, and dialect density (DD) of African American children residing in two different geographical regions of the United States (East Coast and Midwest). Method: Data were obtained from 64 African American school-age children between the ages of 7 and 12 years from two geographic regions. Children were assessed using a combination of standardized tests and narrative samples elicited from wordless picture books. Bivariate correlation and multiple regression analyses were used to determine relationships to and relative contributions of oral language, literacy, age, and geographic region to DD. Results: Results of correlation analyses demonstrated a negative relationship between DD measures and children's literacy skills. Age-related findings between geographic regions indicated that the younger sample from the Midwest outscored the East Coast sample in reading comprehension and sentence complexity. Multiple regression analyses identified five variables (i.e., geographic region, age, mean length of utterance in morphemes, reading fluency, and phonological awareness) that accounted for 31% of the variance of children's DD--with geographic region emerging as the strongest predictor. Conclusions: As in previous studies, the current study found an inverse relationship between DD and several literacy measures. Importantly, geographic region emerged as a strong predictor of DD. This finding highlights the need for a further study that goes beyond the mere description of relationships to comparing geographic regions and specifically focusing on racial composition, poverty, and school success measures through direct data collection.

This pilot study examined the feasibility of a home-school partnership for improving emergent literacy skills in Spanish-speaking pre-school children of migrant farmworkers. Parents were requested to send labeled drawings of family activities to their children's classroom for supplementing bilingual language and literacy instruction. Participants were 19 children (between 2;6 and 5;2) assigned randomly to experimental (n = 11) or control (n = 8) classrooms. Pretest-posttest measures in Spanish and English were obtained using the Early Literacy Skills Assessment (ELSA). Results indicated significant increases in pre- to posttest English and Spanish scores for the experimental group, but not for the control group in alphabetic and print knowledge. Parental participation rates (as measured by weekly drawing submissions) exceeded 90%. These results suggest that integrating parent-generated content into classroom language intervention activities may be feasible both in terms of parental involvement as well as children's emergent literacy skills development.

In recent years, the existence of perennial firn aquifers in the Antarctic Peninsula (AP) has been confirmed by in situ observations. Previous studies have suggested that these subsurface aquifers, together with meltwater ponds at the surface, provide a reservoir of liquid water to feed propagating fractures, promoting hydrofracture-driven ice-shelf disintegration. This study maps perennial firn aquifers in the AP from space using C-band Synthetic Aperture Radar imagery from ESA's Sentinel-1 (S1) mission. With these observations, we detect firn aquifers at 1 km × 1 km resolution, for the period 2017 to 2020. Existing methods, that use S1 data and rely on a backscatter intensity difference threshold approach, are prone to misclassify late-melt events as aquifers, when applied to the AP. Therefore, we have developed and evaluated a new approach that is better suited to the Antarctic environment. The new method exploits the characteristic, gradual backscatter increase during the (partial) refreezing of the liquid water in the firn layer after the peak of the melt season. Most firn aquifers are detected in the north and northwest of the AP, as well as on the Wilkins and George VI ice shelves. Aquifer locations detected with the present methodology agree with in situ observations and with model simulations of firn water content. [ABSTRACT FROM AUTHOR]

The influence of the Madden–Julian oscillation (MJO) on the middle atmosphere (MA) and particularly on MA temperature is of interest for both the understanding of MJO-induced teleconnections and research on the variability of the MA. We analyze statistically the connection of the MJO and the MA zonal mean temperature based on observations by the Microwave Limb Sounder (MLS) satellite instrument. We consider all eight MJO phases, different seasons and the state of the quasi-biennial oscillation (QBO). We show that MA temperature anomalies are significantly related to the MJO and its temporal development. The MJO signal in the zonal mean MA temperature is characterized by a particular spatial pattern in the MA, which we link to the interhemispheric coupling (IHC) mechanism, as a major outcome of this study. The signal with the largest magnitude is found in the polar MA during boreal winter with temperature deviations on the order of ±10K when the QBO at 50 hPa is in its easterly phase. Other atmospheric conditions and locations also exhibit temperature signals, which are, however, weaker or noisier. We also analyze the change in the temperature signal while the MJO progresses from one phase to the next. We find a gradual altitude shift in parts of the IHC pattern, which can be seen more or less clearly depending on the atmospheric conditions. The statistical link between the MJO and the MA temperature highlights illustratively the far-reaching connections across different atmospheric layers and geographical regions in the atmosphere. Additionally, it highlights close linkages of known dynamical features of the atmosphere, particularly the MJO, the IHC, the QBO and sudden stratospheric warmings (SSWs). Because of the wide coverage of atmospheric regions and included dynamical features, the results might help to further constrain the underlying dynamical mechanisms and could be used as a benchmark for the representation of atmospheric couplings on the intraseasonal timescale in atmospheric models. [ABSTRACT FROM AUTHOR]

This study used a survey approach to investigate the current state of speech-language preservice academic and clinical preparation for providing early intervention (EI) services to culturally and linguistically diverse (CLD) populations. Information was obtained from speech-language pathologists (SLPs) employed in EI settings regarding their perceptions of (a) second language proficiency, (b) academic and clinical preparation in CLD issues, (c) access to continuing education regarding CLD populations, and (d) confidence levels in providing services to CLD families. In addition, information was obtained from university personnel regarding their perceptions of the adequacy of students' academic preparation for working with CLD families and the availability of specific coursework in the areas of CLD and EI. Results from the 189 responding SLPs in the state of Michigan indicated that more than half considered their graduate education to be less than adequate. However, more than two-thirds (67%) indicated that they felt qualified and competent to provide speech-language pathology services to CLD families. In contrast, the majority of university personnel felt that their graduate programs adequately prepared students for serving CLD infants, toddlers, and their families. Implications of the mismatch between SLPs' perceptions of inadequate preparation and university personnel's view of training adequacy are discussed.

It is debated whether the ecotoxicity of active substances (ASs) contained in synthetic pesticides applied in conventional agriculture (conASs) differs from nature-based ASs used in organic agriculture (orgASs). Using the official pesticide use statistics, we evaluated the ecotoxicity of ASs used in apple and grapevine production in Austria. In 2022, 49 conASs and 21 orgASs were authorized for apple production and 60 conASs and 23 orgASs were authorized for grapevine production in Austria. Based on the latest publicly available data on the actual use of pesticides in apple and grapevine production (from the year 2017), we evaluated their ecotoxicity based on information in the freely accessible Pesticide Properties and Bio-Pesticides Databases. The results showed that although the amount of ASs applied per hectare of field was higher in organic farming, the intrinsic toxicities of ASs used in conventional farming were much higher. The number of lethal toxic doses (LD50) of ASs applied in conventional apple orchards was 645%, 15%, and 6011% higher for honeybees, birds, and earthworms, respectively, than in organic apple production. In conventional vineyards, lethal doses for honeybees, birds, and earthworms were 300%, 129%, and 299% higher than in organic vineyards. We conclude that promoting organic farming would therefore contribute to the better protection of biodiversity on agricultural land and beyond.

This study used a mail survey to gather information from 409 school-based speech-language pathologists (SLPs) in the state of Michigan regarding the types of language assessment procedures they employed when assessing children's language skills. Descriptive data regarding respondents' demographic, caseload, and employment characteristics were also obtained. Results indicated that respondents were a homogenous group with homogenous assessment practices. Although respondents used both formal and informal procedures when assessing English-speaking children's skills, informal procedures were used more frequently. With regard to informal procedures, almost all responding SLPs (98%) reported frequently using parent-teacher interviews as an assessment procedure. Among formal, standardized procedures, the "Clinical Evaluation of Language Functions" was used frequently by the highest proportion of respondents (79%). Implications regarding SLPs' conformity to the American Speech-Language Hearing Association's recommended guidelines for unbiased language assessment are discussed. (Contains 8 tables.)

Purpose: This study was designed to investigate the frequency with which school-based speech-language pathologists (SLPs) used recommended practices when assessing the language skills of bilingual students. The study also investigated the frequency with which SLPs used formal, standardized tests versus informal, alternative procedures with this population. Method: A total of 596 surveys were mailed out to school-based SLPs in the state of Michigan who were members of the Michigan Speech, Language, and Hearing Association (MSHA) during the 2003-2004 academic year. Of the 409 usable surveys that were returned, 130 respondents indicated being involved in assessing bilingual children and comprised the sample used in this study. Results: Results indicated that SLPs used formal, standardized English tests more frequently than informal assessment procedures when assessing bilingual students. Further in-depth analyses of SLPs' responses indicated that neither factors related to their years of experience or factors related to their academic preparation were significantly related to their use of recommended assessment practices. However, significant differences in use were noted based on respondents' employment settings. Clinical Implications: This study underscores the need for academic training programs and professional organizations to intentionally disseminate information regarding the expediency of alternative testing procedures. Implications for the adequate nonbiased assessment of bilingual children are discussed.

Medicare, as a publicly funded insurance program, has produced significant improvement in the overall health of America's elderly populations. However, health disparities still persist between Hispanic and non-Hispanic White populations in terms of overall access to health services. This study utilized data from the Hispanic Established Population for Epidemiological Studies of the Elderly (H-EPESE) survey (1993 to 1994), to compare the relationship between levels of English proficiency and access to Medicare and other health insurance among 3,050 Hispanics who were elderly. Results of chi-square tests of independence indicated a significant relationship (p = .001) between respondents' levels of English proficiency and access to Medicare and other health insurance. Implications regarding the impact of limited English proficiency on access to adequate health care for Hispanics who are elderly are discussed.

Consolidation with PD-1/PD-L1-based immune checkpoint blockade after concurrent platinum-based chemo-radiotherapy has become the new standard of care for advanced stage III unresectable non-small cell lung cancer (NSCLC) patients. In order to further improve therapy outcomes, innovative combinatorial treatment strategies aim to target additional immunosuppressive barriers in the tumor microenvironment such as the CD73/adenosine pathway. CD73 and adenosine are known as crucial endogenous regulators of lung homeostasis and inflammation, but also contribute to an immunosuppressive tumor microenvironment. Furthermore, the CD73/adenosine pathway can also limit the immune-activating effects of cytotoxic therapies by degrading the pro-inflammatory danger molecule ATP, which is released into the tumor microenvironment and normal lung tissue upon therapy-induced cell damage. Thus, while targeting CD73 may enhance the efficacy of radio-immunotherapies in cancer treatment by mitigating tumor immune escape and improving immune-mediated tumor killing, it also raises concerns about increased immune-related adverse events (irAEs) in the normal tissue. In fact, combined radio-immunotherapies bear an increased risk of irAEs in the lungs, and additional pharmacologic inhibition of CD73 may further enhance the risk of overwhelming or overlapping pulmonary toxicity and thereby limit therapy outcome. This review explores how therapeutic interventions targeting CD73/adenosine dynamics could enhance radiation-induced immune activation in combined radio-immunotherapies, whilst potentially driving irAEs in the lung. We specifically investigate the interactions between radiotherapy and the CD73/adenosine pathway in radiation pneumonitis. Additionally, we compare the incidence of (radiation) pneumonitis reported in relevant trials to determine if there is an increased risk of irAEs in the clinical setting. By understanding these dynamics, we aim to inform future strategies for optimizing radio-immunotherapy regimens, ensuring effective cancer control while preserving pulmonary integrity and patient quality of life.

This paper offers an insight into a single case study, the permit process of the Nasa mountain – Násávárre mining case in Nordland County, Norway. At Násávárre, the Chinese-owned mining company Elkem plans to open a pit mine to extract quartz. The area in question has the highest reindeer density in Nordland County, and the proposed mining operation would affect five Indigenous Sámi reindeer herding districts on both the Norwegian and the Swedish side of Sápmi. Despite incentives aimed at improving corporate respect for Indigenous rights such as the OECD Due Diligence Guidance, Indigenous peoples often face asymmetric power relations and uneven playing fields, particularly in terms of costs and capacity to respond to corporate positions on and understandings of Indigenous knowledges and rights. The knowledge base of this encounter, as it is experienced by the reindeer herders, can be discussed in terms of structural and agential factors. Our analysis focuses on the extent to which the reindeer herders have been enabled to engage with Elkem, with a particular emphasis on the reindeer herders’ experience of how their knowledges have been assessed by the company. The work is based on a review of case documents.