Search results for: practice as policy

Authors: Marie-Josee Lavallee

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Adorno’s reputation as an abstract and pessimistic thinker who indulged in a critic of capitalist society and culture without bothering himself with opening prospects for change, and who has no interest in political activism, recently begun to be questioned. This paper, which has a twofold objective, will push revisionist readings a step further by putting forward the thesis that revolutionary praxis has been an enduring concern for Adorno, surfacing throughout his entire work. On the other hand, it will hold that his understanding of the relationships between theory and praxis, which will be explained by referring to Ernst Bloch’s distinction between the warm and cold currents of Marxism, can help to interpret the paralysis of revolutionary practice in our own time under a new light. Philosophy and its tasks have been an enduring topic of Adorno’s work from the 1930s to Negativ Dialektik. The writings in which he develops these ideas stand among his most obscure and abstract so that their strong ties to the political have remained mainly overlooked. Adorno’s undertaking of criticizing and ‘redeeming’ philosophy and metaphysics is inseparable from a care for retrieving the capacity to act in the world and to change it. Philosophical problems are immanent to sociological problems, and vice versa, he underlines in his Metaphysik. Begriff and Problem. The issue of truth cannot be severed from the contingent context of a given idea. As a critical undertaking extracting its contents from reality, which is what philosophy should be from Adorno's perspective, the latter has the potential to fully reveal the reification of the individual and consciousness resulting from capitalist economic and cultural domination, thus opening the way to resistance and revolutionary change. While this project, according to his usual method, is sketched mainly in negative terms, it also exhibits positive contours which depict a socialist society. Only in the latter could human suffering end, and mutilated individuals experiment with reconciliation in an authentic way. That Adorno’s continuous plea for philosophy’s self-critic and renewal hides an enduring concern for revolutionary praxis emerges clearly from a careful philosophical analysis of his writings on philosophy and a selection of his sociological work, coupled with references to his correspondences. This study points to the necessity of a serious re-evaluation of Adorno’s relationship to the political, which will impact on the interpretation of his whole oeuvre, is much needed. In the second place, Adorno's dialectical conception of theory and praxis is enlightening for our own time, since it suggests that we are experiencing a phase of creative latency rather an insurmountable impasse.

Keywords: Frankfurt school, philosophy and revolution, revolutionary praxis, Theodor W. Adorno

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Authors: Costas Christodoulides

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Excessive use of social networking sites (SNS) and the Internet by high school pupils and university students, can cause consequences similar to those observed in substance or gambling related addictions, negatively influence individual well-being notwithstanding self-assessments that people make about their life and experiences. The present study examined, for the first time in Cyprus, the levels of problematic use of the Social Media and the Internet among Cypriot pupils and students aiming at contributing to the discussion about the need for a more conclusive policy framework in the island. The Bergen Social Media Addiction Scale (BSMAS) and the Generalized Problematic Internet Use Scale 2 (GPIUS-2) were adapted to a Cypriot version and along with a sociodemographic questionnaire were introduced to a sample of 1059 young persons in order to respectively assess the addiction risk for Social Media Use and the risk of Problematic Internet Use. The sample consisted of 59% females, aged 15 to 35 (M=18.9 years, SD=3.20), 465 of them were high school students and 594 university students. Of 1059 respondents from 4 high-schools and 5 Universities (HEI) in Cyprus, 8.3% of the sample had BSMAS scores suggestive of addiction. Approximately a quarter of the sample (24%), demonstrated GPIUS-2 scores suggestive of high risk for problematic internet use. It is notable that differences seem to exist across gender with the score of the female population (11.1%) reaching levels of addiction to social media more than twice the level of addiction of the male population (4.3%). Also, the female population of high school students seems to be at the most vulnerable position for problematic internet use (28%). The 26% of the sample often or very often used some SNSs to forget of personal problems. The results of this study show that half of those surveyed used the Internet to feel better when they were upset or to escape the isolation they felt. Among the sample population, the study reports that 60% of the pupils and female university students are in agreement with the relevant statements. Conclusively, this study suggests that SNSs addiction levels among pupils and students in Cyprus ought to be an important public health concern. The same if not more alarming is the identified by the study prevalence of problematic Internet use among the same population. These results confirm international trends reported by scholarly research while also suggest that particular categories such as high school pupils and young females may be more exposed to problem SNSs and Internet use. Preventive strategies need first to acknowledge the problem in order to then formulate an effective strategy for prevention and intervention. For relevant authorities it is of primary importance to “exploit” the fact that high schools and universities can be seen as small communities and units potentially available for forging alliances for healthy Social Media and Internet use.

Keywords: problematic internet use, social media addiction, social networking sites, well-being

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Authors: Sevinj Asgarova

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Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

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Authors: Noelene Rose

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The DSM has been plagued with conceptual issues since its inception, not least discriminant validity and comorbidity issues. An attempt to remain a-theoretical in the divide between the psycho-dynamicists and the behaviourists contributed to much of this, in particular relating to the Personality Disorders. With the DSM-5, although the criterion have remained unchanged, major conceptual and structural directions have been flagged and proposed in section III. The biggest changes concern the Personality Disorders. While Narcissistic Personality Disorder (NPD) was initially tagged for removal, instead the addition of section III proposes a move away from a categorical approach to a more dimensional approach, with a measure of Global Function of Personality. This global measure is an assessment of impairment of self-other relations; a measure of trait narcissism. In the same way mainstream psychology has struggled in its diagnosis of narcissism, so too in its treatment. Kohut’s self psychology represents the most significant inroad in theory and treatment for the narcissistic disorders. Kohut had moved away from a categorical system, towards disorders of the self. According to this theory, disorders of the self are the result of childhood trauma (impaired attunement) resulting in a developmental arrest. Self-psychological, Psychodynamic treatment of narcissism, however, is expensive, in time and money and outside the awareness or access of most people. There is more than a suggestion that narcissism is on the increase, created in trauma and worsened by a fearful world climate. A dimensional model of narcissism, from mild to severe, requires cut off points for diagnosis. But where do we draw the line? Mainstream psychology is inclined to set it high when there is some degree of impairment in functioning in daily life. Transpersonal Psychology is inclined to set it low, with the concept that we all have some degree of narcissism and that it is the point and the path of our life journey to transcend our focus on our selves. Mainstream psychology stops its focus on trait narcissism with a healthy level of self esteem, but it is at this point that Transpersonal Psychology can complement the discussion. From a Transpersonal point of view, failure to begin the process of self-transcendence will also create emotional symptoms of meaning or purpose, often later in our lives, and is also conceived of as a developmental arrest. The maps for this transcendence are hidden in plain sight; in the chakras of kundalini yoga, in the sacraments of the Catholic Church, in the Kabbalah tree of life of Judaism, in Maslow’s hierarchy of needs, to name a few. This paper outlines some proposed research exploring the use of daily practices that can be incorporated into the therapy room; practices that utilise meditation, visualisation and imagination: that are informed by spiritual technology and guided by the psychodynamic theory of Self Psychology.

Keywords: narcissism, self-psychology, self-practice, self-transcendence

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Authors: Ioannis Souris

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In this paper, we would like to present how we taught German through playwriting and analyze the usefulness of this method for teaching languages and cultivating a sense of political agency in students and teachers alike. Last academic year, we worked at the German Saturday School in Greenwich, London. This school offers Saturday German lessons to children whose parents are German, living in London. The lessons are two hours long, and the children’s level of German varies according to how often or how much German is spoken at home or how often the families visit Germany (as well as other factors which will be discussed in more detail in the paper). The directors of the school provide teachers with learning material and course books, but they strongly encourage individual input on lesson structure and methods of teaching German. The class we taught consisted of six eight-to-nine-year-olds. Midway into the academic year, we ran out of teaching material, and we, therefore, decided to write a play. In the paper, we would like to explore the process we followed in creating or writing this play and how this encouraged the children to collaborate and exercise their skills in writing, storytelling, speaking, and opinion-sharing. We want to examine the impact this project had on the children who wrote and performed the play, the wider community of the Saturday school, and the development of our language teaching practice. We found, for instance, that some students, who were quiet or shy, became very open and outspoken in the process of writing and performing the play. They took the initiative and led the process, putting us, their teachers, in the role of simple observers or facilitators. When we showed the play in front of the school, the other children and teachers, as audience members, also became part of the process as they commented on the plot, language, and characters and gave feedback on further development. In the paper, we will discuss how this teaching project fits into recent developments in the research of creativity and the teaching of languages and how engagement with creative approaches to teaching has the potential to question and subvert traditional notions of ‘lesson’, ‘teacher’, and ‘student’. From the moment a questioning of norms takes place, we inadvertently raise questions about politics, agency, and resistance. We will conclude the paper with a definition of what we mean by ‘political agency’ within the context of our teaching project and education, in general, and why inspiring creativity and imagination within teaching can be considered a political act. Finally, our aim in this paper will be to propose the possibility of analyzing teaching languages through creativity and political agency theories.

Keywords: innovation in language teaching and learning, language acquisition and learning, language curriculum development, language education

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Authors: Per Blomqvist

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The overall aim of this study is to highlight how the degree project-course in teacher education has developed over time at Swedish universities, above all regarding changes in the formative assessment practices in relation to student's opportunities to take part in writing processes that can develop both their independent critical thinking, subject knowledge, and academic writing skills. Theoretically, the study is based on deliberative and transformative perspectives of teaching academic writing in higher education. The deliberative perspective is motivated by the fact that it is the universities and their departments' responsibility to give the students opportunities to develop their academic writing skills, while there is little guidance on how this can be implemented. The transformative perspective is motivated by the fact that education needs to be adapted to the student's prior knowledge and developed in relation to the student group. Given the academisation of education and the new student groups, this is a necessity. The empirical data consists of video recordings of teacher groups' conversations at three Swedish universities. The conversations were conducted as so-called collective remembering interviews, a method to stimulate the participants' memory through social interaction, and focused on addressing issues on how the degree project-course in teacher education has changed over time. Topic analysis was used to analyze the conversations in order to identify common descriptions and expressions among the teachers. The result highlights great similarities in how the degree project-course has changed over time, both from a deliberative and a transformative perspective. The course is characterized by a “strong framing,” where the teachers have great control over the work through detailed instructions for the writing process and detailed templates for the text. This is justified by the fact that the education has been adapted based on the student teachers' lack of prior subject knowledge. The strong framing places high demands on continuous discussions between teachers about, for example, which tools the students have with them and which linguistic and textual tools are offered in the education. The teachers describe that such governance often leads to conflicts between teachers from different departments because reading and writing are always part of cultural contexts and are linked to different knowledge, traditions, and values. The problem that is made visible in this study raises questions about how students' opportunities to develop independence and make critical judgments in academic writing are affected if the writing becomes too controlled and if passing students becomes the main goal of education.

Keywords: formative assessment, academic writing, degree project, higher education, deliberative perspective, transformative perspective

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Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern

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Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.

Keywords: thyroid cancer, clinical registry, population health, quality improvement

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Authors: Usman Asif, Klaus Schmidt

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In recent years, the development of alternate fuel vehicles has helped to reduce carbon emissions worldwide. As the number of vehicles will continue to increase in the future, the energy demand will also increase. Therefore, we must consider automotive technologies that are efficient and less harmful to the environment in the long run. Battery Electric Vehicles (BEVs) have gained popularity in recent years because of their lower maintenance, lower fuel costs, and lower carbon emissions. Nevertheless, BEVs show several disadvantages, such as slow charging times and lower range than traditional combustion-powered vehicles. These factors keep many people from switching to BEVs. The authors of this research believe that these limitations can be overcome by using fuel cell technology. Fuel cell technology converts chemical energy into electrical energy from hydrogen power and therefore serves as fuel to power the motor and thus replacing heavy lithium batteries that are expensive and hard to recycle. Also, in contrast to battery-powered electric vehicle technology, Fuel Cell Electric Vehicles (FCEVs) offer higher ranges and lower fuel-up times and therefore are more competitive with electric vehicles. However, FCEVs have not gained the same popularity as electric vehicles due to stringent legal frameworks, underdeveloped infrastructure, high fuel transport, and storage costs plus the expense of fuel cell technology itself. This research will focus on the legal frameworks for hydrogen-powered vehicles, and how a change in these policies may affect and improve hydrogen fueling infrastructure and lower hydrogen transport and storage costs. These policies may also facilitate reductions in fuel cell technology costs. In order to attain a better framework, a number of countries have developed conceptual roadmaps. These roadmaps have set out a series of objectives to increase the access of FCEVs to their respective markets. This research will specifically focus on policies in Japan, Europe, and the USA in their attempt to shape the automotive industry of the future. The researchers also suggest additional policies that may help to accelerate the advancement of FCEVs to mass-markets. The approach was to provide a solid literature review using resources from around the globe. After a subsequent analysis and synthesis of this review, the authors concluded that in spite of existing legal challenges that have hindered the advancement of fuel-cell technology in the automobile industry in the past, new initiatives that enhance and advance the very same technology in the future are underway.

Keywords: fuel cell electric vehicles, fuel cell technology, legal frameworks, policies and regulations

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Authors: Robin Root

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A fundamental premise of medical anthropology is that clinical phenomena are simultaneously cultural, political, and economic: none more so than the linked acronyms HIV/AIDS. For the medical researcher, HIV/AIDS signals an epidemiological pandemic and a pathophysiology. For persons diagnosed with an HIV-related condition, the acronym often conjures dread, too often marking and marginalizing the afflicted irretrievably. Critical medical anthropology is uniquely equipped to theorize the linkages that bind individual and social wellbeing to global structural and culture-specific phenomena. This paper reports findings from an anthropological study of HIV/AIDS in Swaziland, site of the highest HIV prevalence in the world. The project, initiated in 2005, has documented experiences of HIV/AIDS, religiosity, and treatment and care as well as drought and famine. Drawing on interviews with Swazi religious and traditional leaders about their experiences of leadership amidst worsening economic conditions, environmental degradation, and an ongoing global health crisis, the paper provides uncommon insights for global health practitioners whose singular paradigm for designing and delivering interventions is biomedically-based. In contrast, this paper details the role of local leaders in mediating extreme social suffering and resilience in ways that medical science cannot model but which radically impact how sickness is experienced and health services are delivered and accessed. Two concepts help to organize the paper’s argument. First, a ‘moral economy of language’ is central to showing up the implicit ‘technologies of knowledge’ that inhere in scientific and religious discourses of HIV/AIDS; people draw upon these discourses strategically to navigate highly vulnerable conditions. Second, Paulo Freire’s ethnographic focus on a culture’s 'dangerous words' opens up for examination how ‘sex’ is dangerous for religion and ‘god’ is dangerous for science. The paper interrogates hegemonic and ‘lived’ discourses, both biomedical and religious, and contributes to an important literature on the moral economies of health, a framework of explication and, importantly, action appropriate to a wide-range of contemporary global health phenomena. The paper concludes by asserting that it is imperative that global health planners reflect upon and ‘check’ their hegemonic policy platforms by, one, collaborating with local authoritative agents of ‘what sickness means and how it is best treated,’ and, two, taking account of the structural barriers to achieving good health.

Keywords: Africa, biomedicine, HIV/AIDS, qualitative research , religion

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Authors: G. Melo, J. Felix, S. Maciel, C. Fernandes, W. Rodrigues

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In Brazilian public policy, the Centres of Reference for Social Assistance (CRAS in Portuguese) are part of the Unified Social Assistance System (SUAS in Portuguese). SUAS is responsible for addressing spontaneous or currently active cases that are brought forth from other services in the social assistance network. The following case was reviewed by CRAS’s team in Recife, Brazil, after a complaint of child abuse was filed against the mother of a 7-year-old girl by the girl’s aunt. The girl is the daughter of an incestuous relationship between her mother and her older brother. The complaint was registered by service staff and five interventions were subsequently carried out on behalf of the child. These interventions provided a secure place for dialogue with both the child and her family and allowed for an investigation of the abuse to proceed. They took place in the child’s school as well as her aunt’s residence. At school, the child (with her classmates) watched a video and listened to a song about the prevention of child abuse. This was followed up with a second intervention to determine any signs of Post-Traumatic Stress Disorder (PTSD), by having the child play with the mobile app ‘My Angela’. Books on the themes of family and fear were also read to the child on different occasions at her school – after every intervention she was asked to draw something related to fear and her concept of a family. After the interventions and discussing the case as a team, we reached several conclusions: 1) The child did not appear to show any symptoms of PTSD; 2) She normally fantasized about her future and life story; 3) She did not allow herself to be touched by strangers with whom she lacks a close relationship (such as classmates or her teacher); 4) Through her drawings, she reproduced the conversations she had had with the staff; 5) She habitually covered her drawings when asked questions about the abuse. In this particular clinical case, we want to highlight that the role of the Psychologist’s intervention at CRAS is to attempt to resolve the issue promptly (and not to develop a prolonged clinical study based on traditional methods), by making use of the available tools from the social assistance network, and by making referrals to the relevant authorities, such as the Public Ministry, so that final protective actions can be taken and enforced. In this case, the Guardian Council of the Brazilian Public Ministry was asked to transfer the custody of the child to her uncle. The mother of the child was sent to a CAPS (Centre for Psychosocial Care), having been diagnosed with psychopathology. The child would then participate in NGO programs that allow for a gradual reduction of social exposure to her mother before being transferred to her uncle’s custody in Sao Paulo.

Keywords: child abuse, intervention, social psychology, violence

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Authors: F. Ghani, T. S. O’Donovan

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Today, the global solar thermal market is dominated by two collector types; the flat plate and evacuated tube collector. With regards to the number of installations worldwide, the evacuated tube collector is the dominant variant primarily due to the Chinese market but the flat plate collector dominates both the Australian and European markets. The market share of the evacuated tube collector is, however, growing in Australia due to a common belief that this collector type is ‘more efficient’ and, therefore, the better choice for hot water applications. In this study, we investigate this issue further to assess the validity of this statement. This was achieved by methodically comparing the performance and economics of several solar thermal systems comprising of; a low-performance flat plate collector, a high-performance flat collector, and an evacuated tube collector coupled with a storage tank and pump. All systems were simulated using the commercial software package Polysun for four climate zones in Australia to take into account different weather profiles in the study and subjected to a thermal load equivalent to a household comprising of four people. Our study revealed that the energy savings and payback periods varied significantly for systems operating under specific environmental conditions. Solar fractions ranged between 58 and 100 per cent, while payback periods range between 3.8 and 10.1 years. Although the evacuated tube collector was found to operate with a marginally higher thermal efficiency over the selective surface flat plate collector due to reduced ambient heat loss, the high-performance flat plate collector outperformed the evacuated tube collector on thermal yield. This result was obtained as the flat plate collector possesses a significantly higher absorber to gross collector area ratio over the evacuated tube collector. Furthermore, it was found for Australian regions operating with a high average solar radiation intensity and ambient temperature, the lower performance collector is the preferred choice due to favorable economics and reduced stagnation temperature. Our study has provided additional insight into the thermal performance and economics of the two prevalent solar thermal collectors currently available. A computational investigation has been carried out specifically for the Australian climate due to its geographic size and significant variation in weather. For domestic hot water applications were fluid temperatures between 50 and 60 degrees Celsius are sought, the flat plate collector is both technically and economically favorable over the evacuated tube collector. This research will be useful to system design engineers, solar thermal manufacturers, and those involved in policy to encourage the implementation of solar thermal systems into the hot water market.

Keywords: solar thermal, energy analysis, flat plate, evacuated tube, collector performance

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Authors: Wang Yang

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Shenzhen is a modern city of China's reform and opening-up policy, the development of urban morphology has been established on the administration of the Chinese government. This city`s planning paradigm is primarily affected by the spatial structure and human behavior. The subjective urban agglomeration center is divided into several groups and centers. In comparisons of this effect, the city development law has better to be neglected. With the continuous development of the internet, extensive data technology has been introduced in China. Data mining and data analysis has become important tools in municipal research. Data mining has been utilized to improve data cleaning such as receiving business data, traffic data and population data. Prior to data mining, government data were collected by traditional means, then were analyzed using city-relationship research, delaying the timeliness of urban development, especially for the contemporary city. Data update speed is very fast and based on the Internet. The city's point of interest (POI) in the excavation serves as data source affecting the city design, while satellite remote sensing is used as a reference object, city analysis is conducted in both directions, the administrative paradigm of government is broken and urban research is restored. Therefore, the use of data mining in urban analysis is very important. The satellite remote sensing data of the Shenzhen city in July 2018 were measured by the satellite Modis sensor and can be utilized to perform land surface temperature inversion, and analyze city heat island distribution of Shenzhen. This article acquired and classified the data from Shenzhen by using Data crawler technology. Data of Shenzhen heat island and interest points were simulated and analyzed in the GIS platform to discover the main features of functional equivalent distribution influence. Shenzhen is located in the east-west area of China. The city’s main streets are also determined according to the direction of city development. Therefore, it is determined that the functional area of the city is also distributed in the east-west direction. The urban heat island can express the heat map according to the functional urban area. Regional POI has correspondence. The research result clearly explains that the distribution of the urban heat island and the distribution of urban POIs are one-to-one correspondence. Urban heat island is primarily influenced by the properties of the underlying surface, avoiding the impact of urban climate. Using urban POIs as analysis object, the distribution of municipal POIs and population aggregation are closely connected, so that the distribution of the population corresponded with the distribution of the urban heat island.

Keywords: POI, satellite remote sensing, the population distribution, urban heat island thermal map

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Authors: Ergham Al Bachir

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This study adopts strategic leadership (Upper Echelons) as the core theory and contextual leadership theory as the research lens. This research asks how the external context impacts strategic leadership effectiveness to achieve the outcomes in pluralistic organizations (PO). The study explores how the context influences the selection of CEOs, top management teams (TMT), and their leadership effectiveness. POs are characterized by the multiple objectives of their top management teams, divergent objectives, multiple strategies, and multiple governing authorities. The research question is explored by means of a qualitative multiple-case study focusing on healthcare, real estate, and financial services organizations. The data sources are semi-structured interviews, documents, and direct observations. The data analysis strategy is inductive and deploys thematic analysis and cross-case synthesis. The findings differentiate between national and international CEOs' delegation of authority and relationship with the Board of Directors. The findings identify the elements of the dynamic context that influence TMT and PO outcomes. The emergent hybrid strategic and contextual leadership framework shows how the different contextual factors influence strategic direction, PO context, selection of CEOs and TMT, and the outcomes in four pluralistic organizations. The study offers seven theoretical contributions to Upper Echelons, strategic leadership, and contextual leadership research. (1) The integration of two theories revealed how CEO’s impact on the organization is complementary to the contextual impact. (2) Conducting this study in the Middle East contributes to strategic leadership and contextual leadership research. (3) The demonstration of the significant contextual effects on the selection of CEOs. (4 and 5) Two contributions revealed new links between the context, the Board role, internal versus external CEOs, and national versus international CEOs. (6 and 7) This study offered two definitions: what accounts for CEO leadership effectiveness and organizational outcomes. Two methodological contributions were also identified: (1) Previous strategic leadership and Upper Echelons research are mainly quantitative, while this study adopts qualitative multiple-case research with face-to-face interviews. (2) The extrication of the CEO from the TMT advanced the data analysis in strategic leadership research. Four contributions are offered to practice: (1) The CEO's leadership effectiveness inside and outside the organization. (2) Rapid turnover of predecessor CEOs signifies the need for a strategic and contextual approach to CEOs' succession. (3) TMT composition and education impact on TMT-CEO and TMT-TMT interface. (4) Multilevel strategic contextual leadership development framework.

Keywords: strategic leadership, contextual leadership, upper echelons, pluralistic organizations, cross-cultural leadership

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Authors: Sau Kam Adeline Chan

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World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.

Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error

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Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

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Authors: Maria Barbano Acevedo-Gomez, Elena Sonsoles Rodriguez-Lopez, Sofia Olivia Calvo-Moreno, Angel Basas-Garcia, Cristophe Ramirez

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Introduction: Urinary incontinence (UI) is defined as the involuntary leakage of urine. In persons who practice sport, its prevalence is 36.1% (95% CI 26.5%-46.8%) and varies as it seems to depend on the intensity of exercise, movements, and impact on the ground. Such high impact sports are likely to generate higher intra-abdominal pressures and leading to pelvic floor muscle weakness. Even though the emphasis of this research is on female athletes, all women should perform pelvic floor muscle exercises as a part of their general physical exercise. Pelvic floor exercises are generally considered the first treatment against urinary incontinence. Objective: The main objective of the present study was to determine the knowledge of the pelvic floor and of the UI in elite athletes and know if they incorporate pelvic floor strengthening in their training. Methods: This was an observational study conducted on 754 elite athletes. After collecting questions about the pelvic floor, UI, and sport-related data, participants completed the questionnaire International Consultation on Incontinence Questionnaire-UI Short-Form (ICIQ-SF). Results: 57.3% of the athletes reflect not having knowledge of their pelvic floor, 48.3% do not know what strengthening exercises are, and around 90% have never practiced them. 78.1% (n=589) of all elite athletes do not include pelvic floor exercises in their training. Of the elite athletes surveyed, 33% had UI according to ICIQ-SF (mean age 23.75 ± 7.74 years). In response to the question 'Do you think you have or have had UI?', Only 9% of the 754 elite athletes admitted they presently had UI, and 13.3% indicated they had had UI at some time. However, 22.7% (n=171) reported they had experienced urine leakage while training. Of the athletes who indicated they did not have UI in the ICIQ-SF, 25.7% stated they did experience urine leakage during training (χ² [1] = 265.56; p < 0.001). Further, 12.3% of the athletes who considered they did not have UI and 60% of those who admitted they had had UI on some occasion stated they had suffered some urine leakage in the past 3 months (χ² [1] = 287.59; p < 0.001). Conclusions: There is a lack of knowledge about UI in sport. Through the use of validated questionnaires, we observed a UI prevalence of 33%, and 22.7% reported they experienced urine leakage while training. These figures contrast with only 9% of athletes who reported they had or had in the past had UI. This discrepancy could reflect the great lack of knowledge about UI in sports and that sometimes an athlete may consider that urine leakage is normal and a consequence of the demands of training. These data support the idea that coaches, physiotherapists, and other professionals involved in maximizing the performance of athletes should include pelvic floor muscle exercises in their training programs. Measures such as this could help to prevent UI during training and could be a starting point for future studies designed to develop adequate prevention and treatment strategies for this embarrassing problem affecting young athletes, both male and female.

Keywords: athletes, pelvic floor, performance, prevalence, sport, training, urinary incontinence

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Authors: Mariateresa Torchia, Helene Cristini, Hannele Kauppinen

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Leadership plays a vital role in organizations. Leaders provide directions and facilitate the processes that enable organizations to achieve their goals and objectives. However, while productivity and financial objectives are often given the greatest emphasis, leaders also have the responsibility for instituting standards of ethical conduct and moral values that guide the behavior of employees. Leaders’ behaviors such as support, empowerment and a high-quality relationship with their employees might not only prevent stress, but also improve employees’ stress coping meanwhile contributing to their affective well-being. Stemming from Girard’s Mimetic Theory, this study aims at understanding how leaders can foster well-being in organizations. To do so, we explore which is the role leaders play in conflict management, resentment management and negative emotions dissipation. Furthermore, we examine whether and to what extent religiosity impacts the way in which leaders operate in relation to employees’ well-being. Indeed, given that organizational values are crucial to ethical behavior and firms’ values may be steeled by a deep sense of spirituality and religious identification, there is a need to take a closer look at the role religion and spirituality play in influencing the way leaders impact employees’ well-being. Thus, religion might work as an overarching logic that provides a set of principles guiding leaders’ everyday practices and relations with employees. We answer our research questions using a qualitative approach. We interviewed 27 Christian leaders (members of the Christian Entrepreneurs and Leaders Association – EDC, a non-profit organization created in 1926 including 3,000 French Christian Leaders & Entrepreneurs). Our results show that well-being can have a different meaning in relation to the type of companies, size, culture, country of analysis. Moreover the values and believes of leaders influence the way they see and foster well-being among employees. Furthermore, leaders can have both a positive or negative impact on well-being. Indeed on the one side, they could increase well-being in the company while on the other hand, they could be the source of resentment and conflicts among employees. Finally, we observed that Christian leaders possess characteristics that are sometimes missing in leaders (humility, inability to compare with others, attempt to be coherent with their values and beliefs, interest in the common good instead of the personal interest, having tougher dilemmas, collectively undertaking the firm). Moreover the Christian leader believes that the common good should come before personal interest. In other words, to them, not only short –termed profit shouldn’t guide strategical decisions but also leaders should feel responsible for their employees’ well-being. Last but not least, the study is not an apologia of Christian, yet it discusses the implications of these values through the light of Girard’s mimetic theory for both theory and practice.

Keywords: Christian leaders, employees well-being, leadership, mimetic theory

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Authors: Aster Anderson Rugamba

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Context: Live music in Burundi is currently facing neglect and a decline in popularity, resulting in artists struggling to generate income from this field. Additionally, live music from Burundi has not been able to gain traction in the international market. It is essential to establish various structures and organizations to promote cultural events and support artistic endeavors in music and performing arts. Research Aim: The aim of this research is to seek new knowledge and understanding in the field of live music and its content in Burundi. Furthermore, it aims to connect with other professionals in the industry, make new discoveries, and explore potential collaborations and investments. Methodology: The research will utilize both quantitative and qualitative research methodologies. The quantitative approach will involve a sample size of 57 musician artists in Burundi. It will employ closed-ended questions and gather quantitative data to ensure a large sample size and high external validity. The qualitative approach will provide deeper insights and understanding through open-ended questions and in-depth interviews with selected participants. Findings: The research expects to find new theories, methodologies, empirical findings, and applications of existing knowledge that can contribute to the development of live music in Burundi. By exploring the challenges faced by artists and identifying potential solutions, the study aims to establish live music as a catalyst for development and generate a positive impact on both the Burundian and international community. Theoretical Importance: Theoretical contributions of this research will expand the current understanding of the live music industry in Burundi. It will propose new theories and models to address the issues faced by artists and highlight the potential of live music as a lucrative and influential industry. By bridging the gap between theory and practice, the research aims to provide valuable insights for academics, professionals, and policymakers. Data Collection and Analysis Procedures: Data will be collected through surveys, interviews, and archival research. Surveys will be administered to the sample of 57 musician artists, while interviews will be conducted to gain in-depth insights from selected participants. The collected data will be analyzed using both quantitative and qualitative methods, including statistical analysis and thematic analysis, respectively. This mixed-method approach will ensure a comprehensive and rigorous examination of the research questions addressed.

Keywords: business music in burundi, music in burundi, promotion of art, burundi music culture

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Authors: Salma Akter, Md. Kamal Uddin

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Quality of life is a vast and comprehensive concept refers overall well-being of society. Current research and efforts of policymakers and planners are concerned to increase the urban quality of life through the sustainable development of city and country. While such efforts effectively improve the quality of life of urban dwellers through improved social, economic and housing infrastructures, very little has been paid to improve low-income settlement users more specifically government provided shelter projects. The top-down shelter policies and its objective indicators (physical design elements and physical environmental elements) indicators on low-income groups merely can ensure grassroots needs, aspiration and well-being refer as subjective qualities obliged to compromise with the quality of life. This research, therefore, aims to measure the quality of life of such government-provided low-income settlements. To do so, a conceptual framework has been developed to measure quality of life with arguing that quality of life depends on both objective and subjective indicators and needs to measure across three scales of living environment refers to macro (community), meso (neighborhood or shelter/built environment), and micro (family). The top-down shelter project, Dakshin Chandani Mahal Ashrayan Prakalpa is a resettlement/housing project of Government of Bangladesh for providing shelters and human resources development activities like education, microcredit, and training programme to landless, homeless and rootless people has been taken as case study. The study area is located at Dighalia Upazila, Khulna Bangladesh. In terms of methodology, this research is primarily exploratory and adopts a case study method and deductive approach for evaluating the quality of life. Data have been obtained from relevant literature review, key informant interview, focus group discussion, necessary drawings, photographs and participant observation across dwelling, neighborhood, and community level. Findings have revealed that Shelter users mostly compromise the quality of life at community level due to insufficient physical design elements and facilities while neighborhood and dwelling level have been manifested similar result like former ones. Thus, the outcome of this study can be beneficial for a global-level understating of the compromising the ‘quality of life’ under top-down shelter policy. Locally, for instance, in the context of Bangladesh, it can help policymakers and concerned authorities to formulate the shelter policies and take initiatives to improve the well-being of marginalized.

Keywords: Ashrayan Prakalpa, compromise, displaced people, quality of life

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Authors: Satoshi Kusaka

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The term ‘competency’ is attracting considerable scholarly attention worldwide with the advance of globalization in the 21st century and with the arrival of a knowledge-based society. In the current world environment, familiarity with varied disciplines is regarded to be vital for personal success. The idea of a competency-based educational system was mooted by the ‘Definition and Selection of Competencies (DeSeCo)’ project that was conducted by the Organization for Economic Cooperation and Development (OECD). Further, attention to this topic is not limited to developed countries; it can also be observed in developing countries. For instance, the importance of a competency-based curriculum was mentioned in the ‘2013 Harmonized Curriculum Framework for the East African Community’, which recommends key competencies that should be developed in primary schools. The introduction of such curricula and the reviews of programs are actively being executed, primarily in the East African Community but also in neighboring nations. Taking Mozambique as a case in point, the present paper examines the conception of ‘competency’ as a target of frontline education in developing countries. It also aims to discover the manner in which the syllabus, textbooks and lessons, among other things, in primary-level math education are developed and to determine the challenges faced in the process. This study employs the perspective of competency-based education design to analyze how the term ‘competency’ is defined in the primary-level math syllabus, how it is reflected in the textbooks, and how the lessons are actually developed. ‘Practical competency’ is mentioned in the syllabus, and the description of the term lays emphasis on learners' ability to interactively apply socio-cultural and technical tools, which is one of the key competencies that are advocated in OECD's ‘Definition and Selection of Competencies’ project. However, most of the content of the textbooks pertains to ‘basic academic ability’, and in actual classroom practice, teachers often impart lessons straight from the textbooks. It is clear that the aptitude of teachers and their classroom routines are greatly dependent on the cultivation of their own ‘practical competency’ as it is defined in the syllabus. In other words, there is great divergence between the ‘syllabus’, which is the intended curriculum, and the content of the ‘textbooks’. In fact, the material in the textbooks should serve as the bridge between the syllabus, which forms the guideline, and the lessons, which represent the ‘implemented curriculum’. Moreover, the results obtained from this investigation reveal that the problem can only be resolved through the cultivation of ‘practical competency’ in teachers, which is currently not sufficient.

Keywords: competency, curriculum, mathematics education, Mozambique

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Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

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Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

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Authors: Amina Naidja, Zedira Khammar, Ines Soltani

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This study investigates the impact of urban development on the urban heat island (UHI) effect in the semi-arid Aures region of Algeria, integrating remote sensing data with statistical analysis and community surveys to examine the interconnected environmental and social dynamics. Using Landsat 8 satellite imagery, temporal variations in the Normalized Difference Vegetation Index (NDVI), Normalized Difference Built-up Index (NDBI), and land use/land cover (LULC) changes are analyzed to understand patterns of urbanization and environmental transformation. These environmental metrics are correlated with land surface temperature (LST) data derived from remote sensing to quantify the UHI effect. To incorporate the social dimension, a structured questionnaire survey is conducted among residents in selected urban areas. The survey assesses community perceptions of urban heat, its impacts on daily life, health concerns, and coping strategies. Statistical analysis is employed to analyze survey responses, identifying correlations between demographic factors, socioeconomic status, and perceived heat stress. Preliminary findings reveal significant correlations between built-up areas (NDBI) and higher LST, indicating the contribution of urbanization to local warming. Conversely, areas with higher vegetation cover (NDVI) exhibit lower LST, highlighting the cooling effect of green spaces. Social survey results provide insights into how UHI affects different demographic groups, with vulnerable populations experiencing greater heat-related challenges. By integrating remote sensing analysis with statistical modeling and community surveys, this study offers a comprehensive understanding of the environmental and social implications of urban development in semi-arid climates. The findings contribute to evidence-based urban planning strategies that prioritize environmental sustainability and social well-being. Future research should focus on policy recommendations and community engagement initiatives to mitigate UHI impacts and promote climate-resilient urban development.

Keywords: urban heat island, remote sensing, social analysis, NDVI, NDBI, LST, community perception

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Authors: Zainab Atia, Hongwei He, Panagiotis Sarantopoulos

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Over the past few years, firms have witnessed a massive increase in sophisticated algorithmic deployment, which has become quite pervasive in today’s modern society. With the wide availability of data for retailers, the ability to track consumers using algorithmic pricing has become an integral option in online platforms. As more companies are transforming their businesses and relying more on massive technological advancement, pricing algorithmic systems have brought attention and given rise to its wide adoption, with many accompanying benefits and challenges to be found within its usage. With the overall aim of increasing profits by organizations, algorithmic pricing is becoming a sound option by enabling suppliers to cut costs, allowing better services, improving efficiency and product availability, and enhancing overall consumer experiences. The adoption of algorithms in retail has been pioneered and widely used in literature across varied fields, including marketing, computer science, engineering, economics, and public policy. However, what is more, alarming today is the comprehensive understanding and focus of this technology and its associated ethical influence on consumers’ perceptions and behaviours. Indeed, due to algorithmic ethical concerns, consumers are found to be reluctant in some instances to share their personal data with retailers, which reduces their retention and leads to negative consumer outcomes in some instances. This, in its turn, raises the question of whether firms can still manifest the acceptance of such technologies by consumers while minimizing the ethical transgressions accompanied by their deployment. As recent modest research within the area of marketing and consumer behavior, the current research advances the literature on algorithmic pricing, pricing ethics, consumers’ perceptions, and price fairness literature. With its empirical focus, this paper aims to contribute to the literature by applying the distinction of the two common types of algorithmic pricing, dynamic and personalized, while measuring their relative effect on consumers’ behavioural outcomes. From a managerial perspective, this research offers significant implications that pertain to providing a better human-machine interactive environment (whether online or offline) to improve both businesses’ overall performance and consumers’ wellbeing. Therefore, by allowing more transparent pricing systems, businesses can harness their generated ethical strategies, which fosters consumers’ loyalty and extend their post-purchase behaviour. Thus, by defining the correct balance of pricing and right measures, whether using dynamic or personalized (or both), managers can hence approach consumers more ethically while taking their expectations and responses at a critical stance.

Keywords: algorithmic pricing, dynamic pricing, personalized pricing, price ethicality

Procedia PDF Downloads 91

Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit

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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.

Keywords: diabetes, health disparities, health policy, obesity, socio-economic position

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Authors: Bollu Mounica

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Background: Nowadays drug related problems were seen very commonly within the health care practice. These could result in the medication errors, adverse events, drug interactions and harm to patients. Pharmacist has an identified role in minimizing and preventing such type of problems. Objectives: To detect the incidence of drug related problems for the hospitalized patient, and to analyze the clinical pharmacist interventions performed during the review of prescription orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large tertiary care teaching hospital. Methods: It was a retrospective, observational and interventional study. The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. For a period starting November 2012 until December 2014, the inpatient medication charts and orders were identified and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services in a tertiary care teaching hospital on routine daily activities. Data was collected and evaluated. The causes of this problem were identified. Results: A total of 360 patients were followed. Male (71.66%) predominance was noted over females (28.33%). Drug related problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors (26.11%), improper drug selection (17.22%), followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing (26.11%), and drug change (18.05%). Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Conclusion: Our study showed that the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes needed in the prescriptions. In this context, routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of DRPs and may prevent their occurrence.

Keywords: drug related problems, clinical pharmacist, drug prescriptions, drug related problems, intervention

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Authors: Anette Alén

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Intellectual property (IP) regimes have traditionally been designed to integrate various conflicting elements stemming from private entitlement and the public good. In IP laws and regulations, this design takes the form of specific uses of protected subject-matter without the right-holder’s consent, or exhaustion of exclusive rights upon market release, and the like. More recently, the pursuit of ‘balance’ has gained ground in the conceptualization of these conflicting elements both in terms of IP law and related policy. This can be seen, for example, in European Union (EU) copyright regime, where ‘balance’ has become a key element in argumentation, backed up by fundamental rights reasoning. This development also entails an ever-expanding dialogue between the IP regime and the constitutional safeguards for property, free speech, and privacy, among others. This study analyses the concept of ‘balance’ in EU copyright law: the research task is to examine the contents of the concept of ‘balance’ and the way it is operationalized and pursued, thereby producing new knowledge on the role and manifestations of ‘balance’ in recent copyright case law and regulatory instruments in the EU. The study discusses two particular pieces of legislation, the EU Digital Single Market (DSM) Copyright Directive (EU) 2019/790 and the finalized EU Artificial Intelligence (AI) Act, including some of the key preparatory materials, as well as EU Court of Justice (CJEU) case law pertaining to copyright in the digital era. The material is examined by means of document analysis, mapping the ways ‘balance’ is approached and conceptualized in the documents. Similarly, the interaction of fundamental rights as part of the balancing act is also analyzed. Doctrinal study of law is also employed in the analysis of legal sources. This study suggests that the pursuit of balance is, for its part, conducive to new battles, largely due to the advancement of digitalization and more recent developments in artificial intelligence. Indeed, the ‘balancing act’ rather presents itself as a way to bypass or even solidify some of the conflicting interests in a complex global digital economy. Indeed, such a conceptualization, especially when accompanied by non-critical or strategically driven fundamental rights argumentation, runs counter to the genuine acknowledgment of new types of conflicting interests in the copyright regime. Therefore, a more radical approach, including critical analysis of the normative basis and fundamental rights implications of the concept of ‘balance’, is required to readjust copyright law and regulations for the digital era. Notwithstanding the focus on executing the study in the context of the EU copyright regime, the results bear wider significance for the digital economy, especially due to the platform liability regime in the DSM Directive and with the AI Act including objectives of a ‘level playing field’ whereby compliance with EU copyright rules seems to be expected among system providers.

Keywords: balance, copyright, fundamental rights, platform liability, artificial intelligence

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Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

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Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

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Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

Abstract:

Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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Authors: Ramesh Chinnasamy, Srishti Semalty, Vishnu S. Nair, Thirumurugan Vedagiri, Mahesh Ganeshan, Gautam Talukdar, Karthy Sivapushanam, Abhijit Das

Abstract:

Snakes form an integral component of ecological systems. Human population explosion and associated acceleration of habitat destruction and degradation, has led to a rapid increase in human-snake encounters. The study aims at understanding the level of awareness, knowledge, and attitude of the people towards human-snake negative interaction and role of awareness programmes in the Moyar river valley, Tamil Nadu. The study area is part of the Mudumalai and the Sathyamangalam Tiger Reserves, which are significant wildlife corridors between the Western Ghats and the Eastern Ghats in the Nilgiri Biosphere Reserve. The data was collected using questionnaire covering 644 respondents spread across 18 villages between 2018 and 2019. The study revealed that 86.5% of respondents had strong negative perceptions towards snakes which were propelled by fear, superstitions, and threat of snakebite which was common and did not vary among different villages (F=4.48; p = <0.05) and age groups (X2 = 1.946; p = 0.962). Cobra 27.8% (n = 294) and rat snake 21.3% (n = 225) were the most sighted species and most snake encounter occurred during the monsoon season i.e., July 35.6 (n = 218), June 19.1% (n = 117) and August 18.4% (n = 113). At least 1 out of 5 respondents was reportedly bitten by snakes during their lifetime. The most common species of snakes that were the cause of snakebite were Saw scaled viper (32.6%, n = 42) followed by Cobra 17.1% (n = 22). About 21.3% (n = 137) people reported livestock loss due to pythons and other snakes 21.3% (n = 137). Most people, preferred medical treatment for snakebite (87.3%), whereas 12.7%, still believed in traditional methods. The majority (82.3%) used precautionary measure by keeping traditional items such as garlic, kerosene, and snake plant to avoid snakes. About 30% of the respondents expressed need for technical and monetary support from the forest department that could aid in reducing the human-snake conflict. It is concluded that the general perception in the study area is driven by fear and negative attitude towards snakes. Though snakes such as Cobra were widely worshiped in the region, there are still widespread myths and misconceptions that have led to the irrational killing of snakes. Awareness and innovative education programs rooted in the local context and language should be integrated at the village level, to minimize risk and the associated threat of snakebite among the people. Results from this study shall help policy makers to devise appropriate conservation measures to reduce human-snake conflicts in India.

Keywords: Envenomation, Health-Education, Human-Wildlife Conflict, Neglected Tropical Disease, Snakebite Mitigation, Traditional Practitioners

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