Respiratory Adherence Care Enhancer Questionnaire: Identifying Self-Management Barriers of Inhalation Corticosteroids in Asthma

Introduction: Suboptimal self-management of inhaled corticosteroids (ICS) in asthma patients is frequently observed in clinical practice and associated with poor asthma control. Driving factors for suboptimal self-management are complex and consist of a range of behavioral barriers (cognitive, affective and practical) with a considerable inter-individual variability. Identification of individual barriers facilitates the use of corresponding behavior change techniques and tailored care to improve asthma treatment outcomes.Objective: This study describes the development and validation of the ‘Respiratory Adherence Care Enhancer’ (RACE) questionnaire to identify individual barriers to self-management of ICS therapy in asthma patients.Methods: The development included: 1) an inventory of self-management barriers based on a literature review, 2) expert assessment on relevance and completeness of this set, linking these barriers to behavioral domains of the Theoretical Domains Framework (TDF) and 3) the formulation of corresponding questions assessing each of the barriers. A cross-sectional study was performed for validation. Primary care asthma patients were invited to fill out the RACE-questionnaire prior to a semi-structured telephonic interview as golden standard. Barriers detected from the questionnaire were compared to those mentioned in the interview.Results: The developed questionnaire is made up of 6 TDF-domains, covering 10 self-management barriers with 23 questions. For the validation 64 patients completed the questionnaire, of whom 61 patients were interviewed. Cronbach’s alpha for the consistency of questions within the barriers ranged from 0.58 to 0.90. Optimal cut-off values for the presence of barriers were determined at a specificity between 67 and 92% with a sensitivity between 41 and 83%. Significant Areas Under the Receiver Operating Curves values were observed for 9 barriers with values between 0.69 and 0.86 (p-value <0.05), except for ‘Knowledge of ICS medication’ with an insignificant value of 0.53.Conclusion: The RACE-questionnaire yields adequate psychometric characteristics to identify individual barriers to self-management of ICS therapy in asthma patients, facilitating tailored care.

Are Energy-Vulnerable Households More Prone to Informative, Market, and Behavioral Biases?

The present paper focuses primarily on investigating whether energy-vulnerable households are more prone to informative, market, and behavioral biases. In this direction, a stated preference approach was used to elicit information about human behavior and cognitive barriers in the context of energy poverty based on both subjective and objective indicators. For the purposes of the survey, a questionnaire was developed that included around 40 questions about housing conditions and information, market, and behavioral barriers related to energy efficiency, energy vulnerability, etc., and specific survey hypotheses were tested employing non-parametric tests. The survey was carried out between November 2020 and January 2021 involving residents of Metsovo, a mountain settlement in Greece. In total, 303 participants took place in the survey through personal interviews, which were conducted remotely due to the COVID-19 pandemic-related distancing measures, using a video platform. The analysis shows that households that face thermal discomfort or are in arrears on energy bills seem to be more prone to certain behavioral and other biases. This conclusion is not confirmed for households that face condensation, mold and damp problems or are classified as energy-poor under the “ten percent rule”. The main conclusion drawn is that the income status of the household plays a greater role compared to its classification as energy vulnerable. Nevertheless, the findings of the study need to be confirmed by future research, because the research specifically on how energy poverty affects people’s decision making is extremely limited. In any case, the results are worrisome and illustrate the need for more effective energy poverty policies that will take into account the effects of scarcity on household decision making.

Consequences of coupled barriers to gene flow for the build-up of genomic differentiation: Reproductive barriers and coupling in corn borers

ABSTRACTTheory predicts that when different barriers to gene flow become coincident, their joint effects enhance reproductive isolation and genomic divergence beyond their individual effects, but empirical tests of this ‘coupling’ hypothesis are rare. Here, we analyze patterns of gene exchange among populations of European corn borer moths that vary in the number of acting barriers, allowing for comparisons of genomic variation when barrier traits or loci are in coincident or independent states. We find that divergence is mainly restricted to barrier loci when populations differ by a single barrier, whereas the coincidence of temporal and behavioral barriers is associated with divergence of two chromosomes harboring barrier loci. Furthermore, differentiation at temporal barrier loci increases in the presence of behavioral divergence, while differentiation at behavioral barrier loci increases in the presence of temporal divergence. Our results demonstrate how the joint action of coincident barrier effects leads to levels of genomic differentiation that far exceed those of single barriers acting alone, consistent with theory arguing that coupling allows indirect selection to combine with direct selection and thereby lead to a stronger overall barrier to gene flow. Thus, the state of barriers – independent or coupled – strongly influences the accumulation of genomic differentiation.

Acoustic and Light Selective Behavioral Guidance Systems for Freshwater Fish

The use of non-physical barriers, particularly based on acoustic and luminous stimuli has been historically used to influence the behavior of fish, mainly for fishing purposes. Nowadays, behavioral barriers and guidance systems have been developed, not only to deter movements of fish, but also to promote behavioral responses with the objective of native fish protection, in particular the potamodromous species, reducing their mortality in the hydraulic structures of dams and guiding them towards transposition systems or to replacement habitats in regularized water bodies. This review details the use of acoustic and luminous systems and their evolution in recent years (Scopus 2012–2019) for the development of selective behavioral barriers for fish. We found that recent technologies try to identify new acoustic and luminous sensory ranges. Ambient sound, sound of predators or luminous spectral bands with different wavelengths have been used to selectively stimulate target and non-target species, in order to improve the effectiveness of repulsive/attractive systems for fish. Guidelines for future research in the area are also present.

KEEPING HARMONY OF INDONESIAN-JAPANESE INTERCULTURAL MARRIAGE INTERACTIONS

The purpose of this study is to explain how intercultural families interact in maintaining harmony within the family, especially the interaction between Indonesian Moms and Japanese Fathers. The method used in this study is qualitative with primary sources through in-depth interviews.Data analysis is done by reducing the data that has been obtained from the interviews, compared with the concept of intercultural communication and acculturation. The data is validated with secondary data that is the result of previous research. The results obtained show that the couple of Indonesian wives and Japanese husbands keep each other harmony interaction by choosing the appropriate language situation required. They use everyday language are: English, Japanese and Indonesian. The dominant language is the language in where they live. This result shows that they are showing respect for each other. The use of the chosen language as an effort to adapt to the culture in where they live includes also invited their children to always appreciate the cultureof their fathers and mothers equally in influence. So the three behavioral barriers do not occur as a priori, prejudice and authority that one against the other. There is a trust between them. Acculturation in this family is seen as a cultural enrichment,cultural differences do not create barriers to family interaction and with the environment. Father and Mother bequeathed culture to their children in a balanced and without dominance, there is balance in power.