684 research outputs found

    The need for a tailored approach within integrated childhood obesity care

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    Childhood obesity is nationally and internationally a problem requiring urgent attention. There is general agreement about the need of an integrated approach which includes both prevention of and integrated care for childhood obesity. In this dissertation, the following main research questions are addressed: How can childhood obesity care better connect to the needs and possibilities of children and their parents? What is needed for healthcare professionals to adopt a tailored approach which empowers and supports children and their parents with sustainable behavioral change towards a healthy lifestyle? The research is done in a multi- and interdisciplinary collaboration between the Obesity Center CGG at Erasmus MC Rotterdam, the Care for Obesity project at Vrije Universiteit Amsterdam, and the LIKE consortium, funded by the Dutch Heart Foundation, ZonMw, and Ministry of Health, Welfare, and Sport.In general, from this dissertation can be concluded that with a tailored approach integrated childhood obesity care can connect to the needs and possibilities of children with obesity and their parents. Healthcare professionals can do this by acknowledging the breadth and complexity of personal and environmental factors in achieving a healthier lifestyle. Understanding the child and parents’ perspective is thereby of great importance. The role of a coordinating professional, the psychosocial and lifestyle assessment, and the combined lifestyle intervention are the key elements of integrated care which need to be structurally reimbursed. In addition, integrated care needs to be available for healthcare professionals to adopt a tailored approach which empowers and supports children and their parents with sustainable behavioral change.<br/

    The need for a tailored approach within integrated childhood obesity care

    Get PDF
    Childhood obesity is nationally and internationally a problem requiring urgent attention. There is general agreement about the need of an integrated approach which includes both prevention of and integrated care for childhood obesity. In this dissertation, the following main research questions are addressed: How can childhood obesity care better connect to the needs and possibilities of children and their parents? What is needed for healthcare professionals to adopt a tailored approach which empowers and supports children and their parents with sustainable behavioral change towards a healthy lifestyle? The research is done in a multi- and interdisciplinary collaboration between the Obesity Center CGG at Erasmus MC Rotterdam, the Care for Obesity project at Vrije Universiteit Amsterdam, and the LIKE consortium, funded by the Dutch Heart Foundation, ZonMw, and Ministry of Health, Welfare, and Sport.In general, from this dissertation can be concluded that with a tailored approach integrated childhood obesity care can connect to the needs and possibilities of children with obesity and their parents. Healthcare professionals can do this by acknowledging the breadth and complexity of personal and environmental factors in achieving a healthier lifestyle. Understanding the child and parents’ perspective is thereby of great importance. The role of a coordinating professional, the psychosocial and lifestyle assessment, and the combined lifestyle intervention are the key elements of integrated care which need to be structurally reimbursed. In addition, integrated care needs to be available for healthcare professionals to adopt a tailored approach which empowers and supports children and their parents with sustainable behavioral change.<br/

    Subtitling Francophone World Cinema: Narratives of Identity, Alterity and Power in Audiovisual Translation

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    Cinematic representations of multilingualism raise questions about communication and mutual understanding not only between characters in films but also between films and their audiences, for whom it is typically necessary to facilitate access to foreign dialogues through different forms of translation. Where languages are pitted against one another, however, or juxtaposed in ways that serve to reveal and explore tensions and hierarchies between different linguistic, cultural and social groups, translation becomes entangled in issues of identity, alterity and power. This thesis untangles and explores these complex interactions between languages and translation as they arise in the practice of subtitling. Specifically, it asks questions about how subtitling can play an active part in the shaping of identity by mediating differences between the local, the national and the global, and how subtitles intersect with the relations of power that exist between different cultures. In turn, the thesis exposes the semiotic and narrative dynamics that subtitles add to films and considers the implications of these findings for the ways we think of audiovisual translation and of its relationship with creative processes and accessibility practices. These questions are considered in the context of multilingualism, not only because issues of language, identity and power relations are inextricably involved in discussions thereof, but because multilingualism is an increasingly common experience for many subtitlers and film audiences alike. This is particularly true of francophone world cinema, from whose corpus the thesis analyses six films across three case studies: Bienvenue chez les Ch’tis (Dany Boon 2008), L’esquive (Abdellatif Kechiche 2003), Inch’Allah dimanche (Yamina Benguigui 2001), Dheepan (Jacques Audiard 2015), Le grand voyage (IsmaĂ«l Ferroukhi 2004) and Exils (Tony Gatlif 2004). Methodologically, the thesis combines semiotic, narrative, and linguistic analysis of the subtitled audiovisual texts, drawing on a range of perspectives within Audiovisual Translation Studies, Postcolonial Translation Studies, Film Studies, French and Francophone Studies and Cultural Studies

    A Culturally Responsive Evaluation Lens to Logic Model Design

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    Culturally responsive evaluation (CRE) is an approach that centers all evaluation processes around the culture of a program’s secondary stakeholders. Specifically, this entails ensuring shared meanings in a group through communication. However, minimal connections have been made between CRE and logic model designs. Logic models commonly used by evaluators are data visualization and communication tools designed to aid in effectively communicating a program’s theory. Nevertheless, little is understood about the role culture plays in this process. This multiphase mixed methods study explored the integration of CRE to logic model designs using individualism and collectivism (IC) as a construct for culture and as a basis for tailoring the designs. Specifically, Phase 1 utilized an exploratory sequential design to develop the Logic Model Knowledge Test (LMKT) based upon expert evaluation insight and Amazon Mechanical Turk (MTurk). This addressed how learning from a logic model can be assessed. The LMKT was designed to assess the understanding of logic model components and the content of the program theory. It yielded good validity and reliability and was used in the final phase of the study. Phase 2 used a quantitative two-group comparison design to answer the question, which measures of IC would be more likely to help inform how people interpret logic models differently? Of three existing measures, Wagner (1995) was identified as a highly reliable measure that better distinguished IC-oriented people. Accordingly, it was used in the final phase of the study. Lastly, Phase 3’s mixed methods experimental design utilizing the LMKT and Wagner’s (1995) IC measure was implemented to help answer six questions regarding whether culturally tailored language, visualizations, or both impacted participants’ visual efficiency (VE) and perceived credibility of the program (CP). The findings suggest collectivistic MTurk participants had higher VE across seven culturally tailored logic model conditions. Collectivistic-oriented participants could better quickly and accurately answer the LMKT questions with less mental effort across all logic model conditions than individualistic-oriented participants. Yet, these conditions did not impact IC MTurk participants’ CP. Participants rated the program theory as credible across the logic model conditions regardless of their IC orientation. The findings provided partial empirical support for integrating CRE in logic model designs. Moreover, they added to the validity of the IC construct and Wagner’s (1995) measure. The findings also had valuable implications for evaluation practice through measures that could be used to better understand stakeholder cultural values aligned with communication styles and their knowledge of logic models. Finally, these same tools could be used for future research on evaluation concerning CRE and logic model designs

    From Houses of Worship to Worship in Houses: The Social Construction of Sacred Places in Early 21st Century China

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    While the concept of worship in houses can be traced back to the Christian house church places in Dura Europos between 233 and 256 AD during the Roman Empire, after the foundation of the People's Republic of China in 1949, this kind of church spaces began to appear all across the country. Characterized by the absence of a formal iconic church building or interior, existing types of secular architectural spaces (apartments, offices, basements, etc.) were rented by the Christian community and converted into sacred spaces. Space is susceptible to manipulations caused by human actions. Now what happens if space is manipulated to house not merely a different function but transcendence? As French Marxist philosopher and sociologist Henri Lefebvre's argument in The Production of Space (1991), space is not only a social product but also a complex social construction, based on values and the social production of meanings, which affects spatial practices and perceptions. An existing space, he says, may outlive its original purpose and the raison d'Ă©tre which initially determined its forms, functions, and structures; it may thus, in a sense, become vacant and susceptible to being diverted, re-appropriated, and utilized for a different purpose than its original intent. With my analysis of the worship places of urban house churches in early 21st-century China from the perspective of urban context and architectural space (foregrounded by the development of informal church space in the historical context of Chinese society and politics), this research shows how religious metaphors function as the productive mediators in the process of knowledge transfer between architectural and other professional discourses by bringing back social imagination to the politically neutral spaces of every day; de facto reconstructing the social through transduction of the metaphor of informal spaces

    Doing Things with Words: The New Consequences of Writing in the Age of AI

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    Exploring the entanglement between artificial intelligence (AI) and writing, this thesis asks, what does writing with AI do? And, how can this doing be made visible, since the consequences of information and communication technologies (ICTs) are so often opaque? To propose one set of answers to the questions above, I begin by working with Google Smart Compose, the word-prediction AI Google launched to more than a billion global users in 2018, by way of a novel method I call AI interaction experiments. In these experiments, I transcribe texts into Gmail and Google Docs, carefully documenting Smart Compose’s interventions and output. Wedding these experiments to existing scholarship, I argue that writing with AI does three things: it engages writers in asymmetrical economic relations with Big Tech; it entangles unwitting writers in climate crisis by virtue of the vast resources, as Bender et al. (2021), Crawford (2021), and Strubell et al. (2019) have pointed out, required to train and sustain AI models; and it perpetuates linguistic racism, further embedding harmful politics of race and representation in everyday life. In making these arguments, my purpose is to intervene in normative discourses surrounding technology, exposing hard-to-see consequences so that we—people in the academy, critical media scholars, educators, and especially those of us in dominant groups— may envision better futures. Toward both exposure and reimagining, my dissertation’s primary contributions are research-creational work. Research-creational interventions accompany each of the three major chapters of this work, drawing attention to the economic, climate, and race relations that word-prediction AI conceals and to the otherwise opaque premises on which it rests. The broader wager of my dissertation is that what technologies do and what they are is inseparable: the relations a technology enacts must be exposed, and they must necessarily figure into how we understand the technology itself. Because writing with AI enacts particular economic, climate, and race relations, these relations must figure into our understanding of what it means to write with AI and, because of AI’s increasing entanglement with acts of writing, into our very understanding of what it means to write

    Plug-in healthcare:Development, ruination, and repair in health information exchange

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    This dissertation explores the work done by people and things in emerging infrastructures for health information exchange. It shows how this work relates to processes of development, production, and growth, as well as to abandonment, ruination, and loss. It argues for a revaluation of repair work: a form of articulation work that attends to gaps and disruptions in the margins of technological development. Often ignored by engineers, policy makers, and researchers, repair sensitizes us to different ways of caring for people and things that do not fit, fall in between categories, and resist social norms and conventions. It reminds us that infrastructures emerge in messy and unevenly distributed sociotechnical configurations, and that technological solutions cannot be simply ‘plugged in’ at will, but require all kinds of work. With that, repair emphasizes the need for more democratic, critical, and reflexive engagements with (and interventions in) health information exchange. Empirically, this study aims to understand how ‘integration’ in health information exchange is done in practice, and to develop concepts and insights that may help us to rethink technological development accordingly. It starts from the premise that the introduction of IT in healthcare is all too often regarded as a neutral process, and as a rational implementation challenge. These widespread views among professionals, managers, and policy makers need to be addressed, as they have very real – and mostly undesirable – consequences. Spanning a period of more than ten years, this study traces the birth and demise of an online regional health portal in the Netherlands (2009-2019). Combining ethnographic research with an experimental form of archive work, it describes sociotechnical networks that expanded, collapsed, and reconfigured around a variety of problems – from access to information and data ownership to business cases, financial sustainability, and regional care. It puts a spotlight on the integration of standards, infrastructures, and users in the portal project, and on elements of collapsing networks that quietly resurfaced elsewhere. The reconstruction of these processes foregrounds different instances of repair work in the portal’s development and subsequent abandonment, repurposing, and erasure. Conceptually, this study contributes to academic debates in health information exchange, including the politics of technology, practices of participatory design, and the role of language in emerging information infrastructures. It latches on to ethnographic studies on information systems and infrastructural work, and brings together insights from actor-network theory, science and technology studies, and figurational sociology to rethink and extend current (reflexive and critical) understandings of technological development. It raises three questions: What work is done in the development and demise of an online health portal? How are relations between people and things shaped in that process? And how can insights from this study help us to understand changing sociotechnical figurations in health information exchange? The final analysis includes five key concepts: the act of building network extensions, the method of tracing phantom networks, the notion of sociotechnical figurations, the logic of plug-in healthcare, and repair as a heuristic device.<br/
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