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1

Johnson, Robert R., Michael J. Salvo, and Meredith W. Zoetewey. "User-Centered Technology in Participatory Culture: Two Decades “Beyond a Narrow Conception of Usability Testing”." IEEE Transactions on Professional Communication 50, no. 4 (December 2007): 320–32. http://dx.doi.org/10.1109/tpc.2007.908730.

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Meesters, Kenny, and Bartel Van de Walle. "Serious Gaming for User Centered Innovation and Adoption of Disaster Response Information Systems." International Journal of Information Systems for Crisis Response and Management 6, no. 2 (April 2014): 1–15. http://dx.doi.org/10.4018/ijiscram.2014040101.

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Global profusion of information technology has spawned a large and varied number of tools and systems to aid disaster responders in managing disaster-related information. To adequately study the conception, development and deployment of such tools and systems, the user and the operational context in which user tasks are performed play a central role. As natural disasters however happen unexpectedly, often occur in remote areas and always impose working conditions of high time pressure and high situational volatility, user involvement is difficult to achieve for adequately studying tools and systems in disaster conditions. Current approaches for adoption in disaster conditions are therefore either resource intensive or lack realism, or both. This paper proposes the use of serious games to balance the realism of a disaster situation with an efficient and effective study setup and execution. Building on existing literature for serious gaming, it presents a serious game that focuses on the information management and decision making processes in an urban search and rescue setting. Through several game instances that have been played in the past three years, it examines the usefulness of serious games as a method to conduct research, to facilitate user centered development and to support dissemination activities.
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Duchastel, Philippe. "Learning Environment Design." Journal of Educational Technology Systems 22, no. 3 (March 1994): 225–33. http://dx.doi.org/10.2190/ekxu-3nqt-y0kb-yf27.

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Learning Environment Design (LED) is an instructional design process that is geared to the design of flexible and user-centered learning resources that constitute inviting environments for learning. LED is a possible successor to Instructional Systems Design (ISD), the process that has flourished in the instructional design field over the past three decades. LED is rooted in a conception of learning that emphasizes information, interest, structure, and regulation. LED explicitly distinguishes between the content and strategy facets of design in order to bring out the importance of both.
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Clossen, Amanda S. "Beyond the Letter of the Law: Accessibility, Universal Design, and Human-Centered Design in Video Tutorials." Pennsylvania Libraries: Research & Practice 2, no. 1 (May 2, 2014): 27–37. http://dx.doi.org/10.5195/palrap.2014.43.

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This article demonstrates how Universal and Human-Centered Design approaches can be applied to the process of library video tutorial creation in order to enhance accessibility. A series of questions that creators should consider in order to focus their design process is discussed. These questions break down various physical and cognitive limitations that users encounter, providing a framework for future video creation that is not dependent on specific software. By approaching accommodations more holistically, videos are created with accessibility in mind from their conception. Working toward the ideal of a video tutorial that is accessible to every user leads to the creation of more clearly worded, effective learning objects that are much more inclusive, making instructional concepts available to users of all abilities.
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Wieczorek, Andrzej. "The conception of selected Technology Assessment method and the possibilities of TS application." Multidisciplinary Aspects of Production Engineering 2, no. 1 (September 1, 2019): 234–42. http://dx.doi.org/10.2478/mape-2019-0023.

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Abstract The article addresses the problem of population aging and the related problem of using and maintenance of technical means by the older persons. Such persons, as participants of the exploitation process, experience various problems. Therefore, the challenge is to adapt technical means to the needs of older people. The response of engineers to this challenge may be the technology assessment, which assumes the adoption of various achievements in the field of philosophy, sociology, psychology or other social sciences as tools for their work. The proposal for such a solution is presented in the article and it is an indicator that allows you to draw conclusions about the real needs of older people. The effect of calculations with its use is the Wi characterization in the function of the human age. This characteristic complements the characteristics obtained on the basis of empirical data about the behavior of a technical mean. The article also presents the possibilities of using the discussed indicator. These include: improving the quality of life of users of technical means at various ages through rational management of company resources, improving the quality of life of users through user-centered design, exclusion from exploitation by the elderly technical means/their components based on social technology assessment, analysis and optimization of needs people of different ages, modeling the movement of older people, elimination of social exclusion of older people, improving the quality of life of people of all ages through appropriate knowledge management.
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Manerov, Martin, Arseniy Syuzyumov, and Sergey Tyurin. "Methodical framework for developing interactive web maps based on the example of Struve Geodetic Arc UNESCO World Heritage Site." InterCarto. InterGIS 26, no. 4 (2020): 228–41. http://dx.doi.org/10.35595/2414-9179-2020-4-26-228-241.

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Today, interactive maps are gaining popularity and are used by both specialists and ordinary users in various fields of science and technology. However, the development of the theoretical base of web cartography and the development of interactive maps lags significantly behind the practical component. Moreover, a systematization of the principles of user-centered design in the field of web mapping is necessary. The aim of this work is to create a methodical framework that can be universal for most interactive web map development projects. The creation of the framework is based on the established scheme of interactive web maps development, the ideas of user-oriented design, as well as on the personal experience of the authors in the development of interactive web maps. The methodical framework covers the following aspects: the need for interactivity of web maps, accessibility on various devices, the dimensional aspect of a map, data structuring, the choice of elements of interaction, the need of usage of third-party maps, multilinguality, the ability to upload user-generated content, the need to create animations, and the choice of the base software. The developed framework helps to form the determining part of the conception of an interactive web map, which is a fundamental step in the proposed process of a web map development. Moreover, the framework facilitates the process of creating interactive web maps and opens up new possibilities and development methods for specialists in web cartography. The authors, using the interactive web map dedicated to the World Heritage Site “Struve Geodetic Arc”, which was developed by them, as an example, clearly demonstrated the conceptual development process based on the methodical framework. The terminology is considered and a new definition of an interactive web map is given.
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Romero-Perales, Elena, Clara Sainz-de-Baranda Andujar, and Celia López-Ongil. "Electronic Design for Wearables Devices Addressed from a Gender Perspective: Cross-Influences and a Methodological Proposal." Sensors 23, no. 12 (June 10, 2023): 5483. http://dx.doi.org/10.3390/s23125483.

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The design of wearable devices has been approached from many perspectives over the years, mainly from a functionality, electronics, mechanics, usability, wearability, or product design perspective. However, there is a missing point in these approaches: the gender perspective. Gender intersects with every approach and, considering the interrelationships and dependencies, can achieve a better adherence, reach a wider audience, and even change the conception of the wearables design paradigm. The electronics design addressed from a gender perspective must consider both the morphological and anatomical impacts and those emanating from socialization. This paper presents an analysis of the different factors to consider when designing the electronics of a wearable device, including the functionality to implement, sensors, communications, or the location, together with their interdependencies, and proposes a user-centered methodology that contemplates a gender perspective at every stage. Finally, we present a use case that validates the proposed methodology in a real design of a wearable device for the prevention of gender-based violence cases. For the application of the methodology, 59 experts have been interviewed, 300 verbatims have been extracted and analyzed, a dataset from the data of 100 women has been created and the wearable devices have been tested for a week by 15 users. The electronics design needs to be addressed from a multidisciplinary approach, by rethinking the decisions taken for granted and analyzing the implications and interrelationships from a gender perspective. We need to enroll more diverse people at every design stage and include gender as one of the variables to study.
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Martínez, Mireia, Kimberly Katte, Ana Maria De Andrés, Aida Ribera, Laia Arnal, Josep Carné, Pilar Rodríguez, et al. "Barcelona Aging coLLaboratory (BALL): an open-innovation ecosystem to co-create and test innovative solutions for older people in real-life settings." International Journal of Integrated Care 23, S1 (December 28, 2023): 612. http://dx.doi.org/10.5334/ijic.icic23236.

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Currently, more than 700 million people worldwide are, at least, 65 years old, with this number expected to surpass 1 billion by 2050. Multi-morbidity and complex health and social care needs will increase in turn, exacerbating the demands for policies and services aimed at older adults, which the COVID-19 pandemic has highlighted as lacking. Furthermore, the increased life expectancy and a more participatory society underline a change in roles, with seniors becoming not just consumers but also producers, constituting a vital part of the economy. With other nine institutions from Catalonia, Spain, the PSPV recently launched the Barcelona Aging coLLaboratory (BALL), an open-innovation, person-centered ecosystem, based on the systemic co-creation of services and products with older people. BALL aims to integrate research and innovation processes in the real-life settings of our communities, as well as to act as an intermediary between citizens, research institutions, universities, private companies and public administrations, thereby adopting a quadruple-helix innovation framework, to co-create value and to prototype, validate and scale-up innovation. The ten participating organizations represent older adults and their caregivers, health and social care providers, research centers and universities, and small- and medium-sized enterprises. Aligned with UN Sustainable Development Goals, BALL seeks to: establish communities of practice aimed at carrying out systemic diagnoses in our communities to identify real needs and challenges related to aging, and propose strategic and operational plans; co-create and implement complex interventions and new services that respond to those real needs; co-create innovative products and test them with end-users in real-life settings. BALL is creating an ethics framework to guarantee the protection, safety and reward of participants in the co-creation process. Since its conception in 2021, BALL has incorporated several innovative projects in its catalogue: ADMIT, focused on transforming the health and social care model in order to ensure integrated care; MoviMent, which alters the physical environment and employs gamification techniques to improve physical activity and cognitive function in older adults admitted to hospitals or long-term care facilities; UDhA-AGIL-App, aimed at guiding healthcare professionals in the prescription of physical activity for older adults according to their needs (physical and cognitive function and technological knowledge) and preferences through a decision support algorithm; AI-EAT, a care robot that seeks to assist disabled older adults with feeding; A-MIDA, a person-centered approach for optimizing pharmacological interventions according to life expectancy and frailty instead of age; and QCOA, a toolkit for evaluating long-term care facilities based on PROMs and PREMs. The impact of BALL will be evaluated yearly in terms of: number of projects, number of pilots tested, number of solutions introduced into the marketplace, number of co-creation sessions and personal interviews performed, different user profiles, number of grant applications and their characteristics (national or European), visibility in media and congresses, number of new sponsorships and market impact/value, among others. We expect to influence the health and social care system and society as a whole by increasing awareness on aging challenges, influencing polices for healthy aging and enhancing local economic activities related to aging." Results: The core components of PN programmes for cancer prevention among PEH agreed cross-nationally with all the relevant key participants are (1) Promote cancer awareness and self-management (Facilitate the delivery of cancer education; Promote healthy behaviours and preventative measures; Encourage user involvement in health-related decisions), (2) Identify health needs and barriers (Develop a personalised approach to assessing user need; Seek solutions regarding barriers to care), (3) Co-ordinate access to care (Develop trusting relationships with and facilitate communication between local health and social care providers; Enhance understanding of the needs of PEH among local health and social care providers; Arrange referrals to healthcare services and cancer screening; Co-ordinate and support attendance of appointments), (4) Offer practical assistance (Arrange transportation, mobile phones, clothing, access to hygiene facilities, and storage of medication; Assist with completion of paperwork). Lessons learned: Results from the discussions indicate a high level of consistency and cross-national agreement about what the core components of the intervention should be, and how this should be designed and implemented. Next Steps: This intervention will be adapted to reflect the country-specifics, to ensure that the PN is appropriate to the four local contexts in which it is piloted. Bibliography Carmichael, C., Smith, L., Aldasoro, E., Gil-Salmerón, A., Alhambra-Borrás, T., Doñate-Martínez, A., Seiler-Ramadas, R. & Grabovac, I. (2022) Exploring the application of the navigation model with people experiencing homelessness: a scoping review, Journal of Social Distress and Homelessness. DOI: 10.1080/10530789.2021.2021363
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Carvalho, Helena, Francis C. Dane, and Shari A. Whicker. "Conceptions of Learning and Teaching for Faculty Who Teach Basic Science." Medical Science Educator 31, no. 2 (March 15, 2021): 745–51. http://dx.doi.org/10.1007/s40670-021-01264-4.

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Abstract Introduction Conceptions of learning and teaching refer to what faculty think about teaching effectiveness. Approaches to teaching refer to the methods they use to teach. Both conceptions and approaches range from student-centered/learning-focused (active learner engagement) to teaching-centered/content-focused (passive learner engagement). This study explored how faculty teaching experience influenced faculty conceptions and their approaches to teaching. The authors hypothesized that more experienced educators appreciate and apply active learning approaches. Methods The authors used a cross-sectional survey to collect anonymous data from the Basic Science faculty at Virginia Tech Carilion School of Medicine (VTCSOM). The survey included the Conceptions of Learning and Teaching scale (COLT; Jacobs et al. 2012) and demographic information. They assessed instrument reliability with Cronbach’s alpha and examined relationships between variables with correlation and chi-square and group differences with ANOVA. Results Thirty-eight percent (50/130) of faculty responded to the survey. COLT scores for student-centered (4.06 ± 0.41) were significantly higher (p < 0.001) than teacher-centered (3.12 ± 0.6). Teacher-centered scores were lower (p < 0.05) for younger (30–39, 2.65 ± 0.48) than older faculty (50–59, 3.57 ± 0.71) and were negatively correlated with using multiple teaching methods (p = 0.022). However, 83% (39/50) reported using both traditional lectures and active approaches. Discussion Faculty conceptions about teaching showed appreciation for active learning, but a tendency to use traditional teaching methods interspersed with student-centered ones. Teaching experience was not related to faculty conceptions but was related to their teaching approaches. The amount of time dedicated to teaching was related to the appreciation of active learning, and young teachers were more student-oriented.
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Novel, Fonds, Clara R. P. Ajisuksmo, and Sri Supriyantini. "The Influence of Processing and Regulation of Learning on Academic Achievement Amongst First Year Undergraduate Psychology Students in University of North Sumatra." Asian Journal of University Education 15, no. 2 (December 28, 2019): 36. http://dx.doi.org/10.24191/ajue.v15i2.7555.

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Transition of learning from secondary to higher education demands new students to do academic adjustments, especially towards the change from rote learning to student-centered learning. Student-centered learning requires students to process learning material with more depth and to regulate their own learning. These skills often relate with academic achievement. The purpose of this study was to investigate the influence of processing and regulation of learning conducted by first-level students on academic achievement. Other factors that affect academic achievement were explored too, such as student’s sex, parental support, conception of learning, and learning orientation . This study used mixed method. Quantitative data was obtained through Inventarisasi Cara Belajar (ICB) or Learning Style Inventory, which was filled by 180 third-semester students. ICB was used for measuring the processing and regulation of learning and their effect on academic achievement, which is depicted by Grade Point Average (GPA). Qualitative data was obtained through group interviews. Results of the study indicate that lack of regulation is the only one variable that can predict student academic achievement with a negative correlation. Several other factors were found to affect student academic achievement, including learning orientation, learning conceptions, learning motivation, academic commitment, and parental support. Researcher then designed a training based on reciprocal-teaching approach as an intervention with students as the participant.
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Lee, Matthew T., Julia Wrigley, and Joanna Dreby. "The Research Article as a Foundation for Subject-Centered Learning and Teaching Public Sociology: Experiential Exercises for Thinking Structurally About Child Care Fatalities." Teaching Sociology 34, no. 2 (April 2006): 173–87. http://dx.doi.org/10.1177/0092055x0603400208.

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This paper is the latest installment in a series that is designed to bridge the gap between teaching and practice by developing classroom applications based on a current research article from the American Sociological Review. We discuss the ways in which a recent ASR paper on child care fatalities can be used to help students explore Burawoy's conception of “public” sociology in a manner that is consistent with a subject-centered pedagogical approach. To illustrate this approach, we offer three experiential exercises designed to facilitate the active engagement of students' hearts, as well as their minds, thereby linking our subject-centered approach to the increasingly popular notion of character education.
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DELMAS, ROBERT, and YAN LIU. "EXPLORING STUDENTS’ CONCEPTIONS OF THE STANDARD DEVIATION." STATISTICS EDUCATION RESEARCH JOURNAL 4, no. 1 (May 29, 2005): 55–82. http://dx.doi.org/10.52041/serj.v4i1.525.

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This study investigated introductory statistics students’ conceptual understanding of the standard deviation. A computer environment was designed to promote students’ ability to coordinate characteristics of variation of values about the mean with the size of the standard deviation as a measure of that variation. Twelve students participated in an interview divided into two primary phases, an exploration phase where students rearranged histogram bars to produce the largest and smallest standard deviation, and a testing phase where students compared the sizes of the standard deviation of two distributions. Analysis of data revealed conceptions and strategies that students used to construct their arrangements and make comparisons. In general, students moved from simple, one-dimensional understandings of the standard deviation that did not consider variation about the mean to more mean-centered conceptualizations that coordinated the effects of frequency (density) and deviation from the mean. Discussions of the results and implications for instruction and further research are presented. First published May 2005 at Statistics Education Research Journal: Archives
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Martin, Gale L. "Centered-Object Integrated Segmentation and Recognition of Overlapping Handprinted Characters." Neural Computation 5, no. 3 (May 1993): 419–29. http://dx.doi.org/10.1162/neco.1993.5.3.419.

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Visual object recognition is often conceived of as a final step in a visual processing system, First, physical information in the raw image is used to isolate and enhance to-be-recognized clumps and then each of the resulting preprocessed representations is fed into the recognizer. This general conception fails when there are no reliable physical cues for isolating the objects, such as when objects overlap. This paper describes an approach, called centered object integrated segmentation and recognition (COISR), for integrating object segmentation and recognition within a single neural network. The application is handprinted character recognition. The approach uses a backpropagation network that scans a field of characters and is trained to recognize whether it is centered over a single character or between characters. When it is centered over a character, the net classifies the character. The approach is tested on a dataset of handprinted digits and high accuracy rates are reported.
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Caldas, Caroline Monte, Amuzza Aylla Pereira dos Santos, Maraysa Jéssyca de Oliveira Vieira, José Augustinho Mendes Santos, Deborah Moura Novaes Acioli, and André Veras Costa. "Atuação da equipe multiprofissional na assistência especializada em HIV/AIDS." Revista Recien - Revista Científica de Enfermagem 11, no. 34 (June 27, 2021): 3–12. http://dx.doi.org/10.24276/rrecien2021.11.34.3-12.

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A assistência às pessoas vivendo com Vírus da Imunodeficiência Humana/Síndrome da Imunodeficiência Adquirida sugere investimentos na prática interdisciplinar, substituindo a concepção fragmentária pela compreensão integral da saúde. Assim, objetivou-se conhecer a percepção das pessoas que vivem com síndrome da imunodeficiência adquirida sobre a assistência recebida pela equipe multiprofissional na perspectiva da integralidade da atenção. Trata-se de um estudo qualitativo, exploratório, fundamentado na teoria da integralidade em saúde. Participaram da pesquisa 18 pessoas que vivem com síndrome da imunodeficiência adquirida acompanhadas no serviço de assistência especializada. Os dados foram coletados mediante entrevista semiestruturada, e submetidos à análise de conteúdo segundo Bardin. Emergiram as categorias: “Percepção da assistência à saúde como modo de acolher o usuário”, “Percepção da assistência às necessidades de saúde como garantia de acesso a procedimentos e serviços” e “A assistência à saúde centrada na figura de um único profissional”. Constatou-se que a assistência da equipe multiprofissional é pouco perceptível pelos usuários, que reconhecem apenas um profissional como responsável pelo cuidado.Descritores: Infecções por HIV, Assistência à Saúde, Equipe de Assistência ao Paciente, Integralidade em Saúde. Performance of the multiprofessional team in specialized care in HIV/AIDSAbstract: Assistance to people living with HIV/AIDS suggests investments in interdisciplinary practice, replacing the fragmentary conception with a comprehensive understanding of health. Thus, the objective was to know the perception of people living with HIV/AIDS on the assistance received by the multidisciplinary team in the perspective of comprehensive care. It is a qualitative, exploratory study, based on the theory of integrality in health. The study included 18 people living with HIV/AIDS accompanied by the specialized assistance service. Data were collected through semi-structured interviews, and submitted to content analysis according to Bardin. The categories emerged: “Perception of health care as a way of welcoming the user”, “Perception of assistance to health needs as a guarantee of access to procedures and services” and “Health care centered on the figure of a single professional”. It was found that the assistance of the multidisciplinary team is barely noticeable by users, who recognize only one professional as responsible for care.Descriptors: HIV Infections, Delivery of Health Care, Patient Care Team, Integrality in Health. Desempeño del equipo multiprofesional en atención especializada en VIH/SIDAResumen: La asistencia a las personas que viven con el VIH/SIDA sugiere inversiones en la práctica interdisciplinaria, reemplazando el concepto fragmentario con una comprensión integral de la salud. Por lo tanto, el objetivo era conocer la percepción de las personas que viven con el VIH/SIDA sobre la asistencia recibida por el equipo multidisciplinario en la perspectiva de la atención integral. Este es un estudio cualitativo, exploratorio, basado en la teoría de la integralidad en salud. El estudio incluyó a 18 personas que viven con VIH/SIDA acompañadas por el servicio de asistencia especializada. Los datos se recopilaron a través de entrevistas semiestructuradas y se sometieron a análisis de contenido según Bardin. Surgieron las categorías: “Percepción de la atención médica como una forma de acoger al usuario”, “Percepción de la asistencia a las necesidades de salud como garantía de acceso a procedimientos y servicios” y “Atención médica centrada en la figura de un solo profesional”. Se descubrió que la asistencia del equipo multidisciplinario apenas se nota por los usuarios, que reconocen a un solo profesional como responsable de la atención.Descriptores: Infecciones por VIH, Prestación de Atención de Salud, Grupo de Atención al Paciente, Integralidad en Salud.
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Clarke, Stephen, Carolyn Ells, Brett D. Thombs, and David Clarke. "Defining elements of patient-centered care for therapeutic relationships: a literature review of common themes." European Journal for Person Centered Healthcare 5, no. 3 (September 26, 2017): 362. http://dx.doi.org/10.5750/ejpch.v5i3.1337.

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Rationale and aims: Patient-centered care is a recognized clinical method and ideal for patient - health professional relationships. Many definitions have influenced its evolution. For this research, our aim was: (1) to assess definitions and descriptions of patient-centered care to draw out elements of patient-centered care that are considered to be important markers of successful patient-centered care in the patient - health professional relationship and (2) to propose a set of elements that collectively reflect the diversity of ‘patient-centered’ definitions that describe the patient-professional relationship in this literature. A secondary aim was (3) to provide elements that could be used for development of a quality assessment tool.Methods: We conducted a critical interpretive review of patient-centered care and patient-centered communication literature, beginning with a critical synthesis that yielded 12 articles that introduced new theoretical and definitional work on patient-centered care and patient-centered communication. We used an inductive and iterative analysis process to identify and group common themes. We used operational language to describe these themes. Results: We identified 6 elements (each with 2 or more sub-elements) of the patient - health professional relationship that are considered important markers of successful patient-centered care (as found in this literature). The 6 elements are: (1) Engaging the Patient as a Whole Person, (2) Recognizing and Responding to Emotions, (3) Fostering a Therapeutic Alliance, (4) Promoting an Exchange of Information, (5) Sharing Decision-Making and (6) Enabling Continuity of Care, Self-Management and Patient Navigation. Conclusions: Comparable fundamental elements were common among most authors within this literature: we found that variation in theory was typically a matter of degree and language. This work contributes analyses towards greater theoretical consistency for conceptions of patient-centered care. It also provides avenues for future development of quality assurance benchmarks.
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Sbai, Abdelkader, Abdeljabbar El Mediouni, Hassan Hakim, and Said Mentak. "Conceptions of The Baccalaureate Students of The Eastern Region of Morocco on the Environment and Sustainable Development." European Journal of Engineering Research and Science 5, no. 10 (October 17, 2020): 1235–42. http://dx.doi.org/10.24018/ejers.2020.5.10.2134.

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The conceptions of the baccalaureate students of Bouarfa and Jerada are analyzed on the basis of a questionnaire relating to the environment and sustainable development. These conceptions are analyzed as interactions between scientific knowledge (K), social practices (P), and value systems (V). The multivariate analyzes used highlight two major poles or systems of conceptions. The first pole brings together people with rather anthropocentric tendencies concerned first with the use of natural resources. The second pole brings together people who tend to be more ecocentric and concerned about preserving the environment. Within these clusters appear sub-groups with different characteristics: for or against GMOs, preservation of the environment, activism in favor of the environment, actions of defense or protection of the environment. Most of the students interviewed lent feelings towards animals, but with a difference from one animal to another and from one city to another (sentiment-centered attitude). These different conceptions deserve to be taken into account in the training of trainers and teaching programs to better assume the objectives of Environmental Education.
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Sbai, Abdelkader, Abdeljabbar El Mediouni, Hassan Hakim, and Said Mentak. "Conceptions of The Baccalaureate Students of The Eastern Region of Morocco on the Environment and Sustainable Development." European Journal of Engineering and Technology Research 5, no. 10 (October 17, 2020): 1235–42. http://dx.doi.org/10.24018/ejeng.2020.5.10.2134.

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The conceptions of the baccalaureate students of Bouarfa and Jerada are analyzed on the basis of a questionnaire relating to the environment and sustainable development. These conceptions are analyzed as interactions between scientific knowledge (K), social practices (P), and value systems (V). The multivariate analyzes used highlight two major poles or systems of conceptions. The first pole brings together people with rather anthropocentric tendencies concerned first with the use of natural resources. The second pole brings together people who tend to be more ecocentric and concerned about preserving the environment. Within these clusters appear sub-groups with different characteristics: for or against GMOs, preservation of the environment, activism in favor of the environment, actions of defense or protection of the environment. Most of the students interviewed lent feelings towards animals, but with a difference from one animal to another and from one city to another (sentiment-centered attitude). These different conceptions deserve to be taken into account in the training of trainers and teaching programs to better assume the objectives of Environmental Education.
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Ezequiel, Oscarina da Silva, Bianca Sakamoto Ribeiro Paiva, Alessandra Lamas Granero Lucchetti, Carlos Eduardo Paiva, Ivana Lúcia Damásio Moutinho, Robson Aparecido dos Santos Boni, and Giancarlo Lucchetti. "Do different pedagogical conceptions result in different quality of life levels?" Revista da Associação Médica Brasileira 66, no. 3 (March 2020): 257–62. http://dx.doi.org/10.1590/1806-9282.66.3.257.

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SUMMARY OBJECTIVE The present study aims to compare medical students’ quality of life (QoL) at two Brazilian institutions with different pedagogical conceptions. METHODS We studied students during the first four years of medical school at two institutions (one using active methodologies and small groups and the other using traditional lectures and large groups). We used a demographic questionnaire and the WHOQOL-BREF. RESULTS 820 medical students were included. No significant differences in quality of life were found in general, nor while evaluating the course phase, except for the physical WHOQOL, which was lower for 2nd-year students at the institution with traditional lectures, even when adjusted for gender. CONCLUSION Our findings revealed that, despite having very distinct pedagogical conceptions and characteristics, there were no significant differences in medical students’ QoL scores between both institutions. These results are surprising and differ from our initial hypothesis, which expected better QoL for those using more active and student-centered methods.
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Veras, Renata Meira, Vitória Batista Calmon de Passos, Caio Cézar Moura Feitosa, and Sheyla Christine Santos Fernandes. "Different training models in health and student conceptions of humanized medical care." Ciência & Saúde Coletiva 27, no. 5 (May 2022): 1781–92. http://dx.doi.org/10.1590/1413-81232022275.23832021en.

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Abstract Since 2009, there have been two training models promoting medical training at the Federal University of Bahia: the traditional and the cycle system. The curricular changes aimed to guide the professional profile for a better performance at the Brazilian Unified Health System and to develop a greater understanding of human diversity, illness and care. This study analyzed whether these models have produced different conceptions about what humanized care means to medical students. The similitude analysis was used, with the support of the Iramuteq software for data treatment. It was observed that both groups share conceptions centered on the patient; however, students graduating from the Interdisciplinary Bachelor Degree in Health demonstrated that they based their ideas on an expanded concept of health considering its various determinants. Students enrolled in the course through their grades at the National High School Examination, exposed perceptions of the topic considering necessary ethical and humanistic aspects but limited to the direct contact between doctor and patient. It is concluded that the previous training in the Interdisciplinary Bachelor’s Degree in Health could be responsible for the development of the students’ critical assessment of the concept of health and the importance of the Humanization of Care.
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Siouta, Eleni, and Ulf Olsson. "Patient Centeredness from a Perspective of History of the Present: A Genealogical Analysis." Global Qualitative Nursing Research 7 (January 2020): 233339362095024. http://dx.doi.org/10.1177/2333393620950241.

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The overall aim of this study, performed in Sweden, was to problematize the contemporary national and transnational discourse on patient centeredness, which during recent decades has become a given, having become established as a dogma in conversations, writing, and thinking about patients and health care. We did that by showing that ideas such as patient centeredness can be seen differently from the way they are depicted in contemporary discourses about health care. In the presented analysis, we drew on Foucault’s concepts of governmentality, ‘history of the present’ and genealogy. This means that we reflected on contemporary conceptions of how phenomena, such as the care seeker, have been constructed within other discourses about health care. Empirically, we used different health policy documents—government reports from three different historical periods. The analysis showed that contemporary narratives about centeredness are neither more, nor less, care seeker-centered than the narratives of yesteryear. Rather, the phenomenon of the care seeker is given different frames and meanings within the framework of different economic and historical discourses about health care. Our analysis raised questions about the contemporary construction of patient centeredness. In a world with such huge economic differences between nations, as well as between citizens within most nations, the contemporary discourse may be limited as it does not problematize structural issues in the same way as previous discourses had done. Perhaps what is needed today are national and international patient-centered or person-centered discourses which also discuss policies and practices that are population- and social group-centered. In the final discussion of the analysis, we identified a new patient-centered discourse, which views the patient as a resource among other resources. The most important limitation of this type of study is that it is only about discourses and policy issues and not about daily practical activities.
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Ahuja, Neel. "Postcolonial Critique in a Multispecies World." PMLA/Publications of the Modern Language Association of America 124, no. 2 (March 2009): 556–63. http://dx.doi.org/10.1632/pmla.2009.124.2.556.

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Histories of race and empire have shaped the field imaginary of species studies from its inception. Politically, the field's animal-activist heritage models its critique on movements for racial justice. Historically, this move links to Enlightenment conceptions of animals that relied on the same objectifying methods used to represent slaves and the poor: sentimentality, representations of cruelty, humane manifestos. Epistemologically, the taxonomic tools that name the objects of analysis have been deployed to define non-Europeans as subspecies or independent species. Geographically, the field's intellectual production is centered in the United States, Australia, and Britain, tied to neocolonial institutions of animal advocacy, and slow in recognizing internal critiques of animal and ecological movements by activists of color.
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Jacquart, Melissa, Rebecca Scott, Kevin Hermberg, and Stephen Bloch-Schulman. "Diversity Is Not Enough." Teaching Philosophy 42, no. 2 (2019): 107–39. http://dx.doi.org/10.5840/teachphil2019417102.

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In philosophy, much attention has rightly been paid to the need to diversify teaching with regard to who teaches, who is taught, and which authors and questions are the focus of study. Less attention, however, has been paid to inclusive pedagogy—the teaching methods that are used, and how they can make or fail to make classes as accessible as possible to the diverse students who enter them. By drawing on experiences from our own teaching as well as research on student-centered, inclusive best practices, we advocate for five principles of inclusive pedagogy: fostering a growth mindset, examining inclusive conceptions of authority, promoting transparency, encouraging flexibility, and, finally, continually promoting self-reflection for both students and teachers.
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jones, pattrice. "Roosters, hawks and dawgs: Toward an inclusive, embodied eco/feminist psychology." Feminism & Psychology 20, no. 3 (August 2010): 365–80. http://dx.doi.org/10.1177/0959353510368120.

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The gendered exploitation of roosters used in cockfighting is a case example of the social construction of gender via animals — a psychosocial process that injures both people and animals. Similar processes of social construction by way of animals occur in relation to race and sexual orientation, with similarly mutually hurtful results. The rehabilitation of roosters used in cockfighting illustrates the utility of an expanded and amended conception of Herman’s principles of trauma recovery enacted within the emerging insights of trans-species psychology. Those insights lead us toward a truly inclusive eco/feminist psychology centered on acceptance of situated human animality and an understanding of traumatic alienation as a factor in both personal and communal problems in living, including climate change. This perspective shifts the ground for clinical practice, mandating explicit attention not only to interpersonal and intrapsychic cleavages but also to schisms between self and nature, other animals, and one’s own animality.
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M. Silva, Juanita, Jessica H. Hunt, and Jasmine Welch-Ptak. "From (and for) the Invisible 10%: Including Students With Learning Disabilities in Problem-Based Instruction." Journal for Research in Mathematics Education 54, no. 4 (July 2023): 260–78. http://dx.doi.org/10.5951/jresematheduc-2020-0117.

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We present the evolving fraction conceptions of two elementary school children with mathematics learning disabilities (MLD). We use qualitative analyses to capture the mathematical knowledge and experiences of each child and show how teaching was used to support advancement of their fractional reasoning. Results illustrate two viable pathways of advancing fractional thinking, both of which reflect students’ increasing levels of units coordination over time. We argue that recognizing and building on each child’s strengths—while respecting and accommodating for their MLD—was central to promoting their learning. Results provide an existence proof of a new evidence base for student-centered, problem-based instruction for students with MLD, grounded in a careful understanding of student mathematical thinking and accommodations for cognitive differences.
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Wijaya, I. Kadek Merta. "KONSEPSI NATAH DAN LEBUH SEBAGAI “RUANG KESEIMBANGAN” DALAM ARSITEKTUR TRADISIONAL BALI." Jurnal Arsitektur ZONASI 2, no. 2 (June 17, 2019): 98. http://dx.doi.org/10.17509/jaz.v2i2.14677.

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Natah and lebuh are interpreted as empty outer space in spatial planning of traditional Balinese settlements. In traditional Bali settlements in mountain areas, natah in the form of elongated empty space that binds or becomes the orientation of the times buildings, while traditional Bali settlements in lowland areas in the form of empty space as a center centered orientation of the building configuration. Lebuh is a space that is is in the outermost part of a residential yard or on a scale the settlements are in the village border in the direction of the teben orientation. Natah space and lebuh usually used as a ceremonial space for renewal (a ritual to neutralize power negative), a wide ritual of banten (giving the ceremony facilities that have been used in front under the entrance), downstreaming the process of ritual activities in a home yard and the village environment, as a space for social activities and local customs. Aim this study is an interpretation of the conception of the balance of the natah space and lebuh on traditional Balinese settlements of residential and residential scale using qualitative interpretative exploratory methods through a system of social activity approaches, rituals and safety evacuation and local and general concepts about the dichotomy of space. The results of the research obtained are the natah space and the lebuh as a empty space outside and being in the orientation of nista or teben containing ritual, social and conception safety seen from the spatial layout and function of the two spaces.
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Fiorati, Regina Celia, and Valeria Meirelles Carril Elui. "Social determinants of health, inequality and social inclusion among people with disabilities." Revista Latino-Americana de Enfermagem 23, no. 2 (April 2015): 329–36. http://dx.doi.org/10.1590/0104-1169.0187.2559.

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OBJECTIVE: to analyze the socio-familial and community inclusion and social participation of people with disabilities, as well as their inclusion in occupations in daily life. METHOD: qualitative study with data collected through open interviews concerning the participants' life histories and systematic observation. The sample was composed of ten individuals with acquired or congenital disabilities living in the region covered by a Family Health Center. The social conception of disability was the theoretical framework used. Data were analyzed according to an interpretative reconstructive approach based on Habermas' Theory of Communicative Action. RESULTS: the results show that the socio-familial and community inclusion of the study participants is conditioned to the social determinants of health and present high levels of social inequality expressed by difficult access to PHC and rehabilitation services, work and income, education, culture, transportation and social participation. CONCLUSION: there is a need to develop community-centered care programs in cooperation with PHC services aiming to cope with poverty and improve social inclusion.
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Turanović, Mirsad, and Amina Ajdinović Mehović. "Strategies of Apparent Empathy and Polarization in Kemalistic Discourse." Društvene i humanističke studije (Online) 8, no. 2(23) (September 5, 2023): 83–102. http://dx.doi.org/10.51558/2490-3647.2023.8.2.83.

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The paper analyzes the discursive strategies of apparent empathy and ideological polarization that were used to legitimize discrimination against covered female students in the Republic of Turkey. We approached this complex social problem from the point of view of critical discourse analysis, which represents an interdisciplinary research area centered on the interest in researching the manipulative use of language. The ban on wearing headscarves in universities in Turkey was the fruit of the Kemalist conception of modernism and hegemony established by the Kemalist elites. An important role in preserving that hegemony was also played by the media, whose primary goal was to legitimize social injustice and protect the social order based on an asymmetric distribution of power. They performed this role of the media through the manipulative use of language within clearly recognizable discursive strategies, which was shown by the analysis of the newspaper text that is the subject of this paper.
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Champoux, Emily, Rory Price, Joan E. Cowdery, Mackenzie Dinh, William J. Meurer, Narmeen Rehman, Caitlin Schille, et al. "Reach Out Emergency Department: Partnering With an Economically Disadvantaged Community in the Development of a Text-Messaging Intervention to Address High Blood Pressure." Health Promotion Practice 21, no. 5 (March 31, 2020): 791–801. http://dx.doi.org/10.1177/1524839920913550.

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Background. Hypertension affects nearly 30% of the U.S. adult population. Due to the ubiquitous nature of mobile phone usage, text messaging offers a promising platform for interventions to assist in the management of chronic diseases including hypertension, including among populations that are historically underserved. We present the intervention development of Reach Out, a health behavior theory–based, mobile health intervention to reduce blood pressure among hypertensive patients evaluated in a safety net emergency department primarily caring for African Americans. Aims. To describe the process of designing and refining text messages currently being implemented in the Reach Out randomized controlled trial. Method. We used a five-step framework to develop the text messages used in Reach Out. These steps included literature review and community formative research, conception of a community-centered behavioral theoretical framework, draft of evidence-based text messages, community review, and revision based on community feedback and finalization. Results. The Reach Out development process drew from pertinent evidence that, combined with community feedback, guided the development of a community-centered health behavior theory framework that led to development of text messages. A total of 333 generic and segmented messages were created. Messages address dietary choices, physical activity, hypertension medication adherence, and blood pressure monitoring. Discussion. Our five-step framework is intended to inform future text-messaging-based health promotion efforts to address health issues in vulnerable populations. Conclusion. Text message–based health promotion programs should be developed in partnership with the local community to ensure acceptability and relevance.
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Kim, Haeri. "3-5 Year Old Children’s Understanding of the Living and Non-living Children." Korean Association For Learner-Centered Curriculum And Instruction 22, no. 21 (November 15, 2022): 993–1008. http://dx.doi.org/10.22251/jlcci.2022.22.21.993.

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Objectives This study aims to understand children’s conception of aliveness through their descriptions of biotic and abiotic objects and the cues that led them to think this way. Methods To this end, 35 children each at 2 different Choongchung province educational institutions were randomly sampled by age for a total of 105 children, who participated in two rounds of interviews including activities. In the first round, the children were given sufficient individual time to draw one or more of the following categories: animals, plants, cars, and houses. Afterwards, each child went through an individual discussion about whether each of their drawings of animals/plants/abiotic objects show an object that is living or not, whether it needs water, whether it needs food, whether it matures and grows, and whether it breathes. In the second stage, 3 picture cards for each category — animals, plants, animate abiotic objects, and inanimate abiotic objects — 12 cards total, were used to ask each child whether they thought the objects drawn on the cards need water, mature and grow, breathe, and are alive, and additionally were requested to share why they believed so. Results The results showed that for children between the ages 3-5, types of conceptualization of aliveness can be categorized into: “movement that proves the object is living,” “vitality that can be discovered in animals and plants: living,” “houses and cars are alive: the flow of breath from the symptoms of life that children discover in abiotic objects,” “naturally created or produced: concepts of synthetic production,” “because it moves when I use it: self-centered concept of life,” “I just feel it: the power of “intuition” in detecting life.” Upon taking a closer look at the comprehension tendencies of children ages 3~5 regarding whether an object is alive or not, most recognize animals are living (age 3 96.2%, age 4 98.1%, age 5 99.0%); however, subjects showed a lower rate of recognition for plants (age 3 83.8%, age 4 68.6%, age 5 82.9%). Conclusions According to the findings, there is a tendency for children’s conception of whether something is living or not to be formed based on cues from the characteristic of mobility, signs of life such as vitality and respiration, the concept of nature versus synthetic production, mixing with self-centered conception, and intuition. This shows that the conceptual understanding children have cannot be separated from characteristics of their developmental stage and that unique features of infancy cannot be excluded from consideration. Thus, the innate biological intuition children have has a non-negligible influence on their biological judgment. However, it was evident that preceding experiences at home or at educational institutions cant alter those judgments to an extent. This suggests that the quality of social knowledge impacts children’s biological judgment.
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Scherer, Alexandre, and Vicente Molina Neto. "O CONHECIMENTO PEDAGÓGICO DO PROFESSOR DE EDUCAÇÃO FÍSICA DA ESCOLA PÚBLICA NO RIO GRANDE DO SUL - UMA ETNOGRAFIA EM PORTO ALEGRE." Movimento (ESEFID/UFRGS) 6, no. 13 (December 30, 2000): 71–80. http://dx.doi.org/10.22456/1982-8918.11786.

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O estudo trata de identificar que conhecimentos sustentam a prática pedagógica do professor de educação física da escola pública da rede estadual de ensino. Nesse sentido, a análise efetiva desta investigação foi centrada nas concepções teóricas, na trajetória profissional e no cotidiano dos professores de educação física. A metodologia utilizada centrou-se na perspectiva qualitativa de um estudo etnográfico envolvendo dezesseis professores e seis escolas da rede pública estadual de ensino na cidade de Porto Alegre. Este trabalho aponta para a necessidade de compreenderse, com mais profundidade, o cotidiano escolar, através de estudos de perspectiva qualitativa, onde a compreensão das relações que abrangem a comunidade escolar sustente uma ação pedagógica dos professores de educação física, sem desconsiderar o contexto social, político, econômico e cultural. The study examines to identify that knowledge sustain the pedagogic practice of physical education teachers of public school, of the state net of teaching. In that sense, the effective analysis of this study was centered in the theoretical conceptions, in the professional trajectory and in the daily of physical education teachers. The used methodology was centered in a qualitative perspective of an ethnographic study involving sixteen teachers and six schools of the public state net of teaching in the city of Porto Alegre. This work points for the need of understanding, with more depth the daily school, through studies
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Healey Akearok, Gwen, Katie Cueva, Jon Stoor, Christina Larsen, Elizabeth Rink, Nicole Kanayurak, Anastasia Emelyanova, and Vanessa Hiratsuka. "Exploring the Term “Resilience” in Arctic Health and Well-Being Using a Sharing Circle as a Community-Centered Approach: Insights from a Conference Workshop." Social Sciences 8, no. 2 (February 2, 2019): 45. http://dx.doi.org/10.3390/socsci8020045.

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In the field of Arctic health, “resilience” is a term and concept used to describe capacity to recover from difficulties. While the term is widely used in Arctic policy contexts, there is debate at the community level on whether “resilience” is an appropriate term to describe the human dimensions of health and wellness in the Arctic. Further, research methods used to investigate resilience have largely been limited to Western science research methodologies, which emphasize empirical quantitative studies and may not mirror the perspective of the Arctic communities under study. To explore conceptions of resilience in Arctic communities, a Sharing Circle was facilitated at the International Congress on Circumpolar Health in 2018. With participants engaging from seven of the eight Arctic countries, participants shared critiques of the term “resilience,” and their perspectives on key components of thriving communities. Upon reflection, this use of a Sharing Circle suggests that it may be a useful tool for deeper investigations into health-related issues affecting Arctic Peoples. The Sharing Circle may serve as a meaningful methodology for engaging communities using resonant research strategies to decolonize concepts of resilience and highlight new dimensions for promoting thriving communities in Arctic populations.
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Chakkour, Tarik. "Application of Two-dimensional Finite Volume Method to Protoplanetary Disks." International Journal of Mechanics 15 (October 20, 2021): 233–45. http://dx.doi.org/10.46300/9104.2021.15.27.

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Many fascinating astrophysical phenomena can be simulated insufficiently by standard numerical schemes for the compressible hydrodynamics equations. In the present work, a high performant 2D hydrodynamical code has been developed. The model is designed for the planetary formation that consists of momentum, continuity and energy equations. Since the two-phase model seems to be hardly executed, we will show in a simplified form, the implementation of this model in one-phase. It is applied to the Solar System that such stars can form planets. The finite volume method (FVM) is used in this model. We aim to develop a first-order well-balanced scheme for the Euler equations in the the radial direction, combined with second-order centered ux following the radial direction. This conception is devoted to balance the uxes, and guarantee hydrostatic equilibrium preserving. Then the model is used on simplified examples in order to show its ca- pability to maintain steady-state solutions with a good precision. Additionally, we demonstrate the performance of the numerical code through simulations. In particularly, the time evolution of gas orbited around the star, and some proper- ties of the Rossby wave instability are analyzed. The resulting scheme shows consequently that this model is robust and simple enough to be easily implemented.
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Brandl, Lea C., and Andreas Schrader. "Serious Games in Higher Education in the Transforming Process to Education 4.0—Systematized Review." Education Sciences 14, no. 3 (March 7, 2024): 281. http://dx.doi.org/10.3390/educsci14030281.

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The digital transformation associated with the Fourth Industrial Revolution is having an impact on the way we teach. Under the term Education 4.0, new teaching methods, new technologies, as well as a student-centered approach, are expected to be used in teaching. One established method of teaching is the use of Serious Games, as it has various positive effects in terms of motivation and engagement. This paper deals with the question of how the transformation towards Education 4.0 influences the way Serious Games are designed and used in the context of higher education. To this end, a systematized literature review was conducted. Out of 550 publications, 28 were included. This revealed works on the general conception as well as studies on Serious Games in various areas of university teaching. The results show different concepts of Serious Games, with the structure often being adapted to learning content and not to students. In terms of technical implementation, Serious Games are mostly web- or desktop-applications instead of new technologies such as VR. As a result, new concepts seem necessary to adapt Serious Games to Education 4.0. In the future, we want to design Serious Games that respond flexibly to students’ needs and make it easy to integrate new technologies.
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KIM, Sunghyun. "Comparative Study of Philosophical Poetics of T. S. Eliot’s Finite Center and Wallace Stevens’ Supreme Fiction: From the Perspective of Sociology of Knowledge." Journal of the T. S. Eliot Society of Korea 33, no. 1 (July 31, 2023): 1–26. http://dx.doi.org/10.14364/t.s.eliot.2023.33.1.1-26.

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It is widely known that T. S. Eliot’s poetics and philosophy are grounded on the epistemology of F. H. Bradley. Wallace Stevens, who played another significant role in the modernist poetics during a similar period, presented his unique philosophy on reality and phenomena in “Notes Toward a Supreme Fiction.” According to Stevens, humans inevitably need the concept of the “supreme fiction” to grasp reality. This paper aims to examine the roles played by Bradley’s concept of the “finite center,” which Eliot employed as a poetic or philosophical concept, and Stevens’ concept of the “supreme fiction” in understanding phenomena and reality, and how these conceptions formed the basis of their respective poetic systems. In the process of such comparative analysis, we will explore how closely Eliot’s adoption of Bradley’s “finite center” aligns with the concept of the “supreme fiction” and examine the significance of these two concepts used by the two poets in terms of the sociology of knowledge.
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Novo, Carolina, Michela Tramonti, Alden Meirzhanovich Dochshanov, Daniela Tuparova, Boiana Garkova, Fatma Eroglan, Tuba Uğraş, Banu Yücel-Toy, and Carlos Vaz de Carvalho. "Design Thinking in Secondary Education: Required Teacher Skills." Education Sciences 13, no. 10 (September 22, 2023): 969. http://dx.doi.org/10.3390/educsci13100969.

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Design Thinking (DT) is a design process originally used in the conception and validation of innovative and technologically efficient human-centered solutions for ill-formed problems. Being an iterative and collaborative process with a human point of view, DT allows adopters to improve several intrapersonal and interpersonal skills, like collaboration, creative thinking, leadership, presentation, project management, ethics, storytelling, negotiation, empathy, willingness to learn, etc. As such, DT has been adopted in several other areas and has also become highly relevant in educational contexts to develop the aforementioned skills in students. It has also been shown to contribute to minimizing the school dropout problem by keeping students motivated and integrated in the school context. Nevertheless, to be successfully implemented, DT requires that the overall educational context is adapted and that teachers are trained to be able to guide, support, and give feedback to students. With that objective in mind and following an analysis of the current situation in secondary education schools in four European countries, a teacher training model was designed to organize and systematize the process of developing teachers’ abilities to manage an educational DT approach. This article presents the analysis of the current situation from the point of view of teachers and students and gives some hints on the resulting teacher training model for integrating Design Thinking skills within secondary education.
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Martin Hard, Bridgette, Nathan Liang, Michelle Wong, and Stephen J. Flusberg. "Metaphors we teach by." Metaphor and the Social World 11, no. 1 (September 8, 2021): 46–70. http://dx.doi.org/10.1075/msw.19021.har.

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Abstract Teaching is a complex activity that people often discuss metaphorically, as when a professor is described as a sculptor molding impressionable students. What do such metaphors reveal about how people conceptualize teaching? Previous work has addressed related questions largely via researcher intuition and qualitative analyses of teacher attitudes. We sought to develop a more principled method for mapping the entailments of metaphorical concepts, using teaching metaphors as a case study. We presented participants with one of four common metaphors for the teacher-student relationship (identified in a preliminary study) and asked them to rate the degree to which a series of teacher attributes fit the metaphor. We then used iterated exploratory factor analysis to identify a small number of dimensions that underlie people’s conceptions of teachers and examined whether the metaphors systematically differed along these dimensions. We found that teaching metaphors bring to mind distinct, coherent clusters of teacher attributes and different intuitions about teacher responsibility and power – a finding we replicated in a larger, pre-registered follow-up study using a new set of participants. This work provides a novel method for mapping the entailments of metaphorical concepts and sets the stage for educational interventions centered on shifting lay theories of teaching.
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Sokolova, Nataliya A., and Ekaterina Yu Lebedeva. "Disputes about Imposed and Made-up Versions." Vestnik of Saint Petersburg University. History 65, no. 4 (2020): 1302–25. http://dx.doi.org/10.21638/11701/spbu02.2020.418.

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The article is dedicated to the analysis of the work by Natalia Potapova “Speaking from their cells: discourse and political strategies of the Decembrists” published in 2017. The main argument of the author is that the investigation falsified the existence of the secret society, and the accused agreed with it as they believed they could express their political views in that way. Both sides of the process, as well as Emperor Nicolas I, at the same time were mostly concerned with the European press. The choice of sources in the book is quite peculiar. Natalia Potapova, criticizing Soviet researchers who focused only on the cases with most radical confessions, is very selective herself. She analyses only the primary interrogation centered around secret society membership. Аll the Decembrists’ memoirs telling about the secret societies are deemed unreliable, and all the historical documents on the topic written before 1825 are treated as non-existing. The materials of the European press, predominantly the British, are widely used in order to model the Russian public opinion as the author believes we lack other information about it. Examining the methods, arguments and conclusions of the author, this article demonstrates that the author’s conception is not convincing, not provedб and contradicts the sources. The author’s interpretation of the last is often arbitrary and not based upon the source study, and it uncritically projects the modern situations and beliefs to the beginning of the 19th century. Thus, the work by Natalia Potapova is not, in the strictest sense, a historical research.
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Michie, Elsie B. "Envious Reading: Margaret Oliphant on George Eliot." Nineteenth-Century Literature 74, no. 1 (June 1, 2019): 87–111. http://dx.doi.org/10.1525/ncl.2019.74.1.87.

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Elsie B. Michie, “Envious Reading: Margaret Oliphant on George Eliot” (pp. 87–111) This essay maps out a model of influence that is not deterministic but instead addresses historical “conditions,” the proximity of authors’ lives to their work, the relationship among texts, and how we read (or fail to read) all those interactions. Using the work of Sianne Ngai and other theoreticians of envy, it presents envy as a productive emotion that drives authors to contemplate the circumstances that make their lives and writing both similar to and different from those of their rivals. It tracks the workings of envy through Margaret Oliphant’s relation to George Eliot, arguing that in the novel Hester: A Story of Contemporary Life (1883) Oliphant created a story centered on envy in order to work through her relation to her more powerful and famous precursor. Depicting two hostile women, who are gradually brought close by being forced to understand each other’s circumstances, Oliphant also used Hester to rework the Eliot novel she loved best, The Mill on the Floss (1860), such that it reflected the circumstances of her own life as much as Eliot’s. Oliphant’s envious reading of Eliot reconfigures the relation between authors, between texts, between lives and works, between readers and what they read. Replacing the linear, generational conception of influence as indebtedness with an image of circumstances that ebb and flow, envious reading opens up a space of creative flux and contingency that points to the present and future as much as to the past.
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Christiansen, Mille Guldager, Mary Jarden, Sara Colomer-Lahiguera, Manuela Eicher, Denise Bryant-Lukosius, Mansoor Raza Mirza, Helle Pappot, and Karin Piil. "Development of a Comprehensive Model for Cancer Symptom Care for Women With Ovarian or Endometrial Cancer." Cancer Care Research Online 4, no. 2 (February 29, 2024): e054. http://dx.doi.org/10.1097/cr9.0000000000000054.

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Background: Women with ovarian or endometrial cancer experience multiple symptoms during chemotherapy. Specialized cancer nurses possess specific knowledge and competencies to effectively monitor and manage treatment-related toxicities and provide self-management support. Objective: To describe the conception and development of a comprehensive cancer symptom model of care in an oncological setting for women diagnosed with ovarian or endometrial cancer. Methods: The participatory evidence-based, patient-focused process for guiding the development, implementation, and evaluation of advanced practice nursing roles—the participatory, evidence-based, patient-centered process for advanced practice (PEPPA) framework directed the process. The first 6 steps of this 9-step framework were utilized to incorporate research evidence, engage, and obtain the input of key stakeholders. Results: Stakeholders (n = 27) contributed with specific knowledge, perspectives, and feedback to the entire development process, and several needs were identified. Following structured discussions, a new model of cancer symptom care with elements such as symptom management, electronic patient-reported outcomes, and an expanded nursing role in the form of nurse-led consultations was developed. Conclusions: We effectively utilized the PEPPA framework to design a new cancer symptom model of care, that was agreed upon by key stakeholders. Implications for Practice: This stakeholder-engaged, and evidence-driven process could be used as a template for others wanting to develop a population-specific model of care to improve cancer symptom management. What is Foundational: With the expansion of the cancer nursing role, the new model has the potential to improve the quality of cancer care and health outcomes related to symptom management.
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Bird, Jessalynn, Marirose Osborne, and Brittany Blagburn. "Reclaiming the Classics for a Diverse and Global World Through OER." KULA: Knowledge Creation, Dissemination, and Preservation Studies 6, no. 1 (January 12, 2022): 1–11. http://dx.doi.org/10.18357/kula.219.

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In the 2019–20 academic year, I redesigned a course on the classics to make both the texts and the context in which they were taught more accessible for and relevant to the predominantly female students of Saint Mary’s College, Notre Dame. The course was re-centered on the dialogue between the ever-evolving and diverse cultures within Greece and the Roman empire and surrounding regions such as Egypt, Ethiopia, and Persia; issues caused by slavery and economic inequality; conceptions of gender roles and sexuality, race and ethnicity, and migration and citizenship; the troubling appropriation of classical motifs and texts by fascist groups in the twentieth century and some alt-right groups and sexual predators in the twenty-first century; and on recent initiatives meant to demonstrate the diversity of both Greek and Roman cultures through documentary, artistic, and archaeological evidence (particularly in the digital humanities and in museums and libraries). I also wanted to make the course close to zero cost for students and to shift to digital texts which lent themselves to interactivity and social scholarship. Our librarian, Catherine Pellegrino, obtained multi-user e-books for modern reinterpretations of classical works still in copyright. A LibreTexts grant enabled the co-authors of this article—the course instructor (and lead author) and two paid student researchers—and a team of summer-employed student collaborators to edit, footnote, and create critical introductions and student activities for various key texts for the course. Many of these texts are now hosted on the LibreTexts OER platform. Beta versions of enriched OER texts and activities were user tested in a synchronous hybrid virtual/physical classroom of twenty-five students, who were taking the course (HUST 292) in the fall semester of 2020.
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Wall, Sarah. "Self-employed nurses as change agents in healthcare: strategies, consequences, and possibilities." Journal of Health Organization and Management 28, no. 4 (August 18, 2014): 511–31. http://dx.doi.org/10.1108/jhom-03-2013-0049.

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Purpose – The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess that facilitate their roles as change agents, what strategies they use to influence change, and what consequences they face for their actions, thus contributing to what is known about organizational change in institutionalized settings such as healthcare. Design/methodology/approach – Focussed ethnography was used to explore self-employed nurses’ work experiences and elucidate the cultural elements of their social contexts, including customs, ideologies, beliefs, and knowledge and the ways that these impact upon the possibilities for change in the system. Findings – These self-employed nurses reflected on the shortcomings in the healthcare system and took entrepreneurial risks that would allow them to practice nursing according to their professional values. They used a number of strategies to influence change such as capitalizing on opportunities, preparing themselves for innovative work, managing and expanding the scope of nursing practice, and building new ideas on foundational nursing knowledge and experience. They had high job satisfaction and a strong sense of contribution but they faced significant resistance because of their non-traditional approach to nursing practice. Originality/value – Despite dramatic restructuring in the Canadian healthcare system, the system remains physician-centered and hospital-based. Nursing ' s professional potential has been largely untapped in any change efforts. Self-employed nurses have positioned themselves to deliver care based on nursing values and to promote alternative conceptions of health and healthcare. This study offers a rare exploration of this unique form of nursing practice and its potential to influence health system reform.
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M’Gonigle, Michael. "Between Globalism and Territoriality: The emergence of an international constitution and the challenge of ecological legitimacy." Canadian Journal of Law & Jurisprudence 15, no. 2 (July 2002): 159–74. http://dx.doi.org/10.1017/s084182090000357x.

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This paper is being written as the implications of September 11 continue to reverberate worldwide, its consequences going who knows where. Nothing, we are told, will be the same again. One aspect of this change will be how we think about international society, including its legal character. In this quest to understand international law in this changing, and uncertain, context, this paper posits a different sort of analysis, one that addresses the dialectical tension between globalism and territorialism. Globalism describes the emerging globally comprehensive legal (and political and economic) regime organized around expanding forms of centralized power. In contrast, territorialism describes an incipient movement to support a diversity of social and physical realms of authority rooted in a geographic tapestry of self-maintaining forms of place-based power. Both terms describe competing forces of social organization such as customary versus bureaucratic forms of regulation. These forces have long existed in a dialectical tension that, neither separate nor distinct, interpenetrate in countless aspects of political and economic life.This dialectical tension permeates human history, but its operational character has been little considered, and its significance little understood. The conception of “territory” is a particularly complex one (especially when understood in its full historical sweep) that has a strong relevance to that foundational concern of international law, sovereignty. Externally, the territorial state is the legal subject. The challenge of this paper is to convey a vision and analytical framework that seeks to understand territory in a fuller sense than is traditionally used. To do so, this paper rechacterizes the increasingly centralized power structure from the perspective of ecological political economy. This perspective is particularly relevant to this age of ecological limits and global constitutionalism.Based on this ecological analysis, the paper proposes a notion of territoriality that gives prominence to the state’s historical other--place-based institutions of cultural and community authority. A territorial framework is then presented as an alternative conception of international ordering to that embodied by globalism. In its self-maintaining diversity, plurality of discursive practices/ways of knowing, and wariness towards the universalizing state-centered system, the territorial approach seeks to put in practice many lessons of the postmodern critique. To pursue this line of enquiry exposes to scrutiny a host of foundational beliefs and assumptions about modern economic and political life. Nevertheless, at the beginning of the 21st century such enquiry is again critically important for international lawyers because the sustainability of continued centralized growth is in question, while its momentum into a constitutional dead-end resists re-direction.
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Boaes, R., M. B. B. Silva, and J. A. Russi. "Sexuality in mental health: Brazilian science production review (2001–2014)." European Psychiatry 33, S1 (March 2016): S592—S593. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2208.

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Aiming at analyzing mental health and sexuality studies, specifically in papers published in Brazil, this dissertation brings a review of the literature carried out in two databases. It can be noticed that studies on sex, gender and sexuality show the complexity of the understanding of human sexual life going from essentialist to constructivist perspectives, conceiving sexuality in several manners. However, studies on madness, mental health and psychosocial care point to different conceptions of mental sickening process, mental health being at the same time a science field and a psychological well-being value to be achieved. Surveys in nursery homes show that institution agents represent the sexuality of a mentally suffering person (MSP) as abnormal or non-existing. The review of academic production on the subject, has put together 685 publications, 43 of them in both, with only 109 from Brazil, these ones having been systematized by title and abstract, only eleven were selected and studied thoroughly. Results show that the analyzed science production is scarce, being the theme just at its beginning in collective health, with the predominance of biomedical approaches focusing in on sexual behavior, with special attention to the vulnerability to IST/HIV/AIDS, the absence of sexual education and gaps in the training to work with sexuality. The conclusion is that the studied Brazilian science production on sexuality in the field of mental health is not centered on sexual and reproductive rights of MSP, while user sexual practices and the representations of professionals come to the fore in the analyses.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Hildén, Raili, and Birgitta Fröjdendahl. "The dawn of assessment literacy." Apples - Journal of Applied Language Studies 12, no. 1 (February 14, 2018): 1–24. http://dx.doi.org/10.17011/apples/urn.201802201542.

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The paper addresses Finnish student teachers’ conceptions of assessment literacy in foreign languages. Student teachers’ assessment literacy (STAL) is a focal constituent of teacher cognition and can, according to prior research, be enhanced by principled instruction (DeLuca & Klinger, 2010; Volante & Fazio, 2007). STAL is suggested to imply knowledge, practice and ethical considerations. The nature and priorities of STAL are guided by local needs. Hence, topical issues in the Finnish language education were taken into account alongside general assessment theory. The research questions targeted firstly the emergent factorial structure of STAL, and secondly, the validity of a predetermined theory-driven model in alignment with official national priorities. The data were gathered on a web-based survey to 77 students prior to the lectures, and to 65 students after the lectures. The survey consisted of 75 statements about attitudes and practices related to various domains of assessment. Mainstream inferential statistics was used to compare the pre- and post-dataset. The componential structure of STAL attitudes remained more stable than the construct of practices across the study unit. The major dimension of both measurements was Acquired confidence in assessment of multiple aspects of language ability in the classroom. The envisaged or real practices underwent a substantial transformation towards a more learner-centered architecture highlighting flexibility and communication. Of the predetermined domains, working skills and professional self-esteem seemed to be most sensitive to a short-term pedagogical intervention. The tentative results pave the way for progressive development in raising the impact of teacher education for improved assessment literacy skills.
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Rocha, João Batista Teixeira, Nilda Vargas Barbosa, Maria Rosa Schetinger, and Maria Ester Pereira. "A concepção sobre a natureza do conhecimento científico de estudantes e professores do ensino médio da região de Santa Maria: influência de um curso baseado na resolução de problemas." Ciência e Natura 22, no. 22 (December 11, 2000): 83. http://dx.doi.org/10.5902/2179460x27113.

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Nowadays, science education has been extensively criticized mainly due to the fact that teaching science procedures have not allowed the formation of individuals that use science knowledge to solve problems on their daily lives. The low quality of science education certainly is responsible for the stereotyped view that population has about science and scientist, and also for the inadequate conceptions about the nature of scientific knowledge.Consequently, the development of methodologies that can enhance the quality of science education are needed. In the present report, the effect of a short course (40 hours) based on the resolution of problems (and that can be classified as apprentice centered) of high-school teachers and students from Santa Maria and surroundings were evaluated. The Nature of Scientific Knowledge Scale (NSKS) was used and this scale is sub-divided in 6 conceptual subscale (amoral, creative, developmental, parsimonious, testable, and unified). The results showed that the experimental courses (muscle contraction, digestion, respiration, and photosynthesis), in which the apprentices are engaged in solving their own problems, improved the students and teachers understanding about the nature of scientific knowledge. The improvement on the test (NSKS) occurred predominantly within the creative subscale, presumably due to the fact that the apprentices had to be creative in order to solve the proposed or generated problems during the course. These results suggest that it would be useful to teachers in service (as well as preservice teachers) to experience problem-based and experimental courses, because a better understanding of the nature of scientific knowledge by science teachers certainly will improve science education, at least with regard to the high-school students understanding.
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La Touche, Roy, and Alba Paris Alemany. "Sobre el Concepto de Ejercicio Terapéutico. La identidad profesional y la organización de la Fisioterapia." Journal of MOVE and Therapeutic Science 5, no. 1 (August 9, 2023): 504–15. http://dx.doi.org/10.37382/jomts.v5i1.1056.

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RESUMEN El presente manuscrito resalta el papel crítico del ejercicio terapéutico en la fisioterapia, delineando su evolución histórica y proponiendo reflexiones para mejorar su implementación en la práctica clínica, la academia y la gestión organizativa. El texto destaca figuras históricas como Per Henrik Ling, pionero del ejercicio terapéutico en el siglo XIX y fundador del Real Instituto Central de Gimnasia en Estocolmo, precursor de la fisioterapia moderna, y Mary McMillan, fundadora de la primera escuela de fisioterapia en Estados Unidos y autora del primer texto de fisioterapia en EE. UU., que introdujo explícitamente el concepto de ejercicio terapéutico. El ejercicio terapéutico se define como una amplia gama de procedimientos basados en el movimiento, utilizados para reducir la discapacidad y mejorar la capacidad funcional y aptitud física. Este se puede aplicar en procesos de prevención y recuperación de diversas condiciones, que abarcan afecciones neurológicas, cardiorrespiratorias y musculoesqueléticas. Las habilidades profesionales en fisioterapia provienen de la capacidad para diagnosticar, evaluar y asesorar a los pacientes, implementar tratamientos centrados en la terapia manual y el ejercicio terapéutico, y emplear conocimientos basados en la evidencia científica. Históricamente, el uso del ejercicio se ha erigido como uno de los pilares terapéuticos de la fisioterapia. Sin embargo, se observa que en España los conceptos y aplicaciones de la prescripción de ejercicio aún no están completamente integrados en la academia y la práctica clínica. El manuscrito propone que es crucial reconocer estas deficiencias para consolidar, integrar y proteger las competencias relacionadas con la prescripción de ejercicio terapéutico. Sugiere que es necesario incrementar la proporción de créditos relacionados con la prescripción de ejercicio terapéutico en el currículo del grado de fisioterapia y se incluyen otras recomendaciones para mejorar la implementación del ejercicio terapéutico desde los puntos de vista clínico, académico y de gestión organizativa. ABSTRACT This manuscript emphasizes the critical role of therapeutic exercise in physical therapy, outlining its historical evolution and proposing considerations for enhancing its implementation in clinical practice, academia, and organizational management. The text highlights historical figures such as Per Henrik Ling, a pioneer of therapeutic exercise in the 19th century and founder of the Royal Central Institute of Gymnastics in Stockholm, a precursor of modern physiotherapy, and Mary McMillan, the founder of the first school of physical therapy in the United States and author of the first physiotherapy text in the U.S., who explicitly introduced the concept of therapeutic exercise. The manuscript defines therapeutic exercise as a broad range of movement-based procedures, used to decrease disability and enhance functional capacity and physical fitness. It can be applied in the prevention and recovery processes of various conditions, encompassing neurological, cardiorespiratory, and musculoskeletal ailments. Professional skills in physiotherapy derive from the ability to diagnose, evaluate, and advise patients, implement treatments centered on manual therapy and therapeutic exercise, and employ knowledge based on scientific evidence. Historically, the use of exercise has emerged as one of the therapeutic pillars of physical therapy. However, it is noted that in Spain, the concepts and applications of exercise prescription are not yet fully integrated into academia and clinical practice. The manuscript proposes that it is crucial to acknowledge these deficiencies to consolidate, integrate, and protect competencies related to therapeutic exercise prescription. It suggests that it is necessary to increase the proportion of credits related to therapeutic exercise prescription in the physiotherapy degree curriculum and includes other recommendations to improve the implementation of therapeutic exercise from clinical, academic, and organizational management perspectives.
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Clithero-Eridon, Amy, Pauline Sameshima, Erin Cameron, Jill Allison, Julia Martinez, Tashya Orasi, Connie Hu, and Roger Strasser. "Deepening Understandings of Social Accountability Using the Arts and Storytelling." Education for Health 37, no. 1 (May 22, 2024): 39–49. http://dx.doi.org/10.62694/efh.2024.30.

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Background: This project aimed to build an understanding of the lived realities of social accountability. The COVID-19 era offered acontextual lens and time marker. Social accountability is gaining importance as an educational concept. To maximize the value, it is essential to know how the concept is interpreted from multiple stakeholder perspectives. Methods: An arts-integrated methodology called Parallaxic Praxis was used to examine the values, meanings, contexts, and lived experiences of social accountability. Participants made art to express and discuss their conceptions of social accountability, viewing and discussing the subtleties and themes that arose from their own and others’ creations. Individual interviews, focus groups, and postworkshop surveys were utilized to identify themes. Results: Due to the timing of the data collection during the COVID-19 pandemic, interpretations of social accountability centered primarily on the pandemic’s effects on perceptions of daily life as well as core personal beliefs. Most individuals viewed medical schools as a place of opportunity to start learning about social accountability, and the majority of individuals answered “yes” when asked if exploring the idea and action of social accountability through arts-integrated methods was valuable to them. Discussion: If the ultimate goal of medical education is creating physicians who are fit-for-purpose, then social accountability needs to be emphasized and reinforced as an important part of their professional identity. Integrating the arts in data collection is a creative means to conduct this study, as the arts allow for diverse audiences to access active and reflective engagement among participants. As a method of expression, it provided additional unique perspectives on one’s own beliefs regarding social accountability and how it is practiced—and what is expected of a socially accountable health system.
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So, Francis K. H. "Economic Obsession in Early Literary Imagination: Shakespeare, Jonson and More." Interlitteraria 24, no. 1 (August 13, 2019): 67–80. http://dx.doi.org/10.12697/il.2019.24.1.6.

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That revenues, profits, wealth, valuables, properties and various forms of riches can be so attractive to most people is because these resources affect the operational mode of social economy and personal well-being. As a major driving force of social development, the desire to accumulate wealth affords people the prospect of leading a comfortable life. Yet the acquisition of which may bring down other people to become poorer and creating potential social injustice. Three interrelated concepts in money spending: consumption, fear of poverty and social justice/injustice are markedly shown in some of the great minds among English writers. In this article, Shakespeare’s The Merchant of Venice, Ben Jonson’s Volpone and Thomas More’s Utopia are used to demonstrate the concerns of the early modern English mentality. Some scholars have suggested that the first two playwrights reflected the fear that their London would come to be ruled by corruption, swindling, greediness, vicious competition and unethical business practices. In this pre-capitalist economy, people are seen to adopt unfair competition and reciprocal malice in order to accumulate wealth. Entrepreneurial liberation in economic affairs sets off the dark side of hu manity in which the playwrights were most probably implicated. To counteract this rapacious thinking, Thomas More offers his conception of a wealthy and happy worldly life. Not to attack the self-centered, bene fit gaining intentions, Utopia builds up a society that claims fairness, commonwealth, more obligations than privileges and the wiping away of vanity. Mercantilism is not denied, yet private property is contained. Written earliest among the three works, Utopia anticipates the two plays that dwell on social evils sparked by over concern for personal gains. Generally, the three works lay the foundation of positive and negative aspects of economy in terms of production, marketing, circulation, consumption and services of the English mind of that era. The social mood borders on the financial and political matters of the bourgeois class while providing a mega-worldview as well as micro-worldview of economic concern of the sixteenth and seventeenth centuries England.
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Sibley, Collin. "Social Progress and the Dravidian “Race” in Tamil Social Thought." Genealogy 8, no. 1 (January 4, 2024): 6. http://dx.doi.org/10.3390/genealogy8010006.

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In the closing decades of the 19th century, a wide range of Tamil authors and public speakers in colonial India became acutely interested in the notion of a Dravidian “race”. This conception of a Dravidian race, rooted in European racial and philological scholarship on the peoples of South India, became an important symbol of Tamil cultural, religious, and social autonomy in colonial and post-colonial Tamil thought, art, politics, and literature. European racial thought depicted Dravidians as a savage race that had been subjugated or displaced by the superior Aryan race in ancient Indic history. Using several key works of colonial scholarship, non-Brahmin Tamil authors reversed and reconfigured this idea to ground their own broad-reaching critiques of Brahmin political and social dominance, Brahmanical Hinduism, and Indian nationalism. Whereas European scholarship largely presented Dravidians as the inferiors of Aryans, non-Brahmin Tamil thinkers argued that the ancient, Dravidian identity of the Tamil people could stand alone without Aryan interference. This symbolic contrast between Dravidian (Tamil, non-Brahmin, South Indian) and Aryan (Sanskritic, Brahmin, North Indian) is a central component of 20th- and 21st-century Tamil public discourse on caste, gender, and cultural autonomy. Tamil authors, speakers, activists, and politicians used and continue to use the symbolic frame of Dravidian racial history to advocate for many different political, cultural, and social causes. While not all of these “Dravidian” discourses are meaningfully politically or socially progressive, the long history of Dravidian-centered, anti-Brahmanical discourse in Tamil South India has helped Tamil Nadu largely rebuff the advances of Hindu nationalist politics, which have become dominant in other cultural regions of present-day India. This piece presents a background on the emergence of the term “Dravidian” in socially critical Tamil thought, as well as its reversal and reconfiguration by Tamil social thinkers, orators, and activists in the 19th, 20th, and 21st centuries. The piece begins with a brief history of the terms “Dravidian” and “Aryan” in Western racial thought. The piece then charts the evolution of this discourse in Tamil public thought by discussing several important examples of Tamil social and political movements that incorporate the conceptual poles of “Dravidian” and “Aryan” into their own platforms.
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Kuo, Kevin H. M., Eiran Warner, Mathew Sermer, and Richard Ward. "The Effect of Comprehensive Care on Maternal and Fetal Outcomes in Sickle Cell Disease Pregnancies." Blood 118, no. 21 (November 18, 2011): 4842. http://dx.doi.org/10.1182/blood.v118.21.4842.4842.

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Abstract Abstract 4842 Introduction: Patients with Sickle Cell Disease (SCD) have increased rates of maternal and fetal complications compared to the general population, including premature rupture of membranes, post-partum infection, low birth weight, small for gestational age (SGA), intrauterine growth retardation (IUGR) and preterm delivery. They also experience higher rates of antepartum complications: painful vasoocclusive crises (VOC), infections, PIH/preeclampsia, abruption, antepartum bleeding, cardiomyopathy, pulmonary hypertension, cerebral vein thrombosis, pneumonia, pyelonephritis, deep vein thrombosis (DVT), transfusion and systemic inflammatory response syndrome. Comprehensive care reduces morbidity and mortality in infancy and early childhood and is the cornerstone of care in SCD. However, the effect of comprehensive care on maternal and fetal outcome in patients with SCD has not been examined. We hypothesize that pre-conception comprehensive care improve maternal and fetal outcomes and reduced rates of antepartum complications in patients with SCD. Methods: We conducted a retrospective review of patients with SCD (SS, SC, S/beta-thalassemia) who delivered at the Mount Sinai Hospital (MSH), a high risk obstetrics care institution in Central Ontario, Canada, between 2000 and 2010 based on the Antenatal Database, Delivery Database, electronic and paper-based medical records. Patients were jointly managed by a maternal-fetal medicine (MFM) specialist and hematologist specialized in hemoglobinopathies. We analyzed the maternal and fetal characteristics and outcomes (age at delivery, genotype, gravida, gestational age, birth weight, number of Caesarian sections and vaginal deliveries), antepartum complications (pregnancy induced hypertension (including pre-eclampsia and eclampsia), gestational diabetes mellitus, preterm premature rupture of membranes, oligohydramnios, abruption/previa, venous thromboembolism, urinary tract infection), and SCD-specific complications (painful vaso-occlusive crises, acute chest syndrome, pneumonia, and transfusion) based on the presence or absence of comprehensive care prior to pregnancy by the Red Blood Cell Disorders (RBCD) Clinic at the University Health Network, a SCD comprehensive care centre from the same catchment area as MSH. t-test was used to compare means of two groups, Fisher's exact test and chi-squared tests were used to compare categorical frequency data, where appropriate. Alpha value of 0.05 was chosen as the level of significance. Results and Discussion: We identified 79 deliveries by 64 patients with SCD who received obstetric care at MSH. Mean gestational age at delivery was 37.69 weeks (95% CI 37.00 to 38.37 weeks) and 21 (27%) were preterm (< 37 weeks). Thirty-one deliveries (39%) were by Caesarian section and 48 were delivered vaginally. Seventeen (22%) were low birth weight (< 2500 g) and 11 (14%) were small for gestational age. Maternal and fetal outcomes and rates of antepartum complications were similar to the existing literature (Powars, 1986; Smith, 1996; Serjeant, 2004; Barfield, 2010). Twenty-eight deliveries by 22 of the 64 patients received comprehensive care at the RBCD clinic prior to their pregnancies for a mean duration of 5 years. There was no significant difference in maternal or fetal outcomes or antepartum complications. The results suggest that the role of comprehensive care prior to conception may not be as crucial in pregnancy outcomes of patients with SCD as previously thought. The lack of difference may also be due to the fact that the patients' care was closely monitored during the pregnancy by both specialists in hemoglobinopathies and high risk obstetrics. Limitations of the study include its single-centered and retrospective nature, exclusion of stillbirths and miscarriages, and small sample size. Also, patients who were enrolled in the comprehensive care program may carry more comorbidities and SCD-specific complications, compared to patients referred from the community, but this was not examined in the present study. Further prospective observational studies of SCD patients in the child-bearing age, with attention to the frequency and type of pre-pregnancy SCD-specific complications, as well as standardized application of comprehensive care, will be helpful in determining whether comprehensive care is useful in reducing antepartum complications in patients with SCD. Disclosures: Kuo: Novartis Canada: Research Funding.

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