Design, Development, and Testing of BEST4Baby, an mHealth Technology to Support Exclusive Breastfeeding in India: Pilot Study.

Background: Exclusive breastfeeding (EBF) at 6 months of age in most low- and middle-income countries, including India, is surprisingly low. There is a relative lack of mobile health apps that specifically focus on leveraging the use of peer counselors (PCs) to support mothers as a means of increasing EBF practices in low- and middle-income countries. Objective: This study aimed to design, develop, and test the usability of Breastfeeding Education Support Tool for Baby (BEST4Baby), a mobile health app specifically designed to support PCs in providing in-home breastfeeding counseling support to mothers in rural India on optimal breastfeeding practices. Methods: A user-centered design process with an agile development methodology was used. The approach involved stakeholders and mothers who were trained to serve as PCs to guide BEST4Baby\u27s design and development, including the app\u27s content and features. PCs were engaged through focus groups with interactive wireframes. During the 24-month pilot study period, we conducted a feasibility test of the BEST4Baby app with 22 PCs who supported home visits with mothers residing in rural India. The intervention protocol required PCs to provide education and follow mothers using the BEST4Baby app, with 9 scheduled home visits from the late prenatal stage to 6 months post partum. BEST4Baby\u27s usability from the PCs\u27 perspective was assessed using the translated System Usability Scale (SUS). Results: The findings of this study align with best practices in user-centered design (ie, understanding user experience, including context with iterative design with stakeholders) to address EBF barriers. This led to the cultural tailoring and contextual alignment of an evidence-based World Health Organization breastfeeding program with an iterative design and agile development of the BEST4Baby app. A total of 22 PCs tested and rated the BEST4Baby app as highly usable, with a mean SUS score of 85.3 (SD 9.1), placing it over the 95th percentile for SUS scores. The approach translated into a highly usable BEST4Baby app for use by PCs in breastfeeding counseling, which also statistically increased EBF practices. Conclusions: The findings suggest that BEST4Baby was highly usable and accepted by mothers serving as PCs to support other mothers in their EBF practices and led to positive outcomes in the intervention group\u27s EBF rates. The pilot study demonstrated that using the specially designed BEST4Baby app was an important support tool for mothers to serve as PCs during the 9 home visits. Trial registration: Clinicaltrials.gov NCT03533725; https://clinicaltrials.gov/ct2/show/NCT03533725

Global nomads, cultural chameleons, strange ones or immigrants? An exploration of Third Culture Kid terminology with reference to the United Arab Emirates

© The Author(s) 2019. The term ‘Third Culture Kid’ (TCK) is commonly used to denote children living in a host culture other than their passport culture during their developmental years. However, its meaning in relation to other terminology referring to a similar concept is a source of interest for many stakeholders. This paper opens up opportunities for further exploring and critiquing the definition of TCK, and opening this up to case studies within the context of the United Arab Emirates and more widely. It is critical to clarify the terminology in light of unprecedented levels of international migration throughout the world. This paper reviews the meaning of culture in relation to TCKs, and explores the meaning of the TCK concept as well as a number of other terms used as alternatives to TCK. A contextualization of the literature follows in relation to the researchers’ own lived experiences in the United Arab Emirates. The term TCK can be seen as part of the general stock of theoretical concepts. This paper acknowledges that it cannot catch all nuances of migrant children in the global context

Stimulating motivation for knowledge sharing: A volunteerism perspective for human behavior in relation to personality traits

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonIn the global economic environment, Knowledge Sharing Behavior (KSB) is prosperous of Higher Educational Institutions (HEIs). Universities play a role in the dissemination of knowledge and knowledgeable graduates for society. They face knowledge-based competition, thus, the dissemination of produced and renewed knowledge among academicians is essential. Yet, insufficient efforts were noted among academics in the context of HEIs. Knowledge management thrives to establish effective and efficient strategies to enhance KSB, however, employees hesitate to share their knowledge. To face this challenge, studies tackled a variety of motivations – intrinsic and extrinsic, that foster KSB in different organizational contexts. Yet, individuals raised some barriers, such as lack of resources and mainly time. This challenge forced knowledge management to enhance motivators continuously for consistent KSB. The literature showed that when informally volunteering (in the workplace), employees prioritize their time and tasks to share knowledge for the common good. High-valued (for others’ interests) motivation as opposed to low-valued (for self-interests) motivation, is essential for academics as knowledge workers. As such, KSB is considered a social or voluntary activity. An argument in the literature questions why individuals respond differently to KSB and its motivational forces. Some studies found that when individuals possess humanitarian values, are motivated by such values. Whereas others found that how to act on humanitarian values is more important. Others argue that an environment with sophisticated technologies is essential to encourage KSB. Noteworthy, there is a consensus among most studies that individual factors are the most influencing contributors to KSB, compared with managerial and technological factors. Personality Traits are considered as prerequisites for predicting KSB, and voluntary behavior as well. However, some studies suggest that knowing personality traits that foster such behavior is not sufficient, and motivational factors should be aligned with the suitable personality traits to predict KSB. In this sense, the literature showed inconclusive and questionable results in examining the effect of personality traits on KSB under the influence of different motivational factors. This could be due to that personality traits interact differently with motivational forces in disparate contexts. This complex interaction developed the need for more empirical evidence. Another reason could be, the complexity of the interaction of individuals’ personality traits with KSB as a construct with two forms, voluntary (up to their will), and solicited (up to others’ request), where each has different characteristics. Another probable reason is that the available studies present theoretical frameworks that partially address the targeted relationships in different contexts, targeting different samples. The literature showed a gap in the empirical studies that examine KSB in its simplistic form (as one construct). There is little research that bridges the gap between predicting voluntary behavior in general and KSB specifically. There is a lack of studies with adequate theoretical frameworks that manipulate the interaction of personality traits and Voluntary Knowledge Sharing Behavior (VKSB) – the proactive form. Meaning, considering the effect of personality traits on KSB as a social or voluntary activity, and ‘Prosocial Value Motive to Volunteering’ as the motivational force to predict V KSB. This study is among the few to bridge this gap and consider the factors that predict voluntary behavior in the area of knowledge sharing. In addressing this gap, this doctoral study developed the research questions: What is the relationship between an individual's personality traits and voluntary knowledge sharing behavior? And what is the mediating role of 'prosocial value motive to volunteering' in this relationship? This study adopted a quantitative research methodology and developed a conceptual model with eleven hypotheses to examine the relationship between personality traits’ and V, and the mediating effect of prosocial value motive to volunteering’ in the relationship. This study is the first in The Kingdom of Bahrain, that adopts a volunteerism perspective to predict academics voluntary KSB in HEIs. The first study in Bahrain to investigate the relationships between HEIs academics’ personality traits and their VKSB, stimulated by their prosocial value motive as a predictor for VKSB. The volunteerism perspective extends the use of the ‘Functional Theory of Volunteer’s Motivation’ in predicting the ‘Voluntary Knowledge Sharing Behavior’, as a social or voluntary engagement, under the mediating effect of ‘Prosocial Value Motive to volunteering’, leading to sustained VKSB. This novelty of work is an attempt to eliminate the gap found in the theoretical contribution and understand the nature of VKSB, its predictors of motivational forces, and academics’ personality traits (PTs). The findings will practically contribute to maintaining the Knowledge Key Performance Indicators (KPIs) and Standards of Bahrain’s HEIs, through personality-based strategies. In turn, the findings will support Bahrain's ten-year plan aims, to position Bahrain as the regional hub for HE. Simultaneously, the vision addresses the Sustainable Development Goals 2030 (SDGs). The empirical results have shown that academics’ personality traits (Conscientiousness, Extraversion, Agreeableness, Neuroticism (reversed) have a positive correlation with VKSB, except Openness to Experience. Further, the prosocial value motive to volunteering has positively mediated the relationship. The theoretical contribution is the development of the empirical model that explains the phenomena of VKSB, in the Bahraini context. Moreover, this reseaarch expands the understanding of the construct of KSB as two forms. It extends the ‘Functional Theory of Volunteer’s Motivation’ in predicting the ‘Voluntary Knowledge Sharing Behavior’, as a social or voluntary engagement, under the mediating effect of ‘Prosocial Value Motive to volunteering’, among Bahraini academics in Bahrain’s HEIs

A Novel Mutation in a Gene Causes Sclerosteosis in a Family of Mediterranean Origin

Background and Objectives: Sclerostin is an SOST gene product that inhibits osteoblast activity and prevents excessive bone formation by antagonizing the Wnt signaling pathway. Sclerosteosis has been linked to loss of function mutations in the SOST gene. It is a rare autosomal recessive disorder characterized by craniotubular hyperostosis and can lead to fatal cerebellar herniation. Our aim is to describe the clinical and radiological features and the new underlying SOST mutation in a patient with sclerosteosis. Case: A 25-year-old female who was referred to the endocrine clinic for suspected excess growth hormone. The patient complained of headaches, progressive blurred vision, hearing disturbances, increased size of feet, proptosis, and protrusion of the chin. She had normal antenatal history except for syndactyly. Images showed diffuse osseous thickening and high bone mineral density. Biochemical and hormonal tests were normal. Due to progressive compressive optic neuropathy, optic nerve fenestration with decompression hemicraniotomy was performed. Sclerosteosis was suspected due to the predominant craniotubular hyperostosis with syndactyly. Using peripheral leucocyte DNA, genomic sequencing of the SOST gene was performed. This identified a novel deletion homozygous mutation in the SOST gene (c.387delG, p.Asp131ThrfsTer116) which disrupts sclerostin function, causing sclerosteosis. Conclusions: Discovery of the molecular basis of sclerosteosis represents an important advance in the diagnosis and management of this fatal disease