Search results for: the Buddhist meditated practitioners

Authors: Michele M. Mahr

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The purpose of this study is to educate, inform, and facilitate scholarly conversation and discussion regarding the implementation of mindfulness techniques when working with individuals with substance use disorder (SUD) or addictive behaviors in mental health. Mindfulness can be recognized as the present moment, non-judgmental awareness, initiated by concentrated attention that is non-reactive and as openheartedly as possible. Individuals with SUD or addiction typically are challenged with triggers, environmental situations, cravings, or social pressures which may deter them from remaining abstinent from their drug of choice or addictive behavior. Also, mindfulness is recognized as one of the cognitive and behavioral treatment approaches and is both a physical and mental practice that encompasses individuals to become aware of internal situations and experiences with undivided attention. That said, mindfulness may be an effective strategy for individuals to employ during these experiences. This study will reveal how mental health practitioners and addiction counselors may find mindfulness to be an essential component of increasing wellness when working with individuals seeking mental health treatment. To this end, mindfulness is simply the ability individuals have to know what is actually happening as it is occurring and what they are experiencing at the moment. In the context of substance abuse and addiction, individuals may employ breathing techniques, meditation, and cognitive restructuring of the mind to become aware of present moment experiences. Furthermore, the notion of mindfulness has been directly connected to the development of neuropathways. The creation of the neural pathways then leads to creating thoughts which leads to developing new coping strategies and adaptive behaviors. Mindfulness strategies can assist individuals in connecting the mind with the body, allowing the individual to remain centered and focused. All of these mentioned above are vital components to recovery during substance abuse and addiction treatment. There are a variety of therapeutic modalities applying the key components of mindfulness, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy for depression (MBCT). This study will provide an overview of both MBSR and MBCT in relation to treating individuals with substance abuse and addiction. The author will also provide strategies for readers to employ when working with clients. Lastly, the author will create and foster a safe space for discussion and engaging conversation among participants to ask questions, share perspectives, and be educated on the numerous benefits of mindfulness within wellness.

Keywords: mindfulness, wellness, substance abuse, mental health

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Authors: Diana K. Kwok

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Despite the fact that Hong Kong government aims to develop an inclusive society, sexual minority students continue to encounter sexual prejudice without legal protection. They also have difficulties accessing relevant services from mental health and educational professionals, who do not receive systematic training to work with sexual minority students. Informed by the literature on sexual prejudice, heterosexual hegemony, genderism, as well as code of practice for frontline practitioners, the authors explored self-perceived knowledge of teachers and sexual minorities on sexuality and sexual prejudice, and how they perceive prejudice towards sexual minorities in Chinese cultural context. Semi-structure qualitative interviews were carried out with 31 school personnel informants (school teachers and counseling team members) and 25 sexual minority informants on their understanding of sexuality knowledge, their perception of sexual prejudice within school context in Hong Kong, as well as their suggested themes on teachers training on sexual prejudice reduction. This presentation specifically focuses on transcripts from sexual minority informants. Data analysis was carried out through NVivo, and followed the procedures spelt out in the qualitative research literature. Trustworthiness of the study was addressed through various strategies. Preliminary themes emerged from transcript content analysis: 1) A gap of knowledge between sexual minority informants and teachers; 2) Perception on sexual prejudice within cultural context; 3) Heterosexual hegemony and genderism within school system; 4) Needs for mandatory training: contents and strategies. The sexual minority informants found that teachers they encountered were predominantly adopted concepts of binary sex and dichotomous gender. Informants also indicated that the teachings of Confucianism cultural values, religiosity in Hong Kong might well be important cultural forces contributing to sexual prejudice manifested in school context. Although human rights and social justice concepts were embedded in professional code of practice of teachers and school helping professionals, informants found that teachers they encountered may face a dilemma when supporting sexual minority students navigating heterosexual hegemony and genderism in, as a consequence of their personal, institutional, cultural and religious backgrounds. Acknowledgments: The sexual prejudice project was funded by the Hong Kong Research Grant Council (ECS28401614), 2015 to 2017.

Keywords: sexual prejudice, Chinese teachers, Chinese sexual minorities, teacher training

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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Authors: Kumar Shashvat, Amol P. Bhondekar

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In the midst of the five senses, odor is the most reminiscent and least understood. Odor testing has been mysterious and odor data fabled to most practitioners. The delinquent of recognition and classification of odor is important to achieve. The facility to smell and predict whether the artifact is of further use or it has become undesirable for consumption; the imitation of this problem hooked on a model is of consideration. The general industrial standard for this classification is color based anyhow; odor can be improved classifier than color based classification and if incorporated in machine will be awfully constructive. For cataloging of odor for peas, trees and cashews various discriminative approaches have been used Discriminative approaches offer good prognostic performance and have been widely used in many applications but are incapable to make effectual use of the unlabeled information. In such scenarios, generative approaches have better applicability, as they are able to knob glitches, such as in set-ups where variability in the series of possible input vectors is enormous. Generative models are integrated in machine learning for either modeling data directly or as a transitional step to form an indeterminate probability density function. The algorithms or models Linear Discriminant Analysis and Naive Bayes Classifier have been used for classification of the odor of cashews. Linear Discriminant Analysis is a method used in data classification, pattern recognition, and machine learning to discover a linear combination of features that typifies or divides two or more classes of objects or procedures. The Naive Bayes algorithm is a classification approach base on Bayes rule and a set of qualified independence theory. Naive Bayes classifiers are highly scalable, requiring a number of restraints linear in the number of variables (features/predictors) in a learning predicament. The main recompenses of using the generative models are generally a Generative Models make stronger assumptions about the data, specifically, about the distribution of predictors given the response variables. The Electronic instrument which is used for artificial odor sensing and classification is an electronic nose. This device is designed to imitate the anthropological sense of odor by providing an analysis of individual chemicals or chemical mixtures. The experimental results have been evaluated in the form of the performance measures i.e. are accuracy, precision and recall. The investigational results have proven that the overall performance of the Linear Discriminant Analysis was better in assessment to the Naive Bayes Classifier on cashew dataset.

Keywords: odor classification, generative models, naive bayes, linear discriminant analysis

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Authors: Stefan Ninković

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The main purpose of this paper is to examine the different theoretical approaches and relevant empirical evidence and thus, recognize some of the most pressing challenges faced by school leaders. This paper starts from the fact that the new mission of the school is characterized by the need for stronger coordination among students' academic, social and emotional learning. In this sense, school leaders need to focus their commitment, vision and leadership on the issues of students' attitudes, language, cultural and social background, and sexual orientation. More specifically, they should know what a good teaching is for student’s at-risk, students whose first language is not dominant in school, those who’s learning styles are not in accordance with usual teaching styles, or who are stigmatized. There is a rather wide consensus around the fact that the traditionally popular concept of instructional leadership of the school principal is no longer sufficient. However, in a number of "pro-leadership" circles, including certain groups of academic researchers, consultants and practitioners, there is an established tendency of attributing school principal an extraordinary influence towards school achievements. On the other hand, the situation in which all employees in the school are leaders is a utopia par excellence. Although leadership obviously can be efficiently distributed across the school, there are few findings that speak about sources of this distribution and factors making it sustainable. Another idea that is not particularly new, but has only recently gained in importance is related to the fact that the collective capacity of the school is an important resource that often remains under-cultivated. To understand the nature and power of collaborative school cultures, it is necessary to know that these operate in a way that they make their all collective members' tacit knowledge explicit. In this sense, the question is how leaders in schools can shape collaborative culture and create social capital in the school. Pressure exerted on schools to systematically collect and use the data has been accompanied by the need for school leaders to develop new competencies. The role of school leaders is critical in the process of assessing what data are needed and for what purpose. Different types of data are important: test results, data on student’s absenteeism, satisfaction with school, teacher motivation, etc. One of the most important tasks of school leaders are data-driven decision making as well as ensuring transparency of the decision-making process. Finally, the question arises whether the existing models of school leadership are compatible with the current social and economic trends. It is necessary to examine whether and under what conditions schools are in need for forms of leadership that are different from those that currently prevail. Closely related to this issue is also to analyze the adequacy of different approaches to leadership development in the school.

Keywords: educational changes, leaders, leadership, school

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Authors: Gruffydd E. Jones

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The world’s largest collection of historical, cultural, and heritage material is unarchived and undocumented in the hands of the public. Not only does this material represent the missing collections in heritage sector archives today, but it is also the key to providing a diverse range of communities with the means to express their history in their own words and to celebrate their unique, personal heritage. The People’s Collection Wales (PCW) acts as a platform on which the heritage of Wales and her people can be collated and shared, at the heart of which is a thriving community engagement programme across a network of museums, archives, and libraries. By providing communities with the archival skillset commonly employed throughout the heritage sector, PCW enables local projects, societies, and individuals to express their understanding of local heritage with their own voices, empowering communities to embrace their diverse and complex identities around Wales. Drawing on key examples from the project’s history, this paper will demonstrate the successful way in which museums have been developed as hubs for community engagement where the public was at the heart of collection and documentation activities, informing collection and curatorial policies to benefit both the institute and its local community. This paper will also highlight how collections from marginalised, under-represented, and minority communities have been published and celebrated extensively around Wales, including adoption by the education system in classrooms today. Any activity within the heritage sector, whether of collection, preservation, digitisation, or accessibility, should be considerate of community engagement opportunities not only to remain relevant but in order to develop as community hubs, pivots around which local heritage is supported and preserved. Attention will be drawn to our digitisation workflow, which, through training and support from museums and libraries, has allowed the public not only to become involved but to actively lead the contemporary evolution of documentation strategies in Wales. This paper will demonstrate how the PCW online access archive is promoting museum collections, encouraging user interaction, and providing an invaluable platform on which a broader community can inform, preserve and celebrate their cultural heritage through their own archival material too. The continuing evolution of heritage engagement depends wholly on placing communities at the heart of the sector, recognising their wealth of cultural knowledge, and developing the archival skillset necessary for them to become archival practitioners of their own.

Keywords: social history, cultural heritage, community heritage, museums, archives, libraries, community engagement, oral history, community archives

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Authors: Ali Benali Djouher Leila

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Labiovelarization of velar consonants and labials is a very widespread phenomenon. It is attested in all the major northern Berber dialects. Only the Tuareg is totally unaware of it. But, even within the large Berber-speaking regions of the north, it is very unstable: it may be completely absent in certain dialects (such as the Bougie region in Kabylie), and its extension and frequency can vary appreciably between the dialects which know it. Some dialects of Great Kabylia or the Chleuh domain, for example, "labiovélarize" more than others from the same region. Thus, in Great Kabylia, the adjective "large" will be pronounced: amqqwran with the At Yiraten and amqqran with the At Yanni, a few kilometers away. One of the problems with them is deciding whether it is one or two phonemes. All the criteria used by linguists in this kind of case lead to the conclusion that they are unique phonemes (a phoneme and not a succession of two phonemes, / k + w /, for example). The phonetic and phonological criteria are moreover clearly confirmed by the morphological data since, in the system of verbal alternations, these complex segments are treated as single phonemes: agree, "to draw, to fetch water," akwer, "to fly," have exactly the same morphology as as "jealous," arem" taste," Ames, "dirty" or afeg, "steal" ... verbs with two radical consonants (type aCC). At the level of notation, both scientific and usual, it is, therefore, necessary to represent the labiovélarized by a single letter, possibly accompanied by a diacritic. In fact, actual practices are diverse. - The scientific representation of type does not seem adequate for current use because its realization is easy only on a microcomputer. The Berber Documentation File used a small ° (of n °) above the writing line: k °, g ° ... which has the advantage of being easy to achieve since it is part of general typographical conventions in Latin script and that it is present on a typewriter keyboard. Mouloud Mammeri, then the Berber Study Group of Vincennes (Tisuraf review), and a majority of Kabyle practitioners over the last twenty years have used the succession "consonant +" semi-vowel / w / "(CW) on the same line of writing; for all the reasons explained previously, this practice is not a good solution and should be abandoned, especially as it particularizes Kabyle in the Berber ensemble. In this study, we were interested in two velar consonants, / g / and / k /, labiovellarized: / gw / and the / kw / (we adopted the addition of the "w") for the representation for ease of writing in graphical mode. It is a question of trying to characterize these four consonants in order to see if they have different places of articulation and if they are distinct (if these velars are distinct from their labiovellarized counterpart). This characterization is done using locus equations.

Keywords: berber consonants;, labiovelarization, locus equations, acoustical caracterization, kabylian dialect, algerian language

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Authors: Peniah Mabaso-Shamano

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The paper evaluates Shona terms that were created to teach Phonetics and Phonology courses at Great Zimbabwe University (GZU). The phonetics and phonology terms to be discussed in this paper were created using different processes and strategies such as translation, borrowing, neologising, compounding, transliteration, circumlocution among many others. Most phonetics and phonology terms are alien to Shona and as a result, there are no suitable Shona equivalents. The lecturers and students for these courses have a mammoth task of creating terminology for the different modules offered in Shona and other Zimbabwean indigenous languages. Most linguistic reference books are written in English. As such, lecturers and students translate information from English to Shona, a measure which is proving to be too difficult for them. A term creation workshop was held at GZU to try to address the problem of lack of terminology in indigenous languages. Different indigenous language practitioners from different tertiary institutions convened for a two-day workshop at GZU. Due to the 'specialized' nature of phonetics and phonology, it was too difficult to come up with 'proper' indigenous terms. The researcher will consult tertiary institutions lecturers who teach linguistics courses and linguistics students to get their views on the created terms. The people consulted will not be the ones who took part in the term creation workshop held at GZU. The selected participants will be asked to evaluate and back-translate some of the terms. In instances where they feel the terms created are not suitable or user-friendly, they will be asked to suggest other terms. Since the researcher is also a linguistics lecturer, her observation and views will be important. From her experience in using some of the terms in teaching phonetics and phonology courses to undergraduate students, the researcher noted that most of the terms created have shortcomings since they are not user-friendly. These shortcomings include terms longer than the English terms as some terms are translated to Shona through a whole statement. Most of these terms are neologisms, compound neologisms, transliterations, circumlocutions, and blends. The paper will show that there is overuse of transliterated terms due to the lack of Shona equivalents for English terms. Most single English words were translated into compound neologisms or phrases after attempts to reduce them to one word terms failed. In other instances, circumlocution led to the problem of creating longer terms than the original and as a result, the terms are not user-friendly. The paper will discuss and evaluate the different phonetics and phonology terms created and the different strategies and processes used in creating them.

Keywords: blending, circumlocution, term creation, translation

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Authors: Roger M. Wall, David G. Proverbs, Yamina Silva, Danny Scipion

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This paper critically reviews the outcomes of a 4 day workshop focused on building resilience to El Niño related Flood Events in northern Perú. The workshop was run jointly by Birmingham City University (BCU) in partnership with Instituto Geofísico del Perú (IGP) and was hosted by the Universidad de Piura (UDEP). The event took place in August 2018 and was funded by the Newton-Paulet fund administered by the British Council. The workshop was a response to the severe flooding experienced in Piura during the El Niño event of March 2017 which damaged over 100,000 homes and destroyed much local infrastructure including around 100 bridges. El Niño is a recurrent event and there is concern that its frequency and intensity may change in the future as a consequence of climate change. A group of 40 early career researchers and practitioners from the UK and Perú were challenged with working together across disciplines to identify key cross-cutting themes and make recommendations for building resilience to similar future events. Key themes identified on day 1 of the workshop were governance; communities; risk information; river management; urban planning; health; and infrastructure. A field study visit took place on day 2 so that attendees could gain first-hand experience of affected and displaced communities. Each of the themes was then investigated in depth on day 3 by small interdisciplinary teams drawing on their own expertise, local knowledge and the experiences of the previous day’s field trip. Teams were responsible for developing frameworks for analysis of their chosen theme and presenting their findings to the whole group. At this point, teams worked together to develop links between the different themes so that an integrated approach could be developed and presented on day 4. This paper describes the approaches taken by each team and the way in which these were integrated to form an holistic picture of the whole system. The findings highlighted the importance of risk-related information and the need for strong governance structures to enforce planning regulations and development. The structured facilitation approach proved to be very effective and it is recommended that the process be repeated with a broader group of stakeholders from across the region.

Keywords: El Niño, integrated flood risk management, Perú, structured facilitation, systems approach, resilience

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Authors: Gulfam Haider, sana danish

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Convolutional Neural Networks (CNNs) have emerged as powerful tools for image classification, and the choice of optimizers profoundly affects their performance. The study of optimizers and their adaptations remains a topic of significant importance in machine learning research. While numerous studies have explored and advocated for various optimizers, the efficacy of these optimization techniques is still subject to scrutiny. This work aims to address the challenges surrounding the effectiveness of optimizers by conducting a comprehensive analysis and evaluation. The primary focus of this investigation lies in examining the performance of different optimizers when employed in conjunction with the popular activation function, Rectified Linear Unit (ReLU). By incorporating ReLU, known for its favorable properties in prior research, the aim is to bolster the effectiveness of the optimizers under scrutiny. Specifically, we evaluate the adjustment of these optimizers with both the original Softmax activation function and the modified ReLU activation function, carefully assessing their impact on overall performance. To achieve this, a series of experiments are conducted using a well-established benchmark dataset for image classification tasks, namely the Canadian Institute for Advanced Research dataset (CIFAR-10). The selected optimizers for investigation encompass a range of prominent algorithms, including Adam, Root Mean Squared Propagation (RMSprop), Adaptive Learning Rate Method (Adadelta), Adaptive Gradient Algorithm (Adagrad), and Stochastic Gradient Descent (SGD). The performance analysis encompasses a comprehensive evaluation of the classification accuracy, convergence speed, and robustness of the CNN models trained with each optimizer. Through rigorous experimentation and meticulous assessment, we discern the strengths and weaknesses of the different optimization techniques, providing valuable insights into their suitability for image classification tasks. By conducting this in-depth study, we contribute to the existing body of knowledge surrounding optimizers in CNNs, shedding light on their performance characteristics for image classification. The findings gleaned from this research serve to guide researchers and practitioners in making informed decisions when selecting optimizers and activation functions, thus advancing the state-of-the-art in the field of image classification with convolutional neural networks.

Keywords: deep neural network, optimizers, RMsprop, ReLU, stochastic gradient descent

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Authors: Gabriel G. Gaft, Xayvinay Xiong, Amanda Sunday

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The emergent pandemic from COVID-19 virus has forced people to adjust to major changes. These changes include all elements of family and work life and required people to engage in novel behaviors. For many people, the social norms to which they have been accustomed no longer prevail. Not surprisingly, such enormous changes in daily life have been associated with greater problems in mental health; and research regarding ways in which mental health professionals can support people is more necessary than ever before. It is often useful to assess people’s reactions through surveys and utilize quantitative data to answer questions about coping strategies etc. It is also likely, however, that a host of individual factors are going to contribute to what might be considered 'good' or 'bad' coping mechanisms to a worldwide pandemic. To this end, qualitative studies—where the individual’s subjective experience is highlighted—are likely to provide more vital information for mental health professionals interested in supporting the particular person in front of them. This study reports on qualitative data, where X participants were asked questions about social distancing, coping strategies, and general attitudes towards social changes resulting from the COVID-19 pandemic. Informal interviews were conducted during the months of June-July 2020. Data were analyzed using Interpretative Phenomenological Analyses. Themes were identified first for each participant and then compared across different individual participants. Several findings emerged. First, all participants understood major health messages being imparted by governing bodies such as the CDC and WHO. The researchers feel this finding is important as it suggests health messages are at least being effectively communicated. Second, there was a clear trend for themes which highlighted the conflicting emotions participants felt about the changes they were expected to endure: positive and negative elements were identified, although a participant who had pre-existing conditions placed greater emphasis on the negative elements. One participant who was particularly interested in impression management also exclusively emphasized negative emotions. Third, participants who were able to reevaluate priorities—what Lazarus might call secondary appraisals—experienced social distancing as a positive rather than negative phenomenon. Finally, participants who were able to develop specific strategies—such as boundaries for work and self-care—reported themes of adjustment and contentment. Taken together, these findings suggest mental health practitioners can assist people to adjust more positively through specific techniques focusing on re-evaluation of life priorities and strategic coping skills.

Keywords: COVID-19, pandemic, phenomenology, virus

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Authors: Lydia Ouma Radoli

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The paradox of documenting history through visuals that objectify gruesome images to depict the prominence of stories intrigues media researchers. In East Africa, the topic has been captured in a variety of media frames, but scantly in scholarly work. This paper adopts Visual Rhetoric and Framing Theories to tease out the drivers behind the criteria for the selection of violent visuals. The paper projects that quantitative and qualitative literature regarding journalists’ personal and work-related exposure to PSTD will give insights into the concept of trauma journalism - reporting of horrific events, e.g., violent crime and terror. The data will be collected through methods such as document analysis (photographs and videos) and in-depth interviews to summarize the informational contents with respect to the research objectives and questions. The study is hinged on the background that the criterion for news production is constructed from the idea that ‘if there’s violence, conflict, and death involved, the story gets top priority.’ The anticipated outcome is to establish trauma experiences of visual rhetors, suggest mitigations, and address gaps in academic research. The findings of the study will sustain the critical role of visual rhetors. Further, media practitioners may find the study useful in assessing the effects and values of visual witnessing. Historically, the criterion for visual news production has been that if there’s violence, conflict, and death involved, the story gets top priority. To capture the goriness of the images, media theorists and sociologists have used the expression: “If it bleeds, it leads.” The statement assumes that audiences are attracted to pictures that show violent images. Further, research on visual aspects of Television news has shown its ability to hold viewers’ attention and cause aggression. This paper samples images and narratives from Journalists who have covered trauma-related events. The samples are indicative of the problem under study, which depicts journalists exposed to traumatic events as not receiving any Psycho-social support within newsrooms. It is hoped that the study could inform policy and practice within developing countries through the interpretations of theoretical and empirical explanations of existing trauma phenomena among journalists.

Keywords: visual-witnessing, media culture, visual rhetoric, imaging violence in East Africa

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Authors: Frances Bernard Kominkiewicz

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Demonstrating the ability to build social justice and peace is integral in undergraduate and graduate education. Many disciplines are involved in peace education and peace studies, and the collaboration of those disciplines are examined in this paper. To the author’s best knowledge, no content analysis research previously existed regarding peace studies and peace education from a multidisciplinarity, interdisciplinarity, and transdisciplinarity perspective. Peacebuilding is taught through these approaches, which adds to the depth, breadth, and richness of peace education and peace studies. This paper presents a content analysis of academic peace studies programs and course descriptions. Variables studied include contributions and foci of disciplines in peace studies programs and students’ engagement in community peacebuilding. The social work discipline, for example, focuses on social and economic justice as one of the nine competencies that undergraduate and graduate students must attain before earning a Bachelor of Social Work degree or a Master of Social Work degree and becoming social work practitioners. Demonstrating the ability to build social justice and peace is integral in social work education. Peacebuilding is taught through such social work courses as conflict resolution, and social work practice with communities and organizations, and these courses are examined in this research through multidisciplinarity, interdisciplinarity, and transdisciplinarity approach. Peace and social justice are linked terms in various fields, including social work. Social justice is of paramount importance in social work programs, and social workers are trained to advocate for human rights and social, economic, and environmental justice. Social workers use knowledge of oppression, globally as well as nationally, in the practice of peace education and peace studies. Social work is at the forefront in advocating for social justice as a discipline and joins with other educators in strengthening the peacebuilding opportunities for students. The content analysis, conducted through a random sample of peace studies and peace education university and college programs in the United States, found that although courses teach the concepts of peace education and peace studies, courses often are not given these titles in the social work discipline. Therefore, this analysis also includes a discussion of the multidisciplinarity, interdisciplinarity, and transdisciplinarity approach to peace education, peace studies, and peacebuilding and the importance of these approaches in educating students about peace. The content analysis further found great variability in the number of disciplines involved in peace studies programs, the focus of those disciplines in peace education, the placement of peace studies and peace education within the university or college, and the number of courses and concentrations available in peace studies and peace education. In conclusion, the research points toward very robust and diverse approaches to peace education with opportunities for further research and discussion.

Keywords: content analysis, interdisciplinarity, multidisciplinarity, peace education programs

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Authors: M. L. W. P. De Silva, R. A. C. Rabel, N. Smith, L. McIntyre, T. J Parkinson, K. A. N. Wijayawardhane

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Curricular integration is an important concept in medical education for developing students’ ability to create connections between different medical disciplines. Problem-Based Learning (PBL) is one of the vehicles through which such integration can be achieved. During the recent review of the veterinary curriculum at the University of Peradeniya, a series of courses in Integrative Veterinary Science (IVS) were introduced, in which PBL was the primary teaching methodology. The objectives of this study were to evaluate students’ opinions on PBL as a teaching method: it should be noted that, within the context of secondary and tertiary education in Sri Lanka, this would be an entirely novel learning experience for the students. Opinions were sought at the conclusion of IVS sessions where students of semesters 2, 4, 6, and 7 (of an 8-semester program) were exposed to a two, 2-hour PBL-based case scenario. The PBL-based case scenario in semesters 2, 4, and 7 were delivered using material previously developed by an experienced PBL practitioner, whilst material for semester 6 was prepared de novo by a less experienced practitioner. Each student (semesters 2: n=38, 4: n=37, 6: n=55, and 7: n=40) completed a questionnaire which asked whether: (i) the course had improved their critical thinking skills; (ii) the learning environment was sufficiently comfortable to express/share student’s opinion; (iii) there was sufficient facilitator guidance; (iv) the online study environment enhanced learning; and (v) the students were overall satisfied with the PBL approach and IVS concept. Responses were given on a 5-point Likert-scale (strongly agree (SA), agree (A), neutral (N), disagree (D), and strongly disagree (SD)). SA and A responses were summed to provide an overall ‘satisfactory’ response. Results were subjected to frequency-distribution statistical analysis. A total of 88.5% of students gave SA+A scores to their overall satisfaction. The proportion of SA+A scores differed between different semesters, such that 95% of semester 2, 4, and 7 students gave SA+A scores, whereas only 69% of semester 6 students did so for their respective sessions. Overall, 96% of the students gave SA+A scores to the question relating to the improvement of critical thinking skills: semester 6 students’ scores were marginally, but not significantly, lower (91% SA+A) than those in other semesters. The difference of scores between semester 6 and the other semesters may be attributed to the different PBL-material used and/or the different experience levels of the practitioners that developed the study material. The use of PBL as a means of teaching IVS curriculum-integration courses was well-received by the students in terms of their overall satisfaction and their perceptions of improved critical thinking skills. Importantly, this was achieved in the face of a methodology that was entirely novel to the students. Finally, the delivery of the PBL medium was readily mastered by the practitioner to whom it was also a novel methodology.

Keywords: critical thinking skills, integration, problem based learning, veterinary education

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Authors: Kanika Gupta, Ashok Kumar

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Biofilms are dense, highly hydrated cell clusters that are irreversibly attached to a substratum, to an interface or to each other, and are embedded in a self-produced gelatinous matrix composed of extracellular polymeric substances. Research in biofilm field has become very significant, as biofilm has shown high mechanical resilience and resistance to antibiotic treatment and constituted as a significant problem in both healthcare and other industry related to microorganisms. The massive information both stated and hidden in the biofilm literature are growing exponentially therefore it is not possible for researchers and practitioners to automatically extract and relate information from different written resources. So, the current work proposes and discusses the use of text mining techniques for the extraction of information from biofilm literature corpora containing 34306 documents. It is very difficult and expensive to obtain annotated material for biomedical literature as the literature is unstructured i.e. free-text. Therefore, we considered unsupervised approach, where no annotated training is necessary and using this approach we developed a system that will classify the text on the basis of growth and development, drug effects, radiation effects, classification and physiology of biofilms. For this, a two-step structure was used where the first step is to extract keywords from the biofilm literature using a metathesaurus and standard natural language processing tools like Rapid Miner_v5.3 and the second step is to discover relations between the genes extracted from the whole set of biofilm literature using pubmed.mineR_v1.0.11. We used unsupervised approach, which is the machine learning task of inferring a function to describe hidden structure from 'unlabeled' data, in the above-extracted datasets to develop classifiers using WinPython-64 bit_v3.5.4.0Qt5 and R studio_v0.99.467 packages which will automatically classify the text by using the mentioned sets. The developed classifiers were tested on a large data set of biofilm literature which showed that the unsupervised approach proposed is promising as well as suited for a semi-automatic labeling of the extracted relations. The entire information was stored in the relational database which was hosted locally on the server. The generated biofilm vocabulary and genes relations will be significant for researchers dealing with biofilm research, making their search easy and efficient as the keywords and genes could be directly mapped with the documents used for database development.

Keywords: biofilms literature, classifiers development, text mining, unsupervised learning approach, unstructured data, relational database

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Authors: Inje Cho

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The leading health risks threatening the world today are associated with a modern lifestyle characterized by sedentary behavior, stress, anxiety, and an obesogenic food environment. To counter this alarming trend, the Centers for Disease Control and Prevention have proffered Physical Activity guidelines to bolster physical engagement. Concurrently, the burgeon of smartphones and mobile applications has witnessed a proliferation of fitness applications aimed at invigorating exercise adherence and real-time activity monitoring. Grounded in the Uses and gratification theory, this study delves into the technological affordances of mobile fitness applications, discerning the mediating influences of escapism and social outcome expectations on attitudes and exercise intention. The theory explains how individuals employ distinct communication mediums to satiate their exigencies and desires. Technological affordances manifest as attributes of emerging technologies that galvanize personal engagement in physical activities. Several features of mobile fitness applications include affordances for goal setting, virtual rewards, peer support, and exercise information. Escapism, denoting the inclination to disengage from normal routines, has emerged as a salient motivator for the consumption of new media. This study postulates that individual’s perceptions technological affordances within mobile fitness applications, can affect escapism and social outcome expectations, potentially influencing attitude, and behavior formation. Thus, the integrated model has been developed to empirically examine the interrelationships between technological affordances, escapism, social outcome expectations, and exercise intention. Structural Equation Modelling serves as the methodological tool, and a cohort of 400 Fitbit users shall be enlisted from the Prolific, data collection platform. A sequence of multivariate data analyses will scrutinize both the measurement and hypothesized structural models. By delving into the effects of mobile fitness applications, this study contributes to the growing of new media studies in sport management. Moreover, the novel integration of the uses and gratification theory, technological affordances, via the prism of escapism, illustrates the dynamics that underlies mobile fitness user’s attitudes and behavioral intentions. Therefore, the findings from this study contribute to theoretical understanding and provide pragmatic insights to developers and practitioners in optimizing the impact of mobile fitness applications.

Keywords: technological affordances, uses and gratification, mobile fitness apps, escapism, physical activity

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Authors: Annette Cosgrove, Carina Ginty, Tony Hall, Cornelia Connolly

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The objectives of this research study is to examine the impact of professional development in Technology Enhanced Learning (TEL) and the digitization of learning in teaching communities across multiple higher education sites in the ATU (Atlantic Technological University *) ( 2020-2025), including the proposal of an evidence-based digital teaching model for use in a future pandemic. The research strategy undertaken for this study is a multi-site study using mixed methods. Qualitative & quantitative methods are being used in the study to collect data. A pilot study was carried out initially, feedback was collected and the research instrument was edited to reflect this feedback before being administered. The purpose of the staff questionnaire is to evaluate the impact of professional development in the area of TEL, and to capture the practitioner's views on the perceived impact on their teaching practice in the higher education sector across ATU (West of Ireland – 5 Higher education locations ). The phenomenon being explored is ‘ the impact of professional development in the area of technology-enhanced learning and on teaching practice in a higher education institution. The research methodology chosen for this study is an Action based Research Study. The researcher has chosen this approach as it is a prime strategy for developing educational theory and enhancing educational practice. This study includes quantitative and qualitative methods to elicit data that will quantify the impact that continuous professional development in the area of digital teaching practice and technologies has on the practitioner’s teaching practice in higher education. The research instruments/data collection tools for this study include a lecturer survey with a targeted TEL Practice group ( Pre and post covid experience) and semi-structured interviews with lecturers. This research is currently being conducted across the ATU multi-site campus and targeting Higher education lecturers that have completed formal CPD in the area of digital teaching. ATU, a West of Ireland university, is the focus of the study. The research questionnaire has been deployed, with 75 respondents to date across the ATU - the primary questionnaire and semi-formal interviews are ongoing currently – the purpose being to evaluate the impact of formal professional development in the area of TEL and its perceived impact on the practitioners teaching practice in the area of digital teaching and learning. This paper will present initial findings, reflections and data from this ongoing research study.

Keywords: TEL, technology, digital, education

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Authors: Gertrude I Hewapathirana, Mohamed M. Moustafa, Michel G. Zaitouni

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The purposes of this research are: (a) to provide an epistemological and ontological understanding of the WLB theory, practice, and research to illuminate how the WLB evolved between 2000 to 2020 and (b) to analyze peer-reviewed research to identify the gaps, hotspots, underlying dynamics, theoretical and thematic trends, influential authors, research collaborations, geographic networks, and the multidisciplinary nature of the WLB theory to guide future researchers. The research used four-step bibliometric network analysis to explore five research questions. Using keywords such as WLB and associated variants, 1190 peer-reviewed articles were extracted from the Scopus database and transformed to a plain text format for filtering. The analysis was conducted using the R version 4.1 software (R Development Core Team, 2021) and several libraries such as bibliometrics, word cloud, and ggplot2. We used the VOSviewer software (van Eck & Waltman, 2019) for network visualization. The WLB theory has grown into a multifaceted, multidisciplinary field of research. There is a paucity of research between 2000 to 2005 and an exponential growth from 2006 to 2015. The rapid increase of WLB research in the USA, UK, and Australia reflects the increasing workplace stresses due to hyper competitive workplaces, inflexible work systems, and increasing diversity and the emergence of WLB support mechanisms, legal and constitutional mandates to enhance employee and family wellbeing at multilevel social systems. A severe knowledge gap exists due to inadequate publications disseminating the "core" WLB research. "Locally-centralized-globally-discrete" collaboration among researchers indicates a "North-South" divide between developed and developing nations. A shortage in WLB research in developing nations and a lack of research collaboration hinder a global understanding of the WLB as a universal phenomenon. Policymakers and practitioners can use the findings to initiate supporting policies, and innovative work systems. The boundary expansion of the WLB concepts, categories, relations, and properties would facilitate researchers/theoreticians to test a variety of new dimensions. This is the most comprehensive WLB landscape analysis that reveals emerging trends, concepts, networks, underlying dynamics, gaps, and growing theoretical and disciplinary boundaries. It portrays the WLB as a universal theory.

Keywords: work-life balance, co-citation networks; keyword co-occurrence network, bibliometric analysis

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Authors: Omid Allan

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The advent of ultra-narrow diameter implants initially offered an alternative to wider conventional implants. However, their design limitations have restricted their applicability primarily to overdentures and cement-retained fixed prostheses, often with unpredictable long-term outcomes. The introduction of the new Miniature Implants has revolutionized the field of implant dentistry, leading to a more streamlined approach. The utilization of Miniature Implants has emerged as a promising alternative to the traditional approach that entails the traumatic sequential bone drilling procedures and the use of conventional implants for full and partial arch restorations. The innovative "BioMiniatures Implant System serves as a groundbreaking bridge connecting mini implants with standard implant systems. This system allows practitioners to harness the advantages of ultra-small implants, enabling minimally invasive insertion and facilitating the application of fixed screw-retained prostheses, which were only available to conventional wider implant systems. This approach streamlines full and partial arch rehabilitation with minimal or even no bone drilling, significantly reducing surgical risks and complications for clinicians while minimizing patient morbidity. The ultra-narrow diameter and self-advancing features of these implants eliminate the need for invasive and technically complex procedures such as bone augmentation and guided bone regeneration (GBR), particularly in cases involving thin alveolar ridges. Furthermore, the absence of a microcap between the implant and abutment eliminates the potential for micro-leakage and micro-pumping effects, effectively mitigating the risk of marginal bone loss and future peri-implantitis. The cumulative experience of restoring over 50 full and partial arch edentulous cases with this system has yielded an outstanding success rate exceeding 97%. The long-term success with a stable marginal bone level in the study firmly establishes these implants as a dependable alternative to conventional implants, especially for full arch rehabilitation cases. Full arch rehabilitation with these implants holds the promise of providing a simplified solution for edentulous patients who typically present with atrophic narrow alveolar ridges, eliminating the need for extensive GBR and bone augmentation to restore their dentition with fixed prostheses.

Keywords: mini-implant, biominiatures, miniature implants, minimally invasive dentistry, full arch rehabilitation

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Authors: Lauren Kathryn Stretch

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A study was conducted in the underprivileged setting of Nelson Mandela Bay, South Africa in order to monitor the progress of learners whose teachers receive training through the Early Inspiration Training Programme. Through tracking children’s growth & development, the effectiveness of the practitioner-training programme, which focuses on empowering women from underprivileged communities in South Africa, was analyzed. The aim was to identify impact & reach and to assess the effectiveness of this intervention programme through identifying impact on children’s growth and development. A Pre- and Post-Test was administered on about 850 young children in Pre-Grade R and Grade R classes in order to understand children’s ability level & the growth that would be evident as a result of effective teacher training. A pre-test evaluated the level of each child’s abilities, including physical-motor development, language, and speech development, cognitive development including visual perceptual skills, social-emotional development & play development. This was followed by a random selection of the classes of children into experimental and control groups. The experimental group’s teachers (practitioners) received 8-months of training & intervention, as well as mentorship & support. After the 8-month training programme, children from the experimental & control groups underwent post-assessment. The results indicate that the impact of effective practitioner training and enhancing a deep understanding of stimulation on young children, that this understanding is implemented in the classroom, highlighting the areas of growth & development in the children whose teachers received additional training & support, as compared to those who did not receive additional training. Monitoring & Evaluation systems not only track children’s ability levels, but also have a core focus on reporting systems, mentorship and providing ongoing support. As a result of the study, an Online Application (for Apple or Android Devices) was developed which is used to track children’s growth via age-appropriate assessments. The data is then statistically analysed to provide direction for relevant & impactful intervention. The App also focuses on effective reporting strategies, structures, and implementation to support organizations working with young children & maximize on outcomes.

Keywords: early childhood development, developmental child assessments, online application, monitoring and evaluating online

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Authors: Qiyao Han, Xianhai Meng

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Urban infrastructures refer to the fundamental facilities and systems that serve cities. Due to the global climate change and human activities in recent years, many urban areas around the world are facing enormous challenges from natural and man-made disasters, like flood, earthquake and terrorist attack. For this reason, urban resilience to disasters has attracted increasing attention from researchers and practitioners. Given the complexity of infrastructure systems and the uncertainty of disasters, this paper suggests that studies of resilience could focus on urban functional sustainability (in social, economic and environmental dimensions) supported by infrastructure systems under disturbance. It is supposed that urban infrastructure systems with high resilience should be able to reconfigure themselves without significant declines in critical functions (services), such as primary productivity, hydrological cycles, social relations and economic prosperity. Despite that some methods have been developed to integrate the resilience and sustainability of individual infrastructure components, more work is needed to enable system-level integration. This research presents a conceptual analysis framework for integrating resilience and sustainability based on fractal theory. It is believed that the ability of an ecological system to maintain structure and function in face of disturbance and to reorganize following disturbance-driven change is largely dependent on its self-similar and hierarchical fractal structure, in which cross-scale resilience is produced by the replication of ecosystem processes dominating at different levels. Urban infrastructure systems are analogous to ecological systems because they are interconnected, complex and adaptive, are comprised of interconnected components, and exhibit characteristic scaling properties. Therefore, analyzing resilience of ecological system provides a better understanding about the dynamics and interactions of infrastructure systems. This paper discusses fractal characteristics of ecosystem resilience, reviews literature related to system-level infrastructure resilience, identifies resilience criteria associated with sustainability dimensions, and develops a conceptual analysis framework. Exploration of the relevance of identified criteria to fractal characteristics reveals that there is a great potential to analyze infrastructure systems based on fractal. In the conceptual analysis framework, it is proposed that in order to be resilient, urban infrastructure system needs to be capable of “maintaining” and “reorganizing” multi-scale critical functions under disasters. Finally, the paper identifies areas where further research efforts are needed.

Keywords: fractal, urban infrastructure, sustainability, system-level resilience

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Authors: Suhair Mereish

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This research is aimed at examining the climate for innovation in organisations with the aim of validating the psychometric properties of the Team Climate Inventory (TCI -14) for Jordan’s collectivist society. The innovativeness of teams may be improved or obstructed by the climate within the team. Further, personal factors are considered an important element that influences the climate for innovation. Accordingly, measuring the employees' personality traits using the Big Five Inventory (BFI-44) could provide insights that aid in understanding how to improve innovation. Thus, studying the climate for innovation and its associations with personality traits is valuable, considering the insights it could offer on employee performance, job satisfaction, and well-being. Essentially, the Team Climate Inventory instrument has never been tested in Jordan’s collectivist society. Accordingly, in order to address the existing gap in the literature as a whole and, more specifically, in Jordan, it is essential to investigate its factorial structure and reliability in this particular context. It is also important to explore whether the factorial structure of the Team Climate Inventory in Jordan’s collectivist society demonstrates a similar or different structure to what has been found in individualistic ones. Lastly, examining if there are associations between the Team Climate Inventory and personality traits of Jordanian employees is pivotal. The quantitative study was carried out among Jordanian employees employed in two of the top 20 companies in Jordan, a shipping and logistics company (N=473) and a telecommunications company (N=219). To generalise the findings, this was followed by collecting data from the general population of this country (N=399). The participants completed the Team Climate Inventory. Confirmatory factor analyses and reliability tests were conducted to confirm the factorial structure, validity, and reliability of the inventory. Findings presented that the four-factor structure of the Team Climate Inventory in Jordan revealed a similar structure to the ones in Western culture. The four-factor structure has been confirmed with good fit indices and reliability values. Moreover, for climate for innovation, regression analysis identified agreeableness (positive) and neuroticism (negative) from the Big Five Inventory as significant predictors. This study will contribute to knowledge in several ways. First, by examining the reliability and factorial structure in a Jordanian collectivist context rather than a Western individualistic one. Second, by comparing the Team Climate Inventory structure in Jordan with findings for the Team Climate Inventory from Western individualistic societies. Third, by studying its relationships with personality traits in that country. Furthermore, findings from this study will assist practitioners in the field of organisational psychology and development to improve the climate for innovation for employees working in organisations in Jordan. It is also expected that the results of this research will provide recommendations to professionals in the business psychology sector regarding the characteristics of employees who hold positive and negative perceptions of the workplace climate.

Keywords: big five inventory, climate for innovation, collectivism, individualism, Jordan, team climate inventory

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Authors: S. H. J. Liu

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This paper aims to explore the role of peer Corrective Feedback (CF) in improving written productions by English-as-a- foreign-language (EFL) learners who work together via Wikispaces. It attempted to determine the effect of peer CF on form accuracy in English, such as grammar and lexis. Thirty-four EFL learners at the tertiary level were randomly assigned into the experimental (with peer feedback) or the control (without peer feedback) group; each group was subdivided into small groups of two or three. This resulted in six and seven small groups in the experimental and control groups, respectively. In the experimental group, each learner played a role as an assessor (providing feedback to others), as well as an assessee (receiving feedback from others). Each participant was asked to compose his/her written work and revise it based on the feedback. In the control group, on the other hand, learners neither provided nor received feedback but composed and revised their written work on their own. Data collected from learners’ compositions and post-task interviews were analyzed and reported in this study. Following the completeness of three writing tasks, 10 participants were selected and interviewed individually regarding their perception of collaborative learning in the Computer-Mediated Communication (CMC) environment. Language aspects to be analyzed included lexis (e.g., appropriate use of words), verb tenses (e.g., present and past simple), prepositions (e.g., in, on, and between), nouns, and articles (e.g., a/an). Feedback types consisted of CF, affective, suggestive, and didactic. Frequencies of feedback types and the accuracy of the language aspects were calculated. The results first suggested that accurate items were found more in the experimental group than in the control group. Such results entail that those who worked collaboratively outperformed those who worked non-collaboratively on the accuracy of linguistic aspects. Furthermore, the first type of CF (e.g., corrections directly related to linguistic errors) was found to be the most frequently employed type, whereas affective and didactic were the least used by the experimental group. The results further indicated that most participants perceived that peer CF was helpful in improving the language accuracy, and they demonstrated a favorable attitude toward working with others in the CMC environment. Moreover, some participants stated that when they provided feedback to their peers, they tended to pay attention to linguistic errors in their peers’ work but overlook their own errors (e.g., past simple tense) when writing. Finally, L2 or FL teachers or practitioners are encouraged to employ CMC technologies to train their students to give each other feedback in writing to improve the accuracy of the language and to motivate them to attend to the language system.

Keywords: peer corrective feedback, computer-mediated communication (CMC), second or foreign language (L2 or FL) learning, Wikispaces

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

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Authors: Nora Alomar, Bianca Alexandra Stefa, Saleh Bazi

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This research uncovers the determinants that drive millennial consumers to adhere to product return of fast-fashion products purchases via e-commerce and what effects it has on consumer experience and satisfaction. Online consumption has skyrocketed, with e-commerce being the only, most reliable, and safe method of shopping during and post Covid-19. It has been noted customers are demanding a wide variety of product characteristics and a generous optimal return policy. The authors have selected to examine millennial consumers as they are digital natives and have an affinity for researching, reading product reviews, and shopping online, with a great spending power due to a higher disposable income in comparison to other generations. A multi-study approach is adopted, where study one (interviews, sample of 20 respondents) investigates the factors that drive product return, and study two (PLS-SEM, sample of 250 respondents) looks into the relationships of product return management against behavioral outcomes by having the generated factors (from study one) as moderators. Five themes are generated from study one (return policies, product characteristics, delivery lead time, seasonality, product trial & overspending). The authors identify that two out of the five factors (seasonality, product trial & overspending) have not been highlighted by the literature. The paper examines 11 hypotheses, where 10 are supported. Findings highlight the quality of the product return management influences the overall millennial customer experience and satisfaction. Findings also indicate that product return management was identified to have a significant negative effect on customer experience. Additionally, seasonality has a significant but negative moderation, which means increasing seasonality decreases the relationship between product return management and customer experience and satisfaction. Results highlight that return policies have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. Moreover, product characteristics are also identified to have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. This study further examines the influence of the factors on direct e-commerce websites and third-party e-commerce websites. Findings showcase a strong statistical significance for the increased rate of return of fast-fashion products on third-party websites. This paper aids practitioners in taking strategic decisions related to return management, to improve the quality of logistical services and, in turn, increase profitability.

Keywords: customer experience, customer satisfaction, e-commerce, fast-fashion, product returns

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Authors: Ana Carolina Felizardo Da Silva

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People with disabilities are those who have limitations of a physical, mental, intellectual or sensory nature and who, therefore, should not be excluded or marginalized. In Brazil, the Brazilian Law for the Inclusion of People with Disabilities defines that people with disabilities have the right to culture, sport, tourism and leisure on an equal basis with other people. Sport for people with disabilities, in its genesis, had a character aimed at rehabilitating men and soldiers, that is, the male figure who returned wounded from war and needed care. By gaining practitioners, the marketing issue emerges and, successively, high performance, what we call Paralympic sport. We found that sport for people with disabilities was designed for men, corroborating the social idea that sport is a masculine and masculinizing environment. In this way, the inclusion of women with disabilities in sports becomes a double challenge because they are women and have a disability. From data collected from official documents of the International Paralympic Committee, it is found that the first report on the participation of women in the Paralympic Games was in 1948, in England, in Stoke Mandeville, a championship considered the firstborn of the games, later, became called the “Paralympic Games”. However, due to the lack of information, the return of the appearance of women participating in the Paralympics took place after long 40 years, in 1984, which demonstrates a large gap of records on the official website referring to women in the games. Despite the great challenge, the number of women has been growing substantially. When collecting data from participants of all 16 editions of the Paralympic Games, in its last edition, held in Tokyo, out of 4,400 competing athletes, 1,853 were women, which represents 42% of the total number of athletes. In this same edition, we had the largest delegation of Brazilian women, represented by 96 athletes out of a total of 260 Brazilian athletes. It is estimated that in the next edition, to be taken place in Paris in 2024, the participation of women will equal or surpass that of men. The certain invisibility of women participating in the Paralympic Games is noticed when we access the database of the Brazilian Paralympic Committee website. It is possible to identify all women medalists of a given edition. On the other side, participating female athletes who did not medal are not registered on the site. Regarding the participation of Brazilian women in the Paralympics, there was a considerable growth in the last two editions, in 2012 there were only 69 women participating, going to 102 in 2016 and 96 in 2021. The same happened in relation to the medalists, going from 8 Brazilians in 2012 to 33 in 2016 and 27 in 2021. In this sense, the present study, aims to analyze how Brazilian women participate in the Paralympics, giving visibility and voice to female athletes. Structured interviews are being carried out with the participants of the games, identifying the difficulties and potentialities of participating with athletes in the competition. The analysis will be carried out through Bardin’s content analysis.

Keywords: paralympics, sport for people with disabilities, woman, woman in sport

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Authors: Gunnar Oskarsson, Irena Georgsdottir

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Tourism has been growing incredibly fast during the past years, including the cruise industry, which is gaining increasing popularity among various groups of travelers. It is a challenging task for companies serving cruise ship passengers with local products and services at the point of destination to reach them in due time with information about their offerings, as well learning how to adapt their offerings and messages to the type of customers arriving on each particular occasion. Although some research has been conducted in this sphere, there is still limited knowledge about many specifics within this sector of the tourist industry. The objective of this research is to examine one of these, with the main goal of studying the segmentation of cruise passengers and to learn about marketing practices directed towards them. A qualitative research method, based on in-depth interviews, was used, as this provides an opportunity to gain insight into the participants’ perspectives. Interviews were conducted with 10 respondents from different companies in the tourist industry in Iceland, who interact with cruise passengers on a regular basis in their work environment. The main objective was to gain an understanding of what distinguishes different customer groups, or segments, in this industry, and of the marketing approaches directed towards them. The main findings reveal that participants note the strongest difference between cruise passengers of different nationalities, passengers coming on different ships (size and type), and passengers arriving at different times of the year. A drastic difference was noticed between nationalities in four main segments, American, British, Other European, and Asian customers, although some of these segments could be divided into even further sub-segments. Other important differencing factors were size and type of ships, quality or number of stars on the ship, and travelling time of the year. Companies serving cruise ship passengers, as well as the customers themselves, could benefit if the offerings of services were designed specifically for particular segments within the industry. Concerning marketing towards cruise passengers, the results indicate that it is carried out almost exclusively through the Internet using; a reliable website and, search engine optimization. Marketing is also by word-of-mouth. This research can assist practitioners by offering a deeper understanding of the approaches that may be effective in marketing local products and services to cruise ship passengers, based on their segmentation and by identifying effective ways to reach them. The research, furthermore, provides a valuable contribution to marketing knowledge for the benefit of an increasingly important market segment in a fast growing tourist industry.

Keywords: capabilities, global integration, internationalisation, SMEs

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Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Spencer Jay Knafelc

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Some mental health practitioners and theorists have suggested that we approach remedying psychological problems by centering and intervening upon patients’ narrations. Such theorists and their corresponding therapeutic approaches see persons as narrators of their lives, where the stories they tell constitute and reflect their sense-making of the world. Psychological problems, according to these approaches to therapy, are often the result of problematic narratives. The solution is the construction of more salubrious narratives through therapy. There is trouble lurking within the history of these narrative approaches. These thinkers tend to denigrate the importance of truth, insisting that narratives are not to be thought of as aiming at truth, and thus the truth of our self-narratives is not important. There are multiple motivations for the tendency to eschew truth’s importance within the tradition of narrative approaches to therapy. The most plausible and interesting motivation comes from the observation that, in general, all dominant approaches to therapy are equally effective. The theoretical commitments of each approach are quite different and are often ostensibly incompatible (psychodynamic therapists see psychological problems as resulting from unconscious conflict and repressed desires, Cognitive-Behavioral approaches see them as resulting from distorted cognitions). This strongly suggests that there must be some cases in which therapeutic efficacy does not depend on truth and that insisting that patient’s therapeutic narratives be true in all instances is a mistake. Lewis’ solution is to suggest that narratives are metaphors. Lewis’ account appreciates that there are many ways to tell a story and that many different approaches to mental health treatment can be appropriate without committing us to any contradictions, providing us with an ostensibly coherent way to treat narratives as non-literal, instead of seeing them as tools that can be more or less apt. Here, it is argued that Lewis’ metaphor approach fails. Narratives do not have the right kind of structure to be metaphors. Still, another way to understand Lewis’ view might be that self-narratives, especially when articulated in the language of any specific approach, should not be taken literally. This is an idea at the core of the narrative theorists’ tendency to eschew the importance of the ordinary understanding of truth. This very tendency will be critiqued. The view defended in this paper more accurately captures the nature of self-narratives. The truth of one’s self-narrative is important. Not only do people care about having the right conception of their abilities, who they are, and the way the world is, but self-narratives are composed of beliefs, and the nature of belief is to aim at truth. This view also allows the recognition of the importance of developing accurate representations of oneself and reality for one’s psychological well-being. It is also argued that in many cases, truth factors in as a mechanism of change over the course of therapy. Therapeutic benefit can be achieved by coming to have a better understanding of the nature of oneself and the world. Finally, the view defended here allows for the recognition of the nature of the tension between values: truth and efficacy. It is better to recognize this tension and develop strategies to navigate it as opposed to insisting that it doesn’t exist.

Keywords: philosophy, narrative, psychotherapy, truth

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