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OBJECTIVES: To document the level of vaccine hesitancy in caregivers of children younger than 12 years of age over the course of the pandemic in Pediatric Emergency Departments (ED). Study design Ongoing multicenter, cross-sectional survey of caregivers presenting to 19 pediatric EDs in the USA, Canada, Israel, and Switzerland during first months of the pandemic (phase1), when vaccines were approved for adults (phase2) and most recently when vaccines were approved for children (phase3). RESULTS: Willingness to vaccinate rate declined over the study period (59.7%, 56.1% and 52.1% in the three phases). Caregivers who are fully vaccinated, who have higher education, and those worried their child had COVID-19 upon arrival to the ED, were more likely to plan to vaccinate in all three phases. Mothers were less likely to vaccinate early in the pandemic, but this hesitancy attenuated in later phases. Older caregivers were more willing to vaccinate, and caregivers of older children were less likely to vaccinate their children in phase 3. During the last phase, willingness to vaccinate was lowest in those who had a primary care provider but did not rely on their advice for medical decisions (34%). Those with no primary care provider and those who do and rely on their medical advice, had similar rates of willingness to vaccinate (55.1% and 52.1%, respectively). CONCLUSIONS: COVID-19 vaccine hesitancy is widespread and growing over time, and public health measures should further try to leverage identified factors associated with hesitancy in order to enhance vaccination rates among children.

The author provides an overview of internationalization in higher education since 2008 to the present. The essay is a partial follow-up to Bone's 2008 paper on internationalization.

Polymer composite materials are widely used in marine applications where an understanding of the long-term performance is essential for economic, safety and durability requirements. Although moisture absorption in composites has been studied for many years, the relationship between the mechanisms of moisture absorption and consequent changes in material behaviour has received much less attention. Understanding degradation is necessary for developing lifetime assessments. In this work, long-term exposure of a unidirectional carbon fibre epoxy composite material in water has been investigated in relation to mechanical property changes and moisture uptake. Using diffusion modelling and microscopy of the fracture surfaces, it is possible to correlate water absorption to experimental data showing how the position of water in the material causes changes to flexural properties (modulus decreased by 14% and strength by 20%) and in the glass transition temperature, Tg reduced by 18%. Flexural modulus has been shown to be most affected by water interaction with the fibre interface; Tg by water interaction within the resin; and flexural strength equally by water interaction with both fibre interface and resin. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to examine potential heterogeneity in longitudinal changes in home-based arts engagement during the first national lockdown and following gradual easing of restrictions in the UK. Furthermore, it sought to explore factors that were associated with patterns of longitudinal changes in home-based arts engagement.Method: Data were from the UCL COVID-19 Social Study. The analytical sample consisted of 29,147 adults in the UK who were followed up for 22 weeks from 21 March to 21 August 2020. Data were analysed using growth mixture models.Results: Our analyses identified five classes of growth trajectories. There were two stable classes showing little change in arts engagement over time (64.4% in total), two classes showing initial increases in arts engagement followed by declines as restrictions were eased (29.8%), and one class showing slight declines during strict lockdown followed by an increase in arts engagement after the easing of restrictions (5.9%). A range of factors were found to be associated with class membership of these arts engagement trajectories, such as age, gender, education, income, employment status, and health.Conclusion: There is substantial heterogeneity in longitudinal changes in home-based arts engagement. For participants whose engagement changed over time, growth trajectories of arts engagement were related to changes in lockdown measures. These findings suggest that some individuals may have drawn on the arts when they needed them the most, such as during the strict lockdown period, even if they usually had lower levels of arts engagement before the pandemic. Overall, our results indicate the importance of promoting arts engagement during pandemics and periods of lockdown as part of public health campaigns. [ABSTRACT FROM AUTHOR]

At the present time, the sewage treatment plants in the United Kingdom produce about 25,000,000 t of sewage sludge each year at a concentration of 4% solids. New regulations in the United Kingdom forbid sea dumping, and in the near future new incinerators will be required to dispose of about 5,000,000 t per year. The research program at the Sheffield University consisted of design and construction of a small-scale cylindrical rotating fluidized bed incinerator with an inside diameter of 200 mm and an axial length of up to 200 mm. The fluidizing medium was silica sand (0.6-0.7 mm) and the bed depth 30-50 mm. The rotational speed of the bed varied between 100 and 1,000 rpm (which produced 1-100 g loading). Coal, oil, sewage sludge, and chicken manure (biomass) were burnt in the bed at temperatures between 700 [degrees] and 900 [degrees] C. Measurements of heat transfer rate, bed temperature, and exhaust gas composition were carried out over a range of operating conditions. The influence of rotational forces on basic fluidization characteristics (pressure drop, minimum fluidization, and particle mixing) were also investigated on a perspex model. The results obtained from the research work demonstrated that the rotating fluidized bed incinerator can produce considerably higher combustion intensities (i.e., process intensification), has a wide turn-down range (i.e., versatile), has low toxic emissions (i.e., clean technology), and has a more easy and rapid start-up than conventional stationary fluidized bed incinerators. Other advantages of the system include: good mixing, simpler fuel injection, low thermal inertia, and good heat transfer rates. Other potential applications for this system include boilers, open cycle gas turbines, and combined gas/steam cycles.

Background: Prescription opioids initiated in opioid-naive patients are associated with long-term opioid use and opioid-related death. Methods: We examined trends in prescribing practices using a data set of outpatient opioid prescriptions in BC from 2013 to 2017. Results: In total, 19 785 practitioners prescribed 15 693867 prescriptions that were dispensed to 1692035 patients. In 2017, 11.5% of British Columbians were given at least one prescription for opioids. Over the 5-year period, opioid prescription rates declined by 1.6%; however, the proportion of patients who received more than 90 morphine milligram equivalents per day increased by 8%. There was heterogeneity of opioid prescriptions across and within specialty groups. Conclusions: We provide population-level data to inform prescribers that there is a need to be aware of opioid prescription variability and its potential effect on long-term opioid use. [ABSTRACT FROM AUTHOR]