Search results for: women’s electoral participation

Authors: Segen Asayehegn

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Introduction: In Tigray, Ethiopia, next to cervical cancer, breast cancer is one of the most common cancer health problems for women. Objectives: This article is proposed to identify the prospective and potential risk factors affecting the time-to-first-recurrence of breast cancer patients in Tigray, Ethiopia. Methods: The data were taken from the patient’s medical record that registered from January 2010 to January 2020. The study considered a sample size of 1842 breast cancer patients. Powerful non-parametric and parametric shared frailty survival regression models (FSRM) were applied, and model comparisons were performed. Results: Out of 1842 breast cancer patients, about 1290 (70.02%) recovered/cured the disease. The median cure time from breast cancer is found at 12.8 months. The model comparison suggested that the lognormal parametric shared a frailty survival regression model predicted that treatment, stage of breast cancer, smoking habit, and marital status significantly affects the first recurrence of breast cancer. Conclusion: Factors like treatment, stages of cancer, and marital status were improved while smoking habits worsened the time to cure breast cancer. Recommendation: Thus, the authors recommend reducing breast cancer health problems, the regional health sector facilities need to be improved. More importantly, concerned bodies and medical doctors should emphasize the identified factors during treatment. Furthermore, general awareness programs should be given to the community on the identified factors.

Keywords: acceleration factor, breast cancer, Ethiopia, shared frailty survival models, Tigray

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Authors: Maria Wendy Mendoza-Solomo

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The study assessed the level of understanding of catholic doctrines in relation to the way of life of Ignatian graduates of Ateneo de Naga University (ADNU). It was conducted to find out if ADNU is successful in leading their students to a deeper moral understanding of the world centered on Jesus Christ through their curriculum, academic programs, activities and practices. This study further evaluated if their graduates live out their Catholic commitment to Christ in their current way of life. It also determined the factors that affected their level of understanding of Catholic doctrines and their current way of life. The descriptive, qualitative, evaluative and correlational analyses determined the level of understanding of the Catholic doctrines and the current way of life of 390 graduates. It also correlated the level of understanding to moral life and worship. The factors that affected the graduates’ level of understanding and their current way of life were measured. A researcher-made instrument was distributed to the respondents either using the traditional way or the online survey to reach out graduates across the globe. Major findings were (1) The weighted mean of graduates’ level of understanding of Catholic doctrines was 4.63. (2) Along moral life, 4.07 while along worship, 3.83. (3) The Catholic doctrines and moral life had Pearson r value of 0.79. The doctrines and worship, 0.87; and worship and moral life, 0.89. (4) The understanding of the doctrines was affected highly by the teacher factor with 4.09 mean. The moral life and worship were affected highly by the teacher and technological factors both ranked 1.5 (4.04). (5) Along Catholic doctrines, the teacher factor had 0.90 r value; and environmental, -0.40. Along moral life, teacher had r value of -0.30; technological (-0.92), socio-economic (-0.93), political (-0.83), and environmental (-0.90). Along worship, the teacher had 0.36 Pearson r value, technological and socio-economic (-0.78), political (-0.73) and environmental (-0.72). Major conclusions were: (1) Graduates had very high level of understanding of the Catholic doctrines as summarized in the Creed which is grounded in the Sacred Scriptures. (2) They live out this Catholic commitment to Christ by obeying the Commandments very extensively but needed more participation in religious and parish activities. They have overwhelming spirituality and religiosity in terms of receiving of sacraments and sacramental practices except reading the Bible and reflecting on its passages. (3) The graduates’ level of understanding of the Catholic doctrines had very strong correlation with their current way of life. (4) Teacher, socio-economic, technological, environmental, and political factors significantly affected their understanding of the Catholic doctrines and their current way of life. (5) The teacher factor had very strong relationship with the doctrines; technological and political, weak; environmental, moderate; and socio-economic, very weak relationship. The teacher factor had weak relationship but the other factors had very strong relationship with moral life and strong relationship with worship.

Keywords: Catholic doctrines, Ignatian graduates, relationship, way of life

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Authors: Leona Ondrejikova, Martin Hill, Antonin Parizek

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The incidence of gestational diabetes mellitus (GDM) is higher in women predisposed to developing intrahepatic cholestasis of pregnancy (ICP). Both diseases are associated with altered steroidogenesis when compared with none-ICP controls. However, the effect of GDM on circulating steroids in ICP patients remains unclear. The question remains, whether the levels of circulating steroids differ between ICP patients with and without GDM. In total 10 ICP patients without GDM (ICP+GDM-), 7 ICP patients with GDM (ICP+GDM+), and 15 controls (ICP-GDM-) were monitored during late gestation, at labor, and during three periods postpartum (day 5, week 3, and week 6 postpartum) (Šimják et al., 2018). The relationships between steroid profiles and patients’ status were evaluated using the ANOVA model consisting of subject factor, between-subject factors Group (ICP+GDM+, ICP+GDM-, ICP-GDM-), gestational age at the diagnosis of ICP and gestational age at labor, and within-subject factor Stage and ICP × Stage interaction. The levels of the C21 and C19 Δ5 steroids and 5α/β-reduced C19 steroids were highest in ICP+GDM+, while those for the ICP-GDM-, and ICP+GDM- groups were lower. In the C21 Δ4 steroids and their 5α/β-reduced metabolites, the steroid levels were highest in the ICP+GDM-, intermediate in the ICP-GDM- and lowest in the ICP+GDM+ group. This higher concentration in ICP+GDM- group may be of importance as the 5α-pregnane-3α,20α-diol disulfate, is considered as the substance inducing ICP. In general, these data show that the comorbidity with GDM substantially changes the steroidome in ICP patients towards the higher activity of steroid CYP17A1 lyase step in adrenal zona reticularis reduced CYP17A1 hydroxylase step in zona fasciculata. This is consistent with our previously published hypothesis about the critical role of maternal zona reticularis in the pathophysiology of ICP. Our present data also indicate that the comorbidity with GDM might moderate the gravity of the ICP in this way.

Keywords: CYP17A1, GC-MS, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy

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Authors: I. Ramalho, S. Campos, M. Dias

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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.

Keywords: endometriosis, histology, observational study, ovarian cancer

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Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

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Authors: Bernard Eze Orji

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The masquerade, which is the most popular indigenous art form in Africa, is obviously identified by its elaborate, weird, and opulent costumes. The costume is the major essential accouterments in the art of the masquerade. From time past, masquerades have performed and enjoyed the freedom associated with its inscrutability and mystification solely because of its costumes. Noninitiates and women watched masquerades from a distance due to the reverence attached to its costumes and performances. In fact, whether in performance or as an item of art, the masquerade costume was seen as an embodiment of a tradition of liveliness, showiness, secrecy, and sacredness. This liveliness and showiness transformed masked characters who are believed to be possessed by spirits of ancestors and animals that inhabited the costumes. However, with the translocation of masquerade in new festivals such as carnival and state-sponsored cultural days, its costumes have been reduced to a mere item of entertainment and aesthetic values. The sacredness and reverence which hitherto elevated masquerade art to the point of wonderment have given way to an aesthetic appreciation of ingenious and individual creativity deployed in these festivals. This is as a result of the realistic and artistic creations that pervade masquerade costumes and masks in these festivals. It is a common sight to see such masquerades of animal and human genera like a lion, elephant, hippopotamus, and antelope; Agbogho Mmuo, Adamma, and Nchiekwa, respectively. This creative flair has emerged to expunge the ritual narratives associated with masquerades in the past. The study utilized performance analysis and aesthetic theory to establish that the creative ingenuity deployed by fine artists and mask designers who combine traditional artifacts to achieve modern masterpieces for the masquerades of the new festivals have reduced the ritual trappings and hype ascribed to masquerades in indigenous societies.

Keywords: costume and mask designs, entertainment, masquerade, ritual

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Authors: Peter O. Nwadike, Sylvia O. Anyadoh-Nwadike, Chukwunonyerem Ogwunga, I. N. S. Dozie

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Purpose: This study was aimed at determining the knowledge and attitude of female workers in six selected rural Local Government Areas of Imo State (Ezinihitte Mbaise, Ngor Okpala, Ohaji/Egbema, Ideato South, Ihitte Uboma and Obowo) towards cervical cancer and its screening. Methodology: Data was collected using a validated open-ended, semi-structured questionnaire. After responses to the questionnaire were received, a seminar on Cervical cancer and its screening was delivered to the respondents. Afterward, a second set of the same questionnaires was administered to the same respondents. A total of 460 women of reproductive age were randomly selected upon their informed consent. Data obtained/responses were analyzed using simple percentages. The chi-square test was used to assess the relationship by testing the hypothesis. Result: Results revealed that, before the seminar, a high average percentage of 72.2% (332) of respondents had not heard of cervical cancer while 27.8% (128) had heard. Of those who know about Cervical cancer, an average of 70.3% (90) showed low knowledge. The majority of respondents, 366 (79.6%), had poor attitudes toward screening. They mostly implicated lack of awareness 205 (44.6%) and lack of funds 104 (22.6%) as major reasons for not participating in the screening test. Few 128 (27.8%) agreed to go for screening and vaccination. After the awareness, 400 (87%) agreed to go for the screening test and vaccination if free/affordable. None of the participants had ever been screened. A significant relationship between attitude to cervical cancer and level of knowledge and academic level and attitude to cervical cancer screening was obtained. Conclusion: This calls for continued enlightenment about cervical cancer screening, especially as soon as sexual activity begins.

Keywords: cervical cancer, rural areas, Imo state, knowledge, attitude

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Authors: Awadh O. Al-Anazi

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As part of the organizational needs toward successful maintaining activities, a proper management system need to be put in place, ensuring the effectiveness of maintenance activities. The management system shall clearly describes the process of identifying, prioritizing, planning, scheduling, execution, and providing valuable feedback for all maintenance activities. Completion and accuracy of the system with proper implementation shall provide the organization with a strong platform for effective maintenance activities that are resulted in efficient outcomes toward business success. The purpose of this research was to introduce a practical tool for measuring the maintenance efficiency level within Saudi organizations. A comprehensive study was launched across many maintenance professionals throughout Saudi leading organizations. The study covered five main categories: work process, identification, planning and scheduling, execution, and performance monitoring. Each category was evaluated across many dimensions to determine its current effectiveness through a five-level scale from 'process is not there' to 'mature implementation'. Wide participation was received, responses were analyzed, and the study was concluded by highlighting major gaps and improvement opportunities within Saudi organizations. One effective implementation of the efficiency enhancement efforts was deployed in Saudi Kayan (one of Sabic affiliates). Below details describes the project outcomes: SK overall maintenance wrench time was measured at 20% (on average) from the total daily working time. The assessment indicates the appearance of several organizational gaps, such as a high amount of reactive work, poor coordination and teamwork, Unclear roles and responsibilities, as well as underutilization of resources. Multidiscipline team was assigned to design and implement an appropriate work process that is capable to govern the execution process, improve the maintenance workforce efficiency, and maximize wrench time (targeting > 50%). The enhanced work process was introduced through brainstorming and wide benchmarking, incorporated with a proper change management plan and leadership sponsorship. The project was completed in 2018. Achieved Results: SK WT was improved to 50%, which resulted in 1) reducing the Average Notification completion time. 2) reducing maintenance expenses on OT and manpower support (3.6 MSAR Actual Saving from Budget within 6 months).

Keywords: efficiency, enhancement, maintenance, work force, wrench time

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Authors: C. M. Williams, R. English, P. King, I. M. Brown

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Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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Authors: Edit Xhajanka, Gresa Baboci, Irene Malagnino, Mimoza Canga, Vito Antonio Malagnino

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Purpose: This study aimed at identifying dental caries increment or reduction, based on factors such as smoking, the scaling of teeth, BMI before and during pregnancy, carbohydrates consumption in relation to childbirth. Material and method: In this observational study, the sample included a total of 98 pregnant women and their age class was 18-45 years old, with a median age of 31.5 years. The setting of the participants resides in Vlora –Albania. Moreover, 64.4% were from the city and 35.6% were from the nearby villages. The study was conducted in the time period January 2018 –June 2021. Body mass index (BMI) was calculated using the standard formula (kg/m²). Maternal pre, during and post-pregnancy BMI was collected by using a validated questionnaire. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: Based on the data analysis, 44.4% of the sample declared that they did smoke before pregnancy and 55.6% not smoked during their pregnancy. As a result, no association was found between smoking and length of pregnancy P=0.95. There is also a strong relation (P=0.000) between the number of teeth with caries before pregnancy and the number of teeth with caries during pregnancy. There is a significant relationship between the scaling of teeth and childbirth, P=0.05. BMI before and during pregnancy in relation to carbohydrates consumption have a significant correlation P=0.004 and P=0.002. The values of BMI before and during pregnancy in relation to childbirth have a strong correlation: P=0.043 and P=0.040, respectively. As a result, obesity was associated with preterm birth. The percentage of children born during 34-36 weeks of pregnancy was 69%, and children born during 32-34 weeks of pregnancy were 31%. CONCLUSION: There was a positive association between dental caries experience, BMI and carbohydrates consumption. Obesity in pregnancy is increasing worldwide; that is why this study suggests the importance of an appropriate weight before and during pregnancy.

Keywords: BMI, dental caries, pregnancy, scaling, smoking

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Authors: Clarence Dissanayake, Anishka A. Hettiarachchi

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Landscape architecture needs to encompass a placemaking process carefully composing and manipulating landscape elements to address perceptual needs of humans, especially aesthetic, psychological and spiritual. The objective of this qualitative investigation is to inquire the impact of elements of rock and water combination on landscape perception and related feelings, emotions, and behavior. The past empirical studies have assessed the impact of landscape elements in isolation on user preference, yet the combined effect of elements have been less considered. This research was conducted with reference to the verity of qualities of water and rock through a visual landscape quality assessment focusing on landscape qualities derived from five visual concepts (coherence, historicity imageability, naturalness, and ephemera). 'Kaludiya Pokuna' archeological site in Anuradhapura was investigated with a sample of University students (n=19, male 14, female 5, age 20-25) using a five-point Likert scale via a perception based questionnaire and a visitor employed photographic survey (VEP). Two hypothetical questions were taken into investigation concerning biophilic (naturalness) and topophilic (historicity) aspects of humans to prefer a landscape with rock and water. The findings revealed that this combination encourages both biophilic and topophilic aspects, but in varying degrees. The identified hierarchy of visual concepts based on visitor’s preference signify coherence (93%), historicity (89%), imageability (79%), naturalness (75%) and ephemera (70%) respectively. It was further revealed that this combination creates a scenery more coherent dominating information processing aspect of humans to perceive a landscape over the biophilic and topophilic aspects. Different characteristics and secondary landscape effects generated by rock and water combination were found to affect in transforming a space into a place, full filling the aesthetic and spiritual aspects of the visitors. These findings enhance a means of making places for people, resource management and historical landscape conservation. Equalization of gender based participation, taking diverse cases and increasing the sample size with more analytical photographic analysis are recommended to enhance the quality of further research.

Keywords: landscape perception, visitor’s preference, rock and water combination, visual concepts

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Authors: Hanjun Hu, Jinxiang Zhang

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With the decline of "growthism", China's urbanization process has shifted from the stage of spatial expansion to the stage of optimization of built-up spaces, and urban renewal has gradually become a new wave of China's urban movement in recent years. The ongoing urban renewal movement in China not only needs to generate new motivation for urban development but also solve the backlog of social problems caused by rapid urbanization, which provides an opportunity for the transformation of China's urban governance model. Unlike previous approaches that focused on physical space and functional renewal, such as urban reconstruction, redevelopment, and reuse, the key challenge of urban renewal in the post-growth era lies in coordinating the complex interest relationships between multiple stakeholders. The traditional theoretical frameworks that focus on the structural relations between social groups are insufficient to explain the behavior logic and mutual cooperation mechanism of various groups and individuals in the current urban renewal practices. Therefore, based on the long-term tracking of the urban renewal practices in the Old City of Nanjing (OCN), this paper introduces the "collective action" theory to deeply analyze changes in the urban renewal governance model in OCN and tries to summarize the governance strategies that promote the formation of collective action within recent practices from a micro-scale. The study found that the practice in OCN experienced three different stages "government-led", "growth coalition" and "asymmetric game". With the transformation of government governance concepts, the rise of residents' consciousness of rights, and the wider participation of social organizations in recent years, the urban renewal in OCN is entering a new stage of "collective renewal action". Through the establishment of the renewal organization model, incentive policies, and dynamic negotiation mechanism, urban renewal in OCN not only achieves a relative balance between individual interests and collective interests but also makes the willingness of residents the dominant factor in formulating urban renewal policies. However, the presentation of "collective renewal action" in OCN is still mainly based on typical cases. Although the government is no longer the dominant role, a large number of resident-led collective actions have not yet emerged, which puts forward new research needs for a sustainable governance policy innovation in this action.

Keywords: urban renewal, collective action theory, governance, cooperation mechanism, China

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Authors: Abara Onu, Augustine Mina Ephraim, Emmanuel Teidi

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Terrorism has been a major challenge and is so dare to the Nigerian government in recent times. The actions and activities of the Islamic sect known as Boko Haram had led to enormous loss of lives and properties in the country, mostly the Northern part of Nigeria. Some of these activities entails bombings, suicide attacks, intimidations, sporadic gunfire of the unarmed, blameless and innocent Nigerians, burning of police stations and churches, kidnappings, raping of school girls and women. Nigeria has also been included amongst one of the terrorist countries of the world. This has serious implications for the development of Nigerian economy. Although, Nigeria had made several worried hard work to deal with these challenges masqueraded by terrorism and insecurity in the country but the rate of insurgency and insecurity is still worrisome. The study looks at exploring the determinants of Boko Haram terrorism in Nigerian security systems and economy. Data used for the study work was from questionnaire administered, using Analysis of Variance (ANOVA) method to analyse the data. The result shows that Ideology and funding are significant basic factors that propelled the Boko Haram group in Nigeria. The Boko Haram disaster poses a significant threat to Nigeria’s economy and the military is the best option and solution in tackling the Boko Haram menace in Nigeria. The work x-rayed the following recommendations; government should declare war on terrorism and as well seek support and cooperation from international communities who in time or the other might have faced with this kind ugly experience and challenge and were able to tackle it. Nigerian Military needs to be more empowered with high dangerous weapons to combat the insurgency as well as beef up security across the Country to curb the threats.

Keywords: terrorism, economy, Boko Haram, Nigeria

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Authors: P. Pérez-Martín, G. Pedrós, P. Martínez-Jiménez, M. Varo-Martínez

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In recent decades, family habits related to children’s displacements to school have changed, increasing motorized travels against active modes. This entails a major negative impact on the urban environment, road safety in cities and the physical and psychological development of children. One of the more common actions used to reverse this trend is Walking School Bus (WSB), which consists of a predefined adult-scorted pedestrian route to school with several stops along the path where schoolchildren are collected. At Tirso de Molina School in Cordoba (Spain), a new ICT-based methodology to deploy WSB has been tested. A mobile app that allows the geoposition of the group, the notification of the arrival and real-time communication between the WSB participants have been presented to the families in order to organize and register the daily participation. After an initial survey to know the travel mode and the spatial distribution of the interested families, three WSB routes have been established and the families have been trained in the app usage. During nine weeks, 33 children have joined the WSB and their parents have accompanied the groups in turns. A high recurrence in the attendance has been registered. Through a final survey, participants have valued highly the tool and the methodology designed, emphasizing as most useful features of the mobile app: notifications system, chat and real-time monitoring. It has also been found that the tool has had a major impact on the degree of confidence of parents regarding the autonomous on foot displacement of their children to school. Moreover, 37,9% of the participant families have reported a total or partial modal shift from car to walking, and the benefits more reported are an increment of the parents available time and less problems in the travel to school daily organization. As a consequence, It has been proved the effectiveness of this user-centric innovative ICT-based methodology to reduce the levels of private car drop offs, minimize barriers of time constraints, volunteer recruitment, and parents’ safety concerns, while, at the same time, increase convenience and time savings for families. This pilot study can offer guidance for community coordinated actions and local authority interventions to support sustainable school travel outcomes.

Keywords: active travel, mobile app, sustainable mobility, urban transportation planning, walking school bus

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Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

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Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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Authors: Lapatrada Numkham, Saowaluk Khakhong, Jeeraporn Kummabutr

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Non-communicable diseases (NCDs) are the leading cause of death in worldwide. Thailand also concerns and focuses on reduction a new case of these diseases. Community Health Volunteers (CHV) is important health personnel in primary health care and performs as a health leader in the community. If the health of CHV changes, it would impact on the performance to promote health of families and community. This cross-sectional study aimed to 1) describe the health status of community health volunteers and 2) examine the factors associated with health status among community health volunteers. The sample included 360 community health volunteers in a province in central Thailand during September-December 2014. Data were collected using questionnaires on health information, knowledge of health behaviors, and health behaviors. Body weight, height, waist circumference (WC), blood pressure (BP), and blood glucose (BS) (fingertip) were assessed. Data were analyzed using descriptive statistics and chi-square test. There were three hundred and sixty participants with 82.5% being women. The mean age was 54 + 8.9 years. Forty-seven percent of the participants had co-morbidities. Hypertension was the most common co-morbidity (26.7%). The results revealed that the health status of the volunteers included: no underlying disease, having risk of hypertension (HT) & diabetes mellitus (DM), and having HT&DM at 38.3%, 30.0%, and 31.7% respectively. The chi-square test revealed that the factors associated with health status among the volunteers were gender, age, WC and body mass index (BMI). The results suggested that community health nurses should; 1) implement interventions to decrease waist circumference and lose weight through education programs, especially females; 2) monitor people that have a risk of HT&DM and that have HT&DM by meeting and recording BP level, BS level, WC and BMI; and 3) collaborate with a district public health officer to initiate a campaign to raise awareness of the risks of chronic diseases among community health volunteers.

Keywords: community health volunteers, health status, risk of non-communicable disease, Thailand

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Authors: Nada Basset

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Purpose: To examine the nature of the civil service sector as an employer through identifying the likely ways to develop employees’ commitment towards change in the civil service sector. Design/Methodology/Approach: a qualitative research approach was followed. Data was collected via a triangulation of interviews, non-participant observation and archival documents analysis. Non-probability sampling took place with a case-study method applied on a sample of 33 civil servants working in the Egyptian Ministry of State for Administrative Development (MSAD) which is the civil service entity acting as the change agent responsible for managing the government administrative reforms plan in the civil service sector. All study participants were actually working in one of the change projects/programmes and had a minimum of 12 months of service in the civil service. Interviews were digitally recorded and transcribed in the form of MS-Word documents, and data transcripts were analyzed manually using MS-Excel worksheets and main research themes were developed and statistics drawn using those Excel worksheets. Findings: The results demonstrate that developing the civil servant’s commitment towards change may require a number of suggested solutions like (1) employee involvement and participation in the planning and implementation processes, (2) linking the employee support to change to some tangible rewards and incentives, (3) appointing some inspirational change leaders that should act as role models, and (4) as a last resort, enforcing employee’s commitment towards change by coercion and authoritarianism. Practical Implications: it is clear that civil servants’ lack of organizational commitment is not directly related to their level of commitment towards change. The research findings showed that civil servants’ commitment towards change can be raised and promoted by getting them involved in the planning and implementation processes, as this develops some sense of belongingness and ownership, thus there is a fair chance that low organizationally committed civil servants can develop high commitment towards change; given they are provided a favorable environment where they are invited to participate and get involved into the move of change. Originality/Value: the research addresses a relatively new area of ‘developing organizational commitment in modern bureaucracies’ by virtue of investigating the levels of civil servants’ commitment towards their jobs and/or organizations -on one hand- and suggesting different ways of developing their commitment towards administrative reform and change initiatives in the Egyptian civil service sector.

Keywords: change, commitment, Egypt, bureaucracy

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Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.

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Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.

Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis

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Authors: Eke Balla Sophie Michelle

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Forest provides a wide range of environmental goods and services among which, biodiversity or consumption goods and constitute public goods. Despite the importance of non-timber forest products (NTFPs) in sustaining livelihood and poverty smoothening in rural communities, they are highly depleted and poorly conserved. Yokadouma is a town where NTFPs is a renewable resource in active exploitation. It has been found that such exploitation is done in the same conditions as other localities that have experienced a rapid depletion of their NTFPs in destination to cities across Cameroon, Central Africa, and overseas. Given these realities, it is necessary to access the consequences of this overexploitation through negative effects on both the population and the environment. Therefore, to enhance participatory conservation initiatives, this study determines the household’s willingness to pay in community forest (CF) of Morikouali-ye, eastern region of Cameroon, for sustainable exploitation of NTFPs using contingent valuation method (CVM) through two approaches, one parametric (Logit model) and the other non-parametric (estimator of the Turnbull lower bound). The results indicate that five species are the most collected in the study area: Irvingia gabonensis, the Ricinodendron heudelotii, Gnetum, the Jujube and bark, their sale contributes significantly to 41 % of total household income. The average willingness to pay through the Logit model and the Turnbull estimator is 6845.2861 FCFA and 4940 FCFA respectively per household per year with a social cost of degradation estimated at 3237820.3253 FCFA years. The probability to pay increases with income, gender, number of women in the household, age, the commercial activity of NTFPs and decreases with the concept of sustainable development.

Keywords: non timber forest product, contingent valuation method, willingness to pay, sustainable development

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Authors: Vedat Kurt, Tansel Koyunoglu, Gamze Kurt, Ozgen Aras

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Low back pain is one of the most common health problem in public. Common symptoms that can be associated with low back pain include; pain, functional disability, gait disturbances. The aim of the study was to investigate the differences between disability scores and gait parameters in subjects with low back pain. Sixty participants are included in our study, (35 men, 25 women, mean age: 37.65±10.02 years). Demographic characteristics of participants were recorded. Pain (visual analog scale) and disability level (Oswestry Disability Index(ODI)) were evaluated. Gait parameters were measured with Zebris-FDM-2 platform. Independent samples t-test was used to analyse the differences between subjects with under 40 points (n=31, mean age:35.8±11.3) and above 40 points (n=29, mean age:39.6±8.1) of ODI scores. Significant level in statistical analysis was accepted as 0.05. There was no significant difference between the ODI scores and groups’ ages. Statistically significant differences were found in step width between subjects with under 40 points of ODI and above 40 points of ODI score(p < 0.05). But there were non-significant differences with other gait parameters (p > 0.05). The differences between gait parameters and pain scores were not statistically significant (p > 0.05). Researchers generally agree that individuals with LBP walk slower and take shorter steps and have asymmetric step lengths when compared with than their age-matched pain-free counterparts. Also perceived general disability may have moderate correlation with walking performance. In the current study, the patients classified as minimal/moderate and severe disability level by using ODI scores. As a result, a patient with LBP who have higher disability level tends to increase support surface. On the other hand, we did not find any relation between pain intensity and gait parameters. It may be caused by the classification system of pain scores. Additional research is needed to investigate the effects of functionality level and pain intensity on gait in subjects with low back pain under different classification types.

Keywords: functionality, low back pain, gait, pain

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Authors: Cláudia Patrocínio, Beatriz Fernandes, Ana Filipa Pires

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Background: Mirror therapy (MT) is used to improve motor function after stroke. During MT, a mirror is placed between the two upper limbs (UL), thus reflecting movements of the non- affected side as if it were the affected side. Objectives: The aim of this review is to analyze the evidence on the effec.tiveness of MT in the recovery of UL function in population with post chronic stroke. Methods: The literature search was carried out in PubMed, ISI Web of Science, and PEDro database. Inclusion criteria: a) studies that include individuals diagnosed with stroke for at least 6 months; b) intervention with MT in UL or comparing it with other interventions; c) articles published until 2023; d) articles published in English or Portuguese; e) randomized controlled studies. Exclusion criteria: a) animal studies; b) studies that do not provide a detailed description of the intervention; c) Studies using central electrical stimulation. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Studies with < 4 on PEDro scale were excluded. Eighteen studies met all the inclusion criteria. Main results and conclusions: The quality of the studies varies between 5 and 8. One article compared muscular strength training (MST) with MT vs without MT and four articles compared the use of MT vs conventional therapy (CT), one study compared extracorporeal shock therapy (EST) with and without MT and another study compared functional electrical stimulation (FES), MT and biofeedback, three studies compared MT with Mesh Glove (MG) or Sham Therapy, five articles compared performing bimanual exercises with and without MT and three studies compared MT with virtual reality (VR) or robot training (RT). The assessment of changes in function and structure (International Classification of Functioning, Disability and Health parameter) was carried out, in each article, mainly using the Fugl Meyer Assessment-Upper Limb scale, activity and participation (International Classification of Functioning, Disability and Health parameter) were evaluated using different scales, in each study. The positive results were seen in these parameters, globally. Results suggest that MT is more effective than other therapies in motor recovery and function of the affected UL, than these techniques alone, although the results have been modest in most of the included studies. There is also a more significant improvement in the distal movements of the affected hand than in the rest of the UL.

Keywords: physical therapy, mirror therapy, chronic stroke, upper limb, hemiplegia

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Authors: Sara D. Garduno-Diaz, Lorena Loriato

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Food selection is one of the main modifiable risk factors for the avoidance of several detrimental health conditions. Excessive and regular sugar intake has been identified as highly unfavorable, yet a highly occurring practice. A proposed approach to modify this eating practice is the online program developed here. The program targets a modification of mindset and lifestyle habits around food, through a four week raw-vegan guided eating program. While the focus of the program is to set up sustainable changes in sugar intake reduction, it also aims to promote a plant-based eating style. Three pilot sessions have been run with participants from seven different countries. Participants are guided through the program via a combination of daily e-mails, a 24-hour support platform, and by-weekly remote live sessions. Meal preparation techniques, as well as cooking instructions, are provided, following set menus developed by a team of professional chefs and nutritionists. Goal setting, as well as alternatives to specific food-related challenges, is addressed. While the program is intended for both women and men, the majority of participants to date have been female. Feedback has been positive, with changes in eating habits have included an elimination of added sugars, an increase in home cooking and vegetable intake, and a reduction in foods of animal origin. Difficulties in following the program have been reported as unavailability of certain ingredients depending on the country of residence of the participants, social and cultural hurdles, and time restrictions. Nevertheless, the results obtained to date indicate this to be a highly interactive program with the potential to be scaled up and applied to various populations as a public health measure on the way to better health.

Keywords: eating habits, food addiction, nutrition education, plant-based, remote practice

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Authors: Irfan Mehmood

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The goal of this paper is to examine Toni Morrison's novels Beloved and The Bluest Eye from a cultural materialistic perspective. The history and society of African Americans provide the inspiration for the stories of Beloved and The Bluest Eye. The cultural materialist elements and characteristics of Morrison's literary text will be highlighted in this study. The topic covered in this paper will include racism, gender discrimination, social class differences, and slavery in the text. In other words, the study will focus on the underrepresented groups in society, including women, slaves, and Afro-Americans. In this aspect, Toni Morrison is a fantastic writer whose works are full of diverse races. Morrison uses her incredibly well-informed language and well-produced stories to attempt to illuminate many facets of American life. She establishes a distinctive style of writing that sharply contrasts the suffering and enslavement of Afro-Americans with the traditional writings of Euro-American authors. Morrison shows a profound understanding of the exploitation of Afro-Americans in terms of race, gender, and class conflict in Beloved and The Bluest Eye. A unique culture and the history of a typically ignored set of people whose minds and societies have been permanently changed by class, racial, and gender discrimination were introduced through the study of Morrison's chosen novels. Toni Morrison places a lot of emphasis on the marginalized members of society, particularly in terms of class, ethnicity, and gender, because the majority of the key characters in her book are black. Therefore, the purpose of this essay is to concentrate on the culturally materialistic elements of Morrison's Beloved and The Bluest Eye and to ascertain the author's position on these minorities.

Keywords: race, slavery, social class, Toni Morrison, African American culture

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Shahida Mohd Sharif, Norsidah Ujang

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Recent research has shown that many of the urban population in Kuala Lumpur, especially from the lower-income group, suffer from socio-psychological problems. They are reported as experiencing anxiety, depression, and stress, which is made worst by the recent COVID-19 pandemic. Much of the population was forced to observe the Movement Control Order (MCO), which is part of pandemic mitigation measures, pushing them to live in isolation as the new normal. The study finds the need to strategize for a better approach to help these people coping with the socio-psychological condition, especially the population from the lower-income group. In Kuala Lumpur, as part of the Local Agenda 21 programme, the Kuala Lumpur City Hall has introduced Green Initiative: Urban Farming, which among the approaches is the community garden. The local authority promotes the engagement to be capable of improving the social environment of the participants. Research has demonstrated that social interaction within community gardens can help the members improve their socio-psychological conditions. Therefore, the study explores the residents’ experience from low-cost flats participating in the community gardening initiative from a social attachment perspective. The study will utilise semi-structured interviews to collect the participants’ experience with community gardening and how the social interaction exchange between the members' forms and develop their ties and trust. For a context, the low-cost flats are part of the government social housing program (Program Perumahan Rakyat dan Perumahan Awam). Meanwhile, the community gardening initiative (Projek Kebun Kejiranan Bandar LA21 KL) is part of the local authority initiative to address the participants’ social, environmental, and economic issues. The study will conduct thematic analysis on the collected data and use the ATLAS.ti software for data organization and management purposes. The findings could help other researchers and stakeholders understand the social interaction experience within community gardens and its relation to ties and trusts. The findings could shed some light on how the participants could improve their social environment, and its report could provide the local authority with evidence-based documentation.

Keywords: community gardening participation, lower-income population, social attachment, social interaction

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Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

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Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: developing country, local resources, nutrition program, urban fringe

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Authors: Achilles Kameas, Eleni Georgakakou, Anna Lisa Amodeo, Aideen Quilty, Aisling Malone, Roberta Albertazzi, Moises Carmona, Concetta Esposito, Ruben David Fernandez Carrasco, Carmela Ferrara, Francesco Garzillo, Mojca Pusnik, Maria Cristina Scarano

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While researchers, especially in academia, study and research the phenomena of inclusion of sexual minority and gender marginalized groups, seldom the European Higher Education Institutions (HEI) act on lowering the cultural and educational barriers to their proactive inclusion. The challenge in European HEIs is that gender, and sexual orientation discrimination remains an issue not adequately addressed. Following a mixed methods research design of quantitative and qualitative research techniques and tools, which is applied in five (5) European countries (Italy, Greece, Ireland, Slovenia, and Spain) and that combines desk research, evaluation, and weighting processes for a Matrix-based on Objective indicators and Survey for students and staff of the HEI to gauge the perception of inclusiveness in the HEI context, XENIA HEI Inclusiveness Index is an instrument that will allow universities to gauge and assess their inclusiveness in the domain of discrimination and exclusion based on gender identity and sexual orientation. The index will allow capturing the depth and reach of policies, programmes, and initiatives of HEIs in tackling the phenomena and dynamics of exclusion of LGBT+ (lesbian, gay, bisexual, trans, and other marginalized groups on the basis of gender and sexual identity) and cisgender women exposed to the risk of discrimination.

Keywords: gender identity, higher education, LGBT+ rights, XENIA inclusiveness index

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Authors: Wusu Conteh

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Since the 1990s, neo-liberalization has become a global agenda. The free market ushered in an unprecedented drive by Multinational Corporations (MNCs) to secure mineral rights in resource-rich countries. Several governments in the Global South implemented a liberalized mining policy with support from the International Financial Institutions (IFIs). MNCs have maintained that voluntary Corporate Social Responsibility (CSR) has engendered socio-economic development in mining-affected communities. However, most resource-rich countries are struggling to transform the resources into sustainable socio-economic development. They are trapped in what has been widely described as the ‘resource curse.’ In an attempt to address this resource conundrum, the African Mining Vision (AMV) of 2009 developed a model on resource governance. The advent of the AMV has engendered the introduction of mandatory community development agreement (CDA) into the legal framework of many countries in Africa. In 2009, Sierra Leone enacted the Mines and Minerals Act that obligates mining companies to invest in Primary Host Communities. The study employs interviews and field observation techniques to explicate the dynamics of the CDA program. A total of 25 respondents -government officials, NGOs/CSOs and community stakeholders were interviewed. The study focuses on a case study of the Sierra Rutile CDA program in Sierra Leone. Extant scholarly works have extensively explored the resource curse and voluntary CSR. There are limited studies to uncover the mandatory CDA and its impact on socio-economic development in mining-affected communities. Thus, the purpose of this study is to explicate the impact of the CDA in Sierra Leone. Using the theory of change helps to understand how the availability of mandatory funds can empower communities to take an active part in decision making related to the development of the communities. The results show that the CDA has engendered a predictable fund for community development. It has also empowered ordinary members of the community to determine the development program. However, the CDA has created a new ground for contestations between the pre-existing local governance structure (traditional authority) and the newly created community development committee (CDC) that is headed by an ordinary member of the community.

Keywords: community development agreement, impact, mandatory, participation

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Authors: Jennifer Gallup, Joel Bocanegra, Greg Callan, Abigail Vaughn

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Students with disabilities (SWD) engaged in a distance summer program delivered over multiple virtual mediums that used gaming principles to teach and practice self-regulated learning (SRL) through the process of exploring possible jobs. Gaming quests were developed to explore jobs and teach transition skills. Students completed specially designed quests that taught and reinforced SRL and problem-solving through individual, group, and teacher-led experiences. SRL skills learned were reinforced through guided job explorations over the context of MinecraftEDU, zoom with experts in the career, collaborations with a team over Marco Polo, and Zoom. The quests were developed and laid out on an accessible web page, with active learning opportunities and feedback conducted within multiple virtual mediums including MinecraftEDU. Gaming mediums actively engage players in role-playing, problem-solving, critical thinking, and collaboration. Gaming has been used as a medium for education since the inception of formal education. Games, and specifically board games, are pre-historic, meaning we had board games before we had written language. Today, games are widely used in education, often as a reinforcer for behavior or for rewards for work completion. Games are not often used as a direct method of instruction and assessment; however, the inclusion of games as an assessment tool and as a form of instruction increases student engagement and participation. Games naturally include collaboration, problem-solving, and communication. Therefore, our summer program was developed using gaming principles and MinecraftEDU. This manuscript describes a virtual learning summer program called Virtual Academy New and Exciting Transitions (VAN) that was redesigned from a face-to-face setting to a completely online setting with a focus on SWD aged 14-21. The focus of VAN was to address transition planning needs such as problem-solving skills, self-regulation, interviewing, job exploration, and communication for transition-aged youth diagnosed with various disabilities (e.g., learning disabilities, attention-deficit hyperactivity disorder, intellectual disability, down syndrome, autism spectrum disorder).

Keywords: autism, disabilities, transition, summer program, gaming, simulations

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Authors: M. Gomez, A. Molina

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The concept of brand equity in the wine tourism area is an interesting topic to explore the factors that determine it. The aim of this study is to address this gap by investigating wine tourism destinations brand equity, and understanding the impact that the denomination of origin (DO) brand image and the destination image have on brand equity. Managing and monitoring the branding of wine tourism destinations is crucial to attract tourist arrivals. The multiplicity of stakeholders involved in the branding process calls for research that, unlike previous studies, adopts a broader perspective and incorporates an internal and an external perspective. Therefore, this gap by comparing managers’ and visitors’ approaches to wine tourism destination brand equity has been addressed. A survey questionnaire for data collection purposes was used. The hypotheses were tested using winery managers and winery visitors, each leading a different position relative to the wine tourism destination brand equity. All the interviews were conducted face-to-face. The survey instrument included several scales related to DO brand image, destination image, and wine tourism destination brand equity. All items were measured on seven-point Likert scales. Partial least squares was used to analyze the accuracy of scales, the structural model, and multi-group analysis to identify the differences in the path coefficients and to test the hypotheses. The results show that the positive influence of DO brand image on wine tourism destination brand equity is stronger for wineries than for visitors, but there are no significant differences between the two groups. However, there are significant differences in the positive effect of destination brand image on both wine tourism destination brand equity and DO brand image. The results of this study are important for consultants, practitioners, and policy makers. The gap between managers and visitors calls for the development of a number of campaigns to enhance the image that visitors hold and, thus, increase tourist arrivals. Events such as wine gatherings and gastronomic symposiums held at universities and culinary schools and participation in business meetings can enhance the perceptions and in turn, the added value, brand equity of the wine tourism destinations. The images of destinations and DOs can help strengthen the brand equity of the wine tourism destinations, especially for visitors. Thus, the development and reinforcement of favorable, strong, and unique destination associations and DO associations are important to increase that value. Joint campaigns are advisable to enhance the images of destinations and DOs and, as a consequence, the value of the wine tourism destination brand.

Keywords: brand equity, managers, visitors, wine tourism

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