5,542 research outputs found

    Sociodemographic, nutritional and health status factors associated with adherence to Mediterranean diet in an agricultural Moroccan adult's population

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    Background. Numerous studies have demonstrated beneficial effects of adherence to the Mediterranean diet (MD) on many chronic diseases, including chronic kidney disease (CKD). Objective. The aim of this study was to assess the adherence of a rural population to the Mediterranean diet, to identify the sociodemographic and lifestyle determinants and to analyze the association between adherence to MD and CKD. Material and Methods. In a cross-sectional study, data on sociodemographic, lifestyle factors, clinical, biochemical parameters and diet were collected on a sample of 154 subjects. Adherence to MD was assessed according to a simplified MD score based on the daily frequency of intake of eight food groups (vegetables, legumes, fruits, cereal or potatoes, fish, red meat, dairy products and MUFA/SFA), using the sex specific sample medians as cut-offs. A value of 0 or 1 was assigned to consumption of each component according to its presumed detrimental or beneficial effect on health. Results. According to the simplified MD score, the study data show that high adherence (44.2%) to MD was characterized by intakes high in vegetables, fruits, fish, cereals, olive oil, and low in meat and moderate in dairy. Furthermore, several factors such as age, marital status, education level, and hypertension status were associated with the adherence to MD in the study population. The majority of subjects with CKD have poor adherence to the MD compared to non-CKD with a statistically insignificant difference. Conclusions. In Morocco, maintaining the traditional MD pattern play crucial role for public health. More research is needed in this area to precisely measure this association

    Comparative Multiple Case Study into the Teaching of Problem-Solving Competence in Lebanese Middle Schools

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    This multiple case study investigates how problem-solving competence is integrated into teaching practices in private schools in Lebanon. Its purpose is to compare instructional approaches to problem-solving across three different programs: the American (Common Core State Standards and New Generation Science Standards), French (Socle Commun de Connaissances, de Compétences et de Culture), and Lebanese with a focus on middle school (grades 7, 8, and 9). The project was conducted in nine schools equally distributed among three categories based on the programs they offered: category 1 schools offered the Lebanese program, category 2 the French and Lebanese programs, and category 3 the American and Lebanese programs. Each school was treated as a separate case. Structured observation data were collected using observation logs that focused on lesson objectives and specific cognitive problem-solving processes. The two logs were created based on a document review of the requirements for the three programs. Structured observations were followed by semi-structured interviews that were conducted to explore teachers' beliefs and understandings of problem-solving competence. The comparative analysis of within-category structured observations revealed an instruction ranging from teacher-led practices, particularly in category 1 schools, to more student-centered approaches in categories 2 and 3. The cross-category analysis showed a reliance on cognitive processes primarily promoting exploration, understanding, and demonstrating understanding, with less emphasis on planning and executing, monitoring and reflecting, thus uncovering a weakness in addressing these processes. The findings of the post-observation semi-structured interviews disclosed a range of definitions of problem-solving competence prevalent amongst teachers with clear divergences across the three school categories. This research is unique in that it compares problem-solving teaching approaches across three different programs and explores underlying teachers' beliefs and understandings of problem-solving competence in the Lebanese context. It is hoped that this project will inform curriculum developers about future directions and much-anticipated reforms of the Lebanese program and practitioners about areas that need to be addressed to further improve the teaching of problem-solving competence

    An Exploration of the Suitability of Pharmacy Education in Saudi Arabia to Prepare Graduates to Meet Healthcare Needs: a Mixed-Methods Study

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    The key role of pharmacists within the health system, particularly in optimising safe, responsible and effective use of medicines, underpins the demand for a highly skilled and competent workforce. Therefore, developing the capacity of pharmacists to attain and maintain essential competencies relevant to the population’s health needs is required to ensure a high standard of patient care, thereby helping to improve patient and population health. In Saudi Arabia, little evidence exists regarding the assessment of national educational programmes’ structure and outcomes. Moreover, no national competency framework exists for pharmacists in any sector or stage of practice. In the absence of such core quality elements to inform pharmacy education assessment and development, the extent to which pharmacy schools in Saudi Arabia prepare competent pharmacists to address societal needs from pharmacy services is unclear. Therefore, this study aimed to explore the extent to which pharmacy education can prepare competent pharmacists to address the healthcare needs for pharmacy practice in Saudi Arabia. An exploratory sequential mixed methods research design was used to address the aim of this study in three phases: individual interviews and focus groups were employed with a purposively selected sample of pharmacy policy makers, pharmacists and the public to explore societal healthcare needs and the roles required of pharmacists to meet those needs; a national online survey of pharmacists and an online nominal group consensus method of pharmacy experts were used to identify competencies considered essential to develop a profession-wide national foundation level competency framework; and a case study in which curriculum mapping of two purposively selected Doctor of Pharmacy (PharmD) curricula was used to assess the extent to which the current pharmacy programme in Saudi Arabia meets the identified competencies of the developed national competency framework. Based on qualitative and quantitative analyses of societal healthcare needs, pharmacists’ roles, core competencies and curricular contents within the local context of Saudi Arabia, findings showed that there is a mismatch between initial education and real practice needs and expectations. While the country’s current needs from pharmacists are to optimise health system capacity and increase access to primary care services and medicines expertise in community pharmacies, the study indicated local education is product-oriented with a focus of curricular content and experiential training opportunities in most schools on preparing future pharmacists for hospital pharmacy practice. The study also identified several gaps between current initial education programmes and the competencies required to practise the expected roles, suggesting that current initial education might not prepare the students sufficiently to provide the full range of quality pharmaceutical services as per the country’s pharmacy practice needs. The study provided a new understanding of graduates’ readiness to practise as per the country’s pharmacy practice needs, the quality of educational programmes and pharmacists' professional development opportunities in Saudi Arabia. Findings maybe used to inform the development of competency-based education and maximise graduates’ capacity to deliver and develop pharmaceutical services effectively to best meet societal healthcare needs in Saudi Arabia

    An empirical investigation of the relationship between integration, dynamic capabilities and performance in supply chains

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    This research aimed to develop an empirical understanding of the relationships between integration, dynamic capabilities and performance in the supply chain domain, based on which, two conceptual frameworks were constructed to advance the field. The core motivation for the research was that, at the stage of writing the thesis, the combined relationship between the three concepts had not yet been examined, although their interrelationships have been studied individually. To achieve this aim, deductive and inductive reasoning logics were utilised to guide the qualitative study, which was undertaken via multiple case studies to investigate lines of enquiry that would address the research questions formulated. This is consistent with the author’s philosophical adoption of the ontology of relativism and the epistemology of constructionism, which was considered appropriate to address the research questions. Empirical data and evidence were collected, and various triangulation techniques were employed to ensure their credibility. Some key features of grounded theory coding techniques were drawn upon for data coding and analysis, generating two levels of findings. These revealed that whilst integration and dynamic capabilities were crucial in improving performance, the performance also informed the former. This reflects a cyclical and iterative approach rather than one purely based on linearity. Adopting a holistic approach towards the relationship was key in producing complementary strategies that can deliver sustainable supply chain performance. The research makes theoretical, methodological and practical contributions to the field of supply chain management. The theoretical contribution includes the development of two emerging conceptual frameworks at the micro and macro levels. The former provides greater specificity, as it allows meta-analytic evaluation of the three concepts and their dimensions, providing a detailed insight into their correlations. The latter gives a holistic view of their relationships and how they are connected, reflecting a middle-range theory that bridges theory and practice. The methodological contribution lies in presenting models that address gaps associated with the inconsistent use of terminologies in philosophical assumptions, and lack of rigor in deploying case study research methods. In terms of its practical contribution, this research offers insights that practitioners could adopt to enhance their performance. They can do so without necessarily having to forgo certain desired outcomes using targeted integrative strategies and drawing on their dynamic capabilities

    Innovation in Energy Security and Long-Term Energy Efficiency Ⅱ

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    The sustainable development of our planet depends on the use of energy. The increasing world population inevitably causes an increase in the demand for energy, which, on the one hand, threatens us with the potential to encounter a shortage of energy supply, and, on the other hand, causes the deterioration of the environment. Therefore, our task is to reduce this demand through different innovative solutions (i.e., both technological and social). Social marketing and economic policies can also play their role by affecting the behavior of households and companies and by causing behavioral change oriented to energy stewardship, with an overall switch to renewable energy resources. This reprint provides a platform for the exchange of a wide range of ideas, which, ultimately, would facilitate driving societies toward long-term energy efficiency

    Evaluating ecosystem interventions for improved health outcomes - The case of the Volta Estuary mangroves and malaria

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    Degradative alteration of ecological systems worldwide is progressing at a time when their influence on human wellbeing is becoming more evident. For some ecosystems and aspects of wellbeing, more concrete knowledge exists. Insights into the science of mangrove-health relationships are however limited and fragmented, with no assessments of human perspectives around these phenomena. This study investigated the nature of the mangrove-human health nexus by assessing the impacts of mangrove ecosystem interventions on health-related ecosystem goods and services and self-reported malaria experiences. Using a mix of methods comprising a systematic literature review, key informant interviews, health questionnaires and Qualitative Comparative Analysis (QCA), this study merges three bodies of work. Research participant viewpoints were synthesised regarding the evolution of mangrove characteristics and use patterns over time, and how these are affected by ecosystem restoration. Survey respondents were also engaged in a recall exercise of malaria experiences over the same period, to provide a basis for causal inference analysis using QCA methodology. Results show that mangrove dependence is declining with ecosystem degradation in Ghana, but ecosystem restoration can modulate some negative health impacts of mangrove degradation, such as infectious disease risk and threats to protein nutrition. Further, specific ecological conditions elicited by ecosystem interventions work together diversely to decrease malaria incidence, but mainly to amplify benefits of current malaria vector control interventions. The causal relationships reveal that certain aspects of wetland restoration can be strengthened to deliver conditions that improve consequences of current malaria management strategies. Environment and health managers must collaborate in policy reorientation, monitoring, evaluation, and capacity building to realise more tangible scientific evidence and sustainable cross-sector outcomes. Ecosystem interventions could plug the shortfalls arising from resource constraints in health policy implementation, towards more uniform outcomes especially in marginal communities

    Multisensory processing, affect and multimodal manipulation: A cognitive-semiotic empirical study of travel documentaries

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    Multisensory processing represents the mirror image of multimodal meaning-making, in that interpreting multimodal discourse predominantly requires multisensory processing, even when different modes rely on the same sensory channels (Khateb et al., 2002), for example images and text in a book (Gibbons, 2012, p. 40). Remley (2017) makes a similar point when discussing the neuroscience of multimodal persuasive messages, when he asserts that “[t]he term ‘multisensory integration’ is the biological equivalent of the term ‘multimodal’ in rhetoric” (p. 9). An understanding of multisensory processing can therefore be (and presumably is) exploited at the stage of text-production as a resource for manipulative multimodal discourses, with all the ideological consequences that entails. The concept of manipulation has been a matter of discussion in critical discourse studies (CDS) and pragmatics for more than a decade. Agreement on how to define and analyse the latter has yet to be reached, although most scholars seem to agree that Relevance Theory (Sperber and Wilson, 1995) can provide a useful entry point thanks to its theorisation of variable contexts and individual cognitive environments (de Saussure, 2005; Maillat, 2013; Maillat and Oswald, 2009; Oswald, 2014). Moreover, the concept of epistemic vigilance (Sperber et al., 2010) has been used to investigate the cognitive barriers that need to be bypassed in order for manipulation to work (Hart, 2013; Mazzarella, 2015). Finally, Sorlin (2017: 133) recently highlighted the need to focus not only on the cognitive aspects influencing manipulation, but also on “the psychological aspect of manipulation that often consists in exploiting the target's weaknesses”, thus pointing towards the dimension of affect as a further explanatory force. This paper begins with an overview of the concepts of manipulation and epistemic vigilance, before discussing insights from the field of multisensory processing in the neurosciences. Then, drawing on some principles from Relevance Theory (Sperber and Wilson, 1995) and looking at some data from travel documentary programmes and their viewers, examples are offered of how manipulation is attempted and achieved through this specific multimodal genre in individual case studies. The focus of the analysis will be on bottom-up (i.e. text-driven) processes and the interpretation/reaction of an audience. The research draws on a novel methodological approach (Castaldi, 2021) that integrates Audience Research (e.g., Schrþder et al., 2003) and Social Semiotics (e.g. Kress and van Leeuwen, 1996, 2001; van Leeuwen, 1999; Machin and Mayr, 2012) in order to analyse media interactions in their individuality. Results suggest that the affective dimension, predominantly attended to through sonic and visual modes, plays a key role for multimodal manipulation to successfully occur

    Brain Computations and Connectivity [2nd edition]

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    This is an open access title available under the terms of a CC BY-NC-ND 4.0 International licence. It is free to read on the Oxford Academic platform and offered as a free PDF download from OUP and selected open access locations. Brain Computations and Connectivity is about how the brain works. In order to understand this, it is essential to know what is computed by different brain systems; and how the computations are performed. The aim of this book is to elucidate what is computed in different brain systems; and to describe current biologically plausible computational approaches and models of how each of these brain systems computes. Understanding the brain in this way has enormous potential for understanding ourselves better in health and in disease. Potential applications of this understanding are to the treatment of the brain in disease; and to artificial intelligence which will benefit from knowledge of how the brain performs many of its extraordinarily impressive functions. This book is pioneering in taking this approach to brain function: to consider what is computed by many of our brain systems; and how it is computed, and updates by much new evidence including the connectivity of the human brain the earlier book: Rolls (2021) Brain Computations: What and How, Oxford University Press. Brain Computations and Connectivity will be of interest to all scientists interested in brain function and how the brain works, whether they are from neuroscience, or from medical sciences including neurology and psychiatry, or from the area of computational science including machine learning and artificial intelligence, or from areas such as theoretical physics

    African American Parenting Style Influence on Children and Adolescents\u27 Academic Success

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    The purpose of this qualitative phenomenological study was to examine how parenting styles influence African American children and adolescents’ academic success. The theory guiding this study was Diana Baumrind’s parenting typologies authoritative, authoritarian, and permissive parenting styles. A sample size of 10 African American participants who had at least one child, 3 months to 18 years of age, were recruited and selected through purposeful and snowball sampling. Each participant was interviewed via recorded Zoom meetings and data were collected utilizing open-ended, semistructured, in-depth interview questions. Three research questions guided this study: (a) what response is given that characterizes parents’ relations with their children at home in relation to their academic achievement? (b) regarding scholastic performance, which PS do African American parents exhibit at home most frequently, and (c) what initiatives may be applied in the school systems to help bridge the educational gap for children from minority groups, particularly, African American pupils? The data were analyzed to form themes and subthemes using the grounded theory method. The study findings revealed that authoritative parenting style was the participants’ primary parenting style of interaction. This research offered practical implications for teachers, parents, school officials, and law enforcement. Five emerging themes (autonomy, literacy builders/literacy enrichment, generational parenting differences/generational parenting similarities, parental academic quality time, and school quality) and six subthemes were derived from the study

    An exploration of adherence and persistence in overactive bladder and other long-term conditions

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    Background and aims Overactive bladder is a common, bothersome, and chronic condition associated with symptoms of urinary urgency, incontinence, increased daytime micturition frequency and nocturia. Despite exerting a significant burden on quality of life, adherence, and persistence behaviours with OAB are particularly poor in comparison with other long-term conditions. The aims of the present work were to explore themes relating to medicine-taking behaviours in OAB and other long-term conditions and to suggest ways to improve them. Methods A systematic literature review was undertaken to understand the current landscape of qualitative work exploring adherence and persistence with OAB patients. A qualitative study involving 1:1 semi-structured interviews was conducted with OAB patients to explore the context and drivers for adherence and persistence behaviours using thematic analysis. A comparative analysis was then undertaken with qualitative papers exploring medicinetaking behaviours in a chronic bowel condition, type II diabetes, and multimorbidity to explore the themes identified in the OAB study for convergence and divergence in other conditions and to contextualise the learnings from the former study. Results The systematic literature review revealed a gap in the literature of qualitative exploration of adherence and persistence behaviours in OAB patients. The OAB study found a range of drivers for non-adherent behaviours including a perceived lack of treatment efficacy, side effects, unclear instructions, and drug and condition hierarchies, as well as the rich context within which these themes sit. The comparative analysis study supported the findings of the OAB study demonstrating evidence of key themes transcending across conditions, including a perceived lack of treatment efficacy and side effects, as well as nuances associated with the OAB experience. Conclusions The present work has identified key drivers for non-adherent behaviours in OAB patients and sets out a number of recommendations categorised within the World Health Organisation’s 5 dimensions of adherence. These include addressing the poor understanding and illness perception of OAB by patients and others, by improving the provision and availability of information, as well as the work of patient support groups; scrutiny on the support within primary care to OAB patients before and after diagnosis; and the encouragement of realistic expectations of the condition and treatment with mindful use of prescriber’s language at the point of prescribing. The present work has further highlighted the utility of conceptual models of adherence such as COM-B and the NCF in understanding medicine-taking behaviours in the context of OAB
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