Search results for: health outcomes

Authors: Sarah Potter, Michele Laliberte

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As eating disorders are associated with high levels of chronicity, impairment, and distress, it is paramount to evaluate factors that may improve treatment outcomes in this group. Individuals with eating disorders exhibit elevated levels of perfectionism and emotion dysregulation, as well as reduced self-compassion. These variables are related to eating disorder outcomes, including shape/weight concerns and psychosocial impairment. Thus, these factors may be tenable targets for treatment within eating disorder populations. However, the relative contributions of perfectionism, emotion dysregulation, and self-compassion to the severity of shape/weight concerns and psychosocial impairment remain largely unexplored. In the current study, mediation analyses were conducted to clarify how perfectionism, emotion dysregulation, and self-compassion are linked to shape/weight concerns and psychosocial impairment. The sample was comprised of 85 patients from an outpatient eating disorder clinic. The patients completed self-report measures of perfectionism, self-compassion, emotion dysregulation, eating disorder symptoms, and psychosocial impairment. Specifically, emotion dysregulation was assessed as a mediator in the relationships between (1) perfectionism and shape/weight concerns, (2) self-compassion and shape/weight concerns, (3) perfectionism and psychosocial impairment, and (4) self-compassion and psychosocial impairment. It was postulated that emotion dysregulation would significantly mediate relationships in the former two models. An a priori hypothesis was not constructed in reference to the latter models, as these analyses were preliminary and exploratory in nature. The PROCESS macro for SPSS was utilized to perform these analyses. Emotion dysregulation fully mediated the relationships between perfectionism and eating disorder outcomes. In the link between self-compassion and psychosocial impairment, emotion dysregulation partially mediated this relationship. Finally, emotion dysregulation did not significantly mediate the relationship between self-compassion and shape/weight concerns. The results suggest that emotion dysregulation and self-compassion may be suitable targets to decrease the severity of psychosocial impairment and shape/weight concerns in individuals with eating disorders. Further research is required to determine the stability of these models over time, between diagnostic groups, and in nonclinical samples.

Keywords: eating disorders, emotion dysregulation, perfectionism, self-compassion

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Authors: J. Bartnicka, J. A. Piedrabuena, R. Portilla, L. Moyano - Cuevas, J. B. Pagador, P. Augat, J. Tokarczyk, F. M. Sánchez Margallo

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Orthopaedic surgeries are characterized by a high degree of complexity. This is reflected by four main groups of resources: 1) surgical team which is consisted of people with different competencies, educational backgrounds and positions; 2) information and knowledge about medical and technical aspects of surgery; 3) medical equipment including surgical tools and materials; 4) space infrastructure which is important from an operating room layout point of view. These all components must be integrated and build a homogeneous organism for achieving an efficient and ergonomically correct surgical workflow. Taking this as a background, there was formulated a concept of international project, called “Online Vocational Training course on ergonomics for orthopaedic Minimally Invasive” (Train4OrthoMIS), which aim is to develop an e-learning tool available in 4 languages (English, Spanish, Polish and German). In the article, there is presented the first project research outcomes focused on three aspects: 1) ergonomic needs of surgeons who work in hospitals around different European countries, 2) the concept of structure of e-learning course, 3) the definition of tools and methods for knowledge assessment adjusted to users’ expectation. The methodology was based on the expert panels and two types of surveys: 1) on training needs, 2) on evaluation and self-assessment preferences. The major findings of the study allowed describing the subjects of four training modules and learning sessions. According to peoples’ opinion there were defined most expected test methods which are single choice test and right after quizzes: “True or False” and “Link elements”. The first project outcomes confirmed the necessity of creating a universal training tool for orthopaedic surgeons regardless of the country in which they work. Because of limited time that surgeons have, the e-learning course should be strictly adjusted to their expectation in order to be useful.

Keywords: international e-learning, ergonomics, orthopaedic surgery, Train4OrthoMIS

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Authors: A. T. Muruviwa

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To-date, the discourse on corporate social responsibility (CSR) has primarily centred on the actions and inactions of corporations; hence, the dominant focus on CSR has been on impacts and outcomes. The obscuring effect of this approach has, arguably, resulted in the emergence of what may be termed a ‘Northern’ agenda on CSR theory and practice, in contrast to an emergency ‘Southern’ discourse, which appears to highlight the crucial issues of poverty reduction, infrastructure development and the broader questions of social provisioning and community empowerment. Some scholars have explicitly called for a CSR research agenda that focuses on the 'reciprocal duties' of the stakeholders in the CSR process rather than fixate on the actions and inactions of business. It is against the backdrop of these contestations that this study assesses the reciprocal relationships amongst CSR stakeholders in a Zimbabwean platinum mining town, with a view to demonstrating how such relationships – and the expectations and obligations embedded in them – impact on the success or failure of CSR initiatives. The existence of mutual relations between the corporation and its stakeholders signifies the successes of CSR processes and hence the outcomes. The company is Zimplats Mining Company; the community is Mhondoro-Ngezi, and the stakeholders are clearly identified in the study. The study utilised a triangulated design, with data collected using a mini survey, focus groups, in-depth interview and observation. The key findings are that the CSR process in the study community is dominated by the mining company. Despite the existence of a CSR framework that recognises government, local leaders and community members as legitimate stakeholders, there is little evidence of concrete contributions made by these stakeholders towards the realisation of CSR objectives. As a result, the community development process – in so far as CSR is concerned – fails to address the developmental concerns of the various stakeholders. On the basis of these findings, the study concludes that there is a crisis of reciprocity in the CSR process in Mhondoro-Ngezi, and that a situation where the conceptualisation of local development needs and the deployment of specific development tools seems to be driven by one stakeholder almost to the exclusion of all others, can only present contradictory development outcomes. The significance of this study is that it allows for the development of a more nuanced and robust CSR discourse. Rather than focusing on the corporate and stakeholder perspectives and outcomes of CSR initiatives, this study examines the CSR- development nexus by interrogating the idea of reciprocal responsibility as a sin qua non to CSR success. This analytical strategy and focus allow the researcher to gain a clear understanding of how stakeholder relationships and duties influence CSR processes and also the overall outcome. At a more practical level, the findings of the study should help to shape the policy on corporate community relationships with a view to enhancing the role of mining in development.

Keywords: community development, processes, reciprocity, stakeholders

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Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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Authors: Francesca Nardi, Kashish Aneja, Katherine Ginsbach

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The COVID-19 pandemic has demonstrated both a need for evidence-based and rights-based public health policy and how challenging it can be to make effective decisions with limited information, evidence, and data. The O’Neill Institute, in conjunction with several partners, has been working since the beginning of the pandemic to collect, analyze, and distribute critical data on public health policies enacted in response to COVID-19 around the world in the COVID-19 Law Lab. Well-designed laws and policies can help build strong health systems, implement necessary measures to combat viral transmission, enforce actions that promote public health and safety for everyone, and on the individual level have a direct impact on health outcomes. Poorly designed laws and policies, on the other hand, can fail to achieve the intended results and/or obstruct the realization of fundamental human rights, further disease spread, or cause unintended collateral harms. When done properly, laws can provide the foundation that brings clarity to complexity, embrace nuance, and identifies gaps of uncertainty. However, laws can also shape the societal factors that make disease possible. Law is inseparable from the rest of society, and COVID-19 has exposed just how much laws and policies intersects all facets of society. In the COVID-19 context, evidence-based and well-informed law and policy decisions—made at the right time and in the right place—can and have meant the difference between life or death for many. Having a solid evidentiary base of legal information can promote the understanding of what works well and where, and it can drive resources and action to where they are needed most. We know that legal mechanisms can enable nations to reduce inequities and prepare for emerging threats, like novel pathogens that result in deadly disease outbreaks or antibiotic resistance. The collection and analysis of data on these legal mechanisms is a critical step towards ensuring that legal interventions and legal landscapes are effectively incorporated into more traditional kinds of health science data analyses. The COVID-19 Law Labs see a unique opportunity to collect and analyze this kind of non-traditional data to inform policy using laws and policies from across the globe and across diseases. This global view is critical to assessing the efficacy of policies in a wide range of cultural, economic, and demographic circumstances. The COVID-19 Law Lab is not just a collection of legal texts relating to COVID-19; it is a dataset of concise and actionable legal information that can be used by health researchers, social scientists, academics, human rights advocates, law and policymakers, government decision-makers, and others for cross-disciplinary quantitative and qualitative analysis to identify best practices from this outbreak, and previous ones, to be better prepared for potential future public health events.

Keywords: public health law, surveillance, policy, legal, data

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Authors: Aida Nurul Safitri, Rosita Sari

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Physics is science, which in its learning there are some product such as theory, fact, concept, law and formula. So that to understand physics lesson students not only need a theory or concept but also mathematical calculation to solve physics problem through formula or equation. This is can be taken from mathematics lesson which obtained by students. This research is to know the influence of mathematics learning outcomes towards physics ability in Senior High School through authentic assessment system. Based on the researches have been discussed, is obtained that mathematic lesson have an important role in physics learning but it according to one aspect only, namely cognitive aspect. In Indonesia, curriculum of 2013 reinforces displacement in the assessment, from assessment through test (measuring the competence of knowledge based on the result) toward authentic assessment (measuring the competence of attitudes, skills, and knowledge based on the process and results). In other researches are mentioned that authentic assessment system give positive responses for students to improve their motivation and increase the physics learning in the school.

Keywords: authentic assessment, curriculum of 2013, mathematic, physics

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Authors: Dalvin D. Hill, Hector M. Castro Garcia

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A growing number of individuals utilize wearable devices on a daily basis. The usage and functionality of these wearable devices vary from user to user. One popular usage of said devices is to track health-related activities that are typically stored on a device’s memory or uploaded to an account in the cloud; based on the current trend, the data accumulated from the wearable device are stored in a standalone location. In many of these cases, this health related datum is not a factor when considering the holistic view of a user’s health lifestyle or record. This health-related data generated from wearable and Internet of Things (IoT) devices can serve as empirical information to a medical provider, as the standalone data can add value to the holistic health record of a patient. This paper proposes a solution to incorporate the data gathered from these wearable and IoT devices, with that a patient’s Personal Health Record (PHR) stored within the confines of a Health Information Exchange (HIE).

Keywords: electronic health record, health information exchanges, internet of things, personal health records, wearable devices, wearables

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Authors: Josephine Mutwale-Ziko, Nonde Lushinga, Inonge Akakandelwa

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The study discusses the effectiveness of health and safety induction practices on construction sites against the background of the Zambian construction industry experience. The research design included the literature review of relevant literature. Questionnaires and interviews were administered to regulatory bodies, health, and safety personnel. Observation was also employed on construction sites to assess the health and safety practices being used. Health and safety in the construction industry are not something to be ignored or overlooked. The construction industry needs to take heed of the serious consequences of inadequate health and safety induction practices. The implications of inadequate health and safety induction procedures included among others threats to profitability, corporate social responsibility and increased turnover of the workforce leading to poor productivity. Adequate health and safety practices can improve the health and wellbeing of employees, reduce financial implications on firms and encourage productivity on construction sites. Despite this, accidents are still prevalent on construction sites in Zambia. The overall result of this research denotes that the implementation of health and safety induction practices is inadequate, as indicated by the negligent and non-adherent attitude to health and safety induction aspects on the sites by most stakeholders on construction sites. Therefore, health and safety induction practices are ineffective as preventive measures for reduction of accidents on construction sites in Zambia.

Keywords: accidents, health and safety, inadequate, induction

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Authors: Batool Ismaeel, Umair Farooq, Saad Mushtaq

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Construction projects in the oil industry can be very complex, having unknown outcomes and uncertainties that cannot be easily predicted. Each project has its unique risks generated by a number of factors which, if not controlled, will impact the successful completion of the project mainly in terms of schedule, cost, quality, and safety. This paper highlights the historic risks associated with projects in the south and east region of Kuwait Oil Company (KOC) collated from the company’s lessons learned database. Starting from Contract Award through to handover of the project to the Asset owner, the gaps in project execution in terms of managing risk will be brought to discussion and where a well-defined systematic approach in project risk management reflecting many claims, change of scope, exceeding budget, delays in engineering phase as well as in the procurement and fabrication of long lead items should be adopted. This study focuses on a proposed feasible approach in risk management for engineering, procurement and construction (EPC) level projects including the various stakeholders involved in executing the works from International to local contractors and vendors in KOC. The proposed approach covers the areas categorized into organizational, design, procurement, construction, pre-commissioning, commissioning and project management in which the risks are identified and require management and mitigation. With the effective deployment and implementation of the proposed risk management system and the consideration of it as a vital key in achieving the project’s target, the outcomes will be more predictable in the future, and the risk triggers will be managed and controlled. The correct resources can be allocated on a timely basis for the company for avoiding any unpredictable outcomes during the execution of the project. It is recommended in this paper to apply this risk management approach as an integral part of project management and investigate further in the future, the effectiveness of this proposed system for newly awarded projects and compare the same with those projects of similar budget/complexity that have not applied this approach to risk management.

Keywords: construction, project completion, risk management, uncertainties

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Authors: Bilal Ahmed

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Rehabilitation of congenital and acquired maxillofacial defects is always a challenging clinical scenario. These defects pose major physiological and psychological threat not only to the patient but to the entire family. There has been an enormous scientific development in maxillofacial rehabilitation with the advent of CAD CAM, 3-D scanning, Osseo-integrated implants and improved restorative materials. There are also specialized centers with latest diagnostic and treatment facilities in the developed countries. However, in certain clinical case scenarios, conventional prosthodontic principles are still the gold standards. Similarly in a less developed world, financial and technical constraints are factors affecting treatment planning and final outcomes. However, we can do a lot of benefits to the affected human beings, even with use of simple and cost-effective conventional prosthodontic techniques and materials. These treatment strategies may sometimes be considered as intermediate or temporary options, but with regular follow-up maintenance these can be used on a definitive basis.

Keywords: maxillofacial defects, obturators, prosthodontics, medical and health sciences

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Authors: Hande Aladağ, Gökçe Aydın

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The world’s population is increasing continuously and rapidly. Moreover, there are other problems such as the decline of natural energy resources, global warming, and environmental pollution. These facts have made sustainability an important and primary topic from future planning perspective. From this perspective, constituting sustainable cities and communities can be considered as one of the key issues in terms of sustainable development goals. The concept of sustainable cities can be evaluated under three headings such as green/sustainable buildings, self – contained cities and sustainable transportation. This study only concentrates on how to form and support a sustainable urban transportation system to contribute to the sustainable urbanization. Urban transportation system inevitably requires many engineering projects with various sizes. Engineering projects generally have four phases, in the following order: Planning, design, construction, operation. The order is valid but there are feedbacks from every phase to every phase in its upstream. In this regard, engineering projects are iterative processes. Sustainability is an integrated and comprehensive concept thus it should be among the primary concerns in every phase of transportation projects. In the study, a meta-analysis will be performed on the related studies in the literature. It is targeted and planned that, as a result of the findings of this meta-analysis, a framework for the list of principles and actions for sustainable transport will be formed. The meta-analysis will be performed to point out and clarify sustainability approaches in every phase of the related engineering projects, with also paying attention to the iterative nature of the process and relative contribution of the action for the outcomes of the sustainable transportation system. However, the analysis will not be limited to the engineering projects, non-engineering solutions will also be included in the meta-analysis. The most important contribution of this study is a determination of the outcomes of a sustainable urban transportation system in terms of energy efficiency, resource preservation and related social, environmental and economic factors. The study is also important because it will give light to the engineering and management approaches to achieve these outcomes.

Keywords: meta-analysis, sustainability, sustainable cities, sustainable urban transportation, urban transportation

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Authors: Kailin K. Zhang, Anne W. Thompson

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Electronic learning for continuing professional education (CPE) and interprofessional education (IPE) in healthcare have been shown to improve learners’ satisfaction, attitudes, and performance. Yet, their impact on behavior change in healthcare professionals through continuing interprofessional education (CIPE) is less known. A scoping review of 32 articles from 2010 to 2020 was conducted using the Arksey and O’Malley framework across all healthcare settings. It focused on evaluating the effectiveness of CIPE on behavior change of healthcare professionals, as well as identifying course features of electronic CIPE programs facilitating behavior change. Eight different types of electronic learning methods, including online programs, tele-education, and social media, were identified as interventions. More than 35,542 healthcare professionals participated in the interventions. Electronic learning for CIPE led to positive behavior outcomes in 30 out of 32 studies, especially through a change in patient care practices. The most successful programs provided interactive and authentic learning experiences tailored to learners’ needs while promoting the direct application of what was learned in their clinical settings. Future research should include monitoring of sustained behavior changes and their resultant patient outcomes.

Keywords: behavior change, continuing interprofessional education, distance learning, electronic learning

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Authors: Erin Lawlor

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In 2008 Time magazine named terrorist rehabilitation as one of the best ideas of the year. The term deradicalisation has become synonymous with rehabilitation within security discourse. The allure for a “quick fix” when managing terrorist populations (particularly within prisons) has led to a focus on prescriptive programmes where there is a distinct lack of exploration into the drivers for a person to disengage or deradicalise from violence. It has been argued that to tackle a snowballing issue that interventions have moved too quickly for both theory development and methodological structure. This overly quick acceptance of a term that lacks rigorous testing, measuring, and monitoring means that there is distinct lack of evidence base for deradicalisation being a genuine process/phenomenon, leading to academics retrospectively attempting to design frameworks and interventions around a concept that is not truly understood. The UK Home Office has openly acknowledged the lack of empirical data on this subject. This lack of evidence has a direct impact on policy and intervention development. Extremism and deradicalisation are issues that affect public health outcomes on a global scale, to the point that terrorism has now been added to the list of causes of trauma, both in the direct form of being victim of an attack but also the indirect context of witnesses, children and ordinary citizens who live in daily fear. This study critiques current deradicalisation discourses to establish whether public health approaches offer opportunities for development. The research begins by exploring the theoretical constructs of both what deradicalisation, and public health issues are. Questioning: What does deradicalisation involve? Is there an evidential base on which deradicalisation theory has established itself? What theory are public health interventions devised from? What does success look like in both fields? From establishing this base, current deradicalisation practices will then be explored through examples of work already being carried out. Critiques can be broken into discussion points of: Language, the difficulties with conducting empirical studies and the issues around outcome measurements that deradicalisation interventions face. This study argues that a public health approach towards deradicalisation offers the opportunity to attempt to bring clarity to the definitions of radicalisation, identify what could be modified through intervention and offer insights into the evaluation of interventions. As opposed to simply focusing on an element of deradicalisation and analysing that in isolation, a public health approach allows for what the literature has pointed out is missing, a comprehensive analysis of current interventions and information on creating efficacy monitoring systems. Interventions, policies, guidance, and practices in both the UK and Australia will be compared and contrasted, due to the joint nature of this research between Sheffield Hallam University and La Trobe, Melbourne.

Keywords: radicalisation, deradicalisation, violent extremism, public health

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Ayoade Adeyemi, Leo Nherera, Paul Trueman, Antje Emmermann

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Background and objectives: Radiofrequency (RF) generated plasma chondroplasty is considered a promising treatment alternative to mechanical debridement (MD) with a shaver. The aim of the study was to perform a cost-effectiveness analysis comparing costs and outcomes following COBLATION chondroplasty versus mechanical debridement in patients with knee pain associated with a medial meniscus tear and idiopathic ICRS grade III focal lesion of the medial femoral condyle from a payer perspective. Methods: A decision-analytic model was developed comparing economic and clinical outcomes between the two treatment options in German patients following knee chondroplasty. Revision rates based on the frequency of repeat arthroscopy, osteotomy and conversion to total knee replacement, reimbursement costs and outcomes data over a 4-year time horizon were extracted from published literature. One-way sensitivity analyses were conducted to assess uncertainties around model parameters. Threshold analysis determined the revision rate at which model results change. All costs were reported in 2016 euros, future costs were discounted at a 3% annual rate. Results: Over a 4 year period, COBLATION chondroplasty resulted in an overall net saving cost of €461 due to a lower revision rate of 14% compared to 48% with MD. Threshold analysis showed that both options were associated with comparable costs if COBLATION revision rate was assumed to increase up to 23%. The initial procedure costs for COBLATION were higher compared to MD and outcome scores were significantly improved at 1 and 4 years post-operation versus MD. Conclusion: The analysis shows that COBLATION chondroplasty is a cost-effective option compared to mechanical debridement in the treatment of patients with a medial meniscus tear and idiopathic ICRS grade III defect of the medial femoral condyle.

Keywords: COBLATION, cost-effectiveness, knee chondroplasty, mechanical debridement

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Authors: Bobuchi Ken-Opurum

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The impacts of climate change on urban settlements is growing. In the global south, communities are even more vulnerable and suffer there is an increased vulnerability from due to climate change disasters such as flooding and high temperatures. This is primarily due to high intensity rainfall, low-lying coasts, inadequate infrastructure, and limited resources. According to the Emergency Events Database, floods were the leading cause of disaster -based deaths in the global south between 2006 and 2015. This includes deaths from heat stress related health outcomes. Adapting to climate vulnerabilities is paramount in reducing the significant redevelopment costs from climate disasters. Governments and urban planners provide top-down approaches such as evacuation, and disaster and emergency communication. While they address infrastructure and public services, they are not always able to address the immediate and critical day to day needs of poor and vulnerable populations. There is growing evidence that some bottom-up strategies and grassroots initiatives of self-build housing such as in urban informal settlements are successful in coping and adapting to hydroclimatic impacts. However, these research findings are not consolidated and the evaluation of the resilience outcomes of the bottom-up strategies are limited. Using self-build housing as a model for sustainable and resilient urban planning, this research aimed to consolidate the flood and heat stress resilient design solutions, analyze the effectiveness of these solutions, and develop guidelines and methods for adopting these design solutions into mainstream housing in megathermal climates. The methodological approach comprised of analyses of over 40 ethnographic based peer reviewed literature, white papers, and reports between the years 2000 and 2019 to identify coping strategies and grassroots initiatives that have been applied by occupants and communities of the global south. The results of the research provide a consolidated source and prioritized list of the best bottom-up strategies for communities in megathermal climates to improve the lives of people in some of the most vulnerable places in the world.

Keywords: resilient, design, megathermal, climate change

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Authors: Ma. Cecilia D. Licuan

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The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

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Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

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The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

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Authors: Sireen Irsheid

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Despite concerted efforts to improve education attainment with progress in recent years, student achievement and attainment remain among the most significant challenges for school districts across the United States. Many scholars have argued that students who do not complete high school do not drop out of school voluntarily but are ‘pushed out’ of schools through multiple mechanisms related to structural and socioeconomic barriers, behavioral health challenges, pedagogical practices, and administrative procedures. Extant literature has shown that living in historically disadvantaged neighborhoods or attending under-resourced schools exacerbates student-level risk factors for grade retention and school pushout. Most efforts to respond to the school pushout phenomenon have focused on individual characteristics of students, with relatively little attention to addressing these multiple system-level characteristics related to perpetuating inequities. This study is built on a growing body of social justice-oriented research concerned with the systemic influences that shape the experiences and mental health challenges of young people. Specifically, this study examined how young people who have been experiencing education inequities make meaning and navigate the structural factors related to neighborhood and school disinvestment and access to resources and supports, and their risk for school pushout. Furthermore, schools as political, cultural, and ideologically reproductive spaces often serve as sites of resistance and can support students who are impacted by educational inequity. Study findings provide education, neighborhood, school psychology, social work practice, and policy considerations.

Keywords: education policy, mental health, school prison nexus, school pushout, structural trauma

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Authors: Shahid Nishat, Keith Thomas

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E-government initiatives attract substantial public investments around the world. These investments are based on the premise of digital transformation of the public services, improved efficiency and transparency, and citizen participation in the social democratic processes. However, many e-Government projects, especially in developing countries, fail to achieve their intended outcomes, and a strong disparity exists between the investments made and outcomes achieved, often referred to as e-Government paradox. Further, there is lack of research on evaluating the impacts of e-Government in terms of public value it creates, which ultimately drives usage. This study aims to address these gaps by identifying key enablers of e-Government success and by proposing a public value based framework to examine impact of e-Government services. The study will extend Delone and McLean Information System (IS) Success model by integrating Technology Readiness (TR) characteristics to develop an integrated success model. Level of analysis will be mobile government applications, and the framework will be empirically tested using quantitative methods. The research will add to the literature on e-Government success and will be beneficial for governments, especially in developing countries aspiring to improve public services through the use of Information Communication Technologies (ICT).

Keywords: e-Government, IS success model, public value, technology adoption, technology readiness

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Authors: Ricardo Bragança, Tom Vinaimont

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This paper discusses the introduction of processes of self-determined learning (heutagogy) into a graduate course on financial modeling, using elements of entangled pedagogy and Biggs’ constructive alignment. To encourage learners to take control of their own learning journey and develop critical thinking and problem-solving skills, each session in the course receives tailor-made media-enhanced pedagogical assets. The design of those assets specifically supports entangled pedagogy, which opposes technological or pedagogical determinism in support of the collaborative integration of pedagogy and technology. Media assets for each of the ten sessions in this course consist of three components. The first component in this three-pronged approach is a game-cut-like cinematographic representation that introduces the context of the session. The second component represents a character from an open-source-styled community that encourages self-determined learning. The third component consists of a character, which refers to the in-person instructor and also aligns learning outcomes and assessment tasks, using Biggs’ constructive alignment, to the cinematographic and open-source-styled component. In essence, the course's metamorphosis helps students apply the concepts they've studied to actual financial modeling issues. The audio-visual media assets create a storyline throughout the course based on gamified and real-world applications, thus encouraging student engagement and interaction. The structured entanglement of pedagogy and technology also guides the instructor in the design of the in-class interactions and directs the focus on outcomes and assessments. The transformation process of this graduate course in financial modeling led to an institutional teaching award in 2021. The transformation of this course may be used as a model for other courses and programs in many disciplines to help with intended learning outcomes integration, constructive alignment, and Assurance of Learning.

Keywords: innovative education, active learning, entangled pedagogy, heutagogy, constructive alignment, project based learning, financial modeling, graduate business education

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Authors: Bengi Demirci

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Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

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Authors: Anshu Radha Aggarwal

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Higher Education (HE) in the India has experienced a series of remarkable changes over the last fifteen years as successive governments have sought to make the sector more efficient and more accountable for investment of public funds. Rapid expansion in student numbers and pressures to widen Participation amongst non-traditional students are key challenges facing HE. Learning outcomes can act as a benchmark for assuring quality and efficiency in HE and they also enable universities to describe courses in an unambiguous way so as to demystify (and open up) education to a wider audience. This paper examines how learning outcomes are used in HE and evaluates the implications for curriculum design and student learning. There has been huge expansion in the field of higher education, both technical and non-technical, in India during the last two decades, and this trend is continuing. It is expected that another about 400 colleges and 300 universities will be created by the end of the 13th Plan Period. This has lead to many concerns about the quality of education and training of our students. Many studies have brought the issues ailing our curricula, delivery, monitoring and assessment. Govt. of India, (via MHRD, UGC, NBA,…) has initiated several steps to bring improvement in quality of higher education and training, such as National Skills Qualification Framework, making accreditation of institutions mandatory in order to receive Govt. grants, and so on. Moreover, Outcome-based Education and Training (OBET) has also been mandated and encouraged in the teaching/learning institutions. MHRD, UGC and NBAhas made accreditation of schools, colleges and universities mandatory w.e.f Jan 2014. Outcome-based Education and Training (OBET) approach is learner-centric, whereas the traditional approach has been teacher-centric. OBET is a process which involves the re-orientation/restructuring the curriculum, implementation, assessment/measurements of educational goals, and achievement of higher order learning, rather than merely clearing/passing the university examinations. OBET aims to bring about these desired changes within the students, by increasing knowledge, developing skills, influencing attitudes and creating social-connect mind-set. This approach has been adopted by several leading universities and institutions around the world in advanced countries. Objectives of this paper is to highlight the issues concerning quality in higher education and quality frameworks, to deliberate on the various education and training models, to explain the outcome-based education and assessment processes, to provide an understanding of the NAAC and outcome-based accreditation criteria and processes and to share best-practice outcomes-based accreditation system and process.

Keywords: learning outcomes, curriculum development, pedagogy, outcome based education

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Authors: Shaun G. Abbott, Rebecca C. Reynolds, James B. Etter, John B. F. de Wit

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The benefits of physical activity (PA) on health are well documented. Low socioeconomic status (SES) is associated with poor health, with PA a suggested mediator. Pedometers and accelerometers offer an effective behavior change tool to increase PA levels. While the role of pedometer and accelerometer use in increasing PA is recognized in many populations, little is known in low-SES groups. We are aiming to assess the effectiveness of pedometer- and accelerometer-based interventions for increasing PA step count and improving subsequent health outcomes among low-SES groups of high-income countries. Medline, Embase, PsycINFO, CENTRAL and SportDiscus databases were searched to identify articles published before 10th July, 2015; using search terms developed from previous systematic reviews. Inclusion criteria are: low-SES participants classified by income, geography, education, occupation or ethnicity; study duration minimum 4 weeks; an intervention and control group; wearing of an unsealed pedometer or accelerometer to objectively measure PA as step counts per day for the duration of the study. We retrieved 2,142 articles from our database searches, after removal of duplicates. Two investigators independently reviewed titles and abstracts of these articles (50% each) and a combined 20% sample were reviewed to account for inter-assessor variation. We are currently verifying the full texts of 430 articles. Included studies will be critically appraised for risk of bias using guidelines suggested by the Cochrane Public Health Group. Two investigators will extract data concerning the intervention; study design; comparators; steps per day; participants; context and presence or absence of obesity and/or chronic disease. Heterogeneity amongst studies is anticipated, thus a narrative synthesis of data will be conducted with the simplification of selected results into percentage increases from baseline to allow for between-study comparison. Results will be presented at the conference in December if selected.

Keywords: accelerometer, pedometer, physical activity, socioeconomic, step count

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Authors: Khaled M. Alqahtani

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Copy number alterations (CNA) are variations in the structure of the genome, where certain regions deviate from the typical two chromosomal copies. These alterations are pivotal in understanding tumor progression and are indicative of patients' survival outcomes. However, effectively modeling patients' survival based on their genomic CNA profiles while identifying relevant genomic regions remains a statistical challenge. Various methods, such as the Cox proportional hazard (PH) model with ridge, lasso, or elastic net penalties, have been proposed but often overlook the inherent dependencies between genomic regions, leading to results that are hard to interpret. In this study, we enhance the elastic net penalty by incorporating an additional penalty that accounts for these dependencies. This approach yields smooth parameter estimates and facilitates variable selection, resulting in a sparse solution. Our findings demonstrate that this method outperforms other models in predicting survival outcomes, as evidenced by our simulation study. Moreover, it allows for a more meaningful interpretation of genomic regions associated with patients' survival. We demonstrate the efficacy of our approach using both real data from a lung cancer cohort and simulated datasets.

Keywords: copy number alterations, cox proportional hazard, lung cancer, regression, sparse solution

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Authors: Mohd Zuhair, Ram Babu Roy

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This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

Keywords: health insurance, out of pocket expenditure, universal healthcare, sustainability

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Authors: Pernille K. Christiansen, Mette Maria Skjøth, Line Lorenzen, Eva Draborg, Christina Anne Vinter, Trine Kjær, Mette Juel Rothmann

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Background and aims: Overweight and obesity are an increasing challenge on a global level. In Denmark, more than one-third of all pregnant women are overweight or obese, and many women exceed the gestational weight gain recommendations from the Institute of Medicine. Being overweight or obese, is associated with a higher risk of adverse maternal and fetal outcomes, including gestational diabetes and childhood obesity. Thus, it is important to focus on the women’s lifestyles between their pregnancies to lower the risk of gestational weight retention in the long run. The objective of this study was to explorer what barriers and challenges postpartum women experience with respect to healthy lifestyles during the postpartum period and to access whether an Information Technology based intervention might be a supportive tool to assist and motivate postpartum women to a healthy lifestyle. Materials and methods: The method is inspired by participatory design. A systematic text condensation was applied to semi-structured focus groups. Five focus group interviews were carried out with a total of 17 postpartum women and two interviews with a total of six health professionals. Participants were recruited through the municipality in Svendborg, Denmark, and at Odense University Hospital in Odense, Denmark, during a four-month period in early 2018. Results: From the women’s perspective, better assistance is needed from the health professionals to obtain or maintain a healthy lifestyle. The women need tools that inform and help them understand and prioritise their own health-related risks, and to motivate them to plan and take care of their own health. As the women use Information Technology on a daily basis, the solution could be delivered through Information Technology. Finally, there is room for engaging the partner more in the communication related to the baby and family’s lifestyle. Conclusion: Postpartum women need tools that inform and motivate a healthy lifestyle postpartum. The tools should allow access to high-quality information from health care professionals, when the information is needed, and also allow engagement from the partner. Finally, Information Technology is a potential tool for delivering tools.

Keywords: information technology, lifestyle, overweight, postpartum

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Authors: Husain A. Murad, Ali A. Dashti, Ali Al-Kandari

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The outbreak of Coronavirus during the Spring semester of 2020 brought new challenges for the teaching of vocational mass communication courses at universities in Kuwait. Using the Media Richness Theory (MRT), this study examines the response of 252 university students on mass communication programs. A questionnaire regarding their perceptions and preferences concerning modes of instruction on vocational courses online, focusing on the four factors of MRT: immediacy of feedback, capacity to include personal focus, conveyance of multiple cues, and variety of language. The outcomes show that immediacy of feedback predicted all criterion variables: suitability of distance learning (DL) for teaching vocational courses, sentiments of students toward DL, perceptions of easiness of evaluation of DL coursework, and the possibility of retaking DL courses. Capacity to include personal focus was another positive predictor of the criterion variables. It predicted students’ sentiments toward DL and the possibility of retaking DL courses. The outcomes are discussed in relation to implications for using DL, as well as constructing an agenda for DL research.

Keywords: distance learning, media richness theory, traditional learning, vocational media courses

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Authors: Darius Danesh, Michael J. Ryan, Alireza Abbasi

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Project Portfolio Management (PPM) is an essential component of an organisation’s strategic procedures, which requires attention of several factors to envisage a range of long-term outcomes to support strategic project portfolio decisions. To evaluate overall efficiency at the portfolio level, it is essential to identify the functionality of specific projects as well as to aggregate those findings in a mathematically meaningful manner that indicates the strategic significance of the associated projects at a number of levels of abstraction. PPM success is directly associated with the quality of decisions made and poor judgment increases portfolio costs. Hence, various Multi-Criteria Decision Making (MCDM) techniques have been designed and employed to support the decision-making functions. This paper reviews possible option to improve the decision-making outcomes in the organisational portfolio management processes using the Analytic Hierarchy Process (AHP) both from academic and practical perspectives and will examine the usability, certainty and quality of the technique. The results of the study will also provide insight into the technical risk associated with current decision-making model to underpin initiative tracking and strategic portfolio management.

Keywords: analytic hierarchy process, decision support systems, multi-criteria decision making, project portfolio management

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Authors: Punam Kumari Mandal, Namita Yangden, Bhumika Rai, Achala Niraula, Sabitra Subedi

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introduction: Family planning not only improves women’s health but also promotes gender equality, better child health, and improved education outcomes, including poverty reduction. The objective of this study is to assess the utilization of family planning methods and associated factors in Sunsari, Nepal. methodology: A cross-sectional analytical study was conducted among women of the reproductive age group (15-49 years) in Sunsari in 2020. Nonprobability purposive sampling was used to collect information from 212 respondents through face-to-face interviews using a Semi-structured interview schedule from ward no 1 of Barju rural municipality. Data processing was done by using SPSS “statistics for windows, version 17.0(SPSS Inc., Chicago, III.USA”). Descriptive analysis and inferential analysis (binary logistic regression) were used to find the association of the utilization of family planning methods with selected demographic variables. All the variables with P-value <0.1 in bivariate analysis were included in multivariate analysis. A P-value of <0.05 was considered to indicate statistical significance at a level of significance of 5%. results: This study showed that the mean age and standard deviation of the respondents were 26±7.03, and 91.5 % of respondent’s age at marriage was less than 20 years. Likewise, 67.5% of respondents use any methods of family planning, and 55.2% of respondents use family planning services from the government health facility. Furthermore, education (AOR 1.579, CI 1.013-2.462)., husband’s occupation (AOR 1.095, CI 0.744-1.610)., type of family (AOR 2.741, CI 1.210-6.210)., and no of living son (AOR 0.259 CI 0.077-0.872)are the factors associated with the utilization of family planning methods. conclusion: This study concludes that two-thirds of reproductive-age women utilize family planning methods. Furthermore, education, the husband’s occupation, the type of family, and no of living sons are the factors associated with the utilization of family planning methods. This reflects that awareness through mass media, including behavioral communication, is needed to increase the utilization of family planning methods.

Keywords: family planning methods, utilization. factors, women, community

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