Daily Contacts Research Articles

Empowering communities: drawing on evidence to build successful community engagement initiatives

Background: Although community engagement is seen as key to achieving citizen-centred and collaborative healthcare systems, organisations and neighbourhood networks are still searching for effective ways to engage citizens in shaping the health and care landscape. Many Dutch regions are currently implementing and fostering community engagement initiatives; however, little is known about which engagement approaches are effective under which circumstances, and how to implement such initiatives successfully. This holds especially true for initiatives focusing on disadvantaged groups. The National Institute for Public Health and the Environment and the University of Tilburg, in co-design with stakeholders of six Dutch community engagement initiatives, are conducting a mixed-methods multiple case study evaluating six community engagement initiatives. The study is following the realist evaluation methodology to investigate which community engagement initiatives are effective in improving communities' health outcomes and the sustainability of healthcare systems. The University of Maastricht is investigating the dynamics between health and citizen participation on a neighbourhood level. As barriers and possibilities for participation are supported by material and spatial components of the environment and constructed in the lack of daily contacts between neighbours and professionals, the study conducts an in-depth ethnography of the life of inhabitants of three low-income neighbourhoods in Maastricht. Local experiences of non-participation are gathered and related to the social and material conditions of the neighbourhoods. Aims and objectives: The workshop's main objectives are to present two distinctive investigations into community engagement and to provide professionals with the analytical tools and the evidence-base to build their own successful initiatives that can help improve communities' health and wellbeing. Format: During the session, we will briefly present our investigations, focusing on our preliminary results. In an interactive group session, we will examine the common lessons learned, including the often divergent ideas and motivations that organisations and communities have regarding community engagement. Discussions about the key enablers and barriers for community engagement initiatives will inspire participants to reflect upon and implement their own initiatives. Target audience: Our target audience includes participants involved or interested in developing and implementing community engagement initiatives, in co-design with communities themselves. Participants will share their own thoughts and experiences during the session. Learnings/take away: Participants will learn that community engagement is expected to bring a wider range of services together that reflect citizens' more holistic views and needs. However, barriers including service fragmentation which hampers professionals' willingness to take on board citizens' more holistic views, will need to be addressed before this can be achieved. Participants will gain insight into the key enablers for overcoming these barriers, like addressing power imbalances between professionals and citizens and within communities. Participants will also learn of the supportive conditions for community engagement such as informal contacts and the availability of publicmeeting places. This will enable them to overcome barriers and build a vision for community engagement that is shared between professionals and citizens.

On Web’s contact structure

The explosive growth of Web and social networks has revealed the need to (re-)analyze the connection structure of the underlying graphs. Kleinberg et al. in 1999 has defined Web-Graph as the graph induced by the (directed) hyperlinks between the (static) Web pages. Since then, the Web-graph model has been the basis for representing the Web connection structure. In the early ‘90s, many authors conjectured that Web-graph was a scale-free network containing very few huge-degree nodes and many small-degree nodes. Over the years, this conjecture has established itself, although with some minor limitations. Our paper aims to contribute to a deeper understanding of some Web dynamics such as the spreading of information and viruses, the measurement of the real attractiveness of a site or the estimation of a potential power of influence in the propagating of ideas or in the promotion of products. Our working hypothesis was that Web’s spreading dynamics are better analyzable considering the actual contact between nodes in a time interval, since the physical link has some drawbacks: (a) it is quite static, (b) it may remain inactive, (c) many accesses to Web resources are performed online, typing something in an address-bar. We show that Web is still a scale-free network, with three main classes of nodes: very few huge nodes, the hubs, a significant number of intermediate nodes, an huge number of small nodes. Note that mini-hubs meet regularly in the real world: many sites present millions of daily contacts; however, they do not reach the size of an hub, but they are not so small that they can be ignored, like small-degree nodes. We suspect that they may be responsible for the local spread of viruses or information on the Web. To extract the data presented in this paper, we analyzed 19 categories of coherent sites, sub-divided into 309 sub-categories, for a total of 56,450 different sites, and we considered the contacts for the entire month of July 2017, where the average number of unique visitors were 257,022, who visited an average of 4,050,957 pages.

Grammatical Influences (Morphological) of Albanian Language in the Languages of Minorities in the Region of Prizren

Abstract The purpose of this paper is to prove the presence of calques (loan translation) of Albanian language in the languages of minorities (Gorani community, Bosnian community) in the region of Prizren. We will make an effort to provide evidence for the role of Albanian as a donor language through daily contacts with the members of the above-mentioned communities. The corpus of this study will be the edited volume of songs and folk tales from minority areas, respectively from the population of Gorani and Bosnian ethnicity and their dialects. The research will be focused in minority areas in the municipality of Dragash (Sharr) where Gorani people live, as well as in other areas of minority language speakers, mainly in Zhupa, in the municipality of Prizren. The paper will be important in enlightening the facts of using the structure of Albanian, both in the spoken language of the minority community and that of Albanian community. The cases where certain elements of Albanian language are encountered in another language, where Albanian appears as a donor language, will be considered as important. The reason which has pushed us to conduct the research regarding the presence of Albanian elements, basically morphological, in a non-Albanian speaking community in Kosovar society, respectively in the multi-ethnic society of Prizren, is the way of speaking of this minority community and the confirmation of the impact of Albanian language and ethno-culture on this minority language since ancient times to the present.

Healthy and cariogenic foods consumption and dental caries: A preschool‐based cross‐sectional study

To evaluate the association of the consumption of healthy and cariogenic foods with the prevalence of untreated dental caries among preschool children. A cross-sectional study was conducted with 427 5-year-old preschoolers. Caries was evaluated through a clinical examination using dmft index. Parents/guardians answered a questionnaire addressing socioeconomic status, eating frequency, and oral hygiene habits. The prevalence of untreated caries was 51%. The multiple models demonstrated a seven percent increase in the prevalence of untreated caries with each additional daily contact with cariogenic foods, whereas a four percent reduction in this prevalence rate was found for each additional contact with healthy foods. When the number of daily contacts with cariogenic and healthy foods was incorporated into the same model, the former reached only borderline statistical significance (p=0.05), whereas the latter maintained an association with lower caries rates (p=0.01). A dietary assessment based solely on the frequency of the consumption of cariogenic foods may not be sufficient to understand the occurrence of dental caries in preschool children. It is necessary a more comprehensive evaluation of the dietary pattern, once a healthy diet can present an association with lower prevalence of caries even among preschool children who consume cariogenic foods.

Economic integration in the Middle East: Israeli‒Palestinian fresh food trade

Violent political conflict results in socioeconomic fragmentation and hampers economic development. In contrast, trade crucially depends on cooperation. The article empirically analyses at the micro-level whether economic interactions affect political attitudes. Trading relations between Israelis and Palestinians are found to be extensive despite the conflict. Education and personal social networks facilitate contacts. Israeli traders do not see themselves as affected by the conflict, but wish for its quick settlement. This lends support to the Rational Group Conflict Theory and the Theory of Liberal Peace. Daily contacts are found to create positive functional interdependence which may be effective in fostering reconciliation in the Middle East.

Estimating the Risk of Influenza-Like Illness Transmission Through Social Contacts: Web-Based Participatory Cohort Study.

BackgroundEpidemiological studies on influenza have focused mostly on enhancing vaccination coverage or promoting personal hygiene behavior. Few studies have investigated potential effects of personal health behaviors and social contacts on the risk of getting influenza-like illness (ILI).ObjectiveTaking advantage of an online participatory cohort, this study aimed to estimate the increased risk of getting ILI after contact with infected persons and examine how personal health behaviors, weather, and air pollution affect the probability of getting ILI.MethodsA Web-based platform was designed for participants to record daily health behaviors and social contacts during the influenza season of October 1, 2015 to March 31, 2016, in Taiwan. Data on sleep, diet, physical activity, self-reported ILI, and contact with infected persons were retrieved from the diaries. Measurements of weather and air pollutants were used for calculating environmental exposure levels for the participants. We fitted a mixed-effects logistic regression model to the daily measurements of the diary keepers to estimate the effects of these variables on the risk of getting ILI.ResultsDuring the influenza season, 160 participants provided 14,317 health diaries and recorded 124,222 face-to-face contacts. The model estimated odds ratio of getting ILI was 1.87 (95% CI 1.40-2.50) when a person had contact with others having ILI in the previous 3 days. Longer duration of physical exercise and eating more fruits, beans, and dairy products were associated with lower risk of getting ILI. However, staying up late was linked to an elevated risk of getting ILI. Higher variation of ambient temperature and worse air quality were associated with increased risk of developing ILI.ConclusionsDeveloping a healthier lifestyle, avoiding contact with persons having ILI symptoms, and staying alert with respect to temperature changes and air quality can reduce the risk of getting ILI.

Telemedicine for Facio-Scapulo-Humeral Muscular Dystrophy: A multidisciplinary approach to improve quality of life and reduce hospitalization rate?

BackgroundFacio-Scapulo-Humeral Muscular Dystrophy (FSHD) is an autosomal dominant inherited disorder characterized by a variable and asymmetric involvement of facial, trunk, upper and lower extremity muscles. Although respiratory weakness is a relatively unknown feature of FSHD, it is not rare. Telemedicine has been used in a variety of health care fields, but only recently, with the advent of sophisticated technology, its interest among health professionals became evident, even in such diseases. ObjectiveTo demonstrate the telemedicine efficacy in FSHD. MethodsFour siblings affected by a severe form of FSHD, living in a rural area far away from the referral center for neuromuscular diseases, who used a wheelchair, suffered from chronic respiratory failure and were provided with long-term non-invasive mechanical ventilation, received a 6-month period of telemedicine support. This consisted of video conferencing (respiratory physiotherapy, psychological support, neurological and pneumological assessment, nurse-coach supervision) and telemonitoring of cardiorespiratory variables (oxygen saturation, blood pressure, and heart rate). ResultsWe performed 540 video conference sessions per patient, including three daily contacts with short monitoring oximetry measurements, blood pressure, and heart-rate measurements, psychological support, neurological and pneumological assessment, nurse-coach supervision. ConclusionsOur findings indicate that our telemedicine system was user-friendly, efficient for the home treatment of FSHD, and allowed reducing hospital admissions.

Who\u2019s holding the baby? A prospective diary study of the contact patterns of mothers with an infant

BackgroundModels of infectious disease are increasingly utilising empirical contact data to quantify the number of potentially infectious contacts between age groups. While a growing body of data is being collected on contact patterns across many populations, less attention has been paid to the social contacts of young infants. We collected information on the social contacts of primary carers of young infants and investigated their potential for use as a proxy for contacts made by their infant.MethodsWe recruited primary carers of infants under one year of age residing in two geographically, demographically and socioeconomically distinct local government areas of Melbourne, Australia — Boroondara and Hume — including a sub-group of Turkish-speaking participants. Participants recorded their own contacts in a paper diary and noted whether their infant was present or absent. Information collected included times at an address; description of location; and details on people contacted at the location. Descriptive summary measures and distributions of contacts by location type, intensity, day of contact and by age are reported.ResultsOf the 226 participants recruited, 220 completed diaries were returned. Participant contact patterns were similar across all groups, with respect to the types of locations, intensity and day of contact, with some variation in the number of unique daily contacts. The infant was present at around 85% of locations at which the primary carer contacted other individuals. The majority of contacts occurring when the infant was present were in Own Home (32%), Retail and Hospitality (18%) and Transport (18%) settings. The mean daily number of unique contacts by infants was estimated as 9.1, 8.7 and 6.5 in Boroondara, Hume (English) and Hume (Turkish), respectively, with a similar age distribution across each of our surveyed groups.ConclusionsOur demonstration that contact patterns of mothers with infants are reasonably robust to socioeconomic and cultural differences is a step forward in modelling infectious disease transmission. With infants spending most of their time in the company of their mother, contact patterns of mothers are a useful proxy measure of infant contact patterns. The age distribution of contacts made by infants estimated in this study may be used to supplement population-wide contact information commonly used in infectious disease transmission models.

The interplay between individual social behavior and clinical symptoms in small clustered groups

BackgroundMixing patterns of human populations play a crucial role in shaping the spreading paths of infectious diseases. The diffusion of mobile and wearable devices able to record close proximity interactions represents a great opportunity for gathering detailed data on social interactions and mixing patterns in human populations. The aim of this study is to investigate how social interactions are affected by the onset of symptomatic conditions and to what extent the heterogeneity in human behavior can reflect a different risk of infection.MethodsWe study the relation between individuals’ social behavior and the onset of different symptoms, by making use of data collected in 2009 among students sharing a dormitory in a North America university campus. The dataset combines Bluetooth proximity records between study participants with self-reported daily records on their health state. Specifically, we investigate whether individuals’ social activity significantly changes during different symptomatic conditions, including those defining Influenza-like illness, and highlight to what extent possible heterogeneities in social behaviors among individuals with similar age and daily routines may be responsible for a different risk of infection for influenza.ResultsOur results suggest that symptoms associated with Influenza-like illness can be responsible of a reduction of about 40% in the average duration of contacts and of 30% in the daily time spent in social interactions, possibly driven by the onset of fever. However, differences in the number of daily contacts were found to be not statistically significant. In addition, we found that individuals who experienced clinical influenza during the study period were characterized by a significantly higher social activity. In particular, both the number of person-to-person contacts and the time spent in social interactions emerged as significant risk factors for influenza infection.ConclusionsOur findings highlight that Influenza-like illness can remarkably reduce the social activity of individuals and strengthen the idea that the heterogeneity in social habits among individuals can significantly contribute in shaping differences among the individuals’ risk of infection.

How to change contracts into beneficial relationships – the results of empirical research

How to change contracts into beneficial relationships – the results of empirical research

Analysing workplace violence towards health care staff in public hospitals using alternative ordered response models: the case of north-eastern Turkey

The main objective of this article is to determine key factors that may have a significant effect on the verbal abuse, emotional abuse and physical assault of health care workers in north-eastern Turkey. A self-administered survey was completed by 450 health care workers in three well-established hospitals in Erzurum, Turkey. Because of the discrete and ordered nature of the dependent variable of the survey, the data were analysed using four distinctive ordered response models. Results revealed that several key variables were found to be a significant determinant of workplace violence, such as the type of health institution, occupational position, weekly working hours, weekly shift hours, number of daily patient contacts, age group of the respondents, experience in the health sector, training against workplace violence and current policies of the hospitals and the Turkish Ministry of Health.

Companionship and time investment in social fields at different life cycle stages: Implications for activity and travel modeling and simulation

In this paper, we employ structural regression models to identify the differences and commonalities among life cycle stages in daily interpersonal contacts and their activity-travel time allocation. The daily contacts (with family, friends, schoolmates, co-workers, clubmates, and others), duration of activities by type, and travel time are the endogenous variables of the system. Life-cycle stages, day of the week, and accessibility are the exogenous variables. The model finds life-cycle dependent roles in interpersonal interactions and intra-household contacts and friends are significant in explaining service, shopping, home-leisure, and out of home social activity durations. Moreover, the many significant indirect paths of this model show we should include human interactions and paths of influence in activity models. We also compare the direct and indirect influence between two models, one that includes number of daily contacts and a second model without daily contacts. Three groups are found as the most sensitive in allocation of time when controlling for daily contacts and they are children younger than 17 years, persons in home duties, and college students. In addition, allocation of time to discretionary activities is the most sensitive to specifications that control for number of daily contacts.

Social Contact Structures and Time Use Patterns in the Manicaland Province of Zimbabwe.

BackgroundPatterns of person-to-person contacts relevant for infectious diseases transmission are still poorly quantified in Sub-Saharan Africa (SSA), where socio-demographic structures and behavioral attitudes are expected to be different from those of more developed countries.Methods and FindingsWe conducted a diary-based survey on daily contacts and time-use of individuals of different ages in one rural and one peri-urban site of Manicaland, Zimbabwe. A total of 2,490 diaries were collected and used to derive age-structured contact matrices, to analyze time spent by individuals in different settings, and to identify the key determinants of individuals’ mixing patterns. Overall 10.8 contacts per person/day were reported, with a significant difference between the peri-urban and the rural site (11.6 versus 10.2). A strong age-assortativeness characterized contacts of school-aged children, whereas the high proportion of extended families and the young population age-structure led to a significant intergenerational mixing at older ages. Individuals spent on average 67% of daytime at home, 2% at work, and 9% at school. Active participation in school and work resulted the key drivers of the number of contacts and, similarly, household size, class size, and time spent at work influenced the number of home, school, and work contacts, respectively. We found that the heterogeneous nature of home contacts is critical for an epidemic transmission chain. In particular, our results suggest that, during the initial phase of an epidemic, about 50% of infections are expected to occur among individuals younger than 12 years and less than 20% among individuals older than 35 years.ConclusionsWith the current work, we have gathered data and information on the ways through which individuals in SSA interact, and on the factors that mostly facilitate this interaction. Monitoring these processes is critical to realistically predict the effects of interventions on infectious diseases dynamics.

Perception of Emotional Facial Expressions in Amyotrophic Lateral Sclerosis (ALS) at Behavioural and Brain Metabolic Level.

IntroductionAmyotrophic lateral sclerosis (ALS) primarily impairs motor abilities but also affects cognition and emotional processing. We hypothesise that subjective ratings of emotional stimuli depicting social interactions and facial expressions is changed in ALS. It was found that recognition of negative emotions and ability to mentalize other’s intentions is reduced.MethodsProcessing of emotions in faces was investigated. A behavioural test of Ekman faces expressing six basic emotions was presented to 30 ALS patients and 29 age-, gender and education matched healthy controls. Additionally, a subgroup of 15 ALS patients that were able to lie supine in the scanner and 14 matched healthy controls viewed the Ekman faces during functional magnetic resonance imaging (fMRI). Affective state and a number of daily social contacts were measured.ResultsALS patients recognized disgust and fear less accurately than healthy controls. In fMRI, reduced brain activity was seen in areas involved in processing of negative emotions replicating our previous results. During processing of sad faces, increased brain activity was seen in areas associated with social emotions in right inferior frontal gyrus and reduced activity in hippocampus bilaterally. No differences in brain activity were seen for any of the other emotional expressions. Inferior frontal gyrus activity for sad faces was associated with increased amount of social contacts of ALS patients.ConclusionALS patients showed decreased brain and behavioural responses in processing of disgust and fear and an altered brain response pattern for sadness. The negative consequences of neurodegenerative processes in the course of ALS might be counteracted by positive emotional activity and positive social interactions.

Ambulant treatment of alcohol withdrawal

Most of the patients addicted to alcohol are socially well integrated. The offer of a low threshold ambulant withdrawal therapy opens an opportunity to build a sustainable therapeutic relationship. The so started empathic addiction therapy will be well accepted and will lead to a satisfying outcome. Using Clomethiazole or Oxazepam in a daily reduced dose and with daily personal contacts, the ambulant withdrawal in patients without seizures or delir in medical history is a secure and successful therapeutic option.

Ethnic Markets in post-Soviet Transitional Space: Their Role in Society and the Research Area

Open-air have become an essential element of the post-socialist transitional space. They appear over vast area from China to Poland and Germany. Coupled with the huge scale and meaningful trading, they formed new phenomenon in the economic, social, political and cultural life. Markets have become mechanism of economic survival for the vast number of people who have lost their former status and sources of income; they created the launching pad for the formation of small and medium-sized businesses. For some time they have been key element of the supply of goods and wage, especially for low-income strata. As the first and final points of shuttle trading system, have integrated into the global system of relationships, not only trade ones, but socio-cultural as well. Open-air have become an important area of economic activity for the cross-border migrant workers, facilitating their economic and cultural integration. In conjunction with their huge role in promoting Chinese and Turkish goods into the emerging markets, the have been treated in urban communities as markets, namely Chinese, Kyrgyz and Caucasian. As such, they quickly outgrew usual marketplaces and turned into sophisticated and self-developing social organisms, clumps of social connections, networks, conflict places, power and control mechanisms. In many Russian cities the largest and migrant clusters formed around these markets. They became a meeting and place of daily mass contacts, cooperation and conflicts; representatives of different languages, cultures and traditions. Markets have gained tremendous symbolic importance, commonly representing lot of new forms of life, economic and cultural practices, ways of social contacts and relationships. The end of the post-socialist era drew line under this very role of markets. They have not disappeared completely, but changed themselves and change their function and place in the community. Many of the have been closed, the remaining ones have been marginalized and relegated to the outskirts of cities and in the periphery of economic life. They are changing their format; and on the site of the former wholesale and retail in the open air now there are hypermarkets, malls, etc. This does not mean the end of ethnic business; it is also being rebuilt and efficiently developing new formats and new rules of the game. Great importance of in the era of post-socialist transitional space is paradoxically combined with weak public attention and little research. Political turmoil and social upheavals overshadowed this problem in the minds of people and in the views of researchers. The purpose of this text is to classify and organize what we know (and what we presumably do not know) about the open-air ethnic markets in the post-Soviet era. Perhaps this work will formulate an agenda for future research.

Value-added functional textiles by plasma-based surface modification

Event Abstract Back to Event Value-added functional textiles by plasma-based surface modification Ranna Tolouei1, Sondes Sondes Gargoubi2, Lucie Levesque1, Pascale Chevallier1, Stephane Turgeon1 and Diego Mantovani1 1 CHU de Quéebec Research Centre, Laval University, Lab. for Biomaterials & Bioengineering (CRC-I), Dept. Min-Met-Materials Engineering, Canada 2 ISET Ksar-Hellal, Textile Engineering Laboratory, Tunisia Recently, there has been a strong interest in providing fabrics with greater wearing comfort while remaining fresh and odor free as well as the ability to impart antimicrobial properties[1]. The innovative combination of controllable topographical and chemical modifications of the material will be a step forward for surface engineering towards real life application: to make surfaces less liable to microbial adhesion, or easier to be cleaned, with the addition of an antimicrobial agent. The fabric surfaces are not only exposed to abrasion and wear caused by daily contacts, but also to aggressive laundry procedures. So far, many different methods have been studied using approaches such as polymeric grafting or polymeric coating accompanied by lack of stability[2]. Thus, higher mechanical and chemical stabilities become mandatory properties for such materials and need to be taken into consideration during the design process. Using plasma-based process techniques, thereby obtaining a highly stable and homogenous functional surface could be a potential alternative. Materials and Methods Cotton knit fabric samples were were cut into size of 1×1 cm2 and cleaned in successive baths of acetone and diethyl ether anhydrous for 10 minutes before being used. Surface modifications were performed using a hybrid plasma enhanced chemical vapor deposition (PE-CVD) reactor, operating at 13.56 MHz at room temperature. Hydrogen and nitrogen (N2:H2) were used as gas precursors for plasma pre-treatment of cotton fabric to enhance antimicrobial dye uptake. Methane was used for deposition of biocidal doped amorphous carbon (aC) nanocoating on the cotton fabric. Chemical state of surface was characterized by X-ray photoelectron spectroscopy (XPS), Fourier transform infrared (FTIR) spectroscopy and scanning electron microscopy (SEM). The wettability of the surfaces after each modification has been measured using static water contact angle (WCA). The antibacterial activity of the treated fabric was estimated against Escherichia coli (ATCC 11229). To evaluate durability of wash, a hospital laundry process was chosen[3]. Results: The morphological changes due to plasma treatments were investigated by SEM as shown in Figure 1. It reveals a fairly smooth surface for untreated and N2:H2 pretreated samples, whereas nanocoating deposition caused a significant morphological change. Surface chemical composition analyses, by XPS, exhibited that the aC deposition was efficient as carbon became the major component of the surface: 95.4 at.% for nanocoated sample versus 67 at.% for untreated one. N2:H2 pretreated samples displayed high amount of nitrogen (at.%). Depending on plasma modification process the wetting behavior of cotton fabric could be tailored. Indeed, the WCA demonstrate the effect of plasma treatment by changing untreated cotton fabric wettability from ~ 100° to hydrophobic state (~145°) or hydrophilic state (~ 80°) by aC nanocoating and N2:H2 pretreatment, respectively. Antibacterial test revealed that nanocoated samples as well as N2:H2 pretreated samples with antimicrobial agents shown antibacterial activity against E. Coli as compared to untreated cotton fabric before and after laundry. Discussion and Conclusions: Our results clearly show the feasibility of low temperature plasma based process to modify the surface of fabric towards tuning the wetting behavior and antibacterial property. Moreover, stable antibacterial activity has been achieved by deposition of nanocoating on the surface of cotton fabric. The goal of the present work was to propose an appropriate treatment for functionalization of cotton fabric, which can be applied by textile industry using ecofriendly and non-toxic agents and processes. This work was partially supported by NSERC-Canada, CIHR-Canada, CFI-Canada, FRQ-NT-Quebec, and MRI-Quebec.

Social contacts, vaccination decisions and influenza in Japan

BackgroundContact patterns and vaccination decisions are fundamental to transmission dynamics of infectious diseases. We report on age-specific contact patterns in Japan and their effect on influenza vaccination behaviour.MethodsJapanese adults (N=3146)...

Surrogacy: The experience of Greek commissioning women.

Available studies on surrogacy are extremely limited. Findings suggest that surrogacy is experienced as problem free, with a significant number of commissioning mothers maintaining contact with the surrogates over time. To explore the experiences of Greek commissioning women regarding the surrogacy arrangement and birth of a child through surrogacy. The data of this study were collected from 7 intended mothers who had either a long history of infertility or serious health problems. Interviews were tape-recorded, transcribed and analysed employing content analysis. The analysis of the women's accounts revealed three themes: (a) a shared journey, (b) the birth of a long-awaited child, and (c) the surrogacy disclosure. The surrogacy process became the women's affairs, with their partners offering backstage support. A very close bond was developed with the surrogates, characterised by daily contacts and care-giving behaviours. While this bond was abruptly discontinued after the child's birth, it was interiorised with all participants being grateful to their surrogate. The timing and content of the surrogacy disclosure to family and child(ren) were carefully chosen by participants, who avoided providing information when egg donation was involved. Findings are reassuring for women who want to parent a child through a surrogate arrangement, and suggest that the availability of counselling services may help intended mothers to cope with disclosure issues.

Web-enabled conversational interactions as a method to improve cognitive functions: Results of a 6-week randomized controlled trial

IntroductionIncreasing social interaction could be a promising intervention for improving cognitive function. We examined the feasibility of a randomized controlled trial to assess whether conversation-based cognitive stimulation through personal computers, webcams, and a user-friendly interactive Internet interface had high adherence and a positive effect on cognitive function among older adults without dementia. MethodsDaily 30-minute face-to-face communications were conducted during a 6-week trial period in the intervention group. The control group received only a weekly telephone interview. The cognitive status of normal subjects and those with mild cognitive impairment was operationally defined as a global clinical dementia rating of 0 and 0.5, respectively. Age, sex, education, mini mental state examination score, and clinical dementia rating score were balancing factors in randomization. The subjects were recruited using mass-mailing invitations. The pre- to postintervention differences in the cognitive test scores and loneliness scores were compared between the control and intervention groups using linear regression models. ResultsEighty-three subjects participated (41 in the intervention group and 42 in the control group). Their mean ± standard deviation age was 80.5 ± 6.8 years. Adherence to the protocol was high. There was no dropout and mean percentage of days completed of the targeted trial days among the intervention group was 89% (range 77%–100%). Among the cognitively intact participants, the intervention group improved more than did the control group on a semantic fluency test (P = .003) at the post-trial assessment and a phonemic fluency test (P = .004) at the 18-week assessments. Among those with mild cognitive impairment, a trend (P = .04) toward improved psychomotor speed was observed in the intervention group. ConclusionDaily conversations by way of user-friendly Internet communication programs demonstrated high adherence. Among the cognitively intact, the intervention group showed greater improvement in tests of language-based executive functions. Increasing daily social contacts through communication technologies could offer cost-effective home-based prevention methods. Additional studies with a longer follow-up duration are required to examine whether the intervention slows cognitive declines and delays the onset of dementia.