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As the understanding of health care worker lived experience during coronavirus disease 2019 (COVID-19) grows, the experiences of those utilizing emergency health care services (EHS) during the pandemic are yet to be fully appreciated.
The objective of this research was to explore lived experience of EHS utilization in Victoria, Australia during the COVID-19 pandemic from March 2020 through March 2021.
An explorative qualitative design underpinned by a phenomenological approach was applied. Data were collected through semi-structured, in-depth interviews, which were transcribed verbatim and analyzed using Colaizzi’s approach.
Qualitative data were collected from 67 participants aged from 32 to 78-years-of-age (average age of 52). Just over one-half of the research participants were male (54%) and three-quarters lived in metropolitan regions (75%). Four key themes emerged from data analysis: (1) Concerns regarding exposure and infection delayed EHS utilization among participants with chronic health conditions; (2) Participants with acute health conditions expressed concern regarding the impact of COVID-19 on their care, but continued to access services as required; (3) Participants caring for people with sensory and developmental disabilities identified unique communication needs during interactions with EHS during the COVID-19 pandemic; communicating with emergency health care workers wearing personal protective equipment (PPE) was identified as a key challenge, with face masks reported as especially problematic for people who are deaf or hard-of-hearing; and (4) Children and older people also experienced communication challenges associated with PPE, and the need for connection with emergency health care workers was important for positive lived experience during interactions with EHS throughout the pandemic.
This research provides an important insight into the lived experience of EHS utilization during the COVID-19 pandemic, a perspective currently lacking in the published peer-reviewed literature.
Balloon valvuloplasty and surgical aortic valvotomy have been the treatment mainstays for congenital aortic stenosis in children. Choice of intervention often differs depending upon centre bias with limited relevant, comparative literature.
This study aims to provide an unbiased, contemporary matched comparison of these balloon and surgical approaches.
Retrospective analysis of patients with congenital aortic valve stenosis who underwent balloon valvuloplasty (Queensland Children’s Hospital, Brisbane) or surgical valvotomy (Royal Children’s Hospital, Melbourne) between 2005 and 2016. Patients were excluded if pre-intervention assessment indicated ineligibility to either group. Propensity score matching was performed based on age, weight, and valve morphology.
Sixty-five balloon patients and seventy-seven surgical patients were included. Overall, the groups were well matched with 18 neonates/25 infants in the balloon group and 17 neonates/28 infants in the surgical group. Median age at balloon was 92 days (range 2 days – 18.8 years) compared to 167 days (range 0 days – 18.1 years) for surgery (rank-sum p = 0.08). Mean follow-up was 5.3 years. There was one late balloon death and two early surgical deaths due to left ventricular failure. There was no significant difference in freedom from reintervention at latest follow-up (69% in the balloon group and 70% in the surgical group, p = 1.0).
Contemporary analysis of balloon aortic valvuloplasty and surgical aortic valvotomy shows no difference in overall reintervention rates in the medium term. Balloon valvuloplasty performs well across all age groups, achieving delay or avoidance of surgical intervention.
Incumbent city councillors have an almost insurmountable advantage in Canadian municipal elections. This article aims to improve our understanding of the municipal incumbency advantage by considering the ability of electors to correctly identify the two most competitive candidates in one's ward and the factors associated with being able to do so. Using survey data from the Canadian Municipal Election Study (CMES), we consider the case of the 2018 elections in Mississauga, a city with typically high rates of incumbent re-election. Survey respondents were asked to identify the two most competitive candidates in their local ward races. We find that comparatively few electors are able to recognize which challenger serves as the strongest threat to a sitting councillor, a finding that suggests that coordination problems may help to contribute to high rates of incumbent success. We identify several individual-level and ward-level correlates of correctly identifying the first-place and second-place finishers. We do note, however, that there is a significant amount of variation among the thousands of municipalities in Canada, so findings from this case should be tested in other settings, including larger or smaller cities where levels of information might be different.
Previous research has identified a lack of clarification regarding paramedic professional obligation to work. Understanding community expectations of paramedics will provide some clarity around this issue. The objective of this research was to explore the expectations of a sample of Australian community members regarding the professional obligation of paramedics to respond during pandemics.
The authors used qualitative methods to gather Australian community member perspectives immediately before the onset of the coronavirus disease 2019 (COVID-19) pandemic. Focus groups were used for data collection, and a thematic analysis was conducted.
The findings revealed 9 key themes: context of obligation (normal operations versus crisis situation), hierarchy of obligation (individual versus organizational obligation), risk acceptability, acceptable occupational risk (it’s part of the job), access to personal protective equipment, legal and ethical guidelines, education and training, safety, and acceptable limitations to obligation. The factors identified as being acceptable limitations to professional obligation are presented as further sub-themes: physical health, mental health, and competing personal obligations.
The issue of professional obligation must be addressed by ambulance services as a matter of urgency, especially in light of the COVID-19 coronavirus pandemic. Further research is recommended to understand how community member expectations evolve during and after the COVID-19 coronavirus pandemic.
Disaffection of youth from politics is a well-documented phenomenon in many countries. In this article, we consider whether the social networks of young people have the same influence on political engagement as they have been found to have for older adults. We use a single dataset to test the effects of discussion and disagreement on the political engagement of young people (30 and under) and older adults. We find that social network discussion has a stronger effect on the engagement of young people but that disagreement has no clear differential effect.
Voter participation is widely viewed as invaluable by democratic theorists, and a large majority of members of the Canadian public believe that low turnout weakens Canadian democracy. In response to decreasing rates of turnout in federal elections, Elections Canada has run advertising campaigns during the last several election campaigns encouraging Canadians to participate by voting. Using Election Canadian Study data from 2006 and 2008, this note examines the effect of Elections Canada's advertisements upon turnout and the partisan outcome of elections. Results reveal that the ad campaigns have effects upon both factors. The ads increase turnout among segments of the population with traditionally low turnout rates and are associated with an overall decrease in the Conservative party's vote share.
We observed with HARPS, the Rossiter-McLaughlin effect for 40 of the 75 transiting hot Jupiters discovered in the Southern Hemisphere by WASP. Our observations reveal a wide distribution in orbital inclinations indicative of past dynamical interactions. Our data also demonstrate the important effect produced by tidal interactions in shaping the spin–orbit (β) angle distribution. We briefly present and interpret the data we collected in a series of graphs.
Abstract. Concern about the environment has grown around the world. Important work has assessed the correlates of support for the environment and its relationship to values (for example, Inglehart, 1995). Recent comparative work on political party positioning demonstrates how the issue has increasingly taken on a left–right dimension (Dalton, 2009). Filling a void in the literature, this paper explores how and whether the environmental issue has been incorporated into the ideological space of Canadian citizens and reflected in the views of the major political parties outside of Quebec. In particular, we first consider the extent to which the environment is a left–right issue in the minds of Canadian citizens. We follow this by assessing the effect of environmental concern on citizens' views of political parties and whether this issue tends to operate as a positional or valence issue in differentiating political parties. We use the Canadian Election Studies from 2000–2006 to address these research questions empirically.
Résumé. L'intérêt pour la protection de l'environnement s'est intensifié autour du monde. Des recherches ont été menées sur la corrélation entre l'idéologie et la protection de l'environnement (par exemple, Inglehart 1995). Une étude récente sur le positionnement des partis politiques en matière d'environnement démontre que la question prend de plus en plus une dimension gauche–droite (Dalton 2009). Dans le but de combler un manque dans la littérature, cet article tente d'établir dans quelle mesure l'environnement a effectivement été intégré dans l'espace idéologique des citoyens canadiens et se reflète dans l'opinion sur les principaux partis politiques à l'extérieur du Québec. Nous examinons d'abord jusqu'à quel point l'environnement est considéré par les Canadiens comme un enjeu politique de gauche ou de droite. Nous évaluons ensuite l'effet de cet intérêt pour l'environnement sur l'opinion des citoyens canadiens à l'égard des partis politiques en vue de déterminer s'il s'agit là d'un enjeu de valeur ou d'un enjeu positionnel dans les choix politiques et électoraux. Nous appuyons empiriquement notre étude sur les données de l'Étude électorale canadienne de 2000 à 2006.
A yield problem is observed with tungsten vias formed on copper interconnects. Copper migration can occur during chemical vapor deposition (CVD) of tungsten, if there are defects in the liner inside the via. Copper can react quickly with SiH4 during the early stages of tungsten deposition, when SiH4-reduction of WF6 is used. Under severe conditions, large amounts of copper diffuse out of the underlying metal layer, resulting in copper silicide formation in the via and leaving voids in the copper wire. Copper migration can be minimized by reducing the time that the wafers are exposed to SiH4.
Abstract. The last two decades have witnessed dramatic downswings in voter turnout. Turnout decline among the youngest voters has been particularly pronounced, even discounting for normal life-cycle effects. Voting and abstention are habitual, so initial turnout decisions set the course for the life span. Consequently, greater attention to the immediate pre-adult years is necessary. This is the task we undertake using survey data on Ontario adolescents' attitudes toward voting.
Résumé. Les deux dernières décennies témoignent d'un déclin dramatique de la participation électorale. Chez les plus jeunes électeurs, cette tendance s'avère particulièrement prononcée, même en tenant compte des effets habituels du cycle de vie. Le fait de voter ou de s'en abstenir sont une question d'habitude, de sorte que la décision initiale de pparticiper ou non tend à déterminer le comportement pour la vie. Il importe donc d'accorder plus d'attention aux années précédant immédiatement l'âge adulte. C'est la tâche que nous entreprenons en nous appuyant sur les données de sondages portant sur l'attitude des adolescents de l'Ontario à l'égard du vote.
Abstract. While an important component of incumbent support, the effect of economic conditions on vote choice (economic voting) can be undermined by the presence of multilevel institutions; voters are faced with the prospect of evaluating economic conditions and governments at different levels simultaneously. This paper tests the applicability of a model which seeks to account for how and how well voters cope with the complexity of multilevel governance. The accountability-centred model suggests that federal and provincial governments should only be evaluated for those actions and outcomes that they can reasonably be seen to have influence over. Additionally, it is asked whether high information respondents are better able to navigate some of the complexities of Canada's multilevel system. Analyses are conducted using data from the 1993 and 1997 Canadian Election Studies.
Résumé. Les conditions économiques constituent un facteur d'appui électoral important pour les dirigeants politiques. Il semble, toutefois, que l'impact de ce facteur soit amoindri dans les États présentant plusieurs niveaux de gouvernement. Dans les sociétés ayant des institutions multi-paliers, les électeurs ont en effet le défi d'attribuer les performances économiques aux divers paliers de gouvernement. Cet article teste un modèle théorique qui tente d'expliquer comment les électeurs se comportent face à la complexité de la gouvernance multi-paliers au Canada. Le modèle, centré sur la responsabilité des dirigeants, suggère que les gouvernements fédéral et provinciaux devraient uniquement être jugés pour les décisions et résultats politiques sur lesquels ils exercent manifestement une influence. Cet article examine, en outre, la question de savoir si les électeurs bien informés saisissent mieux la complexité de la gouvernance multi-paliers lorsqu'ils évaluent la performance des dirigeants. L'analyse se fonde sur les données de l'Étude électorale canadienne de 1993 et de 1997.
Abstract. Despite widespread attention paid to issues of
representation, how Canadians think and feel about different facets of
representation are inadequately documented and understood. Using data from
the 2000 Canadian Election Study (CES), the article addresses this dearth
of systematic research through an examination of popularly held attitudes
toward three dimensions of political representation: direct versus
representative democracy, the role of the elected representative and
territorial versus non-territorial bases of substantive representation.
Particular attention is paid to the impact of political knowledge and the
individualist/collectivist value cleavage on representational
preferences. Results are discussed in light of current debates regarding
institutional and representational change in Canada.
Résumé. En dépit de l'attention
portée aux enjeux de la représentation, les sentiments et
les idées des Canadiens par rapport aux différents aspects
de la représentation sont mal documentés et compris. Cet
article emploie les données de l'Étude
électorale canadienne (ÉÉC) et cherche à
combler cette lacune en examinant les attitudes populaires par rapport
à trois dimensions de la représentation politique : la
démocratie directe versus représentative, le rôle du
représentant élu, et les bases de représentation
territoriales versus non-territoriales. Nous accordons une attention
particulière aux répercussions du niveau de connaissances
politiques et des valeurs individualistes ou collectivistes sur les
préférences en matière de représentation. Les
résultats sont examinés à la lumière des
débats récents sur le renouveau institutionnel et les
modifications de la représentation au Canada.
Debates about the most appropriate way to research the relationship between old age and death highlight many of the ethical dilemmas facing all researchers, and social researchers specifically. In this chapter, we review the ethical issues that arose when developing the methodology for a one-year pilot study exploring the lives of 100 people over the age of 80. These ethical dilemmas included whether older people with dementia can or should consent to research participation; whether it was appropriate to obtain proxy consent from carers; how the ethical issues which arose were addressed through a Research Ethics Committee (REC); and how we, as researchers, dealt with ethical issues as they arose within the research interaction.
The relationship between old age and death is poorly understood (Harper, 2000). Despite increasing concern about the care of older people, recent health and social care policies on ageing make few references to death and dying. The emphasis is on maintaining and restoring the independence of older people (DoH, 1998; Royal Commission on Long Term Care, 1999). This results in an inadequate policy framework for developing services for older people who are increasingly dependent on others and for whom rehabilitation services are no longer appropriate (Lloyd, 2000). The National Service Framework for Older People (DoH, 2001) marks a new development in government health policy in acknowledging the need for better end-of-life care in old age and for rehabilitation and support as health declines. However, increased awareness does not necessarily translate into improved practice. Evidence suggests strongly that the responses of health and social services to older people’s needs are patchy and inconsistent (Henwood, 2001).
The research project discussed in this chapter aimed to explore these issues in depth from the perspective of older people themselves. By listening to older people’s accounts of their lives, we hoped to better understand their involvement in key decisions made about their lives by health and social care professionals. The project was funded as a pilot study to test and refine our prospective longitudinal approach prior to undertaking a larger study. While older people were the focus of this project, they were also actively involved in the project advisory group helping us to plan and fine tune the research methodology.
Imagine the following scenario. Susan and Tom have just started dating and are dining at a local restaurant. The service has been slow, and as they wait for the check Tom is furious and wants to complain to the manager. Susan, on the other hand, notes how busy the restaurant has been, and feels sympathy for the overworked, harried waiter – if anything, she wants to leave a large tip. Susan and Tom argue about the matter and leave in a huff.
This sort of interpersonal problem, all too familiar to many of us, arises in part when people have different emotional reactions to events. When individuals' emotions diverge in social interactions, they are left to grapple with their different perceptions, action tendencies, and often uncharitable explanations for why they differ. Had Susan and Tom both felt sympathy for the waiter, they would have agreed on the reasons for the slow service, a course of action, and perhaps felt solidarity in their shared response.
Based on the idea that it is adaptive for relationship partners to have similar emotional reactions to events, we propose that people in close relationships develop increasing similarity in their emotional responses over time – a process we call emotional convergence. Furthermore, we propose that people with less power make more of the change necessary for emotional convergence to occur. In this chapter, we elaborate on the theoretical basis for these hypotheses and draw on recent longitudinal studies of relationships to provide supportive evidence.