Search results for: public health insurance

Authors: V. L. M. F. Capellini, A. P. P. M. Maturana, N. C. M. Brondino, M. B. C. L. B. M. Peixoto, A. J. Broughton

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A paradigm shift is a process. The process of implementing inclusive education, a system constructed to support all learners, requires planning, identification, experimentation, and evaluation. In this vein, the purpose of the present study was to evaluate the capacity of one Brazilian state school systems to provide special education students with a quality inclusive education. This study originated at the behest of concerned families of students with special needs who filed complaints with the Municipality of Bauru, São Paulo. These families claimed, 1) children with learning differences and educational needs had not been identified for services, and 2) those who had been identified had not received sufficient specialized educational assistance (SEA) in schools across the City of Bauru. Hence, the Office of Civil Rights for the state of São Paulo (Ministério Público de São Paulo) summoned the local higher education institution, UNESP, to design a research study to investigate these allegations. In this exploratory study, descriptive data were gathered from all elementary and middle schools including 58 state schools and 17 city schools, for a total of 75 schools overall. Data collection consisted of each school's annual strategic action plan, surveys and interviews with all school stakeholders to determine their perceptions of the inclusive education available to students with Special Education Needs (SEN). The data were collected as one of four stages in a larger study which also included field observations of a focal students' experience and a continuing education course for all teachers and administrators in both state and city schools. For the purposes of this study, the researchers were interested in understanding the perceptions of school staff, parents, and students across all schools. Therefore, documents and surveys from 75 schools were analyzed for adherence to federal legislation guaranteeing students with SEN the right to special education assistance within the regular school setting. Results shows that while some schools recognized the legal rights of SEN students to receive special education, the plans to actually deliver services were absent. In conclusion, the results of this study revealed both school staff and families have insufficient planning and accessibility resources, and the schools have inadequate infrastructure for full-time support to SEN students, i.e., structures and systems to support the identification of SEN and delivery of services within schools of Bauru, SP. Having identified the areas of need, the city is now prepared to take next steps in the process toward preparing all schools to be inclusive.

Keywords: inclusion, school, special education, special needs

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Authors: Yuanyuan Song

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Background: As we all know, culture plays a pivotal role in the realm of education, influencing study perceptions and outcomes. Nevertheless, there remains a need to delve into how culture specifically impacts the perception of courses. Therefore, the impact of culture on students' perceptions and academic performance is explored in this study. Drawing from cultural constructionism and conflict theories, it is posited that when students hailing from diverse cultures and backgrounds converge in the same classroom, their perceptions of course content may diverge significantly. This study seeks to unravel the tangible disparities and ascertain how cultural nuances shape students' perceptions of classroom content when encountering diverse cultural contexts within the same learning environment. Methodology: Given the diverse cultural backgrounds of students within the US, this study draws upon data collected from a course offered by a US college. In pursuit of answers to these inquiries, a qualitative approach was employed, involving semi-structured interviews conducted in a college-level science class in the US during 2023. The interviews encompassed approximately nine questions, spanning demographic particulars, cultural backgrounds, science learning experiences, academic outcomes, and more. Participants were exclusively drawn from science-related majors, with each student originating from a distinct cultural context. All participants were undergraduates, and most of them were from eighteen to twenty-five years old, totaling six students who attended the class and willingly participated in the interviews. The duration of each interview was approximately twenty minutes. Results: The findings gleaned from the interview data underscore the notable impact of varying cultural contexts on students' perceptions. This study argues that female science students, for instance, are influenced by gender dynamics due to the predominant male presence in science majors, creating an environment where female students feel reticent about expressing themselves in public. Students of East Asian origin exhibit a stronger belief in the efficacy of personal efforts when contrasted with their North American counterparts. Minority students indicated that they grapple with integration into the predominantly white mainstream society, influencing their eagerness to engage in classroom activities that are conducted by white professors. All of them emphasized the importance of learning science.

Keywords: multiculture education, educational sociology, educational equality, STEM education

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Authors: Ahmet Karakuş, Akif Can Kilic, Emre Alptekin

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A growing number of studies have been conducted to determine how well-being may be predicted using well-designed models. It is necessary to investigate the backgrounds of features in order to construct a viable Subjective Well-Being (SWB) model. We have picked the suitable variables from the literature on SWB that are acceptable for real-world data instructions. The goal of this work is to evaluate the model by feeding it with SWB characteristics and then categorizing the stress levels using machine learning methods to see how well it performs on a real dataset. Despite the fact that it is a multiclass classification issue, we have achieved significant metric scores, which may be taken into account for a specific task.

Keywords: machine learning, multiclassification problem, subjective well-being, perceived stress scale

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Authors: A. Coetzee, C. F. Kelly, E. Even-Zahav

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Dominant approaches to livestock production are harmful to the environment, human health and animal welfare, yet global meat consumption is rising. Sustainable alternative production approaches are therefore urgently required, and ‘free range’ is the main alternative for chicken meat offered in South Africa (and globally). Although the South African Poultry Association provides non-binding guidelines, there is a lack of formal definition and regulation of free range chicken production, meaning it is unclear what this alternative entails and if it is consistently practised (a trend observed globally). The objective of this exploratory qualitative case study is therefore to investigate who and what determines free range chicken. The case study, conducted from a social constructivist worldview, uses semi-structured interviews, photographs and document analysis to collect data. Interviews are conducted with those involved with bringing free range chicken to the market - farmers, chefs, retailers, and regulators. Data is analysed using thematic analysis to establish dominant patterns in the data. The five major themes identified (based on prevalence in data and on achieving the research objective) are: 1) free range means a bird reared with good animal welfare in mind, 2) free range means quality meat, 3) free range means a profitable business, 4) free range is determined by decision makers or by access to markets, and 5) free range is coupled with concerns about the lack of regulation. Unpacking the findings in the context of the literature reveals who and what determines free range. The research uncovers wide-ranging interpretations of ‘free range’, driven by the absence of formal regulation for free range chicken practices and the lack of independent private certification. This means that the term ‘free range’ is socially constructed, thus varied and complex. The case study also shows that whether chicken meat is free range is generally determined by those who have access to markets. Large retailers claim adherence to the internationally recognised Five Freedoms, also include in the South African Poultry Association Code of Good Practice, which others in the sector say are too broad to be meaningful. Producers describe animal welfare concerns as the main driver for how they practice/view free range production, yet these interpretations vary. An additional driver is a focus on human health, which participants achieve mainly through the use of antibiotic-free feed, resulting in what participants regard as higher quality meat. The participants are also strongly driven by business imperatives, with most stating that free range chicken should carry a higher price than conventionally-reared chicken due to increased production costs. Recommendations from this study focus on, inter alia, a need to understand consumers’ perspectives on free range chicken, given that those in the sector claim they are responding to consumer demand, and conducting environmental research such as life cycle assessment studies to establish the true (environmental) sustainability of free range production. At present, it seems the sector mostly responds to social sustainability: human health and animal welfare.

Keywords: chicken meat production, free range, socially constructed, sustainability

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Authors: Imelda Albert Gisip, Tarisah T. Z. Taman

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In Asia, particularly in Malaysia, women entrepreneurs contribute substantially to economic growth. This paper presents a review of women entrepreneurs’ program, focusing on Creating Millionaires among Young Women Entrepreneurs (CREAM@YWE) program in Sabah Malaysia, which aims to accelerate entrepreneurship among young women in Sabah Malaysia. Entrepreneurs are seen as essential for growth, job creation, and social progress, and the virtues of small business for Sabah Maju Jaya (SMJ), the Sabah state government Sabah State development plan for the year 2021-2025. SMJ guides the direction of the government's policies and programs, further guiding the implementation in a planned and strategic manner to achieve targets and goals that coincide with the development needs of the state. One of the government’s agendas is to put more effort into ensuring that women entrepreneurs are well supported and enhanced. Thus, The CreaM@YWE Program was developed in 2018 with the main objective is to produce competitive young women entrepreneurs in Sabah and achieve "millionaire" status. CreaM@YWE Program is an innovation process specifically developed to accelerate the entrepreneurship sector, particularly for women entrepreneurs in Sabah, by incorporating strategic partnerships and collaborations with government agencies and industry players. Being the first of its kind in Sabah, the novelty of this project is providing a supportive ecosystem, including six months of intensive courses guided through "hands-holding”, collaborations with strategic partners, and easy access to government assistance. Since its inception, the program has significantly impacted society’s wellbeing, particularly in empowering young women entrepreneurs in Sabah for the past six years, and has produced many successful women entrepreneurs with “millionaire” status. Generally, improving the women’s enterprise sector in Malaysia needs an overall environment that provides development opportunities for women entrepreneurs, including access to resources and support services. Since achieving the goal of women's entrepreneurship policy requires effective partnerships and inclusiveness, Cream @YWE Program has managed to practice these in assisting small entrepreneurs among young women in Sabah in accessing public goods and business opportunities. This proves that achieving women’s economic empowerment requires sound policies, a holistic approach, and long-term commitment. Thus, this paper presents how the Cream@YWE Program has been supporting Sabah young women entrepreneurs by reforming the business environment to help create opportunities for women while addressing the few existing gender-specific hurdles.

Keywords: young, women, entrepreneurs, Sabah, Malaysia

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Authors: Marcio Freire Cruz, Naoaki Ono, Shigehiko Kanaya, Carlos Arthur Mattos Teixeira Cavalcante

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The systems that record patient care information, known as Electronic Medical Record (EMR) and those that monitor vital signs of patients, such as heart rate, body temperature, and blood pressure have been extremely valuable for the effectiveness of the patient’s treatment. Several kinds of research have been using data from EMRs and vital signs of patients to predict illnesses. Among them, we highlight those that intend to predict, classify, or, at least identify patterns, of sepsis illness in patients under vital signs monitoring. Sepsis is an organic dysfunction caused by a dysregulated patient's response to an infection that affects millions of people worldwide. Early detection of sepsis is expected to provide a significant improvement in its treatment. Preceding works usually combined medical, statistical, mathematical and computational models to develop detection methods for early prediction, getting higher accuracies, and using the smallest number of variables. Among other techniques, we could find researches using survival analysis, specialist systems, machine learning and deep learning that reached great results. In our research, patients are modeled as points moving each hour in an n-dimensional space where n is the number of vital signs (variables). These points can reach a sepsis target point after some time. For now, the sepsis target point was calculated using the median of all patients’ variables on the sepsis onset. From these points, we calculate for each hour the position vector, the first derivative (velocity vector) and the second derivative (acceleration vector) of the variables to evaluate their behavior. And we construct a prediction model based on a Long Short-Term Memory (LSTM) Network, including these derivatives as explanatory variables. The accuracy of the prediction 6 hours before the time of sepsis, considering only the vital signs reached 83.24% and by including the vectors position, speed, and acceleration, we obtained 94.96%. The data are being collected from Medical Information Mart for Intensive Care (MIMIC) Database, a public database that contains vital signs, laboratory test results, observations, notes, and so on, from more than 60.000 patients.

Keywords: dynamic analysis, long short-term memory, prediction, sepsis

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Authors: Giovanni Duran Polo

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Demonstrate the importance of the stages such as Information, Diagnosis, Management, and Intervention is fundamental to have a historical, live, and quality inhabited center. One of the major actions to take is to promote the concept of the management of a historic center with harmonious development. For that, concerned actors should strengthen the concept that said historic center may be the neighborhood of all and for all. The centers of historical cities, presented as any other urban area, social, environmental issues etc; yet they get added value that have no other city neighborhoods. The equity component, either by the urban plan, or environmental quality offered properties of architectural, landscape or some land uses are the differentiating element, while the tool that makes them attractive face pressure exerted by new housing developments or shopping centers. That's why through the experience of working in historical centers, they are declared the actions in heritage areas. This paper will show how the encounter with each of these places are trying to take the phases of information, to gather all the data needed to be closer to the territory with specific data, diagnosis; which allowed the actors to see what state they were, felt how the heart is related to the rest of the city, show what problems affected the situation and what potential it had to compete in a global market. Also, to discuss the importance of the organization, as it is legal and normative basis for it have an order and a concept, when you know what can and what cannot, in an area where the citizen has many myth or history, when he wanted to intervene in protected buildings. It is also appropriate to show how it could develop the intervention phase, where the shares on the tangible elements and intervention for the protection of the heritage property are executed. The management is the final phase which will carry out all that was raised on paper, it's time to orient, explain, persuade, promote, and encourage citizens to take care of the heritage. It is profitable and also an obligation and it is not an insurmountable burden. It has to be said this is the time to pull all the cards to make the historical center and heritage becoming more alive today. It is the moment to make it more inhabited and to transformer it into a quality place, so citizens will cherish and understand the importance of such a place. Inhabited historical centers, endowments and equipment required, with trade quality, with constant cultural offer, with well-preserved buildings and tidy, modern and safe public spaces are always attractive for tourism, but first of all, the place should be conceived for citizens, otherwise everything will be doomed to failure.

Keywords: development, diagnosis, heritage historic center, intervention, management, patrimony

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Authors: Camille Alexis-Garsee, Nicola Payne

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One consequence of the pandemic has been the debilitating health impact that some people experience over a longer period of time, known as long-COVID. This has been predominately researched in adults; however, there is emerging evidence on the effects of long-COVID in children. Research has indicated over half of children who contracted COVID-19 experienced persistent symptoms four months after a confirmed diagnosis. There is little research on the impact of this on children and their families. This study aimed to explore the experiences of children with long-COVID, to enable further understanding of the impacts and needs within this group. Semi-structured interviews, facilitated by children’s drawings, were conducted with 15 children (aged 9-16, 9 females). Inductive thematic analysis was used to analyze the data. The findings tell a story of loss, change and of resilience. Many children were unable to engage in normal daily activities and were unable to attend school, however, all employed self-management techniques to cope with symptoms and were positive for the future. Four main themes were identified: (1) Education challenges: although some schools tried to accommodate the child’s new limitations with provision of flexi-attendance, online classes and a reduced timetable, children struggled to keep up with their schoolwork and needed more support; (2) Disrupted relationships: children felt socially isolated; they were forced to give up co and extra-curricular activities, were no longer in contact with friendship groups and missed out on key experiences with friends and family; (3) Diverse health-related challenges: children’s symptoms affected daily functioning but were also triggers for changes in thoughts and mood; (4) Coping and resilience: children actively engaged in symptom management and were able to ‘self-pace’ and/or employ distraction activities to cope. They were also focused on living a ‘normal’ life and looked to the future with great positivity. A key challenge of the long-term effects of COVID is recognizing and treating the illness in children and the subsequent impact on multiple aspects of their lives. Even though children described feeling disconnected in many ways, their life goals were still important. A multi-faceted approach is needed for management of this illness, with a focus on helping these children successfully reintegrate into society and achieve their dreams.

Keywords: children’s illness experience, COVID-19, long-COVID in children, long-COVID kids, qualitative research

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Authors: Siming Xie

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In social networks, the term homophily refers to the tendency of agents with similar characteristics to link with one another and is so robustly observed across many contexts and dimensions. The starting point of my research is the observation that the “type” of agents is not a single exogenous variable. Agents, despite their differences in race, religion, and other hard to alter characteristics, may share interests and engage in activities that cut across those predetermined lines. This research aims to capture the interactions of homophily effects in a model where agents have two-dimension characteristics (i.e., race and personal hobbies such as basketball, which one either likes or dislikes) and with biases in meeting opportunities and in favor of same-type friendships. A novel feature of my model is providing a matching process with biased meeting probability on different dimensions, which could help to understand the structuring process in multidimensional networks without missing layer interdependencies. The main contribution of this study is providing a welfare based matching process for agents with multi-dimensional characteristics. In particular, this research shows that the biases in meeting opportunities on one dimension would lead to the emergence of homophily on the other dimension. The objective of this research is to determine the pattern of homophily in network formations, which will shed light on our understanding of segregation and its remedies. By constructing a two-dimension matching process, this study explores a method to describe agents’ homophilous behavior in a social network with multidimension and construct a game in which the minorities and majorities play different strategies in a society. It also shows that the optimal strategy is determined by the relative group size, where society would suffer more from social segregation if the two racial groups have a similar size. The research also has political implications—cultivating the same characteristics among agents helps diminishing social segregation, but only if the minority group is small enough. This research includes both theoretical models and empirical analysis. Providing the friendship formation model, the author first uses MATLAB to perform iteration calculations, then derives corresponding mathematical proof on previous results, and last shows that the model is consistent with empirical evidence from high school friendships. The anonymous data comes from The National Longitudinal Study of Adolescent Health (Add Health).

Keywords: homophily, multidimension, social networks, friendships

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Authors: Seyda Can, Meryem Unulu

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Objective: Breast milk is the most fundamental nutritional element for the healthy growth and development of newborns as they supply all the necessary components. Various obstacles such as diseases of mother and child, allergies of the baby, and insufficient breastmilk affect breast-feeding adversely. The wet nursery or breast milk banking is the most important source in providing the nutrients closest to the ideal for the newborn. Despite increasing opinions about its benefits, breast milk banking practice is controversial because of reasons such as ethical problems, traditional beliefs and attitudes, security concerns of families and lack of knowledge. It is thought that the results of this study will create the data for studies to raise the awareness of the society regarding wet nursery, and milk banks. Method: The study was planned and performed in descriptive type. The population of the study consists of mothers that gave birth between October-November 2017 in a public hospital in Turkey, and the sample consisted of 205 mothers chosen by improbable sampling method from the population and accepted to participate in the study. While gathering data, a survey consisting of 33 questions designed to determine the socio-demographic characteristics and their views on wet nursery and breast milk banking. Written ethical committee and institution permit was taken. Before the interview, participants were informed about the purpose and content of the study and oral permit was taken. Result: When the distribution of 205 mothers according to their individual characteristics, it was detected that their age average was 28,16±5,23 and 63,4 of mothers (n=130) had normal delivery. It was determined that clear majority of mothers, 75,6% (n=155) had no breast-feeding problems and 75,1% (n=154) fed the baby only with breast milk. It was detected that 18,5% (n=38) would accept a stranger to be a wet nurse and 60% (n=123) would donate milk if there is a breast milk bank. It was detected 33,2 % (n=68) of participant mothers want to make use of breast milk bank if there is a situation that prevents breast feeding, 38,5 % (n=79) of mothers think breast milk bank would be problematic religiously. Statistical difference was detected between the educational status of women and the rate of wanting breast milk bank practice. As the educational status of mothers increased, their rate of wanting breast milk bank practice increased. Conclusion: It is essential that every baby is breastfed by its mother primarily. However, when this is not possible, in order to implement wet nursery and breast milk banking as an extension of national breast-feeding policy, regulations need to be made and worries should be eased. Also, organizing training programs are also really important to raise awareness of the society and mothers.

Keywords: breast feeding, breast milk, milk banks, wet nursery

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Authors: Rui Lin, Jimmy Xiangji Huang, Gary Spraakman

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This forthcoming systematic review will underscore the imperative of leveraging technology to mitigate social isolation in older adults, particularly in the context of unprecedented global challenges such as the COVID-19 pandemic. With the continual evolution of technology, it becomes crucial to scrutinize the efficacy of interventions and discern how they can alleviate social isolation and augment social well-being among the elderly. This review will strive to clarify the best methods for older adults to utilize cost-effective and user-friendly technology and will investigate how the adaptation and execution of such interventions can be fine-tuned to maximize their positive outcomes. The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to filter pertinent studies. We foresee conducting an analysis of articles and executing a narrative analysis to discover themes and indicators related to quality of life and, technology use and well-being. The review will examine how involving older adults at the community level, applying top practices from community-based participatory research, can establish efficient strategies to implement technology-based interventions designed to diminish social isolation and boost digital use self-efficacy. Applications based on mobile technology and virtual platforms are set to assume a crucial role not only in enhancing connections within families but also in connecting older adults to vital healthcare resources, fostering both physical and mental well-being. The review will investigate how technological devices and platforms can address the cognitive, visual, and auditory requirements of older adults, thus strengthening their confidence and proficiency in digital use—a crucial factor during enforced social distancing or self-isolation periods during pandemics. This review will endeavor to provide insights into the multifaceted benefits of technology for older adults, focusing on how tailored technological interventions can be a beacon of social and mental wellness in times of social restrictions. It will contribute to the growing body of knowledge on the intersection of technology and elderly well-being, offering nuanced understandings and practical implications for developing user-centric, effective, and inclusive technological solutions for older populations.

Keywords: older adults, health service delivery, digital health, social isolation, social well-being

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Authors: Peter Ecke

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This research presents insights from a questionnaire study and autobiographic narrative analyses about the language and cultural backgrounds, challenges, interests, and needs, as well as perceptions about bilingualism and language learning of undergraduate students at a Public University in the southwestern United States. Participants were 650 students, enrolled in college-level general education courses, entitled “Becoming multilingual: Learning and maintaining two or more languages” between 2020 and 2024. Data were collected via pre- and post-course questionnaires administered online through the Qualtrix XM platform and complemented with analyses of excerpts from autobiographical narratives that students produced as part of the course assignments. Findings, for example, show that course participants have diverse linguistic backgrounds. The five most frequently reported L1s were English (about 50% of course participants), Spanish, Arabic, Mandarin, and Korean (in that order). The five most frequently reported L2s were English, Spanish, French, ASL, Japanese, German, and Mandarin (in that order). Participants also reported on their L2, L3, L4, and L5 if applicable. Most participants (over 60%) rated themselves bilingual or multilingual whereas 40% considered themselves to be monolingual or foreign language learners. Only about half of the participants reported feeling very or somewhat comfortable with their language skills, but these reports changed somewhat from the pre- to the post-course survey. About half of participants were mostly interested in learning how to effectively learn a foreign language. The other half of participants reported being most curious about learning about themselves as bi/multilinguals, (re)learning a language used in childhood, learning how to bring up a child as a bi/multilingual or learning about people who speak multiple languages (distributed about evenly). Participants’ comments about advantages and disadvantages of being bilingual remained relatively stable but their agreement with common myths about bilingualism and language learning changed from the pre- to the post-course survey. Students’ reflections in the autobiographical narratives and comments in (institutionally administered) anonymous course evaluations provided additional data on students’ concerns about their current language skills and uses as well as their perceptions about learning outcomes and the usefulness of the general education course for their current and future lives. It is hoped that the presented findings and discussion will spark interest among colleagues in offering similar courses as a resource for college students (and possibly other audiences), including those from migrant, indigenous, multilingual, and multicultural communities to contribute to a more harmonious bilingualism and well-being of college students who are or inspire to become bi-or multilingual.

Keywords: autobiographic narratives, general education university course, harmonious bilingualism and well-being, multilingualism, questionnaire study

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Authors: Prateek Rastogi, Jenash Acharya

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Histopathology examination has been a boon to forensic experts all around the world since its implication in autopsy cases. Whenever a case of sudden death is encountered, forensic experts clandestinely focus on cardiovascular, respiratory, gastrointestinal or cranio-cerebral causes. After ruling out poisoning or trauma, they are left with the only option available, histopathology examination. Besides preserving thoracic and abdominal organs, brain tissues are very less frequently subjected for the analysis. Based on provisional diagnosis documented on hospital treatment record files, one hemisphere of grossly unremarkable cerebrum was confirmatively diagnosed by histopathology examination to be a case of cerebral toxoplasmosis.

Keywords: cerebral toxoplasmosis, sudden death, health information, histopathology

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Authors: Pin Yu Chen, Puay Chuan Lee, Yu Jen Loo, Ju Xia Zhang, Deborah Teo, Jack Wei Chieh Tan, Biauw Chi Ong

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Background: Synchronous communication, such as telephone calls, remains the standard communication method between nurses and other healthcare professionals in Singapore public hospitals despite advances in asynchronous technological platforms, such as instant messaging. Although miscommunication is one of the most common causes of lapses in patient care, there is a scarcity of research characterizing baseline inter-professional healthcare communications in a hospital setting due to logistic difficulties. Objective: This study aims to characterize the frequency and patterns of communication behaviours among healthcare professionals. Methods: The one-week observational study was conducted on Monday through Sunday at the nursing station of a cardiovascular medicine and cardiothoracic surgery inpatient ward at the National Heart Centre Singapore. Subjects were shadowed by two physicians for sixteen hours or consecutive morning and afternoon nursing shifts. Communications were logged and characterized by type, duration, caller, and recipient. Results: A total of 1,023 communication events involving the attempted use of the common telephones at the nursing station were logged over a period of one week, corresponding to a frequency of one event every 5.45 minutes (SD 6.98, range 0-56 minutes). Nurses initiated the highest proportion of outbound calls (38.7%) via the nursing station common phone. A total of 179 face-to-face communications (17.5%), 362 inbound calls (35.39%), 481 outbound calls (47.02%), and 1 emergency alert (0.10%) were captured. Average response time for task-oriented communications was 159 minutes (SD 387.6, range 86-231). Approximately 1 in 3 communications captured aimed to clarify patient-related information. The total duration of time spent on synchronous communication events over one week, calculated from total inbound and outbound calls, was estimated to be a total of 7 hours. Conclusion: The results of our study showed that there is a significant amount of time spent on inter-professional healthcare communications via synchronous channels. Integration of patient-related information and use of asynchronous communication channels may help to reduce the redundancy of communications and clarifications. Future studies should explore the use of asynchronous mobile platforms to address the inefficiencies observed in healthcare communications.

Keywords: healthcare communication, healthcare management, nursing, qualitative observational study

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Authors: Lindsay Foreman

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Introduction: Goals have become synonymous with the quest for the good life and the pursuit of happiness, with coaching and positive psychology gaining popularity as an approach in recent decades. And yet mental health is on the rise and the leading cause of disability, wellbeing is on the decline, stress is leading to 50-60% of workday absences and the need for action is indisputable and urgent. Purpose: The purpose of this study is to better understand two things we cannot see, but that play the most significant role in these outcomes - what we think and how we feel. With many working on the assumption that positive thinking and an optimistic outlook are necessary or valuable components of goal pursuit, this study uncovers the reality of the ‘inner-game’ from the coachees perspective. Method: With a mixed methods design using a Q Method study of subjectivity to ‘make the unseen seen’. First, a wide-ranging universe of subjective thoughts and feelings experienced during goal pursuit are explored.. These are generated from literature and a Qualtrics survey to create a Q-Set of 40 statements. Then 19 participants in professional and organisational settings offer their perspectives on these 40 Q-Set statements. Each rank them in a semi-forced distribution from ‘most like me’ to ‘least like me’ using Q-Sort software. From these individual perspectives, clusters of perspectives are identified using factor analysis and four distinct viewpoints, have emerged. Findings: These Goal Pursuit Viewpoints offer insight into the states and self-talk experienced by coachees and may not reflect the assumption of positive thinking associated with achieving goals. The four Viewpoints are 1) the Positive View, 2) the Realistic View 3) The Dreamer View and 4) The Conflicted View. With only a quarter of the Dreamer View, and a third of the Positive view going on to achieve their goals, these assumptions need review. And with all the Realistic View going on to achieve their goals, the role of self-doubt, overwhelm and anxiousness in goal achievement cannot be overlooked. Contribution: This study offers greater insight and understanding of people's inner experiences as they pursue goals and highlights the necessary and normal negative states associated with goal achievement. It also offers a practical tool of 40 ‘Clarity Card’ Q-set statements to help coaches and coachees explore the current state and help navigate the journey towards goal achievement. It calls into question whether goals should always be part of coaching, and if values, identity, and purpose may play a greater role than goals

Keywords: self-talk, mental health, inner critic, inner coach

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Authors: Fionnuala Tynan, Margaret Nohilly

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Wellbeing in not only a national priority in Ireland but in the international context. A review of the literature highlights the consistent efforts of researchers to define the concept of wellbeing. This study sought to explore the understating of Wellbeing in Irish primary schools. National Wellbeing Guidelines in the Irish context frame the concept of wellbeing through a mental health paradigm, which is but one aspect of wellbeing. This exploratory research sought the views of Irish primary-school teachers on their understanding of the concept of wellbeing and the practical application of strategies to promote wellbeing both in the classroom and across the school. Teacher participants from four counties in the West of Ireland were invited to participate in focus group discussion and workshops through the Education Centre Network. The purpose of this process was twofold; firstly to explore teachers’ understanding of wellbeing in the primary school context and, secondly, for teachers to be co-creators in the development of practical strategies for classroom and whole school implementation. The voice of the teacher participants was central to the research design. The findings of this study indicate that the definition of wellbeing in the Irish context is too abstract a definition for teachers and the focus on mental health dominates the discourse in relation to wellbeing. Few teachers felt that they were addressing wellbeing adequately in their classrooms and across the school. The findings from the focus groups highlighted that while teachers are incorporating a range of wellbeing strategies including mindfulness and positive psychology, there is a clear disconnect between the national definition and the implementation of national curricula which causes them concern. The teacher participants requested further practical strategies to promote wellbeing at whole school and classroom level within the framework of the Irish Primary School Curriculum and enable them to become professionally confident in developing a culture of wellbeing. In conclusion, considering wellbeing is a national priority in Ireland, this research promoted the timely discussion the wellbeing guidelines and the development of a conceptual framework to define wellbeing in concrete terms for practitioners. The centrality of teacher voices ensured the strategies proposed by this research is both practical and effective. The findings of this research have prompted the development of a national resource which will support the implementation of wellbeing in the primary school at both national and international level.

Keywords: primary education, shared understanding, teacher voice, wellbeing

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Authors: Sheila S. Silang

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This research seeks to make an impact analysis on multiple intelligence as the basis for differentiated classroom instruction in TLE. It will also address the felt need of how TLE subject could be taught effectively exhausting all the possible means.This study seek the effect of giving different instruction according to the ability of the students in the following objectives: 1. student’s technological skills enhancement, 2. learning potential improvements 3. having better linkage between school and community in a need for soliciting different learning devices and materials for the learner’s academic progress. General Luna, Quezon is composed of twenty seven barangays. There are only two public high schools. We are aware that K-12 curriculum is focused on providing sufficient time for mastery of concepts and skills, develop lifelong learners, and prepare graduates for tertiary education, middle-level skills development, employment, and entrepreneurship. The challenge is with TLE offerring a vast area of specializations, how would Multiple Intelligence play its vital role as basis in classroom instruction in acquiring the requirement of the said curriculum? 1.To what extent do the respondent students manifest the following types of intelligences: Visual-Spatial, Body-Kinesthetic, Musical, Interpersonal, Intrapersonal, Verbal-Linguistic, Logical-Mathematical and Naturalistic. What media should be used appropriate to the student’s learning style? Visual, Printed Words, Sound, Motion, Color or Realia 3. What is the impact of multiple intelligence as basis for differentiated instruction in T.L.E. based on the following student’s ability? Learning Characteristic and Reading Ability and Performance 3. To what extent do the intelligences of the student relate with their academic performance? The following were the findings derived from the study: In consideration of the vast areas of study of TLE, and the importance it plays in the school curriculum coinciding with the expectation of turning students to technologically competent contributing members of the society, either in the field of Technical/Vocational Expertise or Entrepreneurial based competencies, as well as the government’s concern for it, we visualize TLE classroom teachers making use of multiple intelligence as basis for differentiated classroom instruction in teaching the subject .Somehow, multiple intelligence sample such as Linguistic, Logical-Mathematical, Bodily-Kinesthetic, Interpersonal, Intrapersonal, and Spatial abilities that an individual student may have or may not have, can be a basis for a TLE teacher’s instructional method or design.

Keywords: education, multiple, differentiated classroom instruction, impact analysis

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Authors: Marco Ferretti, Marcello Risitano, Maria Cristina Pietronudo, Lina Ozturk

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A green port is the result of a sustainable long-term strategy adopted by an entire port infrastructure, therefore by the set of actors involved in port activities. The strategy aims to realise the development of sustainable port infrastructure focused on the reduction of negative environmental impacts without jeopardising economic growth. Green technology represents the core tool to implement sustainable solutions, however, they are not a magic bullet. Ports have always been integrated in the local territory affecting the environment in which they operate, therefore, the sustainable strategy should fit with the entire local systems. Therefore, adopting a sustainable strategy means to know how to involve and engage a wide stakeholders’ network (industries, production, markets, citizens, and public authority). The existing research on the topic has not well integrated this perspective with those of sustainability. Research on green ports have mixed the sustainability aspects with those on the maritime industry, neglecting dynamics that lead to the development of the green port phenomenon. We propose an analysis of green ports adopting the lens of ecosystem studies in the field of management. The ecosystem approach provides a way to model relations that enable green solutions and green practices in a port ecosystem. However, due to the local dimension of a port and the port trend on innovation, i.e., sustainable innovation, we draw to a specific concept of ecosystem, those on local innovation systems. More precisely, we explore if a green port is a local innovation system engaged in developing sustainable innovation with a large impact on the territory or merely an innovation adopter. To address this issue, we adopt a comparative case study selecting two innovative ports in Europe: Rotterdam and Genova. The case study is a research method focused on understanding the dynamics in a specific situation and can be used to provide a description of real circumstances. Preliminary results show two different approaches in supporting sustainable innovation: one represented by Rotterdam, a pioneer in competitiveness and sustainability, and the second one represented by Genoa, an example of technology adopter. The paper intends to provide a better understanding of how sustainable innovations are developed and in which manner a network of port and local stakeholder support this process. Furthermore, it proposes a taxonomy of green ports as developers and adopters of sustainable innovation, suggesting also best practices to model relationships that enable the port ecosystem in applying a sustainable strategy.

Keywords: green port, innovation, sustainability, local innovation systems

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Authors: Joonha Park

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This essay examines the Soviet Artist Pavel Korin’s artistic pursuit towards his life-long project, “Requiem/Passing of the Rus,” framing the funeral of Tikhon, the last great defender of the Russian orthodox Church during the Great purge, as the final moment of “Rus,” which is the identity of the Russian people that built up in the 1000 year of history behind Russian Orthodoxy. Korin’s project remains in the form of a series of 29 man-sized portraits and a monumental blank canvas. Born in a family dedicated to iconography, Korin witnessed the historic drama during Stalin’s terror; therefore, he tried to convey the nation’s mourning for the disappearance of “Rus” and disapproval of the Soviet notion of atheism. Yet, due to Korin’s success as a state artist, many believed that the political pressure led Korin to give up his belief and controversy arose over the fact that Korin left the canvas blank. The empty 40-square-meter canvas, which remains untouched in his studio since 1930, supports this theory to an extent. However, resources such as Korin’s notes, primary accounts from his fellow Soviet Artists, and testimonies from his wife suggested that this assumption is incorrect. Moreover, Korin’s uninterrupted relationship with the church and the religious attributes in his commissioned works were brought up as evidence of Korin’s continued belief. The empty canvas not only represents Korin’s discontentment towards the repression and the hardships that the Orthodox Church experienced, but also depicts the identity that coexisted with the Church in order to bequeath this idea to future generations. The faultless canvas surrounded by the striking 29 portraits is a symbol of the highest spirit, similar to that of the iconography paintings placed in every Russian house that unites the Russian people till this day, therefore one can deduce that the legacy of “Requiem” is still relevant to the Russian people even under freedom of religious expression. Consequently, “Requiem” was on display at the Tretyakov Gallery for the first time in public in 2013 even though Korin started creating this piece in 1925, extolling Korin not only as an artist but also as a historian; by recording the turmoil of the Great Oppression, Korin exhibited the social responsibility universal to artists across time and space. In this essay, the legacy Korin left behind, both to his contemporaries and his posterity is reevaluated through the lens of his works, unfinished as they were.

Keywords: Pavel Korin, Art History, Art, Russia, Soviet Union, Requiem, Russian orthodox church, Treytyakov gallery, contemporary art, socialist realism, Maxim Gorky

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Authors: Nivedita Paul

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The changing character of marriage be it arranged marriage, love marriage, polygamy, informal unions, all signify different gender relations in everyday lives. Marriages in India are part and parcel of the kinship and cultural practices. Arranged marriage is still the dominant form of marriage where spouse selection is the initiative and decision of the parents; but its form is changing, as women are now actively participating in spouse selection but with parental consent. Spouse selection related decision making is important because marriage as an institution brings social change and gender inequality; especially in a women’s life as marriages in India are mostly patrilocal. Moreover, the amount of say in spouse selection can affect a woman’s reproductive rights, domestic violence issues, household resource allocation, communication possibilities with the spouse/husband, marital life, etc. The present study uses data from Indian Human Development Survey II (2011-12) which is a nationally representative multitopic survey that covers 41,554 households. Currently, married women of age group 15-49 in their first marriage; whose year of marriage is from 1970s to 2000s have been taken for the study. Based on spouse selection experiences, the sample of women has been divided into three marriage categories-self, semi and family arranged. Women in self arranged or love marriage is the sole decision maker in choosing the partner, in semi arranged marriage or arranged marriage with consent both parents and women together take the decision, whereas in family arranged or arranged marriage without consent only parents take the decision. The main aim of the study is to find the relationship between spouse selection experiences and women’s autonomy in India. Decision making in economic matters, child and health related decision making, mobility and access to resources are taken to be proxies of autonomy. Method of ordinal regression has been used to find the relationship between spouse selection experiences and autonomy after marriage keeping other independent variables as control factors. Results show that women in semi arranged marriage have more decision making power regarding financial matters of the household, health related matters, mobility and accessibility to resources, when compared to women in family, arranged marriages. For freedom of movement and access to resources women in self arranged marriage have the highest say or exercise greatest power. Therefore, greater participation of women (even though not absolute control) in spouse selection may lead to greater autonomy after marriage.

Keywords: arranged marriage, autonomy, consent, spouse selection

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Authors: Cláudia Patrocínio, Beatriz Fernandes, Ana Filipa Pires

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

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

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Authors: Jose Luis Solleiro, Rosario Castanon, Laura Elena Martinez

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The State of Mexico is an administrative entity of Mexico, and it is one of the most important territories due to its great economic and social impact for the whole country, especially since it contributes with more than eight of the national Gross Domestic Product (GDP). The State of Mexico has a population of over seventeen million people and host very important business and productive industries such as Automotive, Chemicals, Pharmaceutical, and Agri-food. In 2017, the State Development Plan (Plan Estatal de Desarrollo in Spanish) which is a policy document that rules State's economic actions and integrates the bases for sectoral and regional programs to achieve regional development), raised innovation as a key aspect to boost competitiveness and productivity of the State of Mexico. Therefore, in line with this proposal, in 2018 the Mexican Council for Science and Technology (COMECYT for its acronym in Spanish), an institution in charge of promoting public science and technology policies in the State of Mexico, took actions towards building up the State´s Innovation System. Hence, the main objective of this paper is to review and analyze the process to create RIS in the State of Mexico. We focus on the key elements of the process, the diverse actors that were involved in it, the activities that were carried out and the identification of the challenges, findings, successes, and failures of the intended exercise. The methodology used to analyze the structure of the Innovation System of the State of Mexico is based on two elements: the case study and the research-action approach. The main objective of the paper, the case study was based on semi-structured interviews with key actors who have participated in the process of launching the RIS of the State of Mexico. Additionally, we analyzed the information reports and other documents that were elaborated during the process of shaping the State's innovation system. Finally, the results obtained in the process were also examined. The relevance of this investigation fundamentally rests in two elements: 1) keeping documental record of the process of building a RIS in Mexico; and 2) carrying out the analysis of this case study recognizing the importance of knowledge extraction and dissemination, so that lessons on this matter may be useful for similar experiences in the future. We conclude that in Mexico, documentation and analysis efforts related to the formation of RIS and interaction processes between innovation ecosystem actors are scarce, so documents like are of great importance, especially since it generates a series of findings and recommendations for the building of RIS.

Keywords: regional innovation systems, innovation, development, competitiveness

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Authors: Edwin Dankano

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Evident by incessant and sporadic attacks on Nigerians poise a serious threat to the unity of Nigeria, and secondly, the single biggest security nightmare to confront Nigeria since after amalgamation of the Southern and Northern protectorates by the British colonialist in 1914 is “Boko Haram” a terrorist organization also known as “Jama’atul Ahli Sunnah Lidda’wati wal Jihad”, or “people committed to the propagation of the Prophet’s teachings and jihad”. The sect also upholds an ideology translated as “Western Education is forbidden”, or rejection of Western civilization and institutions. By some estimates, more than 5,500 people were killed in Boko Haram attacks in 2014, and Boko Haram attacks have already claimed hundreds of lives and territories {caliphates}in early 2015. In total, the group may have killed more than 10,000 people since its emergence in the early 2000s. More than 1 million Nigerians have been displaced internally by the violence, and Nigerian refugee figures in neighboring countries continue to rise. This paper is predicated on secondary sources of data and anchored on the Huntington’s theory of clash of civilization. As such, the paper argued that the rise of Boko Haram with its violent disposition against Western values is a counter response to Western civilization that is fast eclipsing other civilizations. The paper posits that the Boko Haram insurrection going by its teachings, and destruction of churches is a validation of the propagation of the sect as a religious revolt which has resulted in dire humanitarian situation in Adamawa, Borno, Yobe, Bauchi, and Gombe states all in north eastern Nigeria as evident in human casualties, human right abuses, population displacement, refugee debacle, livelihood crisis, and public insecurity. The paper submits that the Nigerian state should muster the needed political will in terms of a viable anti-terrorism measures and build strong legitimate institutions that can adequately curb the menace of corruption that has engulfed the military hierarchy, respond proactively to the challenge of terrorism in Nigeria and should embrace a strategic paradigm shift from anti-terrorism to counter-terrorism as a strategy for containing the crisis that today threatens the secular status of Nigeria.

Keywords: Boko Haram, civilization, fundamentalism, Islam, religion revolt, terror

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Authors: Asiye Nisa Kartal

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An attempt to recognize the undiscovered bounds of Istiklal Street in Istanbul between its sensory experiences (intangible qualities) and physical setting (tangible qualities) could be taken as the first inspiration point for this study. ‘The dramatic physical changes’ and ‘their current impacts on sensory attributions’ of Istiklal Street have directed this study to consider the role of changing the physical layout on sensory dimensions which have a subtle but important role in the examination of urban places. The public places have always been subject to transformation, so in the last years, the changing socio-cultural structure, economic and political movements, law and city regulations, innovative transportation and communication activities have resulted in a controversial modification of Istanbul. And, as the culture, entertainment, tourism, and shopping focus of Istanbul, Istiklal Street has witnessed different changing stages within the last years. In this process, because of the projects being implemented, many buildings such as cinemas, theatres, and bookstores have restored, moved, converted, closed and demolished which have been significant elements in terms of the qualitative value of this area. And, the multi-layered socio-cultural, and architectural structure of Istiklal Street has been changing in a dramatical and controversial way. But importantly, while the physical setting of Istiklal Street has changed, the transformation has not been spatial, socio-cultural, economic; avoidably the sensory dimensions of Istiklal Street which have great importance in terms of intangible qualities of this area have begun to lose their distinctive features. This has created the challenge of this research. As the main hypothesis, this study claims that the physical transformations have led to change in the sensory characteristic of Istiklal Street, therefore the Sensescape of Istiklal Street deserve to be recorded, decoded and promoted as expeditiously as possible to observe the sensory reflections of physical transformations in this area. With the help of the method of ‘Sensewalking’ which is an efficient research tool to generate knowledge on sensory dimensions of an urban settlement, this study suggests way of ‘mapping’ to understand how do ‘changes of physical setting’ play role on ‘sensory qualities’ of Istiklal Street which have been changed or lost over time. Basically, this research focuses on the sensory mapping of Istiklal Street from the 1990s until today to picture, interpret, criticize the ‘sensory mapping of Istiklal Street in present’ and the ‘sensory mapping of Istiklal Street in past’. Through the sensory mapping of Istiklal Street, this study intends to increase the awareness about the distinctive sensory qualities of places. It is worthwhile for further studies that consider the sensory dimensions of places especially in the field of architecture.

Keywords: Istiklal street, sense, sensewalking, sensory mapping

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: Suganya Chandrababu, Dhundy Bastola

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Like in the gut, the subgingival microbiota plays a crucial role in oral hygiene, health, and cariogenic diseases. Human activities like diet, antibiotics, and periodontal treatments alter the bacterial communities, metabolism, and functions in the oral cavity, leading to a dysbiotic state and changes in the plaques of orthodontic patients. Fixed periodontal appliances hinder oral hygiene and cause changes in the dental plaques influencing the subgingival microbiota. However, the microbial species’ diversity and complexity pose a great challenge in understanding the taxa’s community distribution patterns and their role in oral health. In this research, we analyze the subgingival microbial samples from individuals with fixed dental appliances (metal/clear) using an in silico approach. We employ exploratory hypothesis-driven multivariate and regression analysis to shed light on the microbial community and its functional fluctuations due to dental appliances used and identify risks associated with complex disease phenotypes. Our findings confirm the changes in oral microbiota composition due to the presence and type of fixed orthodontal devices. We identified seven main periodontic pathogens, including Bacteroidetes, Actinobacteria, Proteobacteria, Fusobacteria, and Firmicutes, whose abundances were significantly altered due to the presence and type of fixed appliances used. In the case of metal braces, the abundances of Bacteroidetes, Proteobacteria, Fusobacteria, Candidatus saccharibacteria, and Spirochaetes significantly increased, while the abundance of Firmicutes and Actinobacteria decreased. However, in individuals With clear braces, the abundance of Bacteroidetes and Candidatus saccharibacteria increased. The highest abundance value (P-value=0.004 < 0.05) was observed with Bacteroidetes in individuals with the metal appliance, which is associated with gingivitis, periodontitis, endodontic infections, and odontogenic abscesses. Overall, the bacterial abundances decrease with clear type and increase with metal type of braces. Regression analysis further validated the multivariate analysis of variance (MANOVA) results, supporting the hypothesis that the presence and type of the fixed oral appliances significantly alter the bacterial abundance and composition.

Keywords: oral microbiota, statistical analysis, fixed or-thodontal appliances, bacterial abundance, multivariate analysis, regression analysis

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Authors: Joshua Fogel, Rivka Herzog

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Although direct-to-consumer prescription medication advertisements (DTCA) are viewed or heard in many venues, there does not appear to be any research for internet social media DTCA. We study the association of traditional media DTCA and digital media DTCA including internet social media of YouTube, Facebook, and Twitter with three different outcomes. There was one intentions outcome and two different behavior outcomes. The intentions outcome was the agreement level for seeking additional information about a prescription medication after seeing a DTCA. One behavior outcome was the agreement level for obtaining additional information about a prescription medication after seeing a DTCA. The other behavior outcome was the frequency level for obtaining additional information about a prescription medication after seeing a DTCA. Surveys were completed by 635 college students. Predictors included demographic variables, theory of planned behavior variables, health variables, and advertisements seen or heard. Also, in the behavior analyses, additional predictors of intentions and sources for seeking additional prescription drug information were included. Multivariate linear regression analyses were conducted. We found that increased age was associated with increased behavior, women were associated with increased intentions, and Hispanic race/ethnicity was associated with decreased behavior. For the theory of planned behavior variables, increased attitudes were associated with increased intentions, increased social norms were associated with increased intentions and behavior, and increased intentions were associated with increased behavior. Very good perceived health was associated with increased intentions. Advertisements seen in spam mail were associated with decreased intentions. Advertisements seen on traditional or cable television were associated with decreased behavior. Advertisements seen on television watched on the internet were associated with increased behavior. The source of seeking additional information of reading internet print content was associated with increased behavior. No internet social media advertisements were associated with either intentions or behavior. In conclusion, pharmaceutical brand managers and marketers should consider these findings when tailoring their DTCA advertising campaigns and directing their DTCA advertising budget towards young adults such as college students. They need to reconsider the current approach for traditional television DTCA and also consider dedicating a larger advertising budget toward internet television DTCA. Although internet social media is a popular place to advertise, the financial expenditures do not appear worthwhile for DTCA when targeting young adults such as college students.

Keywords: brand managers, direct-to-consumer advertising, internet, social media

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

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

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

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Authors: Sandeep Nath

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There are good stresses and bad stresses. To tell the difference, recognize early signs of stress, and label stress conditions correctly, we need to understand stress triggers and the mechanism of stress as it arises. By understanding this through mindfulness of body, mind, and spirit, we can be prepared to prevent harmful stress from escalating and ruining health; physical, mental, and emotional. We can also prepare others/peers to be stress-free. The understanding of this is available in a form closest to our natural being, in ancient oriental wisdom, and is brought together as actionable habits in the movement called RENEWALism. The constructs of RENEWALism Habits are detailed in this paper, and case studies presented of how mindfulness has equipped individuals with both capability and capacity to handle their situations and environments despite the odds.

Keywords: habits, mindfulness, renewalism, stress

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Authors: Johanna Sagner, María José Sandoval

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At the early stages of adolescence, young people, regardless of a disability or not, start to establish closer friendship ties. Unlike previous developmental phases, these ties are rather reciprocal, more committed, and require more time. Friendship ties during adolescence allow the development of social and personal skills, specifically the skills to start constructing identity. In an inclusive context that incorporates young people with a disability, friendship among peers also takes place. Nonetheless, the relation is shaped, among others, by the alterity construction about the other with disability. Research about peers’ relation between young people with and without disability in an inclusive context has shown that the relation tends to become a helper-helpee relation, where those with a disability are seen as people in need. Prejudices about the others’ condition or distancing from the other because of his/hers disability are common. In this sense, the helper-helpee relation, as a non-reciprocal and protective relation, will not promote friendship between classmates, but a rather asymmetric alterity. Our research is an explorative case study that wants to know how the relation between peers is shaped within a different inclusive program, were also the integrated group has special educational needs. Therefore, we analyze from a qualitative and quantitative approach the data of an inverted inclusive program. This is a unique case of a special public school for visual disability in Germany that includes young people from a mainstream school who had learning difficulties. For the research, we analyze data from interviews, focal interviews and open-ended questions with an interpretative phenomenological analysis approach. The questionnaires include a five point Likert scale, for which we calculate the acceptance rate. The findings show that the alterity relation between pupils is less asymmetrical and represents a rather horizontal alterity. The helper-helpee relation is marked by exchange, since both groups have special educational needs and therefore, those with visual disability and those with learning difficulties help each other indistinctly. Friendship is more present among classmates. The horizontal alterity peers’ relation is influenced by a sort of tie, where none of the groups need more or less help than other groups. Both groups identify that they themselves and the other have special needs. The axiological axe of alterity is not of superiority or inferiority, recognizing each other’s differences and otherness. Another influential factor relates with the amount of time they spend together, since the program does not have a resource room or a teacher who teaches parallel lessons. Two probable causes for that rather equal peer relation might be the constellation of fewer pupils per classroom and the differentiated lessons taught by teachers with a special educational formation.

Keywords: alterity, disability, inverted inclusion, peers’ relation

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