External Support Systems Research Articles

Growth Overcoming Obstacles as a Clinical Nurse Educator: A Qualitative Study.

Clinical nurse educators (CNEs), responsible for nursing education, have begun to address unresolved issues in nursing education overlooked by preceptorship. However, research on this topic is lacking in South Korea, despite the government's 2019 launch of the CNE support project. This study explored the role experience of CNE in South Korea, focusing on their role challenges and the process of overcoming them. Fifteen CNEs from tertiary or secondary general hospitals in South Korea participated in semi-structured, in-depth interviews conducted between August and December 2023. Interviews were recorded and transcribed for conventional content analysis. Four categories emerged: challenges in the role of CNE, personal strategies for growth as a CNE, external support systems for growth as a CNE, and role evolution and emerging challenges for CNEs. This study demonstrates previously unexplored CNE role experiences in South Korea and provides valuable recommendations for enhancing CNE support projects.

Caring for the child with a tracheostomy through the eyes of their caregiver: A photovoice study

PurposeThis qualitative descriptive study aimed to explore the daily experiences of caregivers of children with medical complexity with a tracheostomy at home. MethodsThis study used photovoice, a participatory action research methodology. Adult English-speaking caregivers of children with a tracheostomy, living in Texas, with access to a smartphone were recruited. Photographs taken by participants and an interview guide were used to guide semi-structured interviews with caregivers. ResultsEight participants were recruited. After analyzing photographs and caregiver interviews, four main themes were identified: role transition, daily challenges, finding support, and thriving in the new normal. ConclusionsCaregivers take on multiple roles, including providing medical care, advocating for their children, and educating others. While facing emotional challenges such as guilt, fear, and exhaustion, caregivers rely on external support systems, emphasizing the need for nurses and healthcare providers to provide comprehensive support and improve the accessibility of home nursing services. Practice implicationsThe findings of this study can inform nurse-led interventions and advocacy efforts aimed at supporting marginalized children with medical complexity with a tracheostomy and their families. These efforts may include enhancing communication and collaboration between families, healthcare workers, and the public, providing comprehensive, proactive support for caregivers, and improving access to home nursing services.

Autonomous Vehicle Diagnostics and Support: A Framework for API-Driven Microservices

The rapid evolution of autonomous vehicles (AVs) demands robust and scalable diagnostic and support systems to ensure seamless operations, safety, and performance. This paper presents a framework for API-driven microservices tailored to address the unique diagnostic and support requirements of AVs. Traditional monolithic systems are insufficient for managing the complex, real-time data generated by AVs, necessitating a shift toward microservices architecture. By leveraging API-driven microservices, the proposed framework ensures modularity, scalability, and real-time communication between various vehicle components and external support systems. The framework is designed to support continuous vehicle monitoring, predictive maintenance, fault detection, and real-time decision-making, all while minimizing latency. APIs play a critical role in enabling interaction between different microservices, allowing for seamless data exchange across diverse platforms. This interoperability facilitates integration with third-party services, such as cloud-based diagnostics, real-time traffic information, and software updates. Additionally, the microservices architecture ensures fault isolation, meaning that failures in one service do not compromise the entire system. The framework also emphasizes the importance of cybersecurity and data privacy. Given the sensitive nature of AV data, API security protocols such as OAuth2 and TLS encryption are incorporated to safeguard communication between microservices and external systems. Furthermore, the design is scalable, allowing for the integration of future AV technologies and third-party service enhancements without disrupting existing functionalities. In conclusion, API-driven microservices provide an efficient, flexible, and secure solution for autonomous vehicle diagnostics and support. This framework has the potential to improve AV reliability, reduce downtime, and enhance safety by enabling real-time, data-driven decision-making and proactive maintenance. Future work may explore the integration of machine learning algorithms to further optimize diagnostics and predictive maintenance capabilities. Keywords: Autonomous Vehicles, Microservices, API-Driven Architecture, Diagnostics, Predictive Maintenance, Real-Time Data, Cybersecurity, Vehicle Support Systems, Modularity, Scalability.

Mediating Effect of Principals’ Perceived Workplace Hope on the Relationship Between Workplace Savoring Beliefs and Workplace Resilience

In recent years, principals have been challenged in their school operations by the low birth rate, the promotion of significant education policies, and changes in the power structure of schools in Taiwan. These problems once caused a retirement boom among principals, significantly affecting educational development. Past research on principals’ school operations has focused chiefly on external policies and related support systems, but rarely examined the psychological aspects of the principals themselves. Based on the broaden-and-build theory of positive emotion, this study explored the relationship among principals’ workspace savoring beliefs, principals’ perceived workplace hope, and workplace resilience. A total of 302 principals (66 females, 236 males, with an average age of 55.6 years) from Taiwanese senior high schools completed the paper-based questionnaire. The study results indicate that both principals’ workplace savoring beliefs and workplace hope positively impacted workplace resilience and that perceived workplace hope partially mediated between workplace savoring beliefs and workplace resilience. This study makes specific recommendations for educational authorities, principals, and subsequent research directions based on the above conclusions.

Изучение психосоциальных факторов, влияющих на приверженность пациентов к лечению хронических заболеваний.

This research article scrutinises the psychosocial underpinnings that influence adherence to treatment among patients with chronic diseases, assuming that adherence is a multifaceted phenomenon shaped by a complex set of psychosocial factors. Purpose: the aim of the study is to uncover the complex relationship between these factors and adherence to treatment, using linear sampling to capture the dynamics and temporal evolution of adherence behaviour in the context of chronic illness. Materials and methods. Using a rigorous methodological framework, participants with many chronic conditions were included in the study, with inclusion and exclusion criteria carefully developed to ensure a representative and diverse group. The study utilised a range of validated psychometric tools to quantify psychosocial variables such as social support, stress levels and health beliefs, as well as a multifaceted approach to assess adherence combining self-report, pharmacy records and biometric measures. Advanced statistical analyses, including mixed-effects models and structural equation modelling, were used to identify relationships between psychosocial factors and adherence to treatment, taking into account the complexity and longitudinal nature of the data. Results. The findings highlight the critical role of social support in increasing treatment adherence as well as the detrimental effects of elevated stress levels, emphasising the critical interplay between individual psychological resilience and external support systems. The study also clarifies the influence of health beliefs and illness perceptions on adherence behaviour, advocating a better understanding of the cognitive and affective dimensions that determine patients’ engagement in treatment. Findings. The article concludes by arguing that a paradigm shift towards integrating psychosocial support mechanisms into holistic models of care is needed to increase adherence in chronic disease management. It calls for the implementation of health care policies and practices that not only address the biomedical aspects of chronic disease, but also the psychosocial complexities inherent in long-term disease management. Findings from the study encourage further research into specialised psychosocial interventions aimed at improving adherence and consequently quality of life for people coping with the challenges of chronic illness.

Accessing Rehabilitation after Upper Limb Reconstructive Surgery in Cervical Spinal Cord Injury: A Qualitative Study

Objectives: To investigate the barriers and facilitators to rehabilitation experienced by individuals with cervical SCI after upper limb (UL) reconstructive surgery. Methods: We conducted a prospective cohort study with a follow-up period of up to 24 months. Data collection occurred at two academic and two Veterans Affairs medical centers in the United States. Participants were purposively sampled and included 21 adults with cervical SCI (c-SCI) who had received nerve or tendon transfer surgeries and 15 caregivers. We administered semi-structured interviews about participants' experiences of accessing rehabilitation services after surgery. Results: Four themes emerged from the data: (1) participants encountered greater obstacles in accessing therapy as follow-up time increased; (2) practical challenges (e.g., insurance coverage, opportunity costs, transportation) limited rehabilitation access; (3) individuals with c-SCI and their caregivers desired more information about an overall rehabilitation plan; and (4) external support systems facilitated therapy access. Conclusion: Individuals with c-SCI experience multilevel barriers in accessing rehabilitation care after UL reconstructive surgeries in the United States. This work identifies areas of focus to mitigate these challenges, such as enhancing transparency about the overall rehabilitation process, training providers to work with this population, and developing, testing, and disseminating rehabilitation protocols following UL reconstruction among people with c-SCI.

Development of Early Childhood Education Teachers in Information and Communication Technologies for Literacy or Pedagogy

This study aimed to establish how teachers were capacitated to integrate Information, Communication and Technologies (ICT) towards development of 21st century skills among Early Childhood Education level learners, in the Zimbabwean primary schools. This is in the face of a conglomerate of limitations based on teacher capacity, school culture and access to the ICT resources. The study employed an explanatory sequential mixed methods research design. Quantitative data was collected using questionnaires administered to 126 Early Childhood Development teachers drawn from 230 primary schools, followed by qualitative data collection through analysis of documents, focus group interviews and lesson observations with selected teachers. From analysis of quantitative and qualitative data through SPSS and ATLAS.ti respectively, it was found that teacher training colleges were strong in developing ICT literacy. However, they lacked the capacity to empower the teachers to integrate ICTs for instructional purposes. Such findings retard the achievement of the United Nations Sustainable Development Goals and the Zimbabwe Vision 2030. These goals regard ICTs as a cornerstone in the production of knowledgeable workers and qualified human resources for development of 21st skills among learners. Thus, the study recommends adoption of a model characterised by an institutional organisational context with organised internal and external support systems that facilitate sustainable provision of balanced technological, pedagogical and content knowledge for successful ICT integration in line with the national vision and global trends.

The Influencing Factor of Big Data Adoption for Indonesia Open Government

The development of digital technology in the industrial revolution 4.0 has made all aspects change, including in the field of government. This is a pressure and challenge for public organizations, as well as an opportunity to reform and adapt through Open Government. Open Government is the starting point of the Big Data era along with the Open Data process as a direct implication of openness in government. Big Data is one of the main elements of Open Government required to be adopted in government business processes. Therefore, the readiness of public organizations in adoption is an important thing to be followed up. This study aims to deliver a literature review the influencing factor of organizations readiness for Big Data adoption with the TOE (Technology, Organization, and Environment) conceptual framework. From the literature review, it is known that for the context of technology, several factors, including advantage, compatibility, complexity, scalability, and information security technology infrastructure influence the readiness in Big Data adoption. From the organizational context, the top management support, financial, human resources are also concluded to have a positive influence. Finally, from the environment point of view, the availability of laws and regulations and the focus on public services are external support systems for Big Data adoption.

AGRIBUSINESS CLINIC PLANNING STRATEGY IN JOMBANG REGENCY

Agribusiness clinics are institutions that act as suppliers of agricultural technology innovations so that they are more easily disseminated to farmers and business owners as end users. The concept of clinical agribusiness has been present in Jombang Regency in 2008 as part of Primatani. Currently, the Department of Agriculture has re-launched the agribusiness clinic as the main program in agricultural development in Jombang in 2022. The purpose of this research is to describe the transformation from the old agribusiness clinic concept to a new agribusiness clinic concept, find external and internal environmental support systems in implementing agribusiness clinics in Jombang, and knowing the right strategic planning in the implementation of agribusiness clinics in Jombang Regency. This research is ascriptive qualitative research (level of explanation). Data analysis used is qualitative analysis to describe the transformation of the old concept of agrobusiness clinic to new a concept. Analysis of EFE, IFE, SWOT matrix, IE matrix, and QSPM to determine external and internal environmental system support for clinical agribusiness implementation in Jombang and to find out the right agribusiness planning strategy clinic activities in Jombang. The results of this study are the agribusiness clinic in Jombang has undergone a transformation from the old concept in 2008 to a new concept in 2022. The new concept is the development of the old concept which has undergone adjustments due to changes affecting the agricultural sector. The main external environment support system in the implementation of agribusiness clinics in Jombang Regency the need for healthy and quality agricultural products is increasing. While the main support system of the internal environment is the existence of an extension institution at the district level, namely UPT Implementing Agricultural Extension, and efforts to increase the capacity of farmers and extension workers. The right planning strategy for implementing an agribusiness clinic in Jombang is an Strategy which means utilizing strengths to gain opportunities, namely through strengthening the duties and functions of BPP as the center for implementing agribusiness clinics.

“You take my place; let’s switch!” What It Means to Be a Woman Powerlifter in Parasport

Gendered disability in elite sport has emerged as a pertinent area of inquiry in sport psychology. However, qualitative research aimed at amplifying the voices of marginalized subgroups is notably sparse. Employing a phenomenological approach, we examined the lived experience of a Filipina para powerlifter, probing the intersection of gender, disability, and socioeconomic status in shaping how the participant made sense of life and identity, both within and outside the realm of sport. Three personal experiential themes were generated from the interview data's interpretative phenomenological analysis: “survival of the fittest,” “the voices in my head did not allow me to give up,” and “I am deeply human with a heart.” Narrating the trials she surpassed from childhood to adulthood as an athlete/person with disability (A/PWD), she realized the environmental, socioeconomic, and cultural conditions that handicap her more than her physical impairment alone. Despite bouts with self-pity and disempowerment, the participant drew strength from internal resilience and external support systems, ultimately achieving recognition as her country's first bemedaled Paralympian. This journey fostered profound compassion for her fellow athletes/persons with disabilities. Notwithstanding the limitations of a single-participant study, this research asserts its significant contribution to the scholarly discourse on cultural sport psychology, particularly concerning women of low socioeconomic status in sport for A/PWD. Upholding that the viewpoints and agency of marginalized individuals are heard and respected confirms their position as active participants in knowledge generation within the discipline.

Addressing and Mitigating Educational Inequalities in Rural and Remote Areas of Japan Through Online Learning

This paper explores the current status of rural education within Japan, with a particular emphasis on the integration of online learning technologies and the challenges that arise as a result. Through an analysis of pertinent literature on both rural education and online learning within Japan, this study uncovers the existing disparities between rural and urban education. The research puts forward a set of suggestions influenced by thriving global models, supporting the establishment of peer learning networks and external support systems, cooperative initiatives between urban and rural schools, and the extension of online educational resources. Additionally, the study highlights the significance of cultural awareness in online education design and stresses the need for bespoke learning approaches, incentives to boost students motivation, and provisions for professional development opportunities for teachers. These recommendations provide insights for policymakers, educators, and stakeholders, aiming to enhance educational opportunities and outcomes for students in rural and remote areas of Japan.

The experience of albinism in France: a qualitative study on dyads of parents and their adult child with albinism

BackgroundTo date, almost no research on the psychosocial implications of albinism has been conducted in France and an exploration of albinism-related experiences could be beneficial, in order to better understand this condition. The aim of this study was to examine how French people with albinism and their parents live with and adapt to this condition in all the areas of their lives.MethodsSemi-structured phone interviews were conducted with 9 parent-child dyads, each participating separately. Participants were recruited by convenience sampling, thanks to the combined efforts of a patient association (Genespoir) and professionals from the partner medical referral centers involved in the project. Dyads in which the individual with albinism had any comorbidity were excluded. The interviews were then transcribed and subjected to in-depth thematic analysis. Two codebooks were constructed in a mirrored process: one for people with albinism; the other for their parents. They were finally merged at the end of the coding step.ResultsFour main categories were identified: personal perceptions and social representations of albinism, difficulties and obstacles encountered by people with albinism, resources and facilitators, and the importance of parent-child functioning. The results indicated that experiences of stigmatization during childhood and adolescence are common and that people with albinism face challenges in adapting to certain obstacles related to their visual impairments (VI) (e.g., inability to drive a car; eye strain...). Parents emerged as one, if not as the main, source of support for people with albinism throughout their development. Although external support systems exist to assist them in various aspects of their lives, some of them primarily rely on their own personal resources to cope.ConclusionsThis research highlights the importance of a systemic and transdisciplinary approach to make sure families receive the support that best meets their needs.

Research on the Deformation Law of Foundation Excavation and Support Based on Fluid-Solid Coupling Theory.

To investigate the impact of underground water seepage and soil stress fields on the deformation of excavation and support structures, this study initially identified the key influencing factors on excavation deformation. Subsequently, through a finite element simulation analysis using Plaxis, this study explored the effects of critical factors, such as the excavation support form, groundwater lowering depth, permeability coefficient, excavation layer, and sequence on excavation deformation. Furthermore, a comprehensive consideration of various adverse factors was integrated to establish excavation support early warning thresholds, and optimal dewatering strategies. Finally, this study validated the simulation analysis through an on-site in situ testing with wireless sensors in the context of a physical construction site. The research results indicate that the internal support system within the excavation piles exhibited better stability compared to the external anchor support system, resulting in a 34.5% reduction in the overall deformation. Within the internal support system, the factors influencing the excavation deformation were ranked in the following order: water level (35.5%) > permeability coefficient (17.62%) > excavation layer (11.4%). High water levels, high permeability coefficients, and multi-layered soils were identified as the most unfavorable factors for excavation deformation. The maximum deformation under the coupled effect of these factors was established as the excavation support early warning threshold, and the optimal dewatering strategy involved lowering the water level at the excavation to 0.5 m below the excavation face. The on-site in situ monitoring data obtained through wireless sensors exhibited low discrepancies compared to the finite element simulation data, indicating the high precision of the finite element model for considering the fluid-structure interaction.

Fabrication of a 3D bioprinting model for posterior capsule opacification using GelMA and PLMA hydrogel-coated resin.

Posterior capsule opacification (PCO) remains the predominant complication following cataract surgery, significantly impairing visual function restoration. In this study, we developed a PCO model that closely mimics the anatomical structure of the crystalline lens capsule post-surgery. The model incorporated a threaded structure for accurate positioning and observation, allowing for opening and closing. Utilizing 3D printing technology, a stable external support system was created using resin material consisting of a rigid, hollow base and cover. To replicate the lens capsule structure, a thin hydrogel coating was applied to the resin scaffold. The biocompatibility and impact on cellular functionality of various hydrogel compositions were assessed through an array of staining techniques, including calcein-AM/PI staining, rhodamine staining, BODIPY-C11 staining and EdU staining in conjunction with transwell assays. Additionally, the PCO model was utilized to investigate the effects of eight drugs with anti-inflammatory and anti-proliferative properties, including 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR), THZ1, sorbinil, 4-octyl itaconate (4-OI), xanthohumol, zebularine, rapamycin and caffeic acid phenethyl ester, on human lens epithelial cells (HLECs). Confocal microscopy facilitated comprehensive imaging of the PCO model. The results demonstrated that the GelMA 60 5% + PLMA 2% composite hydrogel exhibited superior biocompatibility and minimal lipid peroxidation levels among the tested hydrogels. Moreover, compared to using hydrogel as the material for 3D printing the entire model, applying surface hydrogel spin coating with parameters of 2000 rpm × 2 on the resin-based 3D printed base yielded a more uniform cell distribution and reduced apoptosis. Furthermore, rapamycin, 4-OI and AICAR demonstrated potent antiproliferative effects in the drug intervention study. Confocal microscopy imaging revealed a uniform distribution of HLECs along the anatomical structure of the crystalline lens capsule within the PCO model, showcasing robust cell viability and regular morphology. In conclusion, the PCO model provides a valuable experimental platform for studying PCO pathogenesis and exploring potential therapeutic interventions.

학교 밖 청소년의 사회적응 경험에 대한 생태학적 사례연구

The study aims to identify the personality competencies out-of-school youths use for social adaptation and to understand their adaptation patterns in and out of the ecosystem. The study, conducted from May to August 2022, involved surveys and inter-views with out-of-school youths and 11 associated individuals (5 youths, 3 parents, 3 ad-visors) in D city. Over four months, data were gathered through individual and focus group interviews and analyzed using Giorgi’s semantic unit analysis. The analysis revealed 228 themes, forming 26 topic groups and 4 categories, related to the adolescents' personality competencies for social adaptation. These youths showed positive life acceptance, future preparedness, and internal and external protective factors aiding their crisis management and adaptation. Additionally, self-reported adaptation patterns of these adolescents yielded 73 themes, 14 topic groups, and 4 categories. Parent and advisor reports on youth adaptation patterns resulted in 71 themes, 13 topic groups, and 4 categories. The study found that these adolescents are adapting to society and maturing through experiences facilitated by external support systems (family support, positive feedback, opportunity provision) and internal character competencies, within a dynamic environment.

Research on the External Technical Support and Intelligent System of China's Green Development under the Internet Background

Research on the External Technical Support and Intelligent System of China's Green Development under the Internet Background

Prevalence and associated factors of school re-entry among teenage mothers in Ghana’s Volta Region: a cross-sectional survey

ABSTRACT This study examines the determinants of school re-entry among teenage mothers in the Ho and Hohoe Municipalities of the Volta Region, Ghana. These districts were selected based on their high prevalence of teenage pregnancy, their representation of urban and semi-urban areas, and the lack of existing research on the topic. Data were collected from 220 teenage mothers through a cross-sectional survey. Multivariate logistic regressions were used to estimate the factors associated with school re-engagement. Results show that 31.8% of the respondents had re-engaged in school, while 70% expressed a willingness to do so. Socioeconomic status, academic performance before pregnancy, parental support, external support, and family history of teenage pregnancy were identified as significant factors influencing school re-engagement. These findings highlight the importance of addressing socioeconomic barriers, strengthening parental and external support systems, and providing the necessary resources to facilitate the re-entry of teenage mothers into the education system.

Coping with transitions during the COVID-19 global pandemic: A case study of early career teachers’ experiences in secondary agricultural Education

The year 2020 marked an era of change and demanded that educators across the globe adapt in new and innovative ways. In secondary agricultural education, teachers experienced significant transitions as a majority of K-12 schools shifted to remote, distance, and online instructional models. Therefore, teachers’ position requirements, obligations, and expectations began to shift dramatically, creating unique challenges for early career teachers. As such, the purpose of this study was to explore the transitions that early-career SBAE teachers in [State] experienced while teaching during the COVID-19 pandemic. Through our analysis, four themes emerged: (1) situation, (2) self, (3) support, and (4) strategies. In the first theme, the early career teachers gave voice to how situational factors greatly influenced the professional transitions they underwent as a result of COVID-19. Self, the second theme, represented the different internal mechanisms, or sources of strength, participants used during the transition process. Meanwhile, support reflected the external support systems participants used during their time of transition into a virtual teaching format. The last theme, strategies, provided insight into the approaches that participants used to address and reduce the negative effects of the pandemic on their teaching. Going forward, we provide critical implications to stoke changes so that early career teachers can better cope with transitions during periods of stress in the post-COVID-19 era.

The Impact of Dyslexia on the Effectiveness of Online Learning: A Systematic Literature Review

Dyslexia can have an impact on online learning outcomes. However, few studies have examined the association between dyslexia and online learning effectiveness. This systematic review focused on the effects of dyslexia on online learning effectiveness to conduct research in three major categories: analysis of impact, analysis of dyslexia on online learning, and analysis of interventions. A screening of two bibliographic databases identified 37 articles that met the inclusion criteria. The study determined that dyslexic learners are uncomforted with online learning and suffer from frustrated self-confidence and decreased academic performance in the learning process. It even affects the learners' evaluation of themselves and causes a decrease in self-efficacy. Among these, research on influencing factors can be divided into two dimensions: internal and external factors. Dyslexic learners are influenced by both the type of dyslexia and their psychological characteristics, as well as by teachers, teaching strategies, online educational environments, and educational media. These influences provide intervention strategies, such as developing customized online learning systems for dyslexic learners and exploring interventions in telerehabilitation medicine. However, no intervention strategies involve adjustments to the internal psychology of dyslexic learners and external support systems. Therefore, more research is needed to explore the differential impact of dyslexia on online learning and to understand the factors that produce this impact to provide a theoretical basis and direction for the generation of instructional strategies for dyslexics and the adaptation of online learning for dyslexics.

Development and evaluation of a virtual simulation experiment system for the course of fluid mechanics

Fluid mechanics is a fundamental course in many disciplines such as civil engineering and hydraulic engineering, with broad applicability and practical significance in engineering. However, the abstractness and multiplicity of its basic concepts hinders students’ first-hand experience during traditional classroom learning, and the time and space limitation of its offline experiment often results in unsatisfying teaching effectiveness. To address these challenges, a set of virtual simulation experiment system is developed for the course of fluid mechanics, along with an external support system to maximize its performance. Evaluation based on curriculum objective achievement shows that this experimental system has significantly improved the teaching effectiveness for the course of fluid mechanics. It promotes students’ independent learning skills and their ability utilizing fluid mechanics knowledge to understand, simplify and solve practical engineering problems.