Search results for: artistic perspective

Authors: Desiree Vandenberghe, Johan Albrecht

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Non-communicable diseases (NCDs) are responsible for the vast majority of deaths in the European Union (EU) and represent a large share of total health care spending. A future increase in this health and financial burden is likely to be driven by population ageing, lifestyle changes and technological advances in medicine. Without adequate prevention measures, this burden can severely threaten population health and economic development. To tackle this challenge, a correct assessment of the current burden of NCDs is required, as well as a projection of potential increases of this burden. The contribution of this paper is to offer perspective on the evolution of the NCD burden towards the future and to give an indication of the potential of prevention policy. A Non-Homogenous, Semi-Markov model for the EU was constructed, which allowed for a projection of the cost burden for the four main NCDs (cancer, cardiovascular disease, chronic respiratory disease and diabetes mellitus) towards 2030 and 2050. This simulation is done based on multiple baseline scenarios that vary in demand and supply factors such as health status, population structure, and technological advances. Finally, in order to assess the potential of preventive measures to curb the cost explosion of NCDs, a simulation is executed which includes increased efforts for preventive health care measures. According to the Markov model, by 2030 and 2050, total costs (direct and indirect costs) in the EU could increase by 30.1% and 44.1% respectively, compared to 2015 levels. An ambitious prevention policy framework for NCDs will be required if the EU wants to meet this challenge of rising costs. To conclude, significant cost increases due to Non-Communicable Diseases are likely to occur due to demographic and lifestyle changes. Nevertheless, an ambitious prevention program throughout the EU can aid in making this cost burden manageable for future generations.

Keywords: non-communicable diseases, preventive health care, health policy, Markov model, scenario analysis

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Authors: Rusne Kregzdaite

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The value of the cultural sector stems from the symbolic exploration that differentiates cultural organisations from other product or service organisations. As a result, the cultural sector has a dual impact on the socio-economic system: the economic value (expressed in terms of market relations) created influences the dynamics of the country's financial indicators, while the cultural (non-market) value indirectly contributes to the welfare of the state through changes in societal values, creativity transformations and cultural needs of the country. Measurement of indirect (cultural value) impacts is difficult, but in the case of the cultural sector (especially when it comes to economically inefficient state-funded culture), it helps to reveal the essential characteristics of the sector. The study aims to analyze the value of cultural organisations that are invisible in market processes and to base it on quantified calculations. This was be done by analyzing the usefulness of the consumer, incorporating not only the price paid but also the social and cultural decision-making factors that determine the spectator's choice (time dedicated for a visit, additional costs, content, previous experiences, corporate image). This may reflect the consumer's real choice to consume (all the costs he incurs may be considered the financial equivalent of his experience with the cultural establishment). The research methodology was tested by analyzing the performing arts sector and applying methods to the Lithuanian national drama theatre case. The empirical research consisted of a survey (more than 800 participants) of Lithuanian national drama theatre visitors to different performances. The willingness to pay and travel costs methods were used. Analysis of different performances lets identifies the factor that increases willingness to pay for the performance and affects theatre attendance. The research stresses the importance of cultural value and social perspective of the cultural sector and relates it to the discussions of public funding of culture.

Keywords: cultural economics, performing arts, willingness to pay, travel cost analysis, performing arts management

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Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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Authors: Merly Patiño Villanueva, Dubys Villarreal Torres, Eduardo Salazar Araujo, Lezly Ramos Macedo

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The concept of sustainability has been influencing business thinking from the perspective of various economic sectors and their environment, looking for concerns related to the risks associated with the indiscriminate consumption of the planet's resources, which have been widely studied and exposed by different public and private organizations. Tourism is not outsider to this reality; therefore, the concept of sustainable tourism evolves towards the integral management of resources, attending the needs of tourists, host communities and service providers, protecting ecosystems and assuring the conservation of the environment and its biodiversity. Considering the above, the purpose of this paper is to identify trends aimed at promoting sustainable tourism in the destinations of Barranquilla (Colombia) and Nayarit (Mexico). This study is part of the realistic epistemological paradigm, based on the existence of a specific environment for the development of tourism activity and the best sustainability practices associated with this industry, which can be observed and studied, therefore, this research contemplates qualitative research techniques such as the focus group and the interview, applied to 8 experts who are part of the value chain of the sector under study, added to a documentary review taken from the scientific databases Wos and Scopus, as well as statistical information published by official bodies. The data obtained were processed with the qualitative analysis software N-VIVO version 13. As a result, trends and actions to promote tourism are identified for the positioning of the cities of Barranquilla (Colombia) and Nayarit (Mexico) as sustainable destinations: first, the recovery of green areas and environmental spaces, as well as the realization of cultural events; promotion and encouragement of the creative industry and finally the realization of international events. It is concluded that both cities develop activities, projects and investments of public initiative, aimed at positioning them as sustainable tourist destinations.

Keywords: marketing, sustainability, tourism management, policies

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Authors: Patience Oluchi Silas, Yemi Adeshina

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Financial transactions involving the use of the internet has become an important practice among commercial banks in Nigeria with the introduction of internet banking and this has improved banking efficiency in rending services to customers. However, customers in Lagos State are enslaved in the fear of insecurity, technical failure, inadequate operational facilities, including improper telecommunications and poor power supply. It is in line with this that this paper explores the obstacles faced by Lagosians, tourists, small scale business owners, companies, customers and the government's attitude in addressing the challenges associated with online banking system in Nigeria through relevant legislations. Internet banking has the potential to transform economic activity and achieve developmental goals. If the associated Challenges are addressed quickly, then it will have the desired impact on the Nigerian economy. In this study, Respondents, mostly bank employees and customers were issued well designed and structured questionnaires to effectively examine the new developments brought about by the introduction of Internet banking and the challenges inhibiting its adoption. Hypotheses were formulated to test assumptions and claims generated from the study. The results were statistically analyzed to address the issues of errors and chances, and at the end, the result of the statistical analysis shows that all especially insecurity, inadequate operational facilities and poor power supply are the significant factors affecting the adoption of internet banking services in Nigeria. The study recommends that for internet banking to assume a developmental dimension in Nigeria and for the country to be fully integrated and respected in global financial environment, the prevalent level of frauds in Lagos State and among Nigerians must first be addressed and the relevant local laws should be put in place and in consonance with international laws and conventions; get the citizens well educated on the intricacies of Internet usage and frauds.

Keywords: internet-banking, adoption, challenges, insecurity, legislation, fraud, Lagos state, statistics

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Authors: Matthew Lee Turnbough

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In 2007 Spain began to experience the effects of a deep economic crisis, which would generate a situation characterised by instability and uncertainty. This has been an obstacle, especially acute for the youth of this country seeking to enter the workforce. As a result of the impact of COVID-19, the youth in Spain are now suffering the effects of a new crisis that has deepened an already fragile labour environment. In this paper, we analyse the discourses that have emerged from a precarious labour market, specifically from two companies dedicated to operating job portals and job listings in Spain, Job Today, and CornerJob. These two start-up businesses have developed mobile applications geared towards young adults in search of employment in the service sector, two of the companies with the highest user rates in Spain. Utilizing a discourse analysis approach, we explore the impact of individualization and how the process of psychologization may contribute to an increasing reliance on individual solutions to social problems. As such, we seek to highlight the expectations and demands that are placed upon young workers and the type of subjectivity that this dynamic could foster, all this within an unstable framework seemingly marked by chance, a context which is key for the emergence of individualization. Furthermore, we consider the extent to which young adults incorporate these discourses and the strategies they employ basing our analysis on the VULSOCU (New Forms of Socio-Existential Vulnerability, Supports, and Care in Spain) research project, specifically the results of nineteen in-depth interviews and three discussion groups with young adults in this country. Consequently, we seek to elucidate the argumentative threads rooted in the process of individualization and underline the implications of this dynamic for the young worker and his/her labour insertion while also identifying manifestations of the goddess of fortune as a representation of chance in this context. Finally, we approach this panorama of social change in Spain from the perspective of the individuals or young adults who find themselves immersed in this transition from one crisis to another.

Keywords: chance, crisis, discourses, individualization, work, youth

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Authors: Feyzan Tuzkaya, Nihan S. Soylu, Caglar Solak, Mehmet Peker, Hilal Peker, Kemal Ozeralp, Ceren Mete, Ezgi Mehmetoglu, Mehmet Karasu, Cihan Elci, Ece Akca, Melek Goregenli

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Perception, evaluation and representation of the environment have been the subject of many disciplines including psychology, geography and architecture. In environmental and social psychology literature there are several evidences which suggest that cognitive representations about a place consisted of not only geographic items but also social and cultural. Mental representations of residence area or a country is influenced and determined by social-demographics, the physical and social context. Thus, all mental representations of a given place are also social representations. Cognitive maps are the main and common instruments that are used to identify spatial images and the difference between physical and subjective environments. The aim of the current study is investigating the mental and social representations of Turkey in university students’ minds. Data was collected from 249 university students from different departments (i.e. psychology, geography, history, tourism departments) of Ege University. Participants were requested to reflect Turkey in their mind onto the paper drawing sketch maps. According to the results, cognitive maps showed geographic aspects of Turkey as well as the context of symbolic, cultural and political reality of Turkey. That is to say, these maps had many symbolic and verbal items related to critics on social and cultural problems, ongoing ethnic and political conflicts, and actual political agenda of Turkey. Additionally, one of main differentiations in these representations appeared in terms of the East and West side of the Turkey, and the representations of the East and West was varied correspondingly participants’ cultural background, their ethnic values, and where they have born. The results of the study were discussed in environmental and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: cognitive maps, East, West, politics, social representations, Turkey

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Authors: Omneya N. Mekhaimer, Elkhayam M. Dorra, A. Samer Ezeldin

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Over the recent decades, studies on organizational culture have gained global attention in the business management literature, where it has been established that the cultural factors embedded in the organization have an implicit yet significant influence on the organization’s success. Unlike other industries, the construction industry is widely known to be operating in a dynamic and adversarial nature; considering the unique characteristics it denotes, thereby the level of disputes has propagated in the construction industry throughout the years. In the late 1990s, the International Council for Research and Innovation in Building and Construction (CIB) created a Task Group (TG-23), which later evolved in 2006 into a Working Commission W112, with a strategic objective to promote research in investigating the role and impact of culture in the construction industry worldwide. To that end, this paper aims to study the influence of organizational culture in the contractor’s organization on the frequency of disputes caused between the owner and the contractor that occur in commercial projects based in Egypt. This objective is achieved by using a quantitative approach through a survey questionnaire to explore the dominant cultural attributes that exist in the contractor’s organization based on the Competing Value Framework (CVF) theory, which classifies organizational culture into four main cultural types: (1) clan, (2) adhocracy, (3) market, and (4) hierarchy. Accordingly, the collected data are statistically analyzed using Statistical Package for Social Sciences (SPSS 28) software, whereby a correlation analysis using Pearson Correlation is carried out to assess the relationship between these variables and their statistical significance using the p-value. The results show that there is an influence of organizational culture attributes on the frequency of disputes whereby market culture is identified to be the most dominant organizational culture that is currently practiced in contractor’s organization, which consequently contributes to increasing the frequency of disputes in commercial projects. These findings suggest that alternative management practices should be adopted rather than the existing ones with an aim to minimize dispute occurrence.

Keywords: construction projects, correlation analysis, disputes, Egypt, organizational culture

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Authors: Jeisson A. Estrella, Laura C. Herrera, Cristian A. Arenas

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The Colombian electricity sector has been transforming through the insertion of new energy sources to generate electricity, one of them being solar energy, which is being promoted by companies interested in photovoltaic technology. The study of this technology is important for electricity generation in general and for the planning of the sector from the perspective of energy complementarity. Precisely in this last approach is where the project is located; we are interested in answering the concerns about the reliability of the electrical system when climatic phenomena such as El Niño occur or in defining whether it is viable to replace or expand thermoelectric plants. Reliability of the electrical system when climatic phenomena such as El Niño occur, or to define whether it is viable to replace or expand thermoelectric plants with renewable electricity generation systems. In this regard, some difficulties related to the basic information on renewable energy sources from measured data must first be solved, as these come from automatic weather stations. Basic information on renewable energy sources from measured data, since these come from automatic weather stations administered by the Institute of Hydrology, Meteorology and Environmental Studies (IDEAM) and, in the range of study (2005-2019), have significant amounts of missing data. For this reason, the overall objective of the project is to complete the global solar irradiance datasets to obtain time series to develop energy complementarity analyses in a subsequent project. Global solar irradiance data sets to obtain time series that will allow the elaboration of energy complementarity analyses in the following project. The filling of the databases will be done through numerical and statistical methods, which are basic techniques for undergraduate students in technical areas who are starting out as researchers technical areas who are starting out as researchers.

Keywords: time series, global solar irradiance, imputed data, energy complementarity

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Authors: Zhang Cong, Cai Runlin, Jia Fengjiao

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The evolution of the urban agglomeration spatial structure requires strong support of the inter-city traffic system. And the inter-city traffic system can not only meet the demand of the urban agglomeration transportation but also guide the economic development. To correctly understand the relationship between inter-city traffic planning and urban agglomeration can help the urban agglomeration coordinated developing with the inter-city traffic system. The Yangtze River Delta is one of the most representative urban agglomerations in China with strong economic vitality, high city levels, diversified urban space form, and improved transport infrastructure. With the promotion of industrial division in the Yangtze River Delta and the regional travel facilitation brought by inter-city traffic, the urban agglomeration is characterized by highly increasing of inter-city transportation demand, the urbanization of regional traffic, adjacent regional transportation links breaking administrative boundaries, the networked channels and so on. Therefore, the development of inter-city traffic system presents new trends and challenges. This paper studies the interactions between inter-city traffic system and regional economic growth, regional factor flow, and regional spatial structure evolution in the Yangtze River Delta from two dimensions of time and space. On this basis, the adaptability of inter-city traffic development mode and urban agglomeration space structure is analyzed. First of all, the coordination between urban agglomeration planning and inter-city traffic planning is judged from the planning level. Secondly, the coordination between inter-city traffic elements and industries and population distributions is judged from the perspective of space. Finally, the coordination of the cross-regional planning and construction of inter-city traffic system is judged. The conclusions can provide an empirical reference for intercity traffic planning in Yangtze River Delta region and other urban agglomerations, and it is also of great significance to optimize the allocation of urban agglomerations and the overall operational efficiency.

Keywords: evolution, interaction, inter-city traffic system, spatial structure

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Authors: Syena Moltaji, Stephanie Posa, Sander Hitzig, Amanda Mayo, Heather Baltzer

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Purpose: To critically assess deficits following thumb amputation and delineate elements of an ideal thumb prosthesis from the end-user perspective. Methods: This was a qualitative study based on grounded theory. End-user stakeholder groups of thumb amputees and prosthetists were interviewed. Transcripts were reviewed whole first for familiarity. Data coding was then performed by two individual authors. Coded units were grouped by similarity and reviewed to reach a consensus. Codes were then analyzed for emergent themes by each author. A consensus meeting was held with all authors to finalize themes. Results: Three patients with traumatic thumb amputation and eight prosthetists were interviewed. Seven themes emerged. First was the significant impact of losing a thumb, in which codes of functional impact, mental impact, and occupational impact were included. The second theme was the unique nature of each thumb amputee, including goals, readiness for prosthesis, nature of the injury, and insurance. The third emergent theme was cost, surrounding government funding, insurability, and prosthetic pricing. The fourth theme was patient frustration, which included mismatches of prosthetic expectations and realities, activity limitations, and causes of devices abandonment. Themes five and six surrounded the strengths and weaknesses of current prosthetics, respectively. Theme seven was the ideal design for a thumb prosthetic, including abilities, suspension, and materials. Conclusions: Representative data from stakeholders mapped the current status of thumb prosthetics. Preferences for an ideal thumb prosthetic emerged, with suggestions for a simple, durable design. The ability to oppose, grasp and sense pressure was reported as functional priorities. Feasible cost and easy fitting emerged as systemic objectives. This data will be utilized in the development of a sensate thumb prosthetic.

Keywords: smart thumb, thumb prosthetic, sensate prosthetic, amputation

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Authors: Asmamaw Yehun, Tsegaye Gogie, Martin Vermeer, Addisu Hunegnaw

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The Global Positioning System (GPS) is a space-based radio positioning system, which is capable of providing continuous position, velocity, and time information to users anywhere on or near the surface of the Earth. The main objective of this work was to estimate the integrated precipitable water vapour (IPWV) using ground GPS and Low Earth Orbit (LEO) Radio Occultation (RO) to study spatial-temporal variability. For LEO-GPS RO, we used Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) datasets. We estimated the daily and monthly mean of IPWV using six selected ground-based GPS stations over a period of range from 2012 to 2016 (i.e. five-years period). The main perspective for selecting the range period from 2012 to 2016 is that, continuous data were available during these periods at all Ethiopian GPS stations. We studied temporal, seasonal, diurnal, and vertical variations of precipitable water vapour using GPS observables extracted from the precise geodetic GAMIT-GLOBK software package. Finally, we determined the cross-correlation of our GPS-derived IPWV values with those of the European Centre for Medium-Range Weather Forecasts (ECMWF) ERA-40 Interim reanalysis and of the second generation National Oceanic and Atmospheric Administration (NOAA) model ensemble Forecast System Reforecast (GEFS/R) for validation and static comparison. There are higher values of the IPWV range from 30 to 37.5 millimetres (mm) in Gambela and Southern Regions of Ethiopia. Some parts of Tigray, Amhara, and Oromia regions had low IPWV ranges from 8.62 to 15.27 mm. The correlation coefficient between GPS-derived IPWV with ECMWF and GEFS/R exceeds 90%. We conclude that there are highly temporal, seasonal, diurnal, and vertical variations of precipitable water vapour in the study area.

Keywords: GNSS, radio occultation, atmosphere, precipitable water vapour

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Authors: Reihane Mehrparvar

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Human age could exceed further by altering gene expression through food intaking, although as a consequence of recent century eating patterns, human life-span getting shorter by emerging irregulating in autophagy mechanism, insulin, leptin, gut microbiota which are important etiological factors of type-2 diabetes, obesity, infertility, cancer, metabolic and autoimmune diseases. However, restricted calorie intake and vigorous exercise might be beneficial for losing weight and metabolic regulation in a short period but could not be implementable in the long term as a way of life. Therefore, the lack of a dietary program that is compatible with the genes of the body is essential. Sweet and high-glycemic-index (HGI) foods were associated with type-2 diabetes and cancer morbidity. The neuropsychological perspective characterizes the inclination of sweet and HGI-food consumption as addictive behavior; hence this process engages preference of gut microbiota, neural node, and dopaminergic functions. Moreover, meal composition is not the only factor that affects body hemostasis. In this narrative review, it is believed to attempt to investigate how the body responded to different food intakes and represent an accurate model based on current evidence. Eating frequently and ingesting unassimilable protein and carbohydrates may not be compatible with human genes and could cause impairments in the self-renovation mechanism. This trajectory indicates our body is more adapted to starvation and eating animal meat and marrow. Here has been recommended a model that takes into account three important factors: frequent eating, meal composition, and circadian rhythm, which may offer a promising intervention for obesity, inflammation, cardiovascular, autoimmune disorder, type-2 diabetes, insulin resistance, infertility, and cancer through intensifying autophagy-mechanism and eliminate medical costs.

Keywords: metabolic disease, anti-aging, type-2 diabetes, autophagy

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Authors: Tien-Hui Chiang

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Human capital discourse encourages many countries to expand the capacity of HEIs. Along with this expansion, the higher education system is redefined as a free market and in turn it is privatized and commercialized. However, the state’s role in education is to balance social justice and capital accumulation. This role is further regulated by a specific form of neoliberalism constituted by social contexts. These correlations call for exploring the influence of human capital discourse on interwoven issues, such as the state’s role in education, higher education policy, and employability. Method: According to the perspective of neoliberal governmentality, answers to the above four research questions are likely to be embedded within discourses in documents related to higher education policies. Consequently, this study adopts a qualitative approach by analyzing official documents, including government reports, official statistics, circulars and official statements. Documents were collected and subjected to content analysis, with a particular focus on the period from 2005 to 2021. The technique of content analysis was applied to decode keywords and core concepts of these documents. Findings: Neoliberalism is exerted through human capital discourse in China particularly in the changes in higher education policies moving from quantitative expansion to quality control via employment or employability. Such changes highlight that the principle of “n”eoliberalism is more suitable for illustrating the practice of free market logic in different social contexts. The modifications of neoliberalism adopted by the Chinese government reflect that the state’s mission is to secure social security or the common good, so that public managerialism - in the form of programs for employment, internship and entrepreneurship - is adopted in the name of the public interest and the collective mission. Public managerialism now is not only targeted towards social institutions but the population more generally, incarnated here by college graduates. Its practice is not only to renovate organizational cultures but to activate people’s commitment to national development.

Keywords: employability, higher education expansion, neoliberalism, human capital discourse

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Authors: Robin Ferguson

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The context which this paper explores is the provision of Technical Vocational Education and Training (TVET) of southern African workers at sea on local and foreign vessels using a blended learning approach. The pedagogical challenge of providing quality education in this context is that multiple African and foreign languages and cultural norms are found amongst the all-male crew; and there are widely differing levels of education, low levels of digital literacy and limited connectivity. The methodology used is a nested case study. The study describes the mechanisms used to provide ongoing, real-time workplace TVET on two foreign vessels. Some training was done in person when the vessels came into port, however, the majority of the TVET was achieved from shore to ship using a combination of commonly available Google and Microsoft Apps and WhatsApp. Voice, video and text in multiple languages were used to accommodate different learning styles. The learning was supported by the development of learning networks using social media. This paper also reflects on the shore-based organisational change processes required to support sea learning. The conceptual framework used is the Theory of Practice Architectures (TPA) as is provides a site-ontological perspective of the sayings/thinkings, doings and relatings of this workplace training which is multiplanar as it plays out at sea and ashore, in-person and on-line. Using TPA, the overarching practice architectures and supporting structures which confound or enable these learning practices are revealed. The contribution which this paper makes is an insight into an innovative vocational pedagogy which promotes ICT-mediated learning amongst workers who suffer from low levels of literacies and limited ICT-access and who work and live in remote places. It is a pedagogy of possibility which crosses the digital divide.

Keywords: theory of practice architecture, microsoft, google, whatsapp, vocational pedagogy, mariners, distributed workplaces

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Authors: Nayab Kanwal, Noor Us Saher

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The management and utilization of food resources is becoming a big issue due to rapid urbanization, wastage and non-sustainable use of food, especially in developing countries. Therefore, the use of seafood as alternative sources is strongly promoted worldwide. Marine pollution strongly affects marine organisms, which ultimately decreases their export quality. The monitoring of contamination in marine organisms is a good indicator of the environmental quality as well as seafood quality. Monitoring the accumulation of chemical elements within various tissues of organisms has become a useful tool to survey current or chronic levels of heavy metal exposure within an environment. In this perspective, this study was carried out to compare the previous and current levels (Year 2012 and 2014) of heavy metals (Cd, Pb, Cr, Cu and Zn) in crabs marketed in Karachi and to estimate the toxicological risk associated with their intake. The accumulation of metals in marine organisms, both essential (Cu and Zn) and toxic (Pb, Cd and Cr), natural and anthropogenic, is an actual food safety issue. Significant (p>0.05) variations in metal concentrations were found in all crab species between the two years, with most of the metals showing high accumulation in 2012. For toxicological risk assessment, EWI (Estimated weekly intake), Target Hazard quotient (THQ) and cancer risk (CR) were also assessed and high EWI, Non- cancer risk (THQ < 1) showed that there is no serious threat associated with the consumption of shellfish species on Karachi coast. The Cancer risk showed the highest risk from Cd and Pb pollution if consumed in excess. We summarize key environmental health research on health effects associated with exposure to contaminated seafood. It could be concluded that considering the Pakistan coast, these edible species may be sensitive and vulnerable to the adverse effects of environmental contaminants; more attention should be paid to the Pb and Cd metal bioaccumulation and to toxicological risks to seafood and consumers.

Keywords: cancer risk, edible crabs, heavy metals pollution, risk assessment

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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: Antonia Syn

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Politicians’ outlooks on the nature of energy futures and an ‘Energy Transition’ have evolved considerably alongside a steady movement towards renewable energies, buttressed by lower technology costs, rising environmental concerns, and favourable national policy decisions. This paper seeks to examine the degree to which an energy transition has become an incontrovertible ‘status quo’ in parliament, and whether politicians share similar understandings of energy futures or narrate different stories under the same label. Parliamentarians construct different understandings of the same reality, in the form of co-existing and competing discourses, shaping and restricting how policy problems and solutions are understood and tackled. Approaching energy policymaking from a parliamentary discourse perspective draws directly from actors’ concrete statements, offering an alternative to policy literature debates revolving around inductive policy theories. This paper uses computer-assisted discourse analysis to describe fundamental discursive changes in British parliamentary debates around energy futures. By applying correspondence cluster analyses to Hansard transcripts from 1986 to 2010, we empirically measure the policy positions of Labour and Conservative politicians’ parliamentary speeches during legislatively salient moments preceding significant energy transition-related policy decisions. Results show the concept of a technology-based, market-driven transition towards fossil-free and nuclear-free renewables integration converged across Labour and the Conservatives within three decades. Specific storylines underwent significant change, particularly in relation to international outlooks, environmental framings, treatments of risk, and increases in rhetoric. This study contributes to a better understanding of the role politics plays in the energy transition, highlighting how politicians’ values and beliefs inevitably determine and delimit creative policymaking.

Keywords: quantitative discourse analysis, energy transition, renewable energy, British parliament, public policy

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Authors: Craig Wight

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Tourism visits to sites associated to varying degrees with death and dying have for some time inspired academic debate and research into what has come to be popularly described as ‘dark tourism’. Research to date has been based on the mobilisation of various social scientific methodologies to understand issues such as the motivations of visitors to consume dark tourism experiences and visitor interpretations of the various narratives that are part of the consumption experience. This thesis offers an alternative conceptual perspective for carrying out research into dark tourism by presenting a discourse analysis of Lithuanian occupation-themed museums using Foucault’s concept of ‘discursive formation’ from ‘Archaeology of Knowledge’. A constructivist methodology is therefore applied to locate the rhetorical representations of Lithuanian and Jewish subject positions and to identify the objects of discourse that are produced in five museums that interpret a historical era defined by occupation, the persecution of people and genocide. The discourses and consequent cultural function of these museums are examined, and the key finding of the research proposes that they authorise a particular Lithuanian individualism which marginalises the Jewish subject position and its related objects of discourse into abstraction. The thesis suggests that these museums create the possibility to undermine the ontological stability of Holocaust and the Jewish-Lithuanian subject which is produced as an anomalous, ‘non-Lithuanian’ cultural reference point. As with any Foucauldian archaeological research, it cannot be offered as something that is ‘complete’ since it captures only a partial field, or snapshot of knowledge, bound to a specific temporal and spatial context. The discourses that have been identified are perhaps part of a more elusive ‘positivity’ which is salient across a number of cultural and political surfaces which are ripe for a similar analytical approach in future. It is hoped that the study will motivate others to follow a discourse-analytical approach to research in order to further understand the critical role of museums in public culture when it comes to shaping knowledge about ‘inconvenient’ pasts.

Keywords: genocide heritage, foucault, Lithuanian tourism, discursive formatoin

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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: Hi̇lal Surat

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People who want to get rid of stress and intensive working tempo for a while head for recreation operations in order to get rest and have fun. Therefore, planning recreation operation makes contributions to social, physiological, economic and psychological development of an individual and the community in a way that the needs of people meet regularly and constantly. The rapid increase of world population rate makes necessary of benefit from natural or man-made resources in a multiple way. Dams and reservoirs which are built near urban area with the aim of electrical energy conversion and agricultural irrigation are considered as natural area providing various opportunities such as recreation operations. Dams have a great importance regarding to protection and improvement of water resources and coming into service of community. There should be a priority to protect these water resources, which are essential for nature and living organisms. It should be taken into consideration that these water resources are the most important input in the area and have high nature value to make sustainability of recreation effectiveness. The Deriner reservoir that has been built yet near the province of Artvin with natural and cultural properties is considered as an alternative option for meeting the needs of people for sportive and recreation activities and as a potential for planning of water-based recreation activities. Hence, in this study, activities that meet the expectations of people who get benefit from the area considering to natural, cultural and sportive recreation opportunities will be developed. In the first place, planning criteria for some sportive and water-based recreation operations will be defined in order to use the area for recreation and sportive activities and these criteria will be a base for a macro planning work within the holistic perspective of natural, cultural, and economical structure of the area. After this time, necessities of local people and evaluation of reservoir recreational potential will be determined, end then different socio-economic groups according to their in-come, age groups will be chosen and the questionnaire which has already prepared will be done these groups, as a result of these questionnaire recreational activities in water necessities will determine and we are going to develop different suggestion for this reservoir.

Keywords: dam, dam lakes, Deriner, recreation, water based activities

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

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

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

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Authors: Mirad Böhm, Diede De Kok

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It goes without saying that for many NGOs a high level of safety and security are crucial issues, which often necessitates the support of military personnel to varying degrees. The relationship between military and NGO personnel is usually a difficult one and while there has been progress, clashes naturally still occur owing to different interpretations of mission objectives amongst many other challenges. NGOs tend to view safety and security as necessary steps towards their goal instead of fundamental pillars of their core ‘business’. The military perspective, however, considers them primary objectives; thus, frequently creating a different vision of how joint operations should be conducted. This paper will argue that internalizing safety and security into the NGO organizational culture is compelling in order to ensure a more effective cooperation with military partners and, ultimately, to achieve their goals. This can be accomplished through a change in perception of safety and security concepts as a fixed and major point on the everyday agenda. Nowadays, there are several training programmes on offer addressing such issues but they primarily focus on the individual level. True internalization of these concepts should reach further by encompassing a wide range of NGO activities, beginning with daily proceedings in office facilities far from conflict zones including logistical and administrative tasks such as budgeting, and leading all the way to actual and potentially hazardous missions in the field. In order to effectuate this change, a tool is required to help NGOs realize, firstly, how they perceive and define safety and security, and secondly, how they can adjust this perception to their benefit. The ‘safety culture ladder’ is a concept that suggests what organizations can and should do to advance their safety. While usually applied to private industrial scenarios, this work will present the concept as a useful instrument to visualize and facilitate the internalization process NGOs ought to go through. The ‘ladder’ allows them to become more aware of the level of their safety and security measures, and moreover, cautions them to take these measures proactively rather than reactively. This in turn will contribute to a rapprochement between military and NGO priority setting in regard to what constitutes a safe working environment.

Keywords: NGO-military cooperation, organisational culture, safety and security awareness, safety culture ladder

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Authors: Carl-Philipp Valentin Beichert, Marcel Seger

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Digital transformation and climate change require small and medium-sized enterprises (SME) to rethink their way of doing business. Inter-firm collaboration is recognized as helpful means of promoting innovation and competitiveness. In this context, collaborations with start-ups offer valuable opportunities through their innovative products, services, and business models. SMEs, and in particular German craft enterprises, play an important role in the country’s society and economy. Companies in this heterogeneous economic sector have unique characteristics and are limited in their ability to innovate due to their small size and lack of resources. Collaborating with start-ups could help to overcome these shortcomings. To investigate how collaborations emerge and what factors are decisive to successfully drive collaboration, we apply an explorative, qualitative research design. A sample of ten case studies was selected, with the collaboration between a start-up and a craft enterprise forming the unit of analysis. Semi-structured interviews with 20 company representatives allow for a two-sided perspective on the respective collaboration. The interview data is enriched by publicly available data and three expert interviews. As a result, objectives, initiation practices, applied collaboration types, barriers, as well as key success factors could be identified. The results indicate a three-phase collaboration process comprising an initiation, concept, and partner phase (ICP). The ICP framework proposed accordingly highlights the success factors (personal fit, communication, expertise, structure, network) for craft enterprises and start-ups for each collaboration phase. The role of a mediator in the start-up company, with strong expertise in the respective craft sector, is considered an important lever for overcoming barriers such as cultural and communication differences. The ICP framework thus provides promising directions for further research and can help practitioners establish successful collaborations.

Keywords: open innovation, SME, craft businesses, startup collaboration, qualitative research

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Authors: Monir Ahmed

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This paper aims at discussing transcendence, spirituality, and well-being in light of the psychology of religion and spirituality. The main purpose of this paper is i) to demonstrate the importance of cognitive psychological process (thoughts, faith, and beliefs) and the doctrine of creation (‘creatio ex nihilo’) in transcendence, spirituality, and well-being; ii) to discuss the relationships among transcendence, spirituality, and well-being. Psychological studies of spiritual and religious phenomena have been advanced in the decade, mainly to understand how faith, spiritual and religious rituals influence or contribute to well-being. Psychologists of religion and spirituality have put forward methods, tools, and approaches necessary for promoting well-being. For instance, Kenneth I. Pargament, an American psychologist of religion and spirituality, developed spiritually integrated psychotherapy for clinical practice in dealing with the spiritual and religious issues affecting well-being. However, not much progress has been made in understanding the ability of transcendence and how such ability influences spirituality and religion as well as well-being. A possible reason could be that well-being has only been understood in a spiritual and religious context. It appears that transcendence, the core element of spirituality and religion, has not been explored adequately for well-being. In other words, the approaches that have been used so far for spirituality, religion, and well-being lack an integrated approach combining theology and psychology. The author of this paper proposes that cognitive-theological understanding involving faith and belief about the creation and the creator, the transcendent God is likely to offer a comprehensive understanding of transcendence as well as spirituality, religion, and their relationships with well-being. The importance of transcendence and the integration of psychology and theology can advance our knowledge of transcendence, spirituality, and well-being. It is inevitable that the creation is contingent and that the ultimate origin, source of the contingent physical reality, is a non-contingent being, the divine creator. As such, it is not unreasonable for many individuals to believe that the source of existence of non-contingent being, although undiscoverable in physical reality but transcendentally exists. ‘Creatio ex nihilo’ is the most fundamental doctrine in the Abrahamic faiths, i.e., Judaism, Christianity and Islam, and is widely accepted scriptural and philosophical background about the creation, creator, the divine that God created the universe out of nothing. Therefore, it is crucial to integrate theology, i.e., ‘creatio ex nihilo’ doctrine and psychology for a comprehensive understanding of transcendence, spirituality and their relationships with well-being.

Keywords: transcendence, spirituality, well-being, ‘creatio ex nihilo’ doctrine

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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: 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: Sandra Baez, Mariana Pino, Mildred Berrio, Hernando Santamaria-Garcia, Lucas Sedeno, Adolfo Garcia, Sol Fittipaldi, Agustin Ibanez

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Schadenfreude refers to the perceiver’s experience of pleasure at another’s misfortune. This is a multidetermined emotion which can be evoked by hostile feelings and envy. The experience of Schadenfreude engages mechanisms implicated in diverse social cognitive processes. For instance, Schadenfreude involves heightened reward processing, accompanied by increased striatal engagement and it interacts with mentalizing and perspective-taking abilities. Patients with Huntington's disease (HD) exhibit reductions of Schadenfreude experience, suggesting a role of striatal degeneration in such an impairment. However, no study has directly assessed the relationship between regional brain atrophy in HD and reduced Schadenfreude. This study investigated whether gray matter (GM) atrophy in HD patients correlates with ratings of Schadenfreude. First, we compared the performance of 20 HD patients and 23 controls on an experimental task designed to trigger Schadenfreude and envy (another social emotion acting as a control condition). Second, we compared GM volume between groups. Third, we examined brain regions where atrophy might be associated with specific impairments in the patients. Results showed that while both groups showed similar ratings of envy, HD patients reported lower Schadenfreude. The latter pattern was related to atrophy in regions of the reward system (ventral striatum) and the mentalizing network (precuneus and superior parietal lobule). Our results shed light on the intertwining of reward and socioemotional processes in Schadenfreude, while offering novel evidence about their neural correlates. In addition, our results open the door to future studies investigating social emotion processing in other clinical populations characterized by striatal or mentalizing network impairments (e.g., Parkinson’s disease, schizophrenia, autism spectrum disorders).

Keywords: envy, Gray matter atrophy, Huntigton's disease, Schadenfreude, social emotions

Procedia PDF Downloads 336

Authors: Luke Taylor, Samantha J. Hall, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman

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Medway School of Pharmacy, as part of an Equality Diversity and Inclusivity (EDI) initiative run by the University of Kent, decided to take steps to try and negate disparities in numeracy competencies within students undertaking the Master of Pharmacy degree in order to combat a trend in pharmacy students’ numerical abilities upon entry. This included a research driven project 1) to identify if pharmacy students are aware of weaknesses in their numeracy capabilities, and 2) recognise where their numeracy skillset is lacking. In addition to gaining this student perspective, a number of actions have been implemented to support students in improving their numeracy competencies. Reflective and quantitative analysis has shown promising improvements for the final year cohort of 2014/15 when compared to previous years. The method of involving student feedback into the structure of numeracy teaching/support has proven to be extremely beneficial to both students and teaching staff alike. Students have felt empowered and in control of their own learning requirements, leading to increased engagement and attainment. School teaching staff have received quality data to help improve existing initiatives and to innovate further in the area of numeracy teaching. In light of the recognised improvements, further actions are currently being trialled in the area of numeracy support. This involves utilising Virtual Learning Environment platforms to provide individualised support as a supplement to the increased numeracy mentoring (staff and peer) provided to students. Mentors who provide group or one-to-one sessions are now given significant levels of training in dealing with situations that commonly arise from mentoring schemes. They are also provided with continued support throughout the life of their degree. Following results from this study, Medway School of Pharmacy hopes to drive increasing numeracy standards within Pharmacy (primarily through championing peer mentoring) as well as other healthcare professions including Midwifery and Nursing.

Keywords: attainment, ethnicity, numeracy, pharmacy, support

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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

Procedia PDF Downloads 177