Academic literature on the topic 'Face-to-face ACLS course'

Background Internet adoption during the past decade has provided opportunities for innovation in advanced cardiac life support (ACLS) training. With pressure on budgets across health care systems, there is a need for more cost-effective solutions. Recently, traditional ACLS training has evolved from passive to active learning technologies. The objective of this study is to compare the cost, cost-savings and return on investment (ROI) of blended ACLS (B-ACLS) and face-to-face ACLS (F-ACLS) in Singapore. Methods: B-ACLS and F-ACLS courses are offered in two training institutes in Singapore. Direct and indirect costs of training were obtained from one of the training providers. ROI was computed using cost-savings over total cost if B-ACLS was used instead of F-ACLS. Results: The estimated annual cost to conduct B-ACLS and F-ACLS were S$43,467 and S$72,793, respectively. Discounted total cost of training over the life of the course (five years) was S$107,960 for B-ACLS and S$280,162 for F-ACLS. Annual productivity loss cost account for 52% and 23% of the costs among the F-ACLS and B-ACLS, respectively. B-ACLS yielded a 160% return on the money invested. There would be 61% savings over the life of the course if B-ACLS were to be used instead of F-ACLS. Conclusion: The B-ACLS course provides significant cost-savings to the provider and a positive ROI. B-ACLS should be more widely adopted as the preferred mode of ACLS training. As a start, physicians looking for reaccreditation of the ACLS training should be encouraged to take B-ACLS instead of F-ACLS.

Introduction: Conventional approaches in advanced cardiac life support (ACLS) are used, including; lectures, video presentations, practical educations on moulage, also employing messenger applications can potentially be regarded as a method to train interns. Objectives: The current study aims to compare two methods of face-to-face and virtual training by WhatsApp messenger, regarding the impact of training on interns’ knowledge and satisfaction for advanced cardio resuscitation rotational interns in emergency medicine. Patients and Methods: In this cross-sectional study, 73 rotation interns of emergency medicine of Tehran University of Medical Sciences from 2017 to 2018 were divided into two groups: 1) face-to-face training, 2) virtual training by using WhatsApp messenger application. Initially, a pretest of 10 questions about main topics in advanced cardiac support was conducted on interns. At the end of training course, a posttest of 20 questions was conducted for both groups. Results: Mean value of pretest was 6.46 for face-to-face training group and 5.97 for WhatsApp group (P=0.29). Posttest mean score was 14.08 for face-to-face group and 12.03 for WhatsApp (P=0.003). Interns’ satisfaction scores were 7.68 and 7.36 for face-to-face and WhatsApp group respectively (P=0.25). Mean scores of pretest and posttest within group had no significant differences between groups, but Cohen’s effect size for face-to-face group was greater than WhatsApp trained group. Conclusion: Face-to-face training was associated with better results in promoting knowledge of interns, compared to WhatsApp training. That’s advisable to employ face-to-face training for interns.

Objectives Childhood adversity has been linked with later victimization of young and middle-aged adults, but few studies have shown persistence of this effect among elders, especially outside of North America. This research examined the association between adverse childhood experiences (ACEs) and elder abuse among older adults aged 60 years and over in Malaysia. Design Cross sectional data were collected via face-to-face interview from June to August 2019. Setting Eight government community health clinics in Kuala Pilah, a district in Negeri Sembilan state approximately 100km from Malaysian capital city Kuala Lumpur. Participants Older adults aged 60 years and above (N = 1984; Mean age 69.2, range 60–93 years) attending all eight government health clinics in the district were recruited for a face-to-face interview about health and well-being. Measurement The Adverse Childhood Experience International Questionnaire (ACE-IQ) and the Revised Conflict Tactics Scale (CTS) were utilized to estimate childhood adversity and elder abuse respectively. Results Multiple logistic regression analysis revealed a significant relationship between the number of cumulative ACEs and elder abuse. Compared to older adults with no self-reported adversity, those reporting three ACEs (OR 2.67, 95% CI 1.84,3.87) or four or more ACEs (OR 1.7, 95% CI 1.16, 2.48) had higher risk of any elder abuse occurrence since age 60 years. The effect was most prominent for financial and psychological elder abuse. The associations persisted in multivariate logistic regression models after adjusting for sociodemographic and health factors. Conclusion Early life adversities were significantly associated with victimization of older adults. Social and emotional support to address elder abuse should recognize that, for some men and women, there is a possibility that vulnerability to maltreatment persisted throughout their life course.

ObjectivesAdverse childhood experiences (ACEs) can affect life-course health and well-being, including risk-taking behaviour and trust. This study explored associations between ACEs and trust in health information on COVID-19, attitudes towards and compliance with COVID-19 restrictions and vaccine hesitancy.DesignNational cross-sectional telephone survey using a sample of landline and mobile numbers stratified by Health Board, deprivation quintile and age group.SettingHouseholds in Wales during national COVID-19 restrictions (December 2020 to March 2021).Participants2285 Welsh residents aged ≥18 years.MeasuresNine ACEs; low trust in National Health Service (NHS) COVID-19 information; supporting removal of social distancing and mandatory face coverings; breaking COVID-19 restrictions; and vaccine hesitancy (rejection or uncertainty of vaccination).ResultsIncreasing ACE counts were independently related to low trust in NHS COVID-19 information, feeling unfairly restricted by government and ending mandatory face coverings. High ACE counts (4+ vs 0 ACEs) were also associated with supporting removal of social distancing. Breaking COVID-19 restrictions increased with ACE count with likelihood doubling from no ACEs to 4+ ACEs. Vaccine hesitancy was threefold higher with 4+ ACEs (vs 0 ACEs) and higher in younger age groups. Thus, modelled estimates of vaccine hesitancy ranged from 3.42% with no ACEs, aged ≥70 years, to 38.06% with 4+ ACEs, aged 18–29 years.ConclusionsACEs are common across populations of many countries. Understanding how they impact trust in health advice and uptake of medical interventions could play a critical role in the continuing response to COVID-19 and controlling future pandemics. Individuals with ACEs suffer greater health risks throughout life and may also be excluded from interventions that reduce infection risks. While pandemic responses should consider how best to reach those suffering from ACEs, longer term, better compliance with public health advice is another reason to invest in safe and secure childhoods for all children.

The AimEvidence shows that, along with other variables, the parenting environment contributes significantly to the educational attainment gap. Whilst ‘face-to-face’ parenting programmes have been shown to be effective, very few studies have examined online models of delivery. Questions to be addressed, therefore, include establishing if widely available online courses enhance parent-child relationships and provide a foundation for learning. The present study examines the efficacy of an 11 module online course about children aged 0–18 years based on the Solihull Approach theoretical model.MethodA between subjects, repeated measures design was used. The scores of 115 self-referred parents/carers were compared before and after completing Understanding Your Child – Online (UYC-OL) between 2013–2015 on the Child-Parent Relationship Scale (CPRS). Paired samples t-tests were performed and Cohen’s d was used to determine effect sizes.ResultsHighly statistically significant improvements were found. Closeness within the parent-child relationship significantly increased (p=<0.0001); whilst conflict significantly decreased (p=<0.0001). Effect sizes were large (d =0.61 and 0.78 respectively).LimitationsThe study provides preliminary evidence only. Demographic information, multiple measures and comparison groups were sacrificed in favour of accessibility and participant engagement.ConclusionThe Solihull Approach online course appears to offer an effective option for enhancing universal parent-child relationships. The implication is that it should be included in population based strategies for increasing resilience, reducing the impact of adverse childhood experiences (ACEs) and closing the attainment gap.

Background. Capacity building is essential in low- and middle-income countries (LMICs) to address the gap in skills to conduct and implement research. Capacity building must not only include scientific and technical knowledge, but also broader competencies, such as writing, disseminating research and achieving work–life balance. These skills are thought to promote long-term career success for researchers in high-income countries (HICs) but the availability of such training is limited in LMICs. Methods. This paper presents the contextualisation and implementation of the Academic Competencies Series (ACES). ACES is an early-career researcher development programme adapted from a UK university. Through consultation between HIC and LMIC partners, an innovative series of 10 workshops was designed covering themes of self-development, engagement and writing skills. ACES formed part of the African Mental Health Research Initiative (AMARI), a multi-national LMIC-led consortium to recruit, train, support and network early-career mental health researchers from four sub-Saharan African countries. Results. Of the 10 ACES modules, three were HIC-LMIC co-led, four led by HIC facilitators with LMIC training experience and three led by external consultants from HICs. Six workshops were delivered face to face and four by webinar. Course attendance was over 90% and the delivery cost was approximately US$4500 per researcher trained. Challenges of adaptation, attendance and technical issues are described for the first round of workshops. Conclusions. This paper indicates that a skills development series for early-career researchers can be contextualised and implemented in LMIC settings, and is feasible for co-delivery with local partners at relatively low cost.

Abstract Background Adverse childhood experiences (ACEs) can affect health and well-being across the life course. Resilience is an individual characteristic that is known to help negate the effect of adversities and potentially transform toxic stress into tolerable stress. Having access to a trusted adult during childhood is critical to helping children build resiliency. Here, we aim to understand the relationship between always having access to trusted adult support and childhood resilience resources, and examine which sources of personal adult support and the number of sources of adult support, best foster childhood resilience. Methods A Welsh national cross-sectional retrospective survey (n = 2497), using a stratified random probability sample. Data were collected via face-to-face interviews at participants’ places of residence by trained interviewers. Analyses use chi-square and binary logistic regression methods. Outcome measures were childhood resilience resources, access to an always-available trusted adult, and sources of personal adult support. Results Prevalence of access to an always-available trusted adult decreased with increasing number of ACEs from 86.6% of individuals with no ACEs, to 44.4% of those with four or more ACEs (≥ 4). In addition, for those experiencing ≥ 4 ACEs, individuals with no access to a trusted adult were substantially less likely than those with access, to report childhood resilience resources. For example, for individuals with ≥ 4 ACEs, those with access to an always-available trusted adult were 5.6 times more likely to have had supportive friends and 5.7 times more likely to have been given opportunities to develop skills to succeed in life, compared to those with no access to a trusted adult. When looking at sources of personal adult support, resilience levels increased dramatically for those individuals who had either one parent only or two parents as sources of support, in comparison to those without parental support. Conclusions Analyses here suggest strong relationships between elements of childhood resilience, constant access to trusted adults and different sources of personal adult support. While the eradication of ACEs remains unlikely, actions to strengthen childhood access to trusted adults may partially ease immediate harms and protect future generations.

We need a clear, unified, and consistent voice to effect the complete dismantling, the abolition, of the mechanisms of animal exploitation.And that will only come from what we say and do, no matter who we are.— Gary L. Francione, animal rights theoristThe history of hashtags is relatively short but littered with the remnants of corporate hashtags which may have seemed a good idea at the time within the confines of the boardroom. It is difficult to understand the rationale behind the use of hashtags as an effective communications tactic in 2019 by corporations when a quick stroll through their recent past leaves behind the much-derided #qantasluxury (Glance), #McDstories (Hill), and #myNYPD (Tran).While hashtags have an obvious purpose in bringing together like-minded publics and facilitating conversation (Kwye et al. 1), they have also regularly been the subject of “hashtag takeovers” by activists and other interested parties, and even by trolls, as the Ecological Society of Australia found in 2015 when their seemingly innocuous #ESA15 hashtag was taken over with pornographic images (news.com.au). Hashtag takeovers have also been used as a dubious marketing tactic, where smaller and less well-known brands tag their products with trending hashtags such as #iphone in order to boost their audience (Social Garden). Hashtags are increasingly used as a way for activists or other interested parties to disrupt a message. It is, I argue, predictable that any hashtag related to an even slightly controversial topic will be subject to some form of activist hashtag takeover, with varying degrees of success.That veganism and the dairy industry should attract such conflict is unsurprising given that the two are natural enemies, with vegans in particular seeming to anticipate and actively engage in the battle for the opposing hashtag.Using a comparative analysis of the #Veganuary and #Februdairy hashtags and how they have been used by both pro-vegan and pro-dairy social media users, this article illustrates that the enthusiastic and well-meaning social media efforts of farmers and dairy supporters have so far been unable to counteract those of well-organised and equally passionate vegan activists. This analysis compares tweets in the first week of the respective campaigns, concluding that organisations, industries and their representatives should be extremely wary of engaging said activists who are not only highly-skilled but are also highly-motivated. Grassroots, ideology-driven activism is a formidable opponent in any public space, let alone when it takes place on the outspoken and unstructured landscape of social media which is sometimes described as the “wild West” (Fitch 5) where anything goes and authenticity and plain-speaking is key (Macnamara 12).I Say Hashtag, You Say Bashtag#Februdairy was launched in 2018 to promote the benefits of dairy. The idea was first mooted on Twitter in 2018 by academic Dr Jude Capper, a livestock sustainability consultant, who called for “28 days, 28 positive dairy posts” (@Bovidiva; Howell). It was a response to the popular Veganuary campaign which aimed to “inspire people to try vegan for January and throughout the rest of the year”, a campaign which had gained significant traction both online and in the traditional media since its inception in 2014 (Veganuary). Hopes were high: “#Februdairy will be one month of dairy people posting, liking and retweeting examples of what we do and why we do it” (Yates). However, the #Februdairy hashtag has been effectively disrupted and has now entered the realm of a bashtag, a hashtag appropriated by activists for their own purpose (Austin and Jin 341).The Dairy Industry (Look Out the Vegans Are Coming)It would appear that the dairy industry is experiencing difficulties in public perception. While milk consumption is declining, sales of plant-based milks are increasing (Kaiserman) and a growing body of health research has questioned whether dairy products and milk in particular do in fact “do a body good” (Saccaro; Harvard Milk Study). In the 2019 review of Canada’s food guide, its first revision since 2007, for instance, the focus is now on eating plant-based foods with dairy’s former place significantly downgraded. Dairy products no longer have their own distinct section and are instead placed alongside other proteins including lentils (Pippus).Nevertheless, the industry has persevered with its traditional marketing and public relations activities, choosing to largely avoid addressing animal welfare concerns brought to light by activists. They have instead focused their message towards countering concerns about the health benefits of milk. In the US, the Milk Processing Education Program’s long-running celebrity-driven Got Milk campaign has been updated with Milk Life, a health focused campaign, featuring images of children and young people living an active lifestyle and taking part in activities such as skateboarding, running, and playing basketball (Milk Life). Interestingly, and somewhat inexplicably, Milk Life’s home page features the prominent headline, “How Milk Can Bring You Closer to Your Loved Ones”.It is somewhat reflective of the current trend towards veganism that tennis aces Serena and Venus Williams, both former Got Milk ambassadors, are now proponents for the plant-based lifestyle, with Venus crediting her newly-adopted vegan diet as instrumental in her recovery from an auto-immune disease (Mango).The dairy industry’s health focus continues in Australia, as well as the use of the word love, with former AFL footballer Shane Crawford—the face of the 2017 campaign Milk Loves You Back, from Lion Dairy and Drinks—focusing on reminding Australians of the reputed nutritional benefits of milk (Dawson).Dairy Australia meanwhile launched their Legendairy campaign with a somewhat different focus, promoting and lauding Australia’s dairy families, and with a message that stated, in a nod to the current issues, that “Australia’s dairy farmers and farming communities are proud, resilient and innovative” (Dairy Australia). This campaign could be perceived as a morale-boosting exercise, featuring a nation-wide search to find Australia’s most legendairy farming community (Dairy Australia). That this was also an attempt to humanise the industry seems obvious, drawing on established goodwill felt towards farmers (University of Cambridge). Again, however, this strategy did not address activists’ messages of suffering animals, factory farms, and newborn calves being isolated from their grieving mothers, and it can be argued that consumers are being forced to make the choice between who (or what) they care about more: animals or the people making their livelihoods from them.Large-scale campaigns like Legendairy which use traditional channels are of course still vitally important in shaping public opinion, with statistics from 2016 showing 85.1% of Australians continue to watch free-to-air television (Roy Morgan, “1 in 7”). However, a focus and, arguably, an over-reliance on traditional platforms means vegans and animal activists are often unchallenged when spreading their message via social media. Indeed, when we consider the breakdown in age groups inherent in these statistics, with 18.8% of 14-24 year-olds not watching any commercial television at all, an increase from 7% in 2008 (Roy Morgan, “1 in 7”), it is a brave and arguably short-sighted organisation or industry that relies primarily on traditional channels to spread their message in 2019. That these large-scale campaigns do little to address the issues raised by vegans concerning animal welfare leaves these claims largely unanswered and momentum to grow.This growth in momentum is fuelled by activist groups such as the People for the Ethical Treatment of Animals (PETA) who are well-known in this space, with 5,494,545 Facebook followers, 1.06 million Twitter followers, 973,000 Instagram followers, and 453,729 You Tube subscribers (People for the Ethical Treatment of Animals). They are also active on Pinterest, a visual-based platform suited to the kinds of images and memes particularly detrimental to the dairy industry. Although widely derided, PETA’s reach is large. A graphic video posted to Facebook on February 13 2019 and showing a suffering cow, captioned “your cheese is not worth this” was shared 1,244 times, and had 4.6 million views in just over 24 hours (People for the Ethical Treatment of Animals). With 95% of 12-24 year olds in Australia now using social networking sites (Statista), it is little wonder veganism is rapidly growing within this demographic (Bradbury), with The Guardian labelling the rise of veganism unstoppable (Hancox).Activist organisations are joined by prominent and charismatic vegan activists such as James Aspey (182,000 Facebook followers) and Earthling Ed (205,000 Facebook followers) in distributing information and images that are influential and often highly graphic or disturbing. Meanwhile Instagram influencers and You Tube lifestyle vloggers such as Ellen Fisher and FreeLee share information promoting vegan food and the vegan lifestyle (with 650,320 and 785,903 subscribers respectively). YouTube video Dairy Is Scary has over 5 million views (Janus) and What the Health, a follow-up documentary to Cowspiracy: The Sustainability Secret, promoting veganism, is now available on Netflix, which itself has 9.8 million Australian subscribers (Roy Morgan, “Netflix”). BOSH’s plant-based vegan cookbook was the fastest selling cookbook of 2018 (Chiorando).Additionally, the considerable influence of celebrities such as Miley Cyrus, Beyonce, Alicia Silverstone, Zac Efron, and Jessica Chastain, to name just a few, speaking publicly about their vegan lifestyle, encourages veganism to become mainstream and increases its widespread acceptance.However not all the dairy industry’s ills can be blamed on vegans. Rising costs, cheap imports, and other pressures (Lockhart, Donaghy and Gow) have all placed pressure on the industry. Nonetheless, in the battle for hearts and minds on social media, the vegans are leading the way.Qualitative research interviewing new vegans found converting to veganism was relatively easy, yet some respondents reported having to consult multiple resources and required additional support and education on how to be vegan (McDonald 17).Enter VeganuaryUsing a month, week or day to promote an idea or campaign, is a common public relations and marketing strategy, particularly in health communications. Dry July and Ocsober both promote alcohol abstinence, Frocktober raises funds for ovarian cancer, and Movember is an annual campaign raising awareness and funds for men’s health (Parnell). Vegans Matthew Glover and Jane Land were discussing the success of Movember when they raised the idea of creating a vegan version. Their initiative, Veganuary, urging people to try vegan for the month of January, launched in 2014 and since then 500,000 people have taken the Veganuary pledge (Veganuary).The Veganuary website is the largest of its kind on the internet. With vegan recipes, expert advice and information, it provides all the answers to Why go vegan, but it is the support offered to answer How to go vegan that truly sets Veganuary apart. (Veganuary)That Veganuary participants would use social media to discuss and share their experiences was a foregone conclusion. Twitter, Facebook, and Instagram are all utilised by participants, with the official Veganuary pages currently followed/liked by 159,000 Instagram followers, receiving 242,038 Facebook likes, and 45,600 Twitter followers (Veganuary). Both the Twitter and Instagram sites make effective use of hashtags to spread their reach, not only using #Veganuary but also other relevant hashtags such as #TryVegan, #VeganRecipes, and the more common #Vegan, #Farm, and #SaveAnimals.Februdairy Follows Veganuary, But Only on the CalendarCalling on farmers and dairy producers to create counter content and their own hashtag may have seemed like an idea that would achieve an overall positive response.Agricultural news sites and bloggers spread the word and even the BBC reported on the industry’s “fight back” against Veganuary (BBC). However the hashtag was quickly overwhelmed with anti-dairy activists mobilising online. Vegans issued a call to arms across social media. The Vegans in Australia Facebook group featured a number of posts urging its 58,949 members to “thunderclap” the Februdairy hashtag while the Project Calf anti-dairy campaign declared that Februdairy offered an “easy” way to spread their information (Sandhu).Februdairy farmers and dairy supporters were encouraged to tell their stories, sharing positive photographs and videos, and they did. However this content was limited. In this tweet (fig. 1) the issue of a lack of diverse content was succinctly addressed by an anti-Februdairy activist.Fig. 1: Content challenges. (#Februdairy, 2 Feb. 2019)MethodUtilising Twitter’s advanced search capability, I was able to search for #Veganuary tweets from 1 to 7 January 2019 and #Februdairy tweets from 1 to 7 February 2019. I analysed the top tweets provided by Twitter in terms of content, assessed whether the tweet was pro or anti Veganuary and Februdairy, and also categorised its content in terms of subject matter.Tweets were analysed to assess whether they were on message and aligned with the values of their associated hashtag. Veganuary tweets were considered to be on message if they promoted veganism or possessed an anti-dairy, anti-meat, or pro-animal sentiment. Februdairy tweets were assessed as on message if they promoted the consumption of dairy products, expressed sympathy or empathy towards the dairy industry, or possessed an anti-vegan sentiment. Tweets were also evaluated according to their clarity, emotional impact and coherence. The overall effectiveness of the hashtag was then evaluated based on the above criteria as well as whether they had been hijacked.Results and FindingsOverwhelmingly, the 213 #Veganuary tweets were on message. That is they were pro-Veganuary, supportive of veganism, and positive. The topics were varied and included humorous memes, environmental facts, information about the health benefits of veganism, as well as a strong focus on animals. The number of non-graphic tweets (12) concerning animals was double that of tweets featuring graphic or shocking imagery (6). Predominantly the tweets were focused on food and the sharing of recipes, with 44% of all pro #Veganuary tweets featuring recipes or images of food. Interestingly, a number of well-known corporations tweeted to promote their vegan food products, including Tesco, Aldi, Iceland, and M&S. The diversity of veganism is reflected in the tweets. Organisations used the hashtag to promote their products, including beauty and shoe products, social media influencers promoted their vegan podcasts and blogs, and, interestingly, the Ethiopian Embassy of the United Kingdom tweeted their support.There were 23 (11%) anti-Veganuary tweets. Of these, one was from Dr. Jude Capper, the founder of Februdairy. The others expressed support for farming and farmers, and a number were photographs of meat products, including sausages and fry-ups. One Australian journalist tweeted in favour of meat, stating it was yummy murder. These tweets could be described as entertaining and may perhaps serve as a means of preaching to the converted, but their ability to influence and persuade is negligible.Twitter’s search tool provided access to 141 top #Februdairy tweets. Of these 82 (52%) were a hijack of the hashtag and overtly anti-Februdairy. Vegan activists used the #Februdairy hashtag to their advantage with most of their tweets (33%) featuring non-graphic images of animals. They also tweeted about other subject matters, including environmental concerns, vegan food and products, and health issues related to dairy consumption.As noted by the activists (see fig. 1 above), most of the pro-Februdairy tweets were images of milk or dairy products (41%). Images of farms and farmers were the next most used (26%), followed by images of cows (17%) (see fig. 2). Fig. 2: An activist makes their anti-Februdairy point with a clear, engaging image and effective use of hashtags. (#Februdairy, 6 Feb. 2019)The juxtaposition between many of the tweets was also often glaring, with one contrasting message following another (see fig. 3). Fig. 3: An example of contrasting #Februdairy tweets with an image used by the activists to good effect, making their point known. (#Februdairy, 2 Feb. 2019)Storytelling is a powerful tool in public relations and marketing efforts. Yet, to be effective, high-quality content is required. That many of the Februdairy proponents had limited social media training was evident; images were blurred, film quality was poor, or they failed to make their meaning clear (see fig. 4). Fig. 4: A blurred photograph, reflective of some of the low-quality content provided by Februdairy supporters. (#Februdairy, 3 Feb. 2019)This image was tweeted in support of Februdairy. However the image and phrasing could also be used to argue against Februdairy. We can surmise that the tweeter was suggesting the cow was well looked after and seemingly content, but overall the message is as unclear as the image.While some pro-Februdairy supporters recognised the need for relevant hashtags, often their images were of a low-quality and not particularly engaging, a requirement for social media success. This requirement seems to be better understood by anti-Februdairy activists who used high-quality images and memes to create interest and gain the audience’s attention (see figs. 5 and 6). Fig. 5: An uninspiring image used to promote Februdairy. (#Februdairy, 6 Feb. 2019) Fig. 6: Anti-Februdairy activists made good use of memes, recognising the need for diverse content. (#Februdairy, 3 Feb. 2019)DiscussionWhat the #Februdairy case makes clear, then, is that in continuing its focus on traditional media, the dairy industry has left the battle online to largely untrained, non-social media savvy supporters.From a purely public relations perspective, one of the first things we ask our students to do in issues and crisis communication is to assess the risk. “What can hurt your organisation?” we ask. “What potential issues are on the horizon and what can you do to prevent them?” This is PR101 and it is difficult to understand why environmental scanning and resulting action has not been on the radar of the dairy industry long before now. It seems they have not fully anticipated or have significantly underestimated the emerging issue that public perception, animal cruelty, health concerns, and, ultimately, veganism has had on their industry and this is to their detriment. In Australia in 2015–16 the dairy industry was responsible for 8 per cent (A$4.3 billion) of the gross value of agricultural production and 7 per cent (A$3 billion) of agricultural export income (Department of Agriculture and Water Resources). When such large figures are involved and with so much at stake, it is hard to rationalise the decision not to engage in a more proactive online strategy, seeking to engage their publics, including, whether they like it or not, activists.Instead there are current attempts to address these issues with a legislative approach, lobbying for the introduction of ag-gag laws (Potter), and the limitation of terms such as milk and cheese (Worthington). However, these measures are undertaken while there is little attempt to engage with activists or to effectively counter their claims with a widespread authentic public relations campaign, and reflects a failure to understand the nature of the current online environment, momentum, and mood.That is not to say that the dairy industry is not operating in the online environment, but it does not appear to be a priority, and this is reflected in their low engagement and numbers of followers. For instance, Dairy Australia, the industry’s national service body, has a following of only 8,281 on Facebook, 6,981 on Twitter, and, crucially, they are not on Instagram. Their Twitter posts do not include hashtags and unsurprisingly they have little engagement on this platform with most tweets attracting no more than two likes. Surprisingly they have 21,013 subscribers on YouTube which featured professional and well-presented videos. This demonstrates some understanding of the importance of effective storytelling but not, as yet, trans-media storytelling.ConclusionSocial media activism is becoming more important and recognised as a legitimate voice in the public sphere. Many organisations, perhaps in recognition of this as well as a growing focus on responsible corporate behaviour, particularly in the treatment of animals, have adjusted their behaviour. From Unilever abandoning animal testing practices to ensure Dove products are certified cruelty free (Nussbaum), to Domino’s introducing vegan options, companies who are aware of emerging trends and values are changing the way they do business and are reaping the benefits of engaging with, and catering to, vegans. Domino’s sold out of vegan cheese within the first week and vegans were asked to phone ahead to their local store, so great was the demand. From their website:We knew the response was going to be big after the demand we saw for the product on social media but we had no idea it was going to be this big. (Domino’s Newsroom)As a public relations professional, I am baffled by the dairy industry’s failure to adopt a crisis-based strategy rather than largely rely on the traditional one-way communication that has served them well in the previous (golden?) pre-social media age. However, as a vegan, persuaded by the unravelling of the happy cow argument, I cannot help but hope this realisation continues to elude them.References@bovidiva. “Let’s Make #Februdairy Happen This Year. 28 Days, 28 Positive #dairy Posts. From Cute Calves and #cheese on Crumpets, to Belligerent Bulls and Juicy #beef #burgers – Who’s In?” Twitter post. 15 Jan. 2018. 1 Feb. 2019 <https://twitter.com/bovidiva/status/952910641840447488?lang=en>.Austin, Lucinda L., and Yan Jin. Social Media and Crisis Communication. 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Aim: The overall aim of this thesis was to undertake and report the findings of a health technology assessment (HTA) on the effectiveness, cost-effectiveness and acceptability of online and LAN-based eLearning, and blended learning, among post-registration healthcare professionals. Methods: This HTA comprised three studies. The first study was a systematic review of 93 randomised controlled trials evaluating the effectiveness of online and LAN-based eLearning on physicians' knowledge, skills, attitude and satisfaction. The second study compared the cost, cost-savings and return on investment between a blended and a face-to-face advanced cardiac life support course for physicians in Singapore. The third study was an online survey that assessed the acceptability of the technology among a sample of optometrists and opticians in Singapore and their scope of practice, primary eye care knowledge, views on extended roles in primary eye care, preferred mode of learning for continuing professional education, and referral behaviour. Results: The systematic review showed that online and LAN-based eLearning or blended learning compared with self-directed or face-to-face learning resulted in higher post-intervention knowledge scores (21 studies; small to large effect size; very poor quality); higher post-intervention skills scores (seven studies; large effect size; low quality); higher attitude scores (one study; very low quality); higher post-intervention satisfaction (four studies; large effect size; low quality); and higher post-intervention practice or behaviour changes (eight studies; large effect size; low quality) among physicians in the intervention groups. Fourteen studies compared eLearning with other forms of eLearning. Among these, four studies reported higher post-intervention knowledge scores (large effect size; very low quality) for participants in the intervention group. Unintended or adverse effects of the intervention were not reported among the included studies. Ninety-three studies (N=16,895) were included of which seventy-six studies compared ODE (including blended) vs self-directed/face-to-face learning. Overall the effect of ODE (including blended) on post-intervention knowledge, skills, attitude, satisfaction, practice or behaviour change and patient outcomes was inconsistent and ranged mostly from no difference between the groups to higher post-intervention score in the intervention group (small to large effect size, very low to low quality evidence). Twenty-one studies reported higher knowledge score (small to large effect size; very low quality) for the intervention while 20 studies reported no difference in knowledge between the groups. Seven studies reported higher skill score in the intervention (large effect size; low quality) while thirteen studies reported no difference in skill score between the groups. One study reported higher attitude score for the intervention (very low quality), while 4 studies reported no difference in attitude score between the groups. Four studies reported higher post-intervention physician satisfaction with the intervention (large effect size; low quality), while six studies reported no difference in satisfaction between the groups. Eight studies reported higher post-intervention practice or behaviour change for the ODE group (small to moderate effect size; low quality) while five studies reported no difference in practice or behaviour change between the groups. One study reported higher improvement in patient outcome, while three others reported no difference in patient outcome between the groups. None of the included studies reported any unintended/adverse effects, cost-effectiveness of the interventions. Although the review only focused on post-registration medical doctors, the technology could be used for the interprofessional education of post-registration medical doctors and other healthcare professionals. Such an initiative would encourage collaborative learning and facilitate task-shifting, which could address the problem of fragmentation in health care. Although eLearning and blended learning technology interventions have been implemented, primary studies have not assessed their cost-effectiveness. Hence, to ascertain the technology’s cost-saving potential, we used a blended advanced cardiac life support (B-ACLS) course as an exemplar and compared its cost to face-to-face advanced life support (F-ACLS) training. The analysis showed that the annual cost of F-ACLS training (USD$72,793) was 1.7 times higher than B-ACLS training (USD$43,467). The discounted total cost of training over the life of the course (5-years) was SGD $107,960 for B-ACLS and S$280,162 for F-ACLS. The cost of productivity loss accounted for 52% and 23% of the costs for F-ACLS and B-ACLS, respectively. B-ACLS yielded a 160% return on the money invested, yielding $1.60 for every dollar spent. There would be a 61% saving for course providers if they delivered a B-ACLS instead of F-ACLS course. The effectiveness component of the HTA showed that online eLearning and blended learning is as effective as traditional learning and has cost-saving potential. We also sought to determine if this technology could be used to train and equip optometrists and opticians in Singapore to take on an extended role in primary care, which would allow some simple primary eye care tasks to be shifted from ophthalmologists to optometrists and ease healthcare access issues at specialist hospital outpatient clinics. The survey of optometrists showed that the current roles of opticians and optometrists in Singapore were limited to diagnostic refraction (92%); colour vision assessment (65%); contact lens fitting and dispensing (62%) amongst others. The average self-rated primary eye care knowledge score was 8.2 ± 1.4; (score range 1-10; 1 = very poor, 10 = excellent). Average self-rated confidence scores for screening for cataract, diabetic retinopathy, chronic glaucoma and age-related macular degeneration were 2.7 ± 1.5; 3.7 ± 1.9; 4.0 ± 1.0 and 2.7 ± 1.5, respectively. Three fourths of the optometrists surveyed felt that they should undertake regular continuing professional education (CPE) to improve their primary eye care knowledge. Blended learning (eLearning and traditional face-to-face lectures) was the most preferred mode (46.8%) for CPE delivery. Conclusions: Overall, the findings from the HTA provide evidence of effectiveness, cost-saving of online eLearning and blended learning for training medical doctors and the acceptance of the technology in a local context to facilitate its wider adoption for training post-registration healthcare professionals’. These research outputs would have direct impact on the adoption of online eLearning, blended learning technologies in universities and educational institutes across the region with consequent impacts on post-registration health professionals’ education and policy. The results of learning will serve as a guide for policy makers to decide on investment in the learning technology and to learn about the associated factors, which would influence its adoption. This thesis resulted in three papers, of which one has been accepted for publication, the two other papers are under review.
Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2018

Innovative since its inception, the ACS Honors Humanities program has a long history of more than 40 years as an interdisciplinary team-taught course that examines essential questions through literature, visual and performing arts, philosophy and history. This innovative approach has continued to motivate successive teaching teams to modify and enhance a program that challenges students academically, utilizing the best possible resources and taking advantage of new technology. The program consists of two year-long, completely integrated i2Flex ACS Athens Honors diploma courses and three i2Flex 20-week enrichment courses accessible to students anywhere. This chapter presents two case studies which explain the transformation of the Honors Humanities course from Face to Face to i2Flex. The authors describe and present examples of how they redesigned the courses. They present data on student feedback and findings regarding the benefits and challenges of adopting the i2Flex methodology for this program. This chapter is intended as a reference for teachers, teachers in training and professionals who train teachers.

Apex courts face a fundamental problem: they cannot succeed in building systematic effectiveness in the face of regular opposition from the other branches of government, but they must sometimes invalidate the acts of those institutions to make rights effective. Chapter 5 considers how a court can build effectiveness while inducing inter-branch cooperation. A key is proportionality, which provides an infrastructure for the construction of dialogic jurisprudence. Constitutional courts delineate “zones of proportionality” within which policymakers enjoy meaningful policy discretion, albeit within guidelines set by the court. The chapter considers how rights-based, constitutional dialogues play out in three contexts, with respect: to legislating, making and enforcement of administrative law, and in the adjudication of private law disputes. These dialogues not only serve to secure other institutions’ acquiescence to the court’s jurisprudence, but drive proportionality reasoning into their decision-making routines, and hence into the legal domains over which they preside.

Children and youth in the foster care system face significant and continuing barriers to both physical and mental health, including lack of a medical home, disruptions in primary care providers, frequent moves to new homes, excessive caseloads for oversight providers, and at times continuing exposure to the risk factors that are considered Adverse Childhood Experiences (ACEs). The underdog DREAMS project sought to alter the course of the foster youth experience via a tri-part model that focused on clinical, research, and advocacy interventions for foster youth and the development of the workforce that supports them through training on the impacts of trauma and poverty.

Chapter 5 reviews the visual evidence on the basis of the stripped picture before the infilling of lost areas of paint. Pentimenti are apparent, most conspicuously in the repositioning of the thumb of the blessing hand. Infrared reflectography reveals detailed changes in the drapery and a few spolveri which indicate the use of a cartoon and shows the use of Leonardo’s hand-print method to soften the modelling of flesh. The vortex curls and the understated anatomy of the hands are typical of Leonardo’s post-1500 style, as is the insistent blurring of the contours of the face. The interlace pattern of the textile bands is founded on an angular geometry of the Islamic kind and reflects Leonardo’s visit to Venice in 1500. The transparent orb is of rock crystal and is marked by gaps or ‘inclusions’, exhibiting optical effects of the kinds that fascinated him, not least the translucency of semi-precious minerals. The crystal orb refers in an innovative way to the crystalline sphere of the fixed stars, thus transforming Christ from the saviour of the world to the saviour of the cosmos. The other optical effect in the painting involves his notions of the working of the eye, with the hands shown more definitely than Christ’s face, akin to a ‘depth of field’ effect in photography. The optical softening of features also acts to render his emotional impact as suggestive and ineffable rather than overtly defined.

Internet technology has found its way into all areas of business and research. The World Wide Web is also used at universities to achieve different goals. On the one hand, it acts as a means of outer appearance, on the other hand, as an instrument of knowledge transfer and knowledge examination. Of course other purposes in addition to those named above do exist. Often different systems are used to achieve the different goals; usually, Web content management systems (WCMS) are used for the outer appearance and learning management systems (LMS) for transfer and examination of knowledge. Although these systems use the same medium (i.e., the WWW), it can be stated that often there is a heterogeneous landscape of systems. Resultant is the object of investigation of the present chapter. The chapter analyses the challenges concerning the integration of public Web sites and LMS a typical European university has to face.

When researchers try to recruit children as participants in a scientific study or when physicians recommend a course of medical treatment for children, a question then arises as to who may authorise such activity. May parents make these decisions on behalf of their children? May children make them independently of their parents? Or should such decisions be made jointly? To address these questions, in this chapter I explore the topic of informed consent, and more precisely, how it is that informed consent authorises children’s research participation and medical treatment. I first ask how we should define competence. In this chapter, I will argue that a person is competent to make a decision if she is able to reflect on the alternative courses of action and the likely consequences of each, and also, crucially, she is aware of the plurality of moral values and the possibility for conflict between those values, and reasonable in the face of such conflicting moral claims. We shall also consider voluntariness. In this chapter, I argue that a person acts voluntarily if she wills the action without being under the liberty-infringing influence of another. One issue to examine here is whether and in what ways parents can, through the exercise of their power, help their children become more competent and yet without limiting their children’s voluntariness.

This chapter continues on from the previous chapter in discussing liability in negligence for physical damage and considers the potential liability that businesses and individuals may face when they provide advice in the nature of their business, when they cause economic losses not associated with physical damage, and where the claimant suffers a psychiatric injury or nervous shock due to the acts of the tortfeasor. Recently, there has been an increase in instances of imposing liability on employers for the stress and associated health problems suffered by their employees. In the absence of physical damage, restrictions are placed on the imposition of liability for pure economic loss, although such loss has been widened to include damages for negligent misstatements. Of crucial importance is that businesses are aware of the implications of providing information in the course of their professional activities that may cause an investor or client loss through negligence.

This chapter continues on from the previous chapter in discussing liability in negligence for physical damage and considers the potential liability that businesses and individuals may face when they provide advice in the nature of their business, when they cause economic losses not associated with physical damage, and where the claimant suffers a psychiatric injury or nervous shock due to the acts of the tortfeasor. Recently, there has been an increase in instances of imposing liability on employers for the stress and associated health problems suffered by their employees. In the absence of physical damage, restrictions are placed on the imposition of liability for pure economic loss, although such loss has been widened to include damages for negligent misstatements. Of crucial importance is that businesses are aware of the implications of providing information in the course of their professional activities that may cause an investor or client loss through negligence.

The World Bank stated that by April 2020, over 220 million or 13 percent of students in tertiary education globally experienced interruptions in studies due to the Coronavirus disease 2019 (COVID-19) pandemic. Similarly, over 65,000 Nigerian law students faced academic disruptions for same reason. Invariably the momentum for Education for Sustainable Development (ESD) has never been stronger than since the COVID-19 pandemic which urgently demands a paradigm shift in lifestyles and transformation of education through relevant learning models, pedagogies and institutional management reforms. Meanwhile, the Council of Legal Education (CLE) in Nigeria which regulates the admission of law students approves of only the single mode conventional face-to-face teaching method which creates gender inequalities and lacks inclusiveness. This is inimical to the attainment of ESD for law education in Nigeria where universities were shut down due to COVID -19 pandemic. Using doctrinal methodology, the paper finds that it would be practically impossible for Nigeria to achieve its national education policy and the ESD targets without the Open and Distance Learning (ODL) system espoused by the National Open University of Nigeria (NOUN) as a viable panacea to academic interruptions attributable to present and future pandemics. However, the critical issue is getting the CLE and the law faculties to adopt this emerging ODL paradigm trend to complement the traditional face to face mode for sustainable law education and legal practice in Nigeria. The paper therefore recommends that the ODL system with its associated Zoom applications should be adopted as a paradigm shift to law education in Nigeria to complement the conventional face to face methods in the university law faculties and Law Schools. Accordingly, the National Assembly of Nigeria should amend the Acts establishing the Law Schools and the National Universities Commission to incorporate ODL system. Furthermore, the Nigerian judiciary should embrace the use of ODL technology in all courts of law for quick and effective dispensation of justice.