Climate Change and Child Health – Importance of Pediatricians for Parents

Background: Children are among the most vulnerable to suffer from health consequences due to climate change. Parents as caregivers play an important role in protecting them adequately. Pediatricians are regularly seen as highly-trusted health professionals, but it remains unclear whether they are an information source for parents regarding climate change and health. According to the Health Action Process Approach, parents’ risk perception is an important pre-intender for intention building. Methods: A sample of parents (N = 243) living in Germany completed an online, cross-sectional survey distributed in summer 2020. Regarding climate change and health, we asked about information sources, relevance estimation, and risk perception of parents. Multiple linear regression with general and individual risk perception as outcomes were used to analyze the effect of knowledge and personal relevance. Results: Parents seek information about climate change and health primarily via internet and social media. Pediatricians are rarely considered as suitable information source. Parents see the highest risk for their child through increasing air pollutants and stronger UV-radiation. Relevance (β = .52, t = 5.79, p < .001) and knowledge (β = .02, t = .36, p = .72) explain 18.2% of general risk perception (F(5, 208) = 9.25, p < .001, ΔR2 = .13). The effect is lower (13%) for individual risk perception (F(5, 189) = 5.67, p < .001, ΔR2 = .07). Conclusions: Pediatricians can play a valuable role in informing parents about climate change and health; nevertheless, they are not yet seen as suitable information sources by parents. Results demonstrate that knowledge about climate change and health is not sufficient to increase risk perception of parents, but strengthening risk perception is possible through rising relevance estimation. When informing parents about the expected health impact of climate change, this should be considered.

UPAYA PENERAPAN METODE LEAN THINKING PADA PROSES PELAYANAN FARMASI RAWAT JALAN

Pharmacy services in a hospital are an inaccessible part of the hospital services as a whole. The accumulation of prescriptions in the pharmacy will cause the prescription process to be long and long, which has an impact on customer waiting times, which of course will have a major impact on customer satisfaction. From the standard time set as Quality Indicators at Bali Jimbaran Hospital, namely: drug processing at the outpatient pharmacy of Bali Jimbaran Hospital is 60 minutes of concocted drugs, 30 minutes of non-concocted drugs. The purpose of this research is to identify activities starting from the input, process and results generated through the Lean approach. The method used is an observational action process research, using lean methods to photograph the outpatient pharmacy service process flow through document review, direct interviews, interviews. The result of the research is an improvement in waiting time, it can be seen that the NVA activities can be eliminated by 66% and VA activities show an increase of 44%. With the many activities that are VA and the elimination of NVA activities, it will accelerate the process of outpatient pharmacy services at the Bali Jimbaran Hospital and improve customer satisfaction, which can be seen from the decrease in customer complaints against outpatient pharmacy services by up to 50%, which was previously 80%. Keywords: Lean, Pharmacist, Waiting time, Value Added, Non-Value Added

The effectiveness of an intervention designed based on health action process approach on diet and medication adherence among patients with type 2 diabetes: a randomized controlled trial

Background Diabetes is a major cause of worldwide morbidity and mortality. Diet and medication non-adherence are common among individuals with diabetes, making glycemic control difficult to attain. This study aimed to evaluate an intervention designed based on Health Action Process Approach (HAPA) to improve adherence to diet and medication among patients with type 2 diabetes in Tehran, Iran. Methods The study was a randomized controlled trial. A total of 248 patients with type 2 diabetes who had low diet and medication adherence were randomly allocated into two intervention (n = 124) and control (n = 124) groups. Intervention group received educational intervention during three months. HAPA constructs, diet and medication adherence, and Hemoglobin A1c (HbA1c) levels were assessed at baseline, one month and six months after the intervention. Mixed Model Analysis was used to compare between and within group changes in the outcomes. Results There was a statistically significant improvement in HbA1c levels after six months (7.77 ± 1.36% vs. 8.07 ± 1.52%, 95% CI, p < 0.001). Diet and medication adherence, intention, task self-efficacy, coping self-efficacy, recovery self-efficacy, action and coping planning, barriers, benefits and perceived social support were significantly improved one month and six months after the intervention (p < 0.001). Conclusion Our intervention designed based on health action process approach led to improvements in diet and medication adherence, and HbA1c among the patients within one and six months. Trial registration: IRCT, IRCT20151208025431N4. Registered 10 March 2018, https://fa.irct.ir

THE ONTOLOGICAL FEATURES OF VERB PHRASES IN NATIONAL GEOGRAPHIC’S VISIONS OF MARS

Verb Phrase (VP) is one of the most important types of phrase for its function. It provides information about the subject of the sentence. Verb Phrase itself has more than one type. It also has ontological aspect, an aspect by which a certain situation is represented. This aspect is made up by features. This study aims at finding out and analyzing the types of VP and their ontological features in National Geographic’s Visions of Mars. By analyzing and understanding the types of VP and their ontological features, readers understand the discourse more. They gain more perspective syntactically. This study employs syntactic approach and is qualitative in nature. The results yield three different types of VP, i.e. action, process, and state where action VP places the highest position. There are four ontological features found in Visions of Mars, i.e. dynamic, agentive, non-evolving, and evolving. The findings imply how Visions of Mars is structured. The deeds are mostly conducted or done by an agent and show prompt situations.

Szorstki i chropowaty dotyk – o dramaturgii zmysłów

Today, the concept of dramaturgy refers primarily to the space of theater or, more broadly, to performative arts. But as the concept of drama has passed into the scientific discourse of sociology, anthropology or literary studies, so is it with dramaturgy. The understanding that appears here refers to its meaning as a special tension on the level of sensually experienced and perceived artistic events. The subject of interest here is the dramatic aesthetics of experience in the field of performing and visual arts. The aesthetic categories related to the senses are often of a physical origin and amorphous in nature. The roughness and harshness of the title in their origin are physical categories that can be experienced primarily through the sense of touch. In this intertwining of senses, we are talking about their dramaturgy, because they cannot usually be separated from each other and various works appeal to touch and other senses at the same time. The process of creating a work and its reception is an action, process, meeting, the playwright of which is both the creator / creator and the recipient. The considerations concern changes in the perception of the senses, from the glorification of the sense of sight to the ennoblement of the “lower” senses, the place and function of the classical and interactive museum and haptic art, as well as the polysensory and immersive reception designed in performance and theater.

SIGNIFICANCE OF DX-CENTERS FOR ACOUSTIC INDUCED RECONSTRUCTION PROCESSES OF DEFECTS IN GaN/AlGaN

The experimental results of amplitude effects are compared (from an ultrasonic wave deformation amplitude – a tension τUS) for electron concentration and changes of the lattice parameter on the same sample GaN/Al0.2Ga0.8N/GaN/AlN. It has been experimentally established that at ultrasonic loading (frequency 5–10 MHz, amplitude – towards 2·104 W/m2) there is a nonlinear increase in the effective electron concentration and an increase in the lattice parameter; at the same time, the mobility of electrons decreases and μН(τUS) ~ |τUS|. The energy parameters of the acoustic activation charge carriers process are calculated from the approximation of experimental amplitude changes – Еа ≈ 50 meV and γn(300 K) ≈ 2,5·10-27 m3. The amplitude dependences (increase) of the relative lattice parameter change (ΔС/С) from the tension τUS have been investigated experimentally at different frequencies. The energy of DX-center transition UDX ≈ 108 meV and the activation volume of this transition γDX ≈ 6,6·10-27 m3 are calculated from the approximation of the experimental amplitude changes. The revealed correlation of the magnitude of acoustic induced effects in different experiments allows to build a quantitative energy model of the acoustic action process based on the properties of metastable DX centers. It is shown that the acoustic induced process occurs due to the dimensional displacement of the DX-center atom (a background impurity of silicon atoms) from the non-central position to the centrally symmetric one; herewith DX-center is ionized, one goes into the d0-state. It is believed that the changes are most likely to occur near penetrating dislocations in the barrier layer Al0.2Ga0.8N – acoustic modulated oscillations of the distance between the possible positions of the donor atom lead to a decrease in the barrier to the displacement of the defect.

Designing Behavioral Feedback Visualizations to Support Health Behavior Change

Health technology has the potential to support behavior change by measuring performance and providing users with visualizations of this performance as feedback. Such visual feedback has had limited success in changing health behaviors, but it is not clear why. We conducted a systematic review of the visual feedback literature to develop an organizational framework representing the visual feedback-action process. We identified the components that have been investigated in the context of visual feedback. These components are classified into four categories: visualization types (e.g., bar graph) and variables (e.g., color); feedback characteristics (e.g., social comparison); psychological processes (e.g., motivation) and action (e.g., exercise). The insights will inform the design of feedback visualizations in a smartphone application to support medication adherence for older adults. More broadly, this integrative perspective will yield principles of feedback visualization techniques and components that influence the behavior change process and develop a roadmap to facilitate the design.

ANALYSIS OF MOTIVATION PHASE OF THE HAPA THEORY (HEALTH ACTION PROCESS APPROACH) AND INTENTION TO EXCLUSIVE BREASTFEEDING IN THE SIDOSERMO PRIMARY HEALTHCARE CENTER, SURABAYA

ABSTRACTExclusive breastfeeding can encourage optimal growth and development, especially during the child’s critical period which spans from when the baby is born until 2 years old. The objective of this study was to analyze the motivational phase of the Health Action Process Approach (HAPA) theory with the intention of exclusive breastfeeding in the work area of the Sidosermo Primary Healthcare Center. This study was a quantitative cross-sectional study with an observational research design. The sampling technique was conducted through the systematic random sampling technique with a total sample of 32 people. The study showed that risk perception has a significant influence on the intention of exclusive breastfeeding with a significance value of 0.014 < α (0.05) and an odds ratio of 0.101. This suggests that respondents who had the right perception about exclusive breastfeeding are 0.101 times more likely to exclusively breasfeed their child than respondents who had a wrong perception. This study also showed that there was a significant influence between self-efficacy towards the intention of exclusive breastfeeding, with a significance value of 0.006 < α (0.05). Respondents who felt that they were able to give exclusive breastfeeding were 17 times more likely to provide exclusive breastfeed than those who felt they were less able. The results of this study indicated that there was an influence between the outcome expectancies with the intention of exclusive breastfeeding with a significance value of 0.004 < α (0.05) and an odds ratio of 28.8. It means that respondents who had high expectations had 28.8 times more intention to provide exclusive breastfeeding than respondents who had low expectations. Keywords: exclusive breastfeeding, intention, Health Action Process Approach (HAPA)

Gesundheitsbezogene Verhaltensänderungen in der nachberuflichen Lebensphase

Zusammenfassung Hintergrund Im Anschluss an die Erwerbszeit gestaltet sich das Gesundheitsverhalten bei Menschen im Ruhestand unterschiedlich. Doch welche Möglichkeiten bestehen aus Sicht der Betroffenen, um gesundheitsrelevante Veränderungsabsichten leichter umzusetzen? Und wie können daraus neue Gewohnheiten etabliert werden? Methodik Im August 2020 erfolgte die Datenerhebung im Rahmen einer qualitativen Forschung durch Face-to-face-Interviews mit deduktiv ausgewählten Personen in der nachberuflichen Lebensphase. Das gewonnene Material wurde systematisch und regelgeleitet auf Basis der qualitativen Inhaltsanalyse nach Mayring ausgewertet. Zur Orientierung diente ein Kodierleitfaden in Anlehnung an das HAPA-Modell (Health Action Process Approach model). Ergebnisse Die Aussagen der Befragten deuten auf eine starke Absichtsbildung als bedeutendsten Vorhersagewert für eine längerfristige Durchführung von gesundheitsfördernden Handlungen hin. Weitere Verstärker zeigen sich in der selbstbestimmten Schaffung neuer Gewohnheiten, der Visualisierung von Vorteilen, einem Barrierenmanagement, Erfolgserlebnissen, Ersatzbefriedigungen und individuellen Handlungsplänen, die auch Freude bereitende Aspekte beinhalten. Schlussfolgerung Unter Beachtung mehrerer beeinflussender Faktoren könnten die Erfolgsaussichten bei selbstgesteckten Gesundheitszielen wirksam erhöht werden. In Eigenregie oder gemeinschaftlich erstellte Konzepte würden dabei als Verstärker wirken. Zu diesem Zweck könnte ein niedrigschwelliges Seminarangebot unterstützend zur Verfügung gestellt und ggf. in Kooperation mit Ärzt*innen, Krankenhäusern oder Rehabilitationseinrichtungen forciert werden. Auch situative Einflüsse scheinen die Absichtsbildung zu beeinflussen und sollten daher in das HAPA-Modell (Health Action Process Approach model) integriert werden.