Search results for: internet of health things

Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee

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Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.

Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh

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Authors: Misagh Faezipour

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This paper explores the effects of screen time on children from a systems engineering perspective. We reviewed literature from several related works on the effects of screen time on children to explore all factors and interrelationships that would impact children that are subjected to using long screen times. Factors such as kids' age, parent attitudes, parent screen time influence, amount of time kids spend with technology, psychosocial and physical health outcomes, reduced mental imagery, problem-solving and adaptive thinking skills, obesity, unhealthy diet, depressive symptoms, health problems, disruption in sleep behavior, decrease in physical activities, problematic relationship with mothers, language, social, emotional delays, are examples of some factors that could be either a cause or effect of screen time. A systems engineering perspective is used to explore all the factors and factor relationships that were discovered through literature. A causal model is used to illustrate a graphical representation of these factors and their relationships. Through the causal model, the factors with the highest impacts can be realized. Future work would be to develop a system dynamics model to view the dynamic behavior of the relationships and observe the impact of changes in different factors in the model. The different changes on the input of the model, such as a healthier diet or obesity rate, would depict the effect of the screen time in the model and portray the effect on the children’s health and other factors that are important, which also works as a decision support tool.

Keywords: children, causal model, screen time, systems engineering, system dynamics

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Authors: Nizamuddin Zainuddin, Adam Mohd Saifudin, Ahmad Yusni Bahaudin, Mohd Hanizan Zalazilah, Roslan Jamaluddin

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Students’ enhanced experience through simulation is a crucial factor that brings reality to the classroom. The enhanced experience is all about developing, enriching and applications of a generic process flow in the field of logistics and transportations. As educational technology has improved, the effective use of simulations has greatly increased to the point where simulations should be considered a valuable, mainstream pedagogical tool. Additionally, in this era of ongoing (some say never-ending) assessment, simulations offer a rich resource for objective measurement and comparisons. Simulation is not just another in the long line of passing fads (or short-term opportunities) in educational technology. It is rather a real key to helping our students understand the world. It is a way for students to acquire experience about how things and systems in the world behave and react, without actually touching them. In short, it is about interactive pretending. Simulation is all about representing the real world which includes grasping the complex issues and solving intricate problems. Therefore, it is crucial before stimulate the real process of inbound and outbound logistics and transportation a generic process flow shall be developed. The paper will be focusing on the validization of the process flow by looking at the inputs gains from the sample. The sampling of the study focuses on multi-national and local manufacturing companies, third party companies (3PL) and government agency, which are selected in Peninsular Malaysia. A simulation flow chart was proposed in the study that will be the generic flow in logistics and transportation. A qualitative approach was mainly conducted to gather data in the study. It was found out from the study that the systems used in the process of outbound and inbound are System Application Products (SAP) and Material Requirement Planning (MRP). Furthermore there were some companies using Enterprises Resources Planning (ERP) and Electronic Data Interchange (EDI) as part of the Suppliers Own Inventories (SOI) networking as a result of globalized business between one countries to another. Computerized documentations and transactions were all mandatory requirement by the Royal Custom and Excise Department. The generic process flow will be the basis of developing a simulation program that shall be used in the classroom with the objective of further enhanced the students’ learning experience. Thus it will contributes to the body of knowledge on the enrichment of the student’s employability and also shall be one of the way to train new workers in the logistics and transportation filed.

Keywords: enhancement, simulation, process flow, logistics, transportation

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Authors: Jennifer Bradley

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With opportunities to live and work abroad on the rise, effective preparation and support for international employees needs to be addressed within the work-site. International employees must build new habits, routines and social networks in an unfamiliar culture. Culture shock typically occurs within the first year and can affect both physical and psychological health. Employers have the opportunity to support staff through the adaptation process and foster healthy habits and routines. Cross-cultural training that includes a combination of instructional teaching, cultural experiences, and practice, is shown to increase the international employee adaptation process. However, little evidence demonstrates that organizations provide all of these aspects for international employees. The occupational therapy practitioner (OTP) offers a unique perspective focusing on the employee transactional relationship and engagement of meaningful occupations to enhance and enable participation in roles, habits and routines within new cultural contexts. This paper examines one such program developed and implemented by an OTP at the New England Center for Children, in Abu Dhabi, United Arab Emirates. The effectiveness of the program was assessed via participant feedback and concluded that an international employee support program that focuses on a variety of meaningful experiences and knowledge can empower employees to navigate healthy practices, develop habits and routines, and foster positive inter-cultural relationships in the organization and community.

Keywords: occupational therapy practitioner, cross cultural training, international employee health, international employee support

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Authors: Jung-Feng Lin, Wei-Tang Chen, Chung-King Hsu, Chun-Pin Lin, Feng-Huei Lin

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One of the objectives of operative dentistry is to maintain pulp health in compromised teeth. Mostly used methods for this purpose are direct pulp capping and pulpotomy, which consist of placement of biocompatible materials and bio-inductors on the exposed pulp tissue to preserve its health and stimulate repair by mineralized tissue formation. In this study, we developed a material (calcium phosphate cement (CPC)/gypsum composite) as the dental pulp capping material for shortening setting time and improving handling properties. We further discussed the influence of five different ratio of gypsum to CPC on HAP conversion, microstructure, setting time, weight loss, pH value, temperature difference, viscosity, mechanical properties, porosity, and biocompatibility.

Keywords: calcium phosphate cement, calcium sulphate hemihydrate, pulp capping, fast setting time

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Authors: Maria L. Ulloa, Ruth M. Crawford, Stephanie Kelly, Joey Domdom

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In recent decades health and social service delivery have become more collaborative and interdisciplinary. Emerging trends suggest the need for an integrative and interprofessional approach to meet the challenges faced by professionals navigating the complexities of health and social service practice environments. Terms such as multidisciplinary practice, interprofessional collaboration, interprofessional education and transprofessional practice have become the common language used across a range of social services and health providers in western democratic systems. In Aotearoa New Zealand, one example of an interprofessional collaborative approach to curriculum design and delivery in health and social service is the development of an innovative Masters of Professional Practice programme. This qualification is the result of a strategic partnership between two tertiary institutions – Whitireia New Zealand (NZ) and the Wellington Institute of Technology (Weltec) in Wellington. The Master of Professional Practice programme was designed and delivered from the perspective of a collaborative, interprofessional and relational approach. Teachers and students in the programme come from a diverse range of cultural, professional and personal backgrounds and are engaged in courses using a blended learning approach that incorporates the values and pedagogies of interprofessional education. Students are actively engaged in professional practice while undertaking the programme. This presentation describes the themes of exploratory qualitative formative observations of engagement in class and online, student assessments, student research projects, as well as qualitative interviews with the programme teaching staff. These formative findings reveal the development of critical practice skills around the common themes of the programme: research and evidence based practice, education, leadership, working with diversity and advancing critical reflection of professional identities and interprofessional practice. This presentation will provide evidence of enhanced learning experiences in higher education and learning in multi-disciplinary contexts.

Keywords: diversity, exploratory research, interprofessional education, professional identity

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Authors: Medha Basu, Kumardeb Banerjee, Dipak Ghosh

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After the massive blow of the COVID-19 pandemic, several health hazards have been reported all over the world. Serious cases of Major Depressive Disorder (MDD) are seen to be common in about 15% of the global population, making depression one of the leading mental health diseases, as reported by the World Health Organization. Various psychological and pharmacological treatment techniques are regularly being reported. Music, a globally accepted mode of entertainment, is often used as a therapeutic measure to treat various health conditions. We have tried to understand how Indian Classical Music can affect the overall well-being of the human brain. A case study has been reported here, where a Flute-rendition has been chosen from a detailed audience response survey, and the effects of that clip on human brain conditions have been studied from both psychological and neural perspectives. Taking help from internationally-accepted depression-rating scales, two questionnaires have been designed to understand both the prolonged and immediate effect of music on various emotional states of human lives. Thereafter, from EEG experiments on 5 participants using the same clip, the parameter ‘ALAY’, alpha frontal asymmetry (alpha power difference of right and left frontal hemispheres), has been calculated. Works of Richard Davidson show that an increase in the ‘ALAY’ value indicates a decrease in depressive symptoms. Using the non-linear technique of MFDFA on EEG analysis, we have also calculated frontal asymmetry using the complexity values of alpha-waves in both hemispheres. The results show a positive correlation between both the psychological survey and the EEG findings, revealing the prominent role of music on the human brain, leading to a decrease in mental unrest and an increase in overall well-being. In this study, we plan to propose the scientific foundation of music therapy, especially from a neurocognition perspective, with appropriate neural bio-markers to understand the positive and remedial effects of music on the human brain.

Keywords: music therapy, EEG, psychological survey, frontal alpha asymmetry, wellbeing

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Authors: Maarja Karbus, Elsbet Lippmaa, Kadri Kööp, Mare Tupits

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Aim: The aim is to describe the experiences and needs of mothers of children with cancer in coping with the child's illness. Background: Cancer affects different life areas. Especially if it is a child, in this case the whole family is involved. Loved ones are mentally affected, there are limitations, and life changes need to be made to make the whole treatment regimen and recovery as comfortable as possible. Also, the whole process is expensive and time consuming. The research is part of a larger project that covers the experiences and needs of parents of children with chronic illness and coping strategies related to the child's illness. Design: Qualitative, empirical, descriptive research. Method: Semi-structured interviews were used to collect data and inductive content analysis was used to analyze the data. The interviews were conducted in the autumn of 2020, 5 respondents participated in the research. Results and Conclusions: The research revealed that the mothers' experiences of coping with a child's disease included health-related experiences, material aspects, changes in lifestyle, support systems and contact with professionals. Regarding the organizational and material aspects of life, the subjects presented experiences with economic problems, adaptation of changes in lifestyle, access to information and changes in the treatment process. With regard to health, the respondents identified experiences with the mother's physical and mental health and experiences with the health of an ill child. The experience of different support systems was related to the support of family, friends, acquaintances, various organizations and specialists. Experiences with specialist support included experiences with family relationships and positive and negatiive experiences with staff. The mothers' needs in dealing with the child's disease included the mother's emotional needs, the support of other family members, and the need for various support systems and services. The needs of coping with the child were the need for understanding, support, confidence, the need to be strong and courageous, the need to ignore one's own needs, and the need for personal time and rest. The needs of other family members included the needs of an ill child and the need to pay attention to other children in the family. The needs of different supporters and services were related to different helpers and different services.

Keywords: cancer, mother, coping, child, need, experience, illness

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Authors: Goran Sporiš, Dinko Vuleta, Stefan Lovro

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The purpose of the present study was to determine the associations between health-related quality of life (HRQOL) and physical activity (PA) in different domains. In this cross-sectional study, participants were 169 Croatian police officers (mean age 35.14±8.95 yrs, mean height 180.93±7.53 cm, mean weight 88.39±14.05 kg, mean body-mass index 26.90±3.39 kg/m2). The dependent variables were two general domains extracted from the HRQOL questionnaire: (1) physical component scale (PCS) and (2) mental component scale (MCS). The independent variables were job-related, transport, domestic and leisure-time PA, along with other factors: age, body-mass index, smoking status, psychological distress, socioeconomic status and time spent in sedentary behaviour. The associations between dependent and independent variables were analyzed by using multiple regression analysis. Significance was set up at p < 0.05. PCS was positively associated with leisure-time PA (β 0.28, p < 0.001) and socioeconomic status (SES) (β 0.16, p=0.005), but inversely associated with job-related PA (β -0.15, p=0.012), domestic-time PA (β -0.14, p=0.014), age (β -0.12, p=0.050), psychological distress (β -0.43, p<0.001) and sedentary behaviour (β -0.15, p=0.009). MCS was positively associated with leisure-time PA (β 0.19, p=0.013) and SES (β 0.20, p=0.002), while inversely associated with age (β -0.23, p=0.001), psychological distress (β -0.27, p<0.001) and sedentary behaviour (β -0.22, p=0.001). Our results added new information about the associations between domain-specific PA and both physical and mental component scale in police officers. Future studies should deal with the same associations in other stressful occupations.

Keywords: health, fitness, police force, relations

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Authors: Amanda Aliende da Matta, Maria del Pilar Fogueiras Bertomeu, Valeria de Ormaechea Otalora, Maria Paz Sandin Esteban, Miriam Comet Donoso

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This communication presents proposed questions about the existential in research on the political participation of young women. The study follows a qualitative methodology, in particular, the applied hermeneutic phenomenological (AHP) method, and the general objective of the research is to give an account of the experience of political participation as a young woman. The study participants are women aged 18 to 35 who have experience in political participation. The techniques of data collection are the descriptive story and the phenomenological interview. Hermeneutic phenomenology as a research approach is based on phenomenological philosophy and applied hermeneutics. The ultimate objective of HP is to gain access to the meaning structures of lived experience by appropriating them, clarifying them, and reflectively making them explicit. Human experiences are always lived through existential: fundamental themes that are useful in exploring meaningful aspects of our life worlds. Everyone experiences the world through the existential of lived relationships, the lived body, lived space, lived time, and lived things. The phenomenological research, then, also tacitly asks about the existential. Existentials are universal themes useful for exploring significant aspects of our life world and of the particular phenomena under study. Four main existentials prove especially helpful as guides for reflection in the research process: relationship, body, space, and time. For example, in our case, we may ask ourselves how can the existentials of relationship, body, space, and time guide us in exploring the structures of meaning in the lived experience of political participation as a woman and a young person. The study is still not finished, as we are currently conducting phenomenological thematic analysis on the collected stories of lived experience. Yet, we have already identified some fragments of texts that show the existential in their experiences, which we will transcribe below. 1) Relationality - The experienced I-Other. It regards how relationships are experienced in our narratives about political participation as young women. One example would be: “As we had known each other for a long time, we understood each other with our eyes; we were all a little bit on the same page, thinking the same thing.” 2) Corporeality - The lived body. It regards how the lived body is experienced in activities of political participation as a young woman. One example would be: “My blood was boiling, but it was not the time to throw anything in their face, we had to look for solutions.”; “I had a lump in my throat and I wanted to cry.”. 3) Spatiality - The lived space. It regards how one experiences the lived space in political participation activities as a young woman. One example would be: “And the feeling I got when I saw [it] it's like watching everybody going into a mousetrap.” 4) Temporality - Lived time. It regards how one experiences the lived time in political participation activities as a young woman. One example would be: “Then, there were also meetings that went on forever…”

Keywords: applied hermeneutic phenomenology, existentials, hermeneutics, phenomenology, political participation

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Authors: Nour Mohamad Fayad

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Complex and extensively researched, the impact of corruption on economic growth seems to be intricate. Many experts believe that corruption reduces economic development. However, counterarguments have suggested that corruption either promotes growth and development or has no significant impact on economic performance. Clearly, there is no consensus in the economics literature regarding the possible relationship between corruption and economic development. Corruption's complex and clandestine nature, which makes it difficult to define and measure, is one of the obstacles that must be overcome when investigating its effect on an economy. In an attempt to contribute to the ongoing debate, this study examines the impact of corruption on economic growth in the Middle East and North Africa (MENA) region between 2000 and 2021 using a Customized Corruption Index-CCI and panel data on MENA countries. These countries were selected because they are understudied in the economic literature, and despite the World Bank's recent emphasis on corruption in the developing world, the MENA countries have received little attention. The researcher used Cobb-Douglas functional form to test corruption in MENA using a customized index known as Customized Corruption Index-CCI to track corruption over almost 20 years, then used the dynamic panel data. The findings indicate that there is a positive correlation between corruption and economic growth, but this is not consistent across all MENA nations. First, the relatively recent lack of data from MENA nations. This issue is related to the inaccessibility of data for many MENA countries, particularly regarding the returns on resources, private malfeasance, and other variables in Gulf countries. In addition, the researcher encountered several restrictions, such as electricity and internet outages, due to the fact that he is from Lebanon, a country whose citizens have endured difficult living conditions since the Lebanese crisis began in 2019. Demonstrating a customized index known as Customized Corruption Index-CCI that suits the characteristics of MENA countries to peculiarly measure corruption in this region, the outcome of the Customized Corruption Index-CCI is then compared to the Corruption Perception Index-CPI and Control of Corruption from World Governance Indicator-CC from WGI.

Keywords: corruption, economic growth, corruption measurements, empirical review, impact of corruption

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Authors: Chrysoula Bousiouta

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Throughout the history of theatre, technology has played an important role both in influencing the relationship between performance and audience and offering different kinds of experiences. The use of technology dates back in ancient times, when the introduction of artifacts, such as “Deus ex machine” in ancient Greek theatre, started. Taking into account the key techniques and experiences used throughout history, this paper investigates how technology, through new media, influences contemporary theatre. In the context of this research, technology is defined as projections, audio environments, video-projections, sensors, tele-connections, all alongside with the performance, challenging audience’s participation. The theoretical framework of the research covers, except for the history of theatre, the theory of “experience economy” that took over the service and goods economy. The research is based on the qualitative and comparative analysis of two case studies, Contact Theatre in Manchester (United Kingdom) and Bios in Athens (Greece). The data selection includes desk research and is complemented with semi structured interviews. Building on the results of the research one could claim that the intended experience of modern/contemporary theatre is that of engagement. In this context, technology -as defined above- plays a leading role in creating it. This experience passes through and exists in the middle of the realms of entertainment, education, estheticism and escapism. Furthermore, it is observed that nowadays, theatre is not only about acting but also about performing; it is that one where the performances are unfinished without the participation of the audience. Both case studies try to achieve the experience of engagement through practices that promote the attraction of attention, the increase of imagination, the interaction, the intimacy and the true activity. These practices are achieved through the script, the scenery, the language and the environment of a performance. Contact and Bios consider technology as an intimate tool in order to accomplish the above, and they make an extended use of it. The research completes a notable record of technological techniques that modern theatres use. The use of technology, inside or outside the limits of film technique’s, helps to rivet the attention of the audience, to make performances enjoyable, to give the sense of the “unfinished” or to be used for things that take place around the spectators and force them to take action, being spect-actors. The advantage of technology is that it can be used as a hook for interaction in all stages of a performance. Further research on the field could involve exploring alternative ways of binding technology and theatre or analyzing how the performance is perceived through the use of technological artifacts.

Keywords: experience of engagement, interactive theatre, modern theatre, performance, technology

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Authors: Nada Alqadri, Omaima Nasir

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Natural compounds are an important source of potential inhibitors; they have a lot of pharma potential with less adverse effects. The effective antiviral activities of natural products have been proved in different studies. The outbreak of COVID-19 in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people's health and lives. Based on previous studies, natural products can be introduced as preventive and therapeutic agents in the fight against COVID-19; considering that no food or supplement has been authorized to prevent COVID-19, individuals continue to search for and consume specific herbs, foods, and commercial supplements for this purpose. This study will be aimed to estimate the uses of herbal and natural products during the COVID-19 infection to determine their usage reasons and evaluate their potential side effects. An online cross-sectional survey of different participants will be conducted and will be a focus on respondents’ chronic disease histories, socio-dmographic characteristics, and frequency and trends of using these products. Descriptive and univariate analyses will be performed to determine prevalence and associations between various products used and respondents’ socio-demographic data. Relationships will be tested using Pearson’s chi-square test or an exact probability test. Our main findings will give evidence of beneficial uses of natural products and herbal medicine as prophylactic and will be a vigorous approach to stop or at least slow down COVID-19 infection and transmission. This will be of great interest of public health, and the results of our study will lend health officials better control on the current pandemic.

Keywords: COVID-19, herbs, natural products, saudi arabia

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Authors: Lilian Nantume Wampande

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Group-based strategies in the delivery of HIV care have opened up new avenues not only for meaningful participation for HIV positive people but also platforms for deconstruction and reconstruction of knowledge about living with the virus. Yet the contributions of such strategies among patients who live in high risk areas are still not explored. This case study research assessed the impact of HIV support networks on sexual health outcomes of HIV positive out-of-school adolescents residing in fishing islands of Kalangala in Uganda. The study population was out-of-school adolescents living with HIV and their sexual partners (n=269), members of their households (n=80) and their health service providers (n=15). Data were collected via structured interviews, observations and focus group discussions between August 2016 and March 2017. Data was then analyzed inductively to extract key themes related to the approaches and outcomes of the groups’ activities. The study findings indicate that support groups unite HIV positive adolescents in a bid for social renegotiation to achieve change but individual constraints surpass the groups’ intentions. Some adolescents for example reported increased fear which led to failure to cope, sexual violence, self-harm and denial of status as a result of the high expectations placed on them as members of the support groups. Further investigations around this phenomenon show that HIV networks play a monotonous role as information sources for HIV positive out-of-school adolescents which limit their creativity to seek information elsewhere. Results still indicate that HIV adolescent groups recognize the complexity of long-term treatment and stay in care leading to improved immunity for the majority yet; there is still scattered evidence about how effective they are among adolescents at different phases in the disease trajectory. Nevertheless, the primary focus of developing adolescent self-efficacy and coping skills significantly address a range of disclosure difficulties and supports autonomy. Moreover, the peer techniques utilized in addition to the almost homogeneous group characteristics accelerates positive confidence, hope and belongingness. Adolescent HIV-support groups therefore have the capacity to both improve and/or worsen sexual health outcomes for a young adolescent who is out-of-school. Communication interventions that seek to increase awareness about ‘self’ should therefore be emphasized more than just fostering collective action. Such interventions should be sensitive to context and gender. In addition, facilitative support supervision done by close and trusted health care providers, most preferably Village Health Teams (who are often community elected volunteers) would help to follow-up, mentor, encourage and advise this young adolescent in matters involving sexuality and health outcomes. HIV/AIDS prevention programs have extended their efforts beyond individual focus to those that foster collective action, but programs should rekindle interpersonal level strategies to address the complexity of individual behavior.

Keywords: adolescent, HIV, support groups, Uganda

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Authors: Mohammad Hossein Badamchi

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In Iran as well as other developing countries instituting innovation and entrepreneurship ecosystems by government around the universities is the new imported fashion of modernization and development in the 21st century. In recent decade various statesmen, policy makers, university administrations, economists and development theorists are emphasizing excitingly about the new “start-ups” which are going to solve all economic problems and backwardness of the country. However, critical study of modernization practices in Iran implies that this new trend is suffering from conventional deficiency of modernization planning in 20th century. This article is going to depict the misunderstandings of a situation which we can name “Pseudo-innovation in a closed society” by presenting these 12 paradoxes of this new system, actually happening in Iran: (1) Innovation without freedom? Fiction of innovation in a patriarchal state (2) Entrepreneurship without free market? Fiction of entrepreneurship in a rentier-state. (3) Ecosystem or a state-glasshouse? Is it possible to make and plan an innovation? (4) Innovation; epistemic or practical? How academic innovation could happen abstractly out of context? (5) Risk and Lucre: innovation to protect power and property?! (6) Silicon-valley mirage: what is in common between American-Iranian polity? (7) Information or Communication? ICT startups to restrict the internet (8) The elite paradox: new proletariat of private sector, new governmental clerk or a new path of brain drain? (9) Innovation or commercialization? Revisiting Schumpeterian creative destruction (10) The friendship of Jungle and fire: paradox of public science and market (11) Innovation and revolution: top-down or bottom-up paradox in an Iranian experience (12) Technology instead of civil society: ultimate result of innovation in a closed society. Through explaining these paradoxes we can gradually penetrate the real rationality of Pseudo-innovation ecosystem in a closed society, which can be understood as new-Neopatriarchy reconstruction of traditional patriarchal politics, economy and culture in Iran.

Keywords: innovation, critical sociology, modernisation, Iran, closed society

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Authors: Adam Gushgari

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The SARS-CoV-2 pandemic has catalyzed the rapid adoption of wastewater-based epidemiology (WBE) methodologies both domestically and internationally. To support the rapid scale-up of pandemic-response wastewater surveillance systems, multiple federal agencies (i.e. US CDC), non-government organizations (i.e. Water Environment Federation), and private charities (i.e. Bill and Melinda Gates Foundation) have funded over $220 million USD supporting development and expanding equitable access of surveillance methods. Funds were primarily distributed directly to municipalities under the CARES Act (90.6%), followed by academic projects (7.6%), and initiatives developed by private companies (1.8%). In addition to federal funding for wastewater monitoring primarily conducted at wastewater treatment plants, state/local governments and private companies have leveraged wastewater sampling to obtain health and lifestyle data on student, prison inmate, and employee populations. We explore the viable paths for expansion of the WBE m1ethodology across a variety of analytical methods; the development of WBE-specific samplers and real-time wastewater sensors; and their application to various governments and private sector industries. Considerable investment in, and public acceptance of WBE suggests the methodology will be applied to other future notifiable diseases and health risks. Early research suggests that WBE methods can be applied to a host of additional “biological insults” including communicable diseases and pathogens, such as influenza, Cryptosporidium, Giardia, mycotoxin exposure, hepatitis, dengue, West Nile, Zika, and yellow fever. Interest in chemical insults is also likely, providing community health and lifestyle data on narcotics consumption, use of pharmaceutical and personal care products (PPCP), PFAS and hazardous chemical exposure, and microplastic exposure. Successful application of WBE to monitor analytes correlated with carcinogen exposure, community stress prevalence, and dietary indicators has also been shown. Additionally, technology developments of in situ wastewater sensors, WBE-specific wastewater samplers, and integration of artificial intelligence will drastically change the landscape of WBE through the development of “smart sewer” networks. The rapid expansion of the WBE field is creating significant business opportunities for professionals across the scientific, engineering, and technology industries ultimately focused on community health improvement.

Keywords: wastewater surveillance, wastewater-based epidemiology, smart cities, public health, pandemic management, substance abuse

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Authors: A. Md. Bayejid Hosen, B. M Zakir Hossain Howlader, C. Yearul Kabir

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Contamination of soil and agricultural products by heavy metals resulting from rapid industrial development has caused major concern. Dietary exposure to heavy metals has been associated with toxic and adverse health effects. The main threats to human health from heavy metals are associated with exposure to Pb, Cd and Hg. The aim of this study was to monitor the presence of heavy metals in cereals collected from different wholesale markets of Dhaka City. One hundred and sixty cereal samples were collected and analyzed for determination of heavy metals. Heavy metals were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). A total of six heavy metals– lead, chromium, cadmium, mercury, arsenic and antimony were estimated. The average concentrations of heavy metals in cereals fall within the safe limit established by regulatory organizations except for Pb (152.4 μg/100g) and Hg (15.13 μg/100g) which exceeded the safe limits. BARI gom-26 was the highest source of Pb (304.1 μg/100g) whereas Haski-29 rice variety contained the highest amount of Hg (60.85 μg/100g). Though all the cereal varieties contained approximately same amount of Cr the naizer sail varieties contained huge amount of Cr (171.8 μg/100g). Among all the cereal samples miniket rice varieties contained the least amount of heavy metals. The concentration of Cr (63.24 μg/100g), Cd (5.54 μg/100g) and As (3.26 μg/100g) in all cereals were below the safe limits. The daily intake of heavy metals was determined using the total weight of cereals consumed each day multiplied by the concentrations of heavy metals in cereals. The daily intake was compared with provisional maximum tolerable daily intake set by different regulatory organizations. The daily intake of Cd (23.0 μg), Hg (63.0 μg) and as (13.6 μg) through cereals were below the risk level except for Pb (634.0 μg) and Cr (263.1 μg). As the main meal of average Bangladeshi people is boiled rice served with some sorts of vegetables, our findings indicate that the residents of Dhaka City are at risk from Pb and Cr contamination. Potential health risks from exposure to heavy metals in self-planted cereals need more attention.

Keywords: contamination, dietary exposure, heavy metals, human health, ICP-MS

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Authors: Goran Begović

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In recent years, many researchers are focusing on non-intrusive measuring methods when it comes to human biosignals. These methods provide solutions for everyday use, whether it’s health monitoring or finessing the workout routine. One of the biggest issues with these solutions is that the sensors’ accuracy is highly variable due to many factors, such as ambiental light, skin color diversity, etc. That is why we wanted to explore different outcomes under those kinds of circumstances in order to find the most optimal algorithm(s) for extracting heart rate (HR) information. The optimization of such algorithms can benefit the wider, cheaper, and safer application of home health monitoring, without having to visit medical professionals as often when it comes to observing heart irregularities. In this study, we explored the accuracy of infrared (IR), red, and green LED sensorics in a controlled environment and compared the results with a medically accurate ECG monitoring device.

Keywords: data science, ECG, heart rate, holter monitor, LED sensors

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Authors: Wiseman Emmanuel Nkhomah, Chiyembekezo Kachimanga, Moses Banda Aron, Julia Higgins, Manuel Mulwafu, Kondwani Mpinga, Mwayi Chunga, Grace Momba, Enock Ndarama, Dickson Sumphi, Atupere Phiri, Fabien Munyaneza

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Background: Data is key to supporting health service delivery as stakeholders, including NGOs rely on it for effective service delivery, decision-making, and system strengthening. Several studies generated debate on data quality from national health management information systems (HMIS) in sub-Saharan Africa. This limits the utilization of data in resource-limited settings, which already struggle to meet standards set by the World Health Organization (WHO). We aimed to evaluate data quality improvement of Neno district HMIS over a 4-year period (2018 – 2021) following quarterly data reviews introduced in January 2020 by the district health management team and Partners In Health. Methods: Exploratory Mixed Research was used to examine report rates, followed by in-depth interviews using Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). We used the WHO module desk review to assess the quality of HMIS data in the Neno district captured from 2018 to 2021. The metrics assessed included the completeness and timeliness of 34 reports. Completeness was measured as a percentage of non-missing reports. Timeliness was measured as the span between data inputs and expected outputs meeting needs. We computed T-Test and recorded P-values, summaries, and percentage changes using R and Excel 2016. We analyzed demographics for key informant interviews in Power BI. We developed themes from 7 FGDs and 11 KIIs using Dedoose software, from which we picked perceptions of healthcare workers, interventions implemented, and improvement suggestions. The study was reviewed and approved by Malawi National Health Science Research Committee (IRB: 22/02/2866). Results: Overall, the average reporting completeness rate was 83.4% (before) and 98.1% (after), while timeliness was 68.1% and 76.4 respectively. Completeness of reports increased over time: 2018, 78.8%; 2019, 88%; 2020, 96.3% and 2021, 99.9% (p< 0.004). The trend for timeliness has been declining except in 2021, where it improved: 2018, 68.4%; 2019, 68.3%; 2020, 67.1% and 2021, 81% (p< 0.279). Comparing 2021 reporting rates to the mean of three preceding years, both completeness increased from 88% to 99% (in 2021), while timeliness increased from 68% to 81%. Sixty-five percent of reports have maintained meeting a national standard of 90%+ in completeness while only 24% in timeliness. Thirty-two percent of reports met the national standard. Only 9% improved on both completeness and timeliness, and these are; cervical cancer, nutrition care support and treatment, and youth-friendly health services reports. 50% of reports did not improve to standard in timeliness, and only one did not in completeness. On the other hand, factors associated with improvement included improved communications and reminders using internal communication, data quality assessments, checks, and reviews. Decentralizing data entry at the facility level was suggested to improve timeliness. Conclusion: Findings suggest that data quality in HMIS for the district has improved following collaborative efforts. We recommend maintaining such initiatives to identify remaining quality gaps and that results be shared publicly to support increased use of data. These results can inform Ministry of Health and its partners on some interventions and advise initiatives for improving its quality.

Keywords: data quality, data utilization, HMIS, collaboration, completeness, timeliness, decision-making

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Authors: Allioua Meryem

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Similar to much of the developing world, Algeria is currently undergoing an epidemiological transition. While mal- and under-nutrition and infectious diseases used to be the main causes of poor health, today there is a higher proportion of chronic, non-communicable diseases (NCDs), including cardiovascular disease, diabetes mellitus, cancer, etc. According to estimates for Algeria from the World Health Organization (WHO), NCDs accounted for 63% of all deaths in 2010. The objective of this study was the assessment of eating habits and anthropometric characteristics in a group of youth aged 15 to 19 years in Tlemcen. This study was conducted on a total effective of 806 youth enrolled in a descriptive cross-sectional study; the classification of nutritional status has been established by international standards IOTF, youth were defined as obese if they had a BMI ≥ 95th percentile, and youth with 85th ≤ BMI ≤ 95th percentile were defined as overweight. Wc is classified by the criteria HD, Wc with moderate risk ≥ 90th percentile and Wc with high risk ≥ 95th percentile. The dietary assessment was based on a 24-hour dietary recall assisted by food records. USDA’S nutrient database for Nutrinux® program was used to analyze dietary intake. Nutrients adequacy ratio was calculated by dividing daily individual intake to dietary recommended intake DRI for each nutrient. 9% of the population was overweight, 3% was obese, 7.5% had abdominal obesity, foods eaten in moderation are chips, cookies, chocolate 1-3 times/day and increased consumption of fried foods in the week, almost half of youth consume sugary drinks more than 3 times per week, we observe a decreased intake of energy, protein (P < 0.001, P = 0.003), SFA (P = 0.018), the NAR of phosphorus, iron, magnesium, vitamin B6, vitamin E, folate, niacin, and thiamin reflecting less consumption of fruit, vegetables, milk, and milk products. Youth surveyed have eating habits at risk of developing obesity and chronic disease.

Keywords: food intake, health, anthropometric characteristics, Algeria

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Authors: Steven M. Sanders, April T. Berry, David W. Hollingsworth

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Previous research has shown that veterans have higher rates of mental health concerns compared to non-veteran populations. A potential risk factor for the development of mental health concerns (i.e., depression & anxiety), particularly in Black veterans, is psychological inflexibility. Psychological inflexibility, a component of Acceptance & Commitment Therapy (ACT), is a process by which behavior is expressed in ways that attempt to control emotional and psychological reactions to uncomfortable stimuli and situations rather than by direct contingencies or personal values. The present study explored the relationship between psychological inflexibility, symptoms of depression, and symptoms of anxiety in a sample of 131 Black veterans. Results demonstrated that Black veterans who endorsed psychological inflexibility also endorsed higher levels of both depression and anxiety symptomology. These findings indicate the deleterious consequences of experiencing psychological inflexibility, which could be treated through ACT.

Keywords: psychological flexibility, veteran, black, psychological distress

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Authors: Sarah Hebbouch

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Two decades ago, research on diasporic women’s participation within Sufi circles would have been inconceivable, not only because of a general lack of recognition of their contribution to Sufism but due to the intimacy of the rituals, often taking place in confined spaces, like zawiyas (Sufi lodges). Recent scholarly attention to female spiritual experience owes to a digital awareness and interest in exploring diasporic community reproduction of those experiences. Within a context where female disciples of a Sufi convent undergo a physical separation from the saint’s sanctuary -because of immigration from the homeland to the host country- technology becomes a social hub accounting for Sufis’ ritual commitment and preservation of cultural capital in the diaspora. This paper elucidates how female Sufi immigrants affiliating with the Boudchichi brotherhood (Morocco-based) maintain ‘a relational network’ and strong social online relationships with their female compatriots in Morocco through the use of online platforms. Sufi communities living in the diaspora find the internet an open interactive space that serves to kindle their distance of spiritual participation and corroborate their transnational belonging. The current paper explores the implications of the use of a digital baseline named “Tariqa Info,” the convent’s digital online platform, and how it mediates everyday ritual performance, the promotion of digital connection, and the communication of ideas and discourses. Such a platform serves the bolstering emotional bonds for transnational female disciples and inclusion within online communities in the homeland. Assisted by an ethnographic lens, this paper discusses the research findings of participatory field observation of Sufi women’s online communities, informed by the need to trace the many ostensible aspects of interconnectedness and divergences.

Keywords: digital connection, Sufi convent, social online relationship, transnational female disciples

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Authors: Jefrey Pilusa, Tumisang Seodigeng

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This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: autoclave, disposal, fuel, incineration, medical waste

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Authors: Kevin Soubly, Kaysara Khatun

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This study applies the existing Middle-Out Perspective (MOP) as a complementing analytical alternative to the customary dichotomous options of top-down vs. bottom-up strategies of international development and commons governance. It expands the framework by applying it to a new context of land management and environmental change, enabling fresh understandings of decision making around land use. Using a case study approach in Central Kalimantan, Indonesia among a village of indigenous Dayak, this study explores influences from both internal and external middle actors, utilizing qualitative empirical evidence and incorporating responses across 25 village households and 11 key stakeholders. Applying the factors of 'agency' and 'capacity' specific to the MOP, this study demonstrates middle actors’ unique capabilities and criticality to change due to their influence across various levels of decision-making. Study results indicate that middle actors play a large role, both passively and actively, both directly and indirectly, across various levels of decision-making, perception-shaping, and commons governance. In addition, the prominence of novel 'passive' middle actors, such as the internet, can provide communities themselves with a level of agency beyond that provided by other middle actors such as NGOs and palm oil industry entities – which often operate at the behest of the 'top' or out of self-interest. Further, the study posits that existing development and decision-making frameworks may misidentify the 'bottom' as the 'middle,' raising questions about traditional development and livelihood discourse, strategies, and support, from agricultural production to forest management. In conclusion, this study provides recommendations including that current policy preconceptions be reevaluated to engage middle actors in locally-adapted, integrative manners in order to improve governance and rural development efforts more broadly.

Keywords: environmental management, governance, Indonesia, land use, middle actors, middle-out perspective

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Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

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Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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Authors: Mohammad Bagher Heidari, Hefzollah Mohammadian

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TETRA (Terrestrial Trunked Radio) is a digital radio communication standard, which has been implemented in several different parts of the gas refinery ninth (phase 12th) by South Pars Gas Complex. Studies on possible impacts on the users' health considering different exposure conditions are missing. Objectives: To investigate possible acute effects of electromagnetic fields (EMF) of two different levels of TETRA hand-held transmitter signals on cognitive function and well-being in healthy young males. Methods: In the present double-blind cross-over study possible effects of short-term (2.5 h) EMF exposure of handset-like signals of TETRA (450 - 470 MHz) were studied in 30 healthy male participants (mean ± SD: 25.4 ±2.6 years). Individuals were tested on nine study days, on which they were exposed to three different exposure conditions (Sham, TETRA 1.5 W/kg and TETRA 10.0 W/kg) in a randomly assigned and balanced order. Participants were tested in the afternoon at a fixed timeframe. Results: Attention remained unchanged in two out of three tasks. In the working memory, significant changes were observed in two out of four subtasks. Significant results were found in 5 out of 35 tested parameters, four of them led to an improvement in performance. Mood, well-being and subjective somatic complaints were not affected by TETRA exposure. Conclusions: The results of the present study do not indicate a negative impact of a short-term EMF- effect of TETRA on cognitive function and well-being in healthy young men.

Keywords: TETRA (terrestrial trunked radio), electromagnetic fields (EMF), mobile telecommunication health research (MTHR), antenna

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Authors: M. J. Ponnambalam

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Physics Outreach in Jamaica has nearly tripled the number of students doing Introductory Calculus-based Physics at the University of the West Indies (UWI, Mona) within 5 years, and thus has shown the importance of Physics Teaching & Learning in Informal Settings. In 1899, the first president of the American Physical Society called Physics, “the science above all sciences.” Sure enough, exactly one hundred years later, Time magazine proclaims Albert Einstein, “Person of the Century.” Unfortunately, Physics seems to be losing that glow in this century. Many countries, big and small, are finding it difficult to attract bright young minds to pursue Physics. At UWI, Mona, the number of students in first year Physics dropped to an all-time low of 81 in 2006, from more than 200 in the nineteen eighties, spelling disaster for the Physics Department! The author of this paper launched an aggressive Physics Outreach that same year, aimed at conveying to the students and the general public the following messages: i) Physics is an exciting intellectual enterprise, full of fun and delight. ii) Physics is very helpful in understanding how things like TV, CD player, car, computer, X-ray, CT scan, MRI, etc. work. iii) The critical and analytical thinking developed in the study of Physics is of inestimable value in almost any field. iv) Physics is the core subject for Science and Technology, and hence of national development. Science Literacy is a ‘must’ for any nation in the 21st century. Hence, the Physics Outreach aims at reaching out to every person, through every possible means. The Outreach work is split into the following target groups: i) Universities, ii) High Schools iii) Middle Schools, iv) Primary Schools, v) General Public, and vi) Physics teachers in High Schools. The programmes, tools and best practices are adjusted to suit each target group. The feedback from each group is highly positive. e.g. In February 2014, the author conducted in 3 Primary Schools the Interactive Show on ‘Science Is Fun’ to stimulate 290 students’ interest in Science – with lively and interesting demonstrations and experiments in a highly interactive way, using dramatization, story-telling and dancing. The feedback: 47% found the Show ‘Exciting’ and 51% found it ‘Interesting’ – totaling an impressive 98%. When asked to describe the Show in their own words, the leading 4 responses were: ‘Fun’ (26%), ‘Interesting’ (20%), ‘Exciting’ (14%) and ‘Educational’ (10%) – confirming that ‘fun’ & ‘education’ can go together. The success of Physics Outreach in Jamaica verifies the following words of Chodos, Associate Executive Officer of the American Physical Society: “If we could get members to go to K-12 schools and levitate a magnet or something, we really think these efforts would bring great rewards.”

Keywords: physics education, physics popularization, UWI, Jamaica

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Authors: Jared R. Chapman

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This study introduces a type of motivational information system called an educational engagement information system (EEIS). An EEIS draws on principles of behavioral economics, motivation theory, and learning cognition theory to design information systems that help students want to improve their performance. This study compares academic outcomes for course sections taught by part- and full-time instructors both with and without an EEIS. Without an EEIS, students in the part-time instructor's course sections demonstrated significantly higher failure rates (a 143.8% increase) and dropout rates (a 110.4% increase) with significantly fewer students scoring a B- or higher (39.8% decrease) when compared to students in the course sections taught by a full-time instructor. It is concerning that students in the part-time instructor’s course without an EEIS had significantly lower academic outcomes, suggesting less understanding of the course content. This could impact retention and continuation in a major. With an EEIS, when comparing part- and full-time instructors, there was no significant difference in failure and dropout rates or in the number of students scoring a B- or higher in the course. In fact, with an EEIS, the failure and dropout rates were statistically identical for part- and full-time instructor courses. When using an EEIS (compared with not using an EEIS), the part-time instructor showed a 62.1% decrease in failures, a 61.4% decrease in dropouts, and a 41.7% increase in the number of students scoring a B- or higher in the course. We are unaware of other interventions that yield such large improvements in academic performance. This suggests that using an EEIS such as Delphinium may compensate for part-time instructors’ limitations of expertise, time, or rewards that can have a negative impact on students’ academic outcomes. The EEIS had only a minimal impact on failure rates (7.7% decrease) and dropout rates (18.8% decrease) for the full-time instructor. This suggests there is a ceiling effect for the improvements that an EEIS can make in student performance. This may be because experienced instructors are already doing the kinds of things that an EEIS does, such as motivating students, tracking grades, and providing feedback about progress. Additionally, full-time instructors have more time to dedicate to students outside of class than part-time instructors and more rewards for doing so. Using adjunct and other types of part-time instructors will likely remain a prevalent practice in higher education management courses. Given that using part-time instructors can have a negative impact on student graduation and persistence in a field of study, it is important to identify ways we can augment part-time instructors’ performance. We demonstrated that when part-time instructors use an EEIS, it can result in significantly lower students’ failure and dropout rates and an increase in the rate of students earning a B- or above; and bring their students’ performance to parity with the performance of students taught by a full-time instructor.

Keywords: gamification, engagement, motivation, academic outcomes

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Authors: Catherine Constantinidis (Nee Tsacalos)

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This paper presents one aspect of the larger Masters qualitative study exploring the roles of married Greek Orthodox clergy, the Priest and Presbytera, under the wing of the Greek Orthodox Archdiocese of Australia. This ground breaking research necessitated the creation of primary data within a phenomenological paradigm drawing from lived experiences of the Priests and Presbyteres in contemporary society. As a Social Worker, a bilingual (Greek/English) Mental Health practitioner and a Presbytera, the questions constantly raised and pondered are: Who do the Priest and Presbytera turn to when they experience difficulties or problems? Where do they go for support? What is in place for their emotional and psychological health and well-being? Who cares for the spiritual carer? Who is there to catch our falling clergy and their wives? What is their 'safety net'? Identified phenomena of angst, stress, frustration and confusion experienced by the Priest and (by extension) the Presbytera, within their position, coupled with basic assumptions, perceptions and expectations about their roles, the role of the organisation (the Church), and their role as spouse often caused confusion and in some cases conflict. Unpacking this complex and multi-dimensional relationship highlighted not only the roller coaster of emotions, potentially affecting their physical and mental health, but also the impact on the interwoven relationships of marriage and ministry. The author considers these phenomena in the light of bilingual cultural and religious organisational practice frameworks, specifically the Greek Orthodox Church, whilst filtering these findings through a mental health lens. One could argue that it is an expectation that clergy (and by default their wives) take on the responsibility to be kind, nurturing and supportive to others. However, when it comes to taking care of self, they are not nearly as kind. This research looks at a recurrent theme throughout the interviews where all participants talked about limited support systems and poor self care strategies and the impact this has on their ministry, mental, emotional, and physical health and ultimately on their relationships with self and others. The struggle all participants encountered at some point in their ministry was physical, spiritual and psychological burn out. The overall aim of the researcher is to provide a voice for the Priest and the Presbytera painting a clearer picture of these roles and facilitating an awareness of struggles and dilemmas faced in their ministry. It is hoped these identified gaps in self care strategies and support systems will provide solid foundations for building a culturally sensitive, empathetic and effective support system framework, incorporating the spiritual and psychological well-being of the Priest and Presbytera, a ‘safety net’. A supplementary aim is to inform and guide ministry practice frameworks for clergy, spouses, the church hierarchy and religious organisations on a local and global platform incorporating some sort of self-care system.

Keywords: care for the carer, mental health, Priest, Presbytera, religion, support system

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