Search results for: socio-political implications

Authors: Lynette Sheridan Burns, Benjamin J. Matthews

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The context of post-industrial journalism is one in which the material circumstances of mechanical publication have been displaced by digital technologies, increasing the distance between the orthodoxy of the newsroom and the culture of journalistic writing. Content is, with growing frequency, created for delivery via the internet, publication on web-based ‘platforms’ and consumption on screen media. In this environment, the question is not ‘who is a journalist?’ but ‘what is journalism?’ today. The changes bring into sharp relief new distinctions between journalistic work and journalistic labor, providing a key insight into the current transition between the industrial journalism of the 20^th century, and the post-industrial journalism of the present. In the 20^th century, the work of journalists and journalistic labor went hand-in-hand as most journalists were employees of news organizations, whilst in the 21^st century evidence of a decoupling of ‘acts of journalism’ (work) and journalistic employment (labor) is beginning to appear. This 'decoupling' of the work and labor that underpins journalism practice is far reaching in its implications, not least for institutional structures. Under these conditions we are witnessing the emergence of expanded ‘entrepreneurial’ journalism, based on smaller, more independent and agile - if less stable - enterprise constructs that are a feature of creative industries. Entrepreneurial journalism is realized in a range of organizational forms from social enterprise, through to profit driven start-ups and hybrids of the two. In all instances, however, the primary motif of the organization is an ideological definition of journalism. An example is the Scoop Foundation for Public Interest Journalism in New Zealand, which owns and operates Scoop Publishing Limited, a not for profit company and social enterprise that publishes an independent news site that claims to have over 500,000 monthly users. Our paper demonstrates that this journalistic work meets the ideological definition of journalism; conducted within the creative industries using an innovative organizational structure that offers a new, viable post-industrial future for journalism.

Keywords: creative industries, digital communication, journalism, post industrial

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Authors: Mohammad Zakir, Saamia Shams

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Background: Provision of quality family planning services remarkably contribute towards increased uptake of modern contraceptive methods and have important implications on reducing fertility rates. The quality of care in family planning has beneficial impact on reproductive health of women, yet little empirical evidence is present to show the relationship between the impact of adequate training of Community Mid Wives (CMW) and quality family planning services. Aim: This study aimed to enhance the knowledge and counseling skills of CMWs in improving the access to quality client-centered family planning services in Pakistan. Methodology: A quasi-experimental longitudinal study using Initial Quality Assurance Scores-Training-Post Training Quality Assurance Scores design with a non- equivalent control group was adopted to compare a set of experimental CMWs that received four days training package including Family Planning Methods, Counselling, Communication skills and Practical training on IUCD insertion with a set of comparison CMWs that did not receive any intervention. A sample size of 100 CMW from Suraj Social Franchise (SSF) private providers was recruited from both urban and rural Pakistan. Results: Significant improvement in the family planning knowledge and counseling skills (p< 0.001) of the CMWs was evident in the experimental group as compared to comparison group with p > 0.05. Non- significant association between pre-test level family planning knowledge and counseling skills was observed in both the groups (p>0.05). Conclusion: The findings demonstrate that adequate training is an important determinant of quality of family planning services received by clients. Provider level training increases the likelihood of contraceptives uptake and decreases the likelihood of both unintended and unwanted pregnancies. Enhancing quality of family planning services may significantly help reduce the fertility and improve the reproductive health indicators of women in Pakistan.

Keywords: community mid wives, family planning services, quality of care, training

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Authors: Murad Ali, Anderson Konan Seny Kan, Khalid A. Maimani

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Based on the theory of organizational design and the theory of knowledge, this study uses complexity theory to explain and better understand the causal impacts of various patterns of organizational structural factors stimulating absorptive capacity (ACAP). Organizational structure can be thought of as heterogeneous configurations where various components are often intertwined. This study argues that impact of the traditional variables which define a firm’s organizational structure (centralization, formalization, complexity and integration) on ACAP is better understood in terms of set-theoretic relations rather than correlations. This study uses a data sample of 347 from a multiple industrial sector in South Korea. The results from PLS-SEM support all the hypothetical relationships among the variables. However, fsQCA results suggest the possible configurations of centralization, formalization, complexity, integration, age, size, industry and revenue factors that contribute to high level of ACAP. The results from fsQCA demonstrate the usefulness of configurational approaches in helping understand equifinality in the field of knowledge management. A recent fsQCA procedure based on a modeling subsample and holdout subsample is use in this study to assess the predictive validity of the model under investigation. The same type predictive analysis is also made through PLS-SEM. These analyses reveal a good relevance of causal solutions leading to high level of ACAP. In overall, the results obtained from combining PLS-SEM and fsQCA are very insightful. In particular, they could help managers to link internal organizational structural with ACAP. In other words, managers may comprehend finely how different components of organizational structure can increase the level of ACAP. The configurational approach may trigger new insights that could help managers prioritize selection criteria and understand the interactions between organizational structure and ACAP. The paper also discusses theoretical and managerial implications arising from these findings.

Keywords: absorptive capacity, organizational structure, PLS-SEM, fsQCA, predictive analysis, modeling subsample, holdout subsample

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Authors: Rajashree Naik, Laxmi Kant Sharma

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Sambhar lake is the largest inland Salt Lake of India, declared as a Ramsar site on 23 March 1990. Due to high salinity and alkalinity condition its biodiversity richness is contributed by haloalkaliphilic flora and fauna along with the diverse land cover including waterbody, wetland, salt crust, saline soil, vegetation, scrub land and barren land which welcome large number of flamingos and other migratory birds for winter harboring. But with the gradual increase in the irrational salt extraction activities, the ecological diversity is at stake. There is an urgent need to assess the ecosystem. Advanced technology like remote sensing and GIS has enabled to look into the past, compare with the present for the future planning and management of the natural resources in a judicious way. This paper is a research work intended to present a vegetation in typical inland lake environment of Sambhar wetland using satellite data of NASA’s EO-1 Hyperion sensor launched in November 2000. With the spectral range of 0.4 to 2.5 micrometer at approximately 10nm spectral resolution with 242 bands 30m spatial resolution and 705km orbit was used to produce a vegetation map for a portion of the wetland. The vegetation map was tested for classification accuracy with a pre-existing detailed GIS wetland vegetation database. Though the accuracy varied greatly for different classes the algal communities were successfully identified which are the major sources of food for flamingo. The results from this study have practical implications for uses of spaceborne hyperspectral image data that are now becoming available. Practical limitations of using these satellite data for wetland vegetation mapping include inadequate spatial resolution, complexity of image processing procedures, and lack of stereo viewing.

Keywords: Algal community, NASA’s EO-1 Hyperion, salt-tolerant species, wetland vegetation mapping

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Authors: Preet Gill, Danus Ravindran

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These The COVID-19 pandemic resulted in widespread implications for medical specialist training programs worldwide, including radiology. The objective of this study was to investigate the impact of COVID-19 on the Australian and New Zealand radiology trainee experience and well-being, as well as to compare the Australasian experience with that reported by other countries. An anonymised electronic online questionnaire was disseminated to all training members of the Royal Australian and New Zealand College of Radiologists who were radiology trainees during the 2020 – 2022 clinical years. Trainees were questioned about their experience from the beginning of the COVID-19 pandemic in Australasia (March 2020) to the time of survey completion. Participation was voluntary. Questions assessed the impact of the pandemic across multiple domains, including workload (inpatient/outpatient & individual modality volume), teaching, supervision, external learning opportunities, redeployment and trainee wellbeing. Survey responses were collated and compared with other peer reviewed publications. Answer options were primarily in categorical format (nominal and ordinal subtypes, as appropriate). An opportunity to provide free text answers to a minority of questions was provided. While our results mirror that of other countries, which demonstrated reduced case exposure and increased remote teaching and supervision, responses showed variation in the methods utilised by training sites during the height of the pandemic. A significant number of trainees were affected by examination cancellations/postponements and had subspecialty training rotations postponed. The majority of trainees felt that the pandemic had a negative effect on their training. In conclusion, the COVID-19 pandemic has had a significant impact on radiology trainees across Australia and New Zealand. The present study has highlighted the extent of these effects, with most aspects of training impacted. Opportunities exist to utilise this information to create robust workplace strategies to mitigate these negative effects should the need arise in the future.

Keywords: COVID-19, radiology, training, pandemic

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Authors: Denise Muro

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Conflict in Syria, producing over 11 million displaced persons, has incited global attention to displacement. Although neighboring countries have borne the largest part of the displacement burden, due to the influx of refugees into Europe, the so-called ‘refugee crisis’ is taking place on two fronts: Syria’s neighboring countries, with millions of refugees, and Europe, a destination goal for so many that European states face unprecedented challenges. With increasing attention to displacement, forcibly displaced persons are consistently portrayed as either un-agentic victims, or as dangerous free agents. Recognizing that these dominant portrayals involve discourses of power and inequality, this research investigates the extent to which this victim-agent dichotomy affects refugees and organizations that work closely with them during initial integration processes in Berlin, Germany. The research measures initial integration based on German policy measures regarding integration juxtaposed with the way refugees and those who work with them understand integration. Additionally, the study examines day-to-day interactions of refugees in Germany as a way to gauge social integration in a bottom-up approach. This study involved a discourse analysis of portrayals of refugees and participant observation and interviews with refugees and those who work closely with them, which took place during fieldwork in Berlin in the summer of 2016. Germany is unique regarding their migration history and lack of successful integration, in part due to the persistent refrain, ‘Wir sind kein einwanderungsland’ (‘We are not an immigration country’). Still, their accepted asylum seeker population has grown exponentially in the past few years. Findings suggest that the victim-agent dichotomy is present and impactful in the process of refugees entering and integrating into Germany. Integration is hindered due to refugees either being patronized or criminalized to such an extent that, despite being constantly told that they must integrate, they cannot become part of German society.

Keywords: discourse analysis, Germany, integration, refugee crisis

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Authors: Patrick Oehler, Nicholas Folger

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Following a new public management approach, Germany has widely reformed its higher education system around the turn of the millennium. Aimed at preparing the country’s publicly funded universities and applied science colleges for a century of glory, the reforms led to the introduction of rigid performance measurement and management practices, which disrupted the inert system on all levels. Yet, many of the new policies met significant resistance, and some of them had to be reversed over time. Ever since Germany has struggled to find a balance between its pre- and its post-millennial approach to performance measurement and management. This contribution combines insights of a joint research project, which was created and funded by the German Federal Ministry of Education and Research with the aim to better understand the effects of its performance measurement and management policies, including those the ministry had implemented over the previous decades. The research project combines researchers from 17 German research institutions who employed a wide range of theories from various disciplines and very diverse research methods to explain performance measurement and management and their consequences on the behavior of various stakeholders in higher education systems. In these projects, performance measurement and management have been researched from three angles—education, research, and third mission. The collaborative project differentiated functional and dysfunctional elements of common performance measurement and management practices, and identified key problems with these practices, such as (1) oversimplification of performance indicators, (2) ‘overmeasurement’ of performance in general, (3) excessive use of quantitative indicators, and (4), a myopic focus on research-focused indicators and a negligence of measures targeting education and third mission. To address these issues, the collaborative project developed alternative approaches to performance measurement and management, including suggestions for qualitative performance measures, improved supervision, review, and evaluations methods, and recommendations how to better balance education, research, and third mission. The authors would like to share the rich findings of the joint research project with an international audience and discuss their implications for alternative higher education systems.

Keywords: performance measurement, performance management, new public management, performance evaluation

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Authors: Samuel O. Akande

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The human-induced climate change is likely to have severe consequences on forest ecosystems in Nigeria. Recent discussions and emphasis on issues concerning the environment justify the need for this research which examined deforestation monitoring in Oban Forest, Nigeria using Remote Sensing techniques. The Landsat images from TM (1986), ETM+ (2001) and OLI (2015) sensors were obtained from Landsat online archive and processed using Erdas Imagine 2014 and ArcGIS 10.3 to obtain the land use/land cover and Normalized Differential Vegetative Index (NDVI) values. Ground control points of deforested areas were collected for validation. It was observed that the forest cover decreased in area by about 689.14 km² between 1986 and 2015. The NDVI was used to determine the vegetation health of the forest and its implications on agricultural sustainability. The result showed that the total percentage of the healthy forest cover has reduced to about 45.9% from 1986 to 2015. The results obtained from analysed questionnaires shown that there was a positive correlation between the causes and effects of deforestation in the study area. The coefficient of determination value was calculated as R² ≥ 0.7, to ascertain the level of anthropogenic activities, such as fuelwood harvesting, intensive farming, and logging, urbanization, and engineering construction activities, responsible for deforestation in the study area. Similarly, temperature and rainfall data were obtained from Nigerian Meteorological Agency (NIMET) for the period of 1986 to 2015 in the study area. It was observed that there was a significant increase in temperature while rainfall decreased over the study area. Responses from the administered questionnaires also showed that futile destruction of forest ecosystem in Oban forest could be reduced to its barest minimum if fuelwood harvesting is disallowed. Thus, the projected impacts of climate change on Nigeria’s forest ecosystems and environmental stability is better imagined than experienced.

Keywords: deforestation, ecosystems, normalized differential vegetative index, sustainability

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Authors: Zhuo Feng, Ying Gao

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Public-private partnership (PPP), as an innovative way to provide infrastructures by the private sector, is being widely used throughout the world. Compared with the traditional mode, PPP emerges largely for merits of relieving public budget constraint and improving infrastructure supply efficiency by involving private funds. However, PPP projects are characterized by large scale, high investment, long payback period, and long concession period. These characteristics make PPP projects full of risks. One of the most important risks faced by the private sector is demand risk because many factors affect the real demand. If the real demand is far lower than the forecasting demand, the private sector will be got into big trouble because operating revenue is the main means for the private sector to recoup the investment and obtain profit. Therefore, it is important to study how the government compensates the private sector when the demand risk occurs in order to achieve Pareto-improvement. This research focuses on price compensation mechanism, an ex-post compensation mechanism, and analyzes, by mathematical modeling, the impact of price compensation mechanism on payoff of the private sector and consumer surplus for PPP toll road projects. This research first investigates whether or not price compensation mechanisms can obtain Pareto-improvement and, if so, then explores boundary conditions for this mechanism. The research results show that price compensation mechanism can realize Pareto-improvement under certain conditions. Especially, to make the price compensation mechanism accomplish Pareto-improvement, renegotiation costs of the government and the private sector should be lower than a certain threshold which is determined by marginal operating cost and distortionary cost of the tax. In addition, the compensation percentage should match with the price cut of the private investor when demand drops. This research aims to provide theoretical support for the government when determining compensation scope under the price compensation mechanism. Moreover, some policy implications can also be drawn from the analysis for better risk-sharing and sustainability of PPP projects.

Keywords: infrastructure, price compensation mechanism, public-private partnership, renegotiation

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Authors: Nazanin Reza Nejad, Kamil Guley

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Shopping is one of the most entertaining activities of daily life. In parallel to this, the successful settings of the stores impress the customers and made it more appealing for the users. The design of the atmosphere is the language of the interior space, and this design directly affects users’ emotions and perceptions. One of the goals of interior design is to increase the quality of the designed space. A well-designed venue satisfies the user and ensures happiness and safety. Thus, customers are turned into frequent users of the store. Spaces without the right designs negatively influence the user. The accurate interior design of the stores becomes crucial at this point. This study aims to act as a guideline for the betterment of the interior design of a newly designed or already existing clothing store located on the shopping streets of the cities. In light of the relevant literature review, the most important point in interior store design is the design and ambiance factors and how these factors are used in the interior space of the stores. Within the scope of this study, 27 clothing stores located on Dereboyu, the largest shopping street in Nicosia, the capital of North Cyprus, were examined. The examined stores were grouped as brand stores and non-brand stores which sell products from different production sites. The observation regarding the interiors of the selected stores was analyzed through qualitative and quantitative research methods. The arrangements of the sub-functions in the stores were analyzed through various reading methods over the plan schemes and recorded images. The sub-functions of all examined stores are compared against the ambiance and design factors in the literature, and results were interpreted accordingly. At the end of the study, the differences among stores that belong to a brand with an identity and stores which have not yet established an identity were identified and compared. The results of the comparisons were used to offer implications for the betterment of the interior design on a future or already existing store on the street. Thus, the study was concluded to be a guideline for people interested in interior store design.

Keywords: atmosphere, ambiance factors, clothing store, identity, interior design

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Authors: Suresh Lokiah

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The emerging trend of integrating robots into elderly care, particularly for assisting patients with dementia, holds the potential to greatly transform the sector. Assisted living facilities, which house a significant number of elderly individuals and dementia patients, constantly strive to engage their residents in stimulating activities. However, due to staffing shortages, they often rely on volunteers to introduce new activities. Despite the availability of social interaction, these residents, frequently overlooked in society, are in desperate need of additional support. Robots designed for elder care are categorized based on their design and functionality. These categories include companion robots, telepresence robots, health monitoring robots, and rehab robots. However, the integration of such robots raises significant ethical concerns, notably regarding privacy, autonomy, and the risk of dehumanization. Privacy issues arise as these robots may need to continually monitor patient activities. There is also a risk of patients becoming overly dependent on these robots, potentially undermining their autonomy. Furthermore, the replacement of human touch with robotic interaction may lead to the dehumanization of care. This paper delves into the ethical considerations of incorporating robotic assistance in eldercare. It proposes a series of guidelines and strategies to ensure the ethical deployment of these robots. These guidelines suggest involving patients in the design and development process of the robots and emphasize the critical need for human oversight to respect the dignity and rights of the elderly and dementia patients. The paper also recommends implementing robust privacy measures, including secure data transmission and data anonymization. In conclusion, this paper offers a thorough examination of the ethical implications of using robotic assistance in elder care. It provides a strategic roadmap to ensure this technology is utilized ethically, thereby maximizing its potential benefits and minimizing any potential harm.

Keywords: human-robot interaction, robots for eldercare, ethics, health, dementia

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Authors: Madhulika Pathak, Polani Seshagiri, Vani Venkatappa

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Blastocyst hatching is an indispensable process for successful implantation. One of the major reasons for implantation failure in IVF clinic is poor quality of embryo, which are not development/hatching-competent. Therefore, attempts are required to develop or enhance the culture system with a molecule recapitulating the autocrine/paracrine factors containing the environment of in-vivo endometrial milieu. We have tried to explore the functional molecules involved in the hamster hatching phenomenon. Blastocyst hatching is governed by several molecules that are entwined and regulate this process, among which cytokines are known to be expressed and are still least explored. Two of such cytokines we have used for our study are IL-1β and its natural antagonist IL-1ra to understand the functional dynamics of cytokines involved in the hatching process. Using hamster, an intriguing experimental model for hatching behavior, we have shown the mRNA (qPCR) and protein (ICC) expression of IL-1β, IL-1ra and IL-1 receptor type 1 throughout all the stages of morula, blastocyst and hatched blastocyst. Post-asserting the expression, the functional role is shown by supplementation studies, where IL-1β supplementation showed enhancement in hatching level (IL-1β treated: 84.1 ± 4.2% vs control: 63.7 ± 3.1 %, N=11), further confirmed by the diminishing effect of IL-1ra on hatching rate (IL-1ra treated: 27.5 ± 11.1% vs control: 67.9 ± 3.1%). The exogenous supplementation of IL-1ra decreased the survival rate of embryos and affected the viability in dose-dependent manner, establishing the importance of IL-1β in blastocyst cell survival. Previously, the cathepsin L and B were established as the proteases that were involved in the hamster hatching process. The inducing effect of IL-1β was correlated with enhanced mRNA level, as analyzed by qPCR, for both CAT L (by 1.9 ± 0.5 fold) and CAT B (by 3.5 ± 0.1) fold which was diminished in presence of IL-1ra (Cat L by 88 percent and Cat B by 94 percent. Moreover, using a specific fluorescent substrate-based assay kit, the enzymatic activity of these proteases was found to be increased in presence of IL-1β (Cat L by 2.1 ± 0.1 fold and CAT B by 2.3 ± 0.7 fold) and was curtailed in presence of IL-1ra. These observations provide functional insights with respect to the involvement of cytokines in the hatching process. This has implications in understanding the hatching biology and improving the embryo development quality in IVF clinics.

Keywords: Blastocyst, Cytokines, Hatching, Interleukin

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Authors: Bliss Singhal

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Epilepsy is a prevalent neurological disorder affecting approximately 50 million individuals worldwide and 1.2 million Americans. There exist millions of pediatric patients with intractable epilepsy, a condition in which seizures fail to come under control. The occurrence of seizures can result in physical injury, disorientation, unconsciousness, and additional symptoms that could impede children's ability to participate in everyday tasks. Predicting seizures can help parents and healthcare providers take precautions, prevent risky situations, and mentally prepare children to minimize anxiety and nervousness associated with the uncertainty of a seizure. This research proposes a comprehensive framework to predict seizures in pediatric patients by evaluating machine learning algorithms on unimodal neuroimaging data consisting of electroencephalogram signals. The bandpass filtering and independent component analysis proved to be effective in reducing the noise and artifacts from the dataset. Various machine learning algorithms’ performance is evaluated on important metrics such as accuracy, precision, specificity, sensitivity, F1 score and MCC. The results show that the deep learning algorithms are more successful in predicting seizures than logistic Regression, and k nearest neighbors. The recurrent neural network (RNN) gave the highest precision and F1 Score, long short-term memory (LSTM) outperformed RNN in accuracy and convolutional neural network (CNN) resulted in the highest Specificity. This research has significant implications for healthcare providers in proactively managing seizure occurrence in pediatric patients, potentially transforming clinical practices, and improving pediatric care.

Keywords: intractable epilepsy, seizure, deep learning, prediction, electroencephalogram channels

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Authors: Maryvone Cunha de Morais, Lilian Cristine Hübner

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Based on a translanguaging theoretical approach, which considers language not as separate entities but as an entire repertoire available to bilingual individuals, this systematic review aimed at analyzing the methods (aims, samples investigated, type of stimuli, and analyses) adopted by studies on translanguaging practices associated with written and oral tasks (separately or integrated) in bilingual education. The PRISMA criteria for systematic reviews were adopted, with the descriptors "translanguaging", "bilingual education" and/or “written and oral tasks" to search in Pubmed/Medline, Lilacs, Eric, Scopus, PsycINFO, and Web of Science databases for articles published between 2017 and 2021. 280 registers were found, and after following the inclusion/exclusion criteria, 24 articles were considered for this analysis. The results showed that translanguaging practices were investigated on four studies focused on written production analyses, ten focused on oral production analysis, whereas ten studies focused on both written and oral production analyses. The majority of the studies followed a qualitative approach, while five studies have attempted to study translanguaging with quantitative statistical measures. Several types of methods were used to investigate translanguaging practices in written and oral production, with different approaches and tools indicating that the methods are still in development. Moreover, the findings showed that students’ interactions have received significant attention, and studies have been developed not just in language classes in bilingual education, but also including diverse educational and theoretical contexts such as Content and Language Integrated Learning, task repetition, Science classes, collaborative writing, storytelling, peer feedback, Speech Act theory and collective thinking, language ideologies, conversational analysis, and discourse analyses. The studies, whether focused either on writing or oral tasks or in both, have portrayed significant research and pedagogical implications, grounded on the view of integrated languages in bi-and multilinguals.

Keywords: bilingual education, oral production, translanguaging, written production

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Authors: Md. Rezaul Karim, Andreas Thiel

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Bangladesh is known as one of the most climate vulnerable countries in the world. Innovative technologies are always the key responses to the management of climate impacts. The objectives of this study are to determine the farmer’s perception of climate variability, to compare farmers’ perceptions with metrological data, and to explore the determinants that affect the likelihood of adoption of the selected Climate Smart Agricultural (CSA) technologies. Data regarding climate change perception, determinants and adoption were collected based on the household survey from stratified and randomly selected 365 farmers of the Biral sub-district under Dinajpur district in drought-prone northern Bangladesh. The likelihood of adoption of CSA technologies was analyzed following a multivariate probit model. The findings show that about 82.5% of the farmers perceived increasing temperature, and 75.1 % of farmers perceived decreasing dry season rainfall over the years, which is similarly relevant to metrological data. About 76.4.7% and 80.85% of farmers were aware of the drought tolerance crops and vermicompost, respectively; more than half of the farmers adopted these practices. Around 70.7% of farmers were aware of perching for insect control, but 46.3% of farmers adopted this practice. Although two-thirds of farmers were aware of crop diversification and pheromone trap, adoption was lower compared to the other three CSAs. Results also indicate that the likelihood of adoption of the selected CSAs is significantly influenced by different factors such as socio-economic characteristics, institutional factors and perceived technological or innovation attributes. The likelihood of adopting drought tolerance crops is affected by 11, while crop diversification and perching method by 7, pheromone trap by 9 and vermicompost by 8 determining factors. Lack of information and unavailability of input appear to be major obstacles to the non-adoption of CSA technologies. This study suggests that policy implications are necessary to promote extension services and overcome the obstacles to the non-adoption of individual CSA technologies. It further recommends that the research study should be conducted in a diverse context, nationally or globally.

Keywords: determinants, adoption, climate smart agriculture, northern Bangladesh

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Authors: Rajkumar Ghosh

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India faces a critical task of water shortage, specifically during dry seasons, which adversely impacts agricultural productivity and food protection. Natural farming, specializing in sustainable practices, demands green water management in smart cities in India. This paper examines how rooftop rainwater harvesting (RRWH) can alleviate water scarcity and support sustainable organic farming practices in India. RRWH emerges as a promising way to increase water availability for the duration of dry intervals and decrease reliance on traditional water sources in smart cities. The look at explores the capacity of RRWH to enhance water use performance, help crop growth, enhance soil health, and promote ecological stability inside the farming ecosystem. The medical paper delves into the advantages, challenges, and implementation techniques of RRWH in organic farming. It addresses demanding situations, including seasonal variability of rainfall, limited rooftop vicinity, and monetary concerns. Moreover, it analyses broader environmental and socio-economic implications of RRWH for sustainable agriculture, emphasizing water conservation, biodiversity protection, and the social properly-being of farming communities. The belief underscores the importance of RRWH as a sustainable solution for reaching the aim of sustainable agriculture in natural farming in India. It emphasizes the want for further studies, policy advocacy, and capacity-building initiatives to promote RRWH adoption and assist the transformation in the direction of sustainable organic farming systems. The paper proposes adaptive strategies to triumph over demanding situations and optimize the advantages of RRWH in organic farming. By way of doing so, India can make vast development in addressing water scarcity issues and making sure a greater resilient and sustainable agricultural future in smart cities.

Keywords: rooftop rainwater harvesting, organic farming, green water management, food protection, ecological stabilty

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Authors: Li-Fang CHou, Chun-Jung Tseng, Sung-Chun Tsai

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Zhong-Yong represents unique values and cognitive beliefs of Chinese culture. Zhong-Yong thinking emphasizes (a) holistic thinking and perspective taking, (b) tolerance of contradictions, and (c) pursuance of a person’s interpersonal and inner harmony. With a unique way of naïve dialectical thinking based on Chinese culture, previous studies have found that people with higher Zhong-Yong thinking have more cognitive resources and resilience to make decision for dilemmas and cope stresses. Creativity is defined as the behavior to create novel and value products and viewed as the most important capital for individuals and enterprises. However, the relationship between Zhong-Yong thinking and creativity is still remaining to be unexplored. Three studies were conducted to explore the effects of Zhong-Yong thinking on creativity. In Study1, with 87 undergraduate students from a university in southern Taiwan as participants, we used questionnaire to measure Zhong-Yong thinking and processed creative task (unusual uses task) to get indicators of fluency and flexibility. After controlling background and openness to experience of Big five, the results showed that Zhong-Yong thinking had significant positive effects on fluency and flexibility. In Study 2, 97 undergraduate students were recruited to do Zhong-Yong thinking task and creative task. The result showed that, compared with control group, the participants had higher creative performance after being primed with Zhong-Yong thinking. In Study 3, we adopted questionnaire survey and took 397 employees from private enterprises in Taiwan as sample. Besides the main effects of Zhong-Yong thinking, the moderating effects on the relationship between leadership behavior and employee’s creative performance were also investigated. We found that (a) Zhong-Yong thinking was positively associated to creative performance; (b) Zhong-Yong thinking strengthened the positive effects of transformational and authoritative leadership on creative performance. Finally, the implications of theory/practice and limitations/future directions were also discussed.

Keywords: Zhong-Yong thinking, creativity and creative performance, unusual uses task, transformational leadership, authoritative leadership

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Authors: Jeffrey Chase

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Historically the profession of Occupational Therapy was closely tied to the treatment of those suffering from mental illness; more recently, and especially in the U.S., the percentage of OTs identifying as working in the mental health area has declined significantly despite the estimate that by 2020 behavioral health disorders will surpass physical illnesses as the major cause of disability worldwide. In the U.S. less than 10% of OTs identify themselves as working with the mentally ill and/or practicing in mental health settings. Such a decline has implications for both those suffering from mental illness and the profession of Occupational Therapy. One reason cited for the decline of OT in mental health has been the limited research in the discipline addressing mental health practice. Despite significant advances in technology and growth in the field of neuroscience, major institutions and funding sources such as the National Institute of Mental Health (NIMH) have noted that research into the etiology and treatment of mental illness have met with limited success over the past 25 years. One major reason posited by NIMH is that research has been limited by how we classify individuals, that being mostly on what is observable. A new classification system being developed by NIMH, the Research Domain Criteria (RDoc), has the goal to look beyond just descriptors of disorders for common neural, genetic, and physiological characteristics that cut across multiple supposedly separate disorders. The hope is that by classifying individuals along RDoC measures that both reliability and validity will improve resulting in greater advances in the field. As a result of this change NIH and NIMH will prioritize research funding to those projects using the RDoC model. Multiple disciplines across many different setting will be required for RDoC or similar classification systems to be developed. During this shift in research methodology OT has an opportunity to reassert itself into the research and treatment of mental illness, both in developing new ways to more validly classify individuals, and to document the legitimacy of previously ill-defined and validated disorders such as sensory integration.

Keywords: global mental health and neuroscience, research opportunities for ot, greater integration of ot in mental health research, research and funding opportunities, research domain criteria (rdoc)

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Authors: Alyona Cerfontyne, Levita D'Souza, Lefteris Patlamazoglou

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Unlike adoption and donor-assisted reproduction, misattributed paternity occurring within the context of spontaneous conception and outside of formally recognised practices of having a child remains largely an understudied phenomenon. In adulthood, to discover misattributed paternity, i.e., that the man you call your father is not related to you genetically, can have profound implications for everyone affected. Until the advent of direct-to-consumer DNA testing 20 years ago, such discoveries were relatively rare. Despite the growing number of individuals uncovering their biogenetic paternity through genetic testing, there is very limited research on misattributed paternity from the perspective of adult children affected by it. No research exists on how to support these individuals through counselling post-discovery. Framed as insider action research, this study aimed to explore the perceived psychosocial consequences of misattributed paternity discoveries and coping strategies used by individuals who discover their misattributed paternity status in adulthood. In total, 12 individuals with misattributed paternity participated in semi-structured interviews in July-August 2022. The collected data was analysed using reflexive thematic analysis. The study’s results indicate that discovering misattributed paternity in adulthood can be likened to a watershed moment forever changing the trajectory of one’s life. Psychological experiences consistent with trauma, as well as grief and loss, re-evaluation of close family relationships, reestablishment of one’s identity, as well as experiencing a profound need to belong are the key themes emerging from the analysis of psychosocial experiences. Post-discovery, individuals with misattributed paternity employ a wide range of emotional and problem-focused coping strategies, amongst which seeking connection with those who understand, searching for information on the new biogenetic family and finding new meanings to life are most prominent. The study contributes both to the academic and practical knowledge of experiences of misattributed paternity and highlights the importance of further research on the topic.

Keywords: discovery of misattributed paternity, misattributed paternity, paternal discrepancy, psychosocial consequences, coping

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Authors: Ana Cristina Lindsay, Sherrie Wallington, Faith Lees, Mary Greaney

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Purpose: Latino children in low-income families are at elevated risk of becoming overweight or obese. The purpose of this study was to examine low-income Latino parents’ beliefs, parenting styles and practices related to their children’s eating and physical activity behaviors while at home. Design and Methods: Qualitative study using focus group discussions with 33 low-income Latino parents of preschool children 2 to 5 years of age. Transcripts were analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and physical activity for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment influences low-income Latino preschool children’s eating and physical activity habits. This information is useful for pediatric nurses in their health promotion and disease prevention efforts with low-income Latino families with young children, and for the development of home-based and parenting interventions to prevent and control childhood obesity among this population group. Practice Implications: Pediatric nurses can facilitate communication, provide education, and offer guidance to low-income Latino parents that support their children’s development of early healthy eating and physical activity habits, while taking into account daily life barriers faced by families. Moreover, nurses can play an important role in the integration and coordination of home-visitation to complement office-based visits and provide a continuum of care to low-income Latino families.

Keywords: home environment, Latino, obesity, parents, healthy eating, physical activity

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Authors: Kebron Abich Asnake

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The outbreak of COVID-19 has had far-reaching socio-economic consequences globally, and Ethiopia is no exception. This abstract provides a summary of a research study on the socio-economic impact of COVID-19 in Ethiopia. The study analyzes the health impact, economic repercussions, social consequences, government response measures, and opportunities for post-crisis recovery. In terms of health impact, the research explores the spread and transmission of the virus, the capacity and response of the healthcare system, and the mortality rate, with a focus on vulnerable populations. The economic impact analysis entails investigating the contraction of the GDP, employment and income loss, disruption in key sectors such as agriculture, tourism, and manufacturing, and the specific implications for small and medium-sized enterprises (SMEs), foreign direct investment, and remittances. The social impact section looks at the disruptions in education and the digital divide, food security and nutrition challenges, increased poverty and inequality, gender-based violence, and mental health issues. The research also examines the measures taken by the Ethiopian government, including health and safety regulations, economic stimulus packages, social protection programs, and support for vulnerable populations. Furthermore, the study outlines long-term recovery prospects, social cohesion, and community resilience challenges. It highlights the need to strengthen the healthcare system and finds a balance between health and economic priorities. The research concludes by presenting recommendations for policy-makers and stakeholders, emphasizing opportunities for post-crisis recovery such as diversification of the economy, enhanced healthcare infrastructure, investment in digital infrastructure and technology, and support for domestic tourism and local industries. This research provides valuable insights into the socio-economic impact of COVID-19 in Ethiopia, offering a comprehensive analysis of the challenges faced and potential pathways towards recovery.

Keywords: impact, covid, ethiopia, health

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Authors: Adam M. Yates, Julie E. Byles

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Hypertension has been identified as a prominent co-morbidity of obesity. To improve clinical intervention of hypertension, it is critical to identify metrics that most accurately reflect risk for increased morbidity. Two of the most relevant and accurate measures for increased risk of hypertension due to excess adipose tissue are Body Mass Index (BMI) and Waist-Height Ratio (WHtR). Previous research has examined these measures in cross-national and cross-ethnic studies, but has most often relied on secondary means such as meta-analysis to identify and evaluate the efficacy of individual body mass measures. In this study, we instead use cross-sectional analysis to assess the cross-ethnic discriminative power of BMI and WHtR to predict risk of hypertension. Using the WHO SAGE survey, which collected anthropometric and biometric data from respondents in six middle-income countries (China, Ghana, India, Mexico, Russia, South Africa), we implement logistic regression to examine the discriminative power of measured BMI and WHtR with a known population of hypertensive and non-hypertensive respondents. We control for gender and age to identify whether optimum cut-off points that are adequately sensitive as tests for risk of hypertension may be different between groups. We report results for OR, RR, and ROC curves for each of the six SAGE countries. As seen in existing literature, results demonstrate that both WHtR and BMI are significant predictors of hypertension (p < .01). For these six countries, we find that cut-off points for WHtR may be dependent upon gender, age and ethnicity. While an optimum omnibus cut-point for WHtR may be 0.55, results also suggest that the gender and age relationship with WHtR may warrant the development of individual cut-offs to optimize health outcomes. Trends through multiple countries show that the optimum cut-point for WHtR increases with age while the area under the curve (AUROC) decreases for both men and women. Comparison between BMI and WHtR indicate that BMI may remain more robust than WHtR. Implications for public health policy are discussed.

Keywords: hypertension, obesity, Waist-Height ratio, SAGE

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Authors: W. Assaad, D. Wilmink, H. R. Pasaribu, H. J. M. Geijselaers

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Shell has developed a mono-diameter well concept for oil and gas wells as opposed to the traditional telescopic well design. A Mono-diameter well design allows well to have a single inner diameter from the surface all the way down to reservoir to increase production capacity, reduce material cost and reduce environmental footprint. This is achieved by expansion of liners (casing string) concerned using an expansion tool (e.g. a cone). Since the well is drilled in stages and liners are inserted to support the borehole, overlap sections between consecutive liners exist which should be expanded. At overlap, the previously inserted casing which can be expanded or unexpanded is called the host casing and the newly inserted casing is called the expandable casing. When the cone enters the overlap section, an expandable casing is expanded against a host casing, a cured cement layer and formation. In overlap expansion, ironing or lengthening may appear instead of shortening in the expandable casing when the pressure exerted by the host casing, cured cement layer and formation exceeds a certain limit. This pressure is related to cement strength, thickness of cement layer, host casing material mechanical properties, host casing thickness, formation type and formation strength. Ironing can cause implications that hinder the deployment of the technology. Therefore, the understanding of ironing becomes essential. A physical model is built in-house to calculate expansion forces, stresses, strains and post expansion casing dimensions under different conditions. In this study, only free casing and overlap expansion of two casings are addressed while the cement and formation will be incorporated in future study. Since the axial strain can be predicted by the physical model, the onset of ironing can be confirmed. In addition, this model helps in understanding ironing and the parameters influencing it. Finally, the physical model is validated with Finite Element (FE) simulations and small-scale experiments. The results of the study confirm that high pressure leads to ironing when the casing is expanded in tension mode.

Keywords: casing expansion, cement, formation, metal forming, plasticity, well design

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Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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Authors: Alex Baratta

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In Britain, accent is arguably still a sensitive issue, and for broad regional accents in particular, the connotations can often be quite negative. Within primary and secondary teaching, what might the implications be for teachers with such accents? To investigate this, the study collected the views of 32 British trainee teachers via semi-structured interviews, and questionnaires, to understand how their accent plays a role in the construction of a professional identity. From the results, it is clear that for teachers from the North and Midlands, in particular, accent modification is something that is required by their mentors; for teachers from the Home Counties, accent is rarely mentioned. While the mentors’ rationale for accent modification is to ensure teachers are better understood and/or to sound ‘professional’, many teachers feel that it is a matter of linguistic prejudice and therefore regard an accent modified for someone else as leading to a fraudulent identity. Moreover, some of the comments can be quite blunt, such as the Midlands teacher who resides in the South being told that it was ‘best to go back to where you come from’ if she couldn’t modify her accent to Southern pronunciation. From the results, there are three broad phonological changes expected: i) Northern/Midlands-accented teachers need to change to Southern pronunciation in words such as bath and bus; thus, a change from [baθ] [bʊs] to [bɑ:θ] [bʌs], ii) Teachers from the North, notably Yorkshire, told to change from monophthongs to diphthongs; thus, a change from [go:] to [goʊ], iii) Glottal stops are to be avoided; a teacher from South London was told by her mentor to write the word ‘water’ with a capital t (waTer), in order to avoid her use of a glottal stop. Thus, in a climate of respect for diversity and equality, this study is timely for the following reasons. First, it addresses an area for which equality is not necessarily relevant – that of accent in British teaching. Second, while many British people arguably have an instinct for ‘broad’ versus more ‘general’ versions of regional accents, there appear to be no studies which have attempted to explain what this means from a purely phonological perspective. Finally, given that the Teachers’ Standards do not mention accent as part of the desired linguistic standards, this study hopes to start a national debate as to whether or not they should, rather than shy away from what can be a potentially complex – and sensitive – topic.

Keywords: accent, accommodation, identity, teaching

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Authors: Thandokazi Nyangiwe, Christopher Amoah, Charles P. Mukumba

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The South African construction sector is threatened by emerging black business forums called construction mafias. The emergence of the construction mafia has culminated in the disruptions and abandonment of construction sites resulting in the loss of jobs for construction workers. The paper examines the origin of construction mafias and their impact on the construction sector, including the potential ways to cope with their operations. A qualitative research approach was adopted for this study using open-ended interview questions to gather information from 30 key construction industry stakeholders, including contractors, subcontractors, consultants, and the construction project communities. Content and thematic analysis were used to analyse the data collected. The findings suggest that most participants do not fully understand the existence and operations of construction mafias in the construction industry. Construction mafias claim to be part of the local business forums. They disrupt construction projects and demand a certain amount, usually 30% of the construction value. Construction mafias frequently resort to intimidation and violence if their demands are unmet. Their operations have resulted in delayed completion of construction projects, abandonment of projects, and loss of income for the contractor and jobs for the construction workers. The interviews were limited to construction stakeholders. Because of the nature of the mafias’ operations, they could not be accessed for interviews for fear of being identified because of the connotation attached to their role as construction mafias. Construction project owners face disruptions of projects resulting in loss of equipment, materials, and income. Therefore, there is a need to sensitise the construction stakeholders in the construction industry regarding the existence and operations of the construction mafia and the implications on construction project performance and delivery. The findings will give insight into the operations of the construction mafias in the South African construction industry, which has caused disruptions in construction project sites. Stakeholders must find solutions to address the construction mafias’ disruptive actions on construction projects. The study presents an initial inquiry that will come up with how to manage and cope with the growing operations of construction mafias in the South African construction industry.

Keywords: black business forums, construction mafia, emergence, implication

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Authors: Maria Monica D. Espinosa

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This study aimed to identify and examine the characteristics of an effective leader in a Hospital institution from the perspectives of military nurse-managers. The researcher extracted the different facets of leadership from the stories of six nurse- managers from a military hospital. The stories which are in pre-reflective stage convey an unbiased perspective from which clinical leadership may be defined. Using Phenomenology as a method of Research, the lived experiences of the military nurse-managers served as empirical data which were reflected upon until the formulation of insights. The information from the co-researchers became gallows from which the characteristics of effective leadership in the clinical area were drawn. These insights were synthesized through layers of reflection that resulted to the knowledge about clinical leadership. The reflections are the following, (a) Clinical leaders develop their skills through experiences and hardwork; (b) Clinical leaders are devoted; (c) Clinical leaders are focused; (d) Clinical leaders are good in interpersonal relationship; (e) Clinical leaders are mentors; (f) Clinical leaders seek affirmation and recognition; and (g) Clinical leaders are responsible and dependable. The common themes that emerged from the nurse manager’s stories showed that clinical leadership maybe attained if leaders possessed the following traits, (a) The gift to establish a steadfast and firm management; (b) The proficiency to guide and encourage others towards the achievement of their goals and objectives; (c) The ability to instigate participative and collaborative work among his/her subordinates and (d) The aptitude and skill to address the institutional concerns in their unit. In the future, Clinical leaders should continually adapt an evaluation program on how they can relate socially with their subordinates, the result of which can be used as a basis in developing strategies on relationship enhancement. Moreover, they should empower the nurses by allowing them to voice out their opinions and concerns regarding assignments, role expectations, and workload issues to improve and strengthen the relationships among nurses. Lastly, they can incorporate a collaborative strategy to promote professional socialization attitudes of nurse managers who work with staff nurses to improve the quality of their proficiencies and enhance a positive clinical environment.

Keywords: clinical leadership, experiences, implications, military nurse - managers, phenomenology

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Authors: Majid Aldalbahi

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In 2009, over 3.4 billion people in the world resided in urban areas as a result of rapid urban growth. This figure is estimated to increase to 6.5 billion by 2050. This urban growth phenomenon has raised challenges for many countries in both the developing and developed worlds. Urban growth is a complicated process involving the spatiotemporal changes of all socio-economic and physical components at different scales. The socio-economic components of urban growth are related to urban population growth and economic growth, while physical components of urban growth and economic growth are related to spatial expansion, land cover change and land use change which are the focus of this research. The interactions between these components are complex and no-linear. Several factors and forces cause these complex interactions including transportation and communication, internal and international migrations, public policies, high natural growth rates of urban populations and public policies. Urban growth has positive and negative consequences. The positive effects relates to planned and orderly urban growth, while negative effects relate to unplanned and scattered growth, which is called sprawl. Although urban growth is considered as necessary for sustainable urbanization, uncontrolled and rapid growth cause various problems including consumption of precious rural land resources at urban fringe, landscape alteration, traffic congestion, infrastructure pressure, and neighborhood conflicts. Traditional urban planning approaches in fast growing cities cannot accommodate the negative consequences of rapid urban growth. Microsimulation programme, and modelling techniques are effective means to provide new urban development, management and planning methods and approaches. This paper aims to use these techniques to understand and analyse the complex interactions for the case study of Riyadh city, a fast growing city in Saudi Arabia.

Keywords: policy implications, urban planning, traffic congestion, urban growth, Suadi Arabia, Riyadh

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Authors: Dammar Bahadur Adhikari

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Community forestry in Nepal has got disproportionately high level of support from government and other actors in forestry sector. Even though master plan for forestry sector (1989) has highlighted community and private forestry as one component, the government policies and other intervention deliberately left out private forestry in its structure and programs. The study aimed at providing the pathway for formulating appropriate policies to address need of different kind of forest management regimes in Rautahat district, Nepal. The key areas the research focused were assessment of current status of private forestry, community forest users' understanding on private forestry; criteria for choosing species of private forestry and factors affecting establishment of private forestry in the area. Qualitative and quantitative data were collected employing questionnaire survey, rapid forest assessment and key informant interview. The study found out that forest policies are imposed due to intense pressure of exogenous forces than due to endogenous demand. Most of the local people opine that their traditional knowledge and skills are not sufficient for private forestry and hence need training on the matter. Likewise, local use, market value and rotation dictate the choice of species for plantation in private forests. Currently district forest office is the only government institution working in the area of private forestry all other governmental and non-governmental organizations have condoned. private forestry. Similarly, only permanent settlers in the area are found to establish private forests other forest users such as migrants and forest encroachers follow opportunistic behavior to meet their forest product need from community and national forests. In this regard, the study recommends taking appropriate step to support other forest management system including private forestry provide community forestry the benefits of competition as suggested by Darwin in 18th century, one and half century back and to help alleviate poverty by channelizing benefits to household level.

Keywords: community forest, forest management, poverty, private forest, users’ group

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Authors: M. D. Antoine

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Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in autism care (e.g., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year following an autism spectrum disorder (ASD) diagnosis to identify challenges and potential barriers to communication within the healthcare system in Ottawa, Canada. From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (e.g., family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (e.g., naturopath, occupational therapist, speech and language pathologist) operating in Ottawa. We interpreted the data using thematic analysis. Findings revealed communication challenges between the parents/caregivers and conventional providers while they experience better communication flow with fewer challenges in alternative care settings. However, parents/caregivers are the only links between the health professionals of both streams. From the five contexts examined: organizational, interpersonal, media, cultural, and political-legal, we found four themes (provider knowledge, care integration, flexible care, and time constraints) underlining specific barriers to communication flow between the parties involved in the care of autistic children. The increasing interest in alternative medicine is forcing changes in the healthcare system. Communications occur outside the norms making openings for better communication and information-sharing increasingly essential. Within the identified themes in the current study, the necessity for better communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers would support effective parent/caregiver-provider communication. The findings of the current study contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.

Keywords: alternative medicine, autism care management, autism spectrum disorder, conventional medicine, parent-provider communication

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