Lack Of Involvement Research Articles

Transforming Educational Institutions: Harnessing the Power of Internet of Things, Cloud, and Fog Computing

The Internet of Things (IoT), cloud, and fog computing are now a reality and have become the vision of the smart world. Self-directed learning approaches, their tools, and smart spaces are transforming traditional institutions into smart institutions. This transition has a positive impact on learner engagement, motivation, attendance, and advanced learning outcomes. In developing countries, there are many barriers to quality education, such as inadequate implementation of standard operating procedures, lack of involvement from learners and parents, and lack of transparent performance measurement for both institutions and students. These issues need to be addressed to ensure further growth and improvement. This study explored the use of smart technologies (IoT, fog, and cloud computing) to address challenges in student learning and administrative tasks. A novel framework (a five-element smart institution framework) is proposed to connect administrators, teachers, parents, and students using smart technologies to improve attendance, pedagogy, and evaluation. The results showed significant increases in student attendance and homework progress, along with improvements in annual results, student discipline, and teacher/parent engagement.

Family conflict over illness beliefs and care strategies: implications for burden in family caregivers

Objectives Family conflict is an understudied aspect of the caregiver experience. Drawing from the stress process model, the present study examined the prevalence and correlates of conflict over illness beliefs (e.g. conflict over the care recipient’s illness and need for facility placement) and family care strategies (e.g. lack of involvement and support from family members). Methods Adult child and spouse caregivers (N = 579) of persons with physical or cognitive impairment from clinic and internet samples completed the Caregiver Reaction Scale (CRS) to assess each topic of conflict and burden. Results Most caregivers reported conflict with family members over care strategies (63%) or illness beliefs (55%). Clinic caregivers reported greater illness beliefs conflict than online caregivers. Adult children reported greater illness beliefs and family care strategies than spouses. Male caregivers were more likely than female caregivers to report care strategies conflict. Caregiver overload was significantly associated with family care strategies conflict. Both conflicts were positively associated with caregiver burden. Conclusions Findings further support that family conflict is a widespread concern associated with burden among online and help-seeking caregivers. Caregiving relationship type and gender may increase likelihood of each conflict. Findings inform recommendations for clinical intervention and assessment of family caregivers.

Remote and technology-mediated working during the COVID-19 pandemic: A qualitative exploration of the experiences of nurses working in general practice (the GenCo Study).

To explore how nurses working in general practice experienced remote and technology-mediated working during the COVID-19 pandemic. Exploratory qualitative study with nursing team members working in general practices in England and national nurse leaders. Data were collected between April and August 2022. Forty participants took part in either semi-structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust. Participants continued to deliver a significant proportion of patient care in-person. However, remote and technology-mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology-mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision-making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks. The study explored how nurses working in general practice during the COVID-19 pandemic engaged with remote and technology-mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision-making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology-mediated working to ensure the future development of safe and effective nursing care in general practice. The paper contributes to understanding of remote and technology-mediated working by nurses working in general practice during the COVID-19 pandemic and indicates to employers and policy makers how this can be supported moving forward. Standards for Reporting Qualitative Research (O'Brien etal.,2014). This was a workforce study so there was no patient or public contribution. The paper highlights specific issues which have implications for the development of remote, technology-mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward.

Knowledge of palliative care and barriers to access among outpatients with cancer.

271 Background: Integrated specialist palliative care (PC) is known to improve outcomes among ambulatory patients with cancer, yet it remains underutilized for this population. It is known that PC is poorly understood among the public, however very little is known about what ambulatory patients with cancer understand about PC or what barriers to access exist. Methods: Outpatients undergoing cancer treatment completed a survey evaluating their familiarity and knowledge of PC (Palliative Care Knowledge Scale; PaCKS), feelings towards PC (before and after reading a standardized definition of PC), barriers to PC, prognostic awareness, and health literacy. We examined variables associated with participants’ familiarity with PC and current interest in receiving PC by fitting logistic regression models. To determine if there was a difference in patients’ feelings toward PC before and after reading the standardized definition, a Chi-Squared test was conducted. All other responses were summarized descriptively. Results: Of 151 participants, 58.9% reported familiarity with palliative care. The average PaCKs score was 11.9 (standard deviation 1.4), and 46.4% of patients received a perfect score, indicating high knowledge of PC overall. Only time since diagnosis (> 1 year vs < 1 year) was associated with significantly increased odds of being familiar with PC (OR 2.93; 95% CI 1.37-6.25). After reading the standardized definition of PC, participants reported feeling significantly less anxious and more reassured; however, more participants were interested in receiving PC in the future compared to at the time of survey completion (74.2% vs 44.4%, respectively). Patients with stage III or IV cancer had significantly increased odds of having interest in receiving PC at the time of study completion compared to patients with stage I or II (OR 2.66; 95% CI: 1.05, 6.76). Having an aggressive cancer was not associated with interest in receiving PC at the time of study completion. Logistic barriers (additional travel or time at the hospital) were commonly reported barriers to attending palliative care appointments. Conclusions: Outpatients with cancer who are being treated at a large academic cancer center have higher familiarity and knowledge of PC than the average American adult. Despite this, anxiety surrounding PC and hesitations regarding early integration of PC persist. Therefore, factors outside of knowledge may be perpetuating the delayed or lack of involvement with PC in oncology. Future work must seek to overcome these barriers to PC integration in outpatient cancer care.

The well-being of nurses working in general practice during the COVID-19 pandemic: A qualitative study (The GenCo Study).

Exploration of experiences of nurses working in general practice during the COVID-19 pandemic to evaluate the impact on nurses' professional well-being. An exploratory qualitative study comprised of case studies of three general practice sites in England and a nationwide interview study of nurses working in general practice and nurse leaders. The study was funded by The General Nursing Council for England and Wales Trust. University of York ethics approval (HSRGC/2021/458/I) and Health Research Authority approval was obtained (IRAS: 30353, Protocol number: R23982, Ref 21/HRA/5132, CPMS: 51834). Forty participants took part. Case site data consisted of interviews/focus groups and national data consisted of semi-structured interviews. Data collection took place between April and August 2022. Analysis was underpinned by West etal.'s The courage of compassion. Supporting nurses and midwives to deliver high-quality care, The King's fund, 2020 ABC framework of nurses' core work well-being needs. The majority of participants experienced challenges to their professional well-being contributed to by lack of recognition, feeling undervalued and lack of involvement in higher-level decision-making. Some participants displayed burnout and stress. Structural and cultural issues contributed to this and many experiences pre-dated, but were exacerbated by, the COVID-19 pandemic. By mapping findings to the ABC framework, we highlight the impact of the COVID-19 pandemic on the well-being of nurses working in general practice and contributing workplace factors. The issues identified have implications for retention and for the future of nursing in general practice. The study highlights how this professional group can be supported in the future. The study contributes to our understanding of the experiences of nurses working in general practice during the COVID-19 pandemic and beyond. Findings have implications for this skilled and experienced workforce, for retention of nurses in general practice, the sustainability of the profession more broadly and care quality and patient safety. Standards for Reporting Qualitative Research (O'Brien etal. in Journal of the Association of American Medical Colleges, 89(9), 1245-1251, 2014). As this was a workforce study there was no patient or public contribution.

“I don’t see the whole picture of their health”: a critical ethnography of constraints to interprofessional collaboration in end-of-life conversations in primary care

ContextInterprofessional collaboration is recommended in caring for frail older adults in primary care, yet little is known about how interprofessional teams approach end-of-life (EOL) conversations with these patients.ObjectiveTo understand the factors shaping nurses’ and allied health clinicians’ involvement, or lack of involvement in EOL conversations in the primary care of frail older adults.Methods/settingA critical ethnography of a large interprofessional urban Family Health Team in Ontario, Canada. Data production included observations of clinicians in their day-to-day activities excluding direct patient care; one-to-one semi-structured interviews with clinicians; and document review. Analysis involved coding data using an interprofessional collaboration framework as well as an analysis of the normative logics influencing practice.ParticipantsInterprofessional clinicians (n = 20) who cared for mildly to severely frail patients (Clinical Frailty Scale) at the Family Health Team.ResultsFindings suggest primary care nurses and allied health clinicians have the knowledge, skills, and inclination to engage frail older adults in EOL conversations. However, the culture of the clinic prioritizes biomedical care, and normalizes nurses and allied health clinicians providing episodic task-based care, which limits the possibility for these clinicians’ engagement in EOL conversations. The barriers to nurses’ and allied health clinicians’ involvement in EOL conversations are rooted in neoliberal-biomedical ideologies that shapes the way primary care is governed and practiced.ConclusionsOur findings help to explain why taking an individual-level approach to addressing the challenge of delayed or avoided EOL conversations, is unlikely to result in practice change. Instead, primary care teams can work to critique and redevelop quality indicators and funding models in ways that promote meaningful interprofessional practice that recognize the expertise of nursing and allied health clinicians in providing high quality primary care to frail older patients, including EOL conversations.

Knowledge of Palliative Care and Barriers to Access Among Outpatients with Cancer

ContextPalliative Care (PC) is poorly understood by laypersons. However, little is known about what ambulatory patients with cancer understand about PC or what barriers to access exist. MethodsOutpatients undergoing cancer treatment completed a survey evaluating their familiarity and knowledge of PC, Palliative Care Knowledge Scale (PaCKS), feelings towards PC (before and after reading a definition of PC), barriers to PC, and prognostic understanding. We summarized responses descriptively and used logistic regression models to examine variables associated with familiarity and interest. ResultsThe survey response rate was 32%. Of 151 participants, 58.9% reported familiarity with PC. The average PaCKs score was 11.9 out of 13 (standard deviation, 1.4), with 46.4% receiving a perfect score, indicating high knowledge of PC. Patients diagnosed more than one year ago had significantly increased odds of being familiar with PC (OR 2.93; 95% CI 1.37–6.25). More participants reported future interest in PC compared to current interest (74.2% vs 44.4%, respectively). Patients with stage III or IV cancer had significantly increased odds of having a current interest in receiving PC compared to patients with stage I or II disease (OR 2.66; 95% CI: 1.05, 6.76). Participants reported feeling significantly less anxious and more reassured after reading a standardized definition of PC (P < 0.05). ConclusionOutpatients with cancer who are being treated at a large academic cancer center exhibit high awareness and knowledge of PC, but anxiety toward PC persists. Factors beyond knowledge may perpetuate the delayed or lack of involvement with PC. Key MessageIn this cross-sectional study of outpatients with cancer, findings suggest that high knowledge of PC may co-exist with a lingering uneasiness towards the service. Additionally, factors beyond knowledge, such as logistic barriers, anxiety, and oncologists' preference may be perpetuating the delay or lack of involvement in PC.

The Institutionalization of Urban Communities of Major Regional Centers of the Russian Federation in the System of Political Conflict Management: Limits of Possibilities

In modern Russia, the problems of institutionalized participation of the communities of major regional centers in political conflict management and decision-making on the urban development agenda are becoming more relevant. Political institutionalization is considered by the authors in the context of the liberal theory of conflict, the neo-institutional approach, and illiberal peacebuilding. The authors draw conclusions on the growth of the subjectivity of urban communities with their lack of involvement in the system of political governance at the city level, based on the data of an empirical study conducted through semi-structured interviews with leaders and activists of urban communities in three major regional centers of Russia - Voronezh, Krasnodar, Yaroslavl, as well as an expert survey in these cities. The analysis of the “Krasnodar Tram” case reveals such problems as the low level of institutional trust in the system of interactions between urban communities and local authorities, as well as the lack of effective mechanisms for coordinating decisions in a conflict. Thus, the political institutionalization of communities is limited in scale, which is due to the state of the public policy space at the municipal level, the hybrid nature of institutional regulation, as well as the structure and characteristics of the activities of the communities themselves.

Greenlandic children placed in out-of-home care: The lack of involvement and participation in one’s own life

In Greenland, more than four times as many children are placed in out-of-home care (OHC) as in comparable countries in the Nordic region. This article is based on qualitative interviews with 38 children placed in residential institutions and shows the children’s own experiences of this and the degree to which they were involved in decisions concerning their own lives. The results of the article point to five main findings. First, the interviewed children usually didn’t know why they were placed in institutional care. Secondly, they didn’t know how long they could stay where they lived. Thirdly, the children expressed a wish for more committed staff. Fourthly, the children missed their families, not least because they were often placed far away from home and only had the opportunity to see their families a few times a year. And finally, around half of the children were satisfied to live in the residential institution they’d been placed in. The results are analysed and discussed in a phenomenological framework of recognition theory and participation theory.

Local purse-seine fishers’ economic losses owing to endangered seabird conservation measures – perceptions and reality

The likelihood of success of a marine protected area (MPA) is strongly dependent on stakeholders’ support. A concern often raised by local fishers is their lack of involvement in the design or management of a MPA and their loss of income owing to lost fishing grounds. We used Algoa Bay, South Africa, as a case study to analyse fisher’s and fish-processing factory managers’ concerns and perceived economic losses from fishing closures using structured interviews. Since 2009, a 20 km-radius purse-seine fishing-exclusion zone has been tested in Algoa Bay to assess the benefit to population recovery of the endangered African penguin Spheniscus demersus. Costs to the industry were estimated in terms of loss of catches and additional travel time to fishing grounds with and without closures. Fisher responses to interviews revealed general support for conservation and MPAs, but individuals interviewed did not feel that the 20 km fishing exclusion zones in Algoa Bay would aid African penguin conservation. While they systematically raised concerns about potential economic costs to their industry from closures, neither their catch sizes nor travel times varied significantly with fishing exclusion measures. Acknowledgement and assessment of the economic concerns may aid in initiating an informed dialogue amongst the various stakeholders in Algoa Bay, which may increase compliance and success of the newly proclaimed Addo elephant National Park MPA. Continued dialogue may also act as a catalyst for more integrated ocean management of biodiversity and human uses in the bay.

An App to Support Fathers' Mental Health and Well-Being: User-Centered Development Study.

Numerous studies describe the popularity and usefulness of parenting programs. In particular, parenting programs are generally viewed as effective for supporting parents' mental well-being during key transition periods. However, the evidence base for fathers is limited owing to their lack of involvement in parenting programs and scarcity of tailored support. This paper aimed to describe the co-design process for a universal digital intervention for fathers (fatherli) and the outline of a logic model with its expected outcomes. Following established guidelines for co-designing and developing complex interventions, we conducted a nonsystematic review of the available literature to gather key information, developed market surveys to assess fathers' needs and interests, consulted with key stakeholders to obtain expert opinions, and engaged in a rapid iterative prototyping process with app developers. Each step was summarized, and the information was collated and integrated to inform a logic model and the features of the resulting intervention. The steps in the co-design process confirmed a need for and interest in a digital intervention for fathers. In response to this finding, fatherli was developed, consisting of 5 key features: a discussion forum for anyone to post information about various topics (the forum), a socializing platform for fathers to create and engage with others in small groups about topics or points of shared interest (dad hub), a tool for fathers to find other fathers with shared interests or within the same geographic location (dad finder), a resource for fathers to access up-to-date information about topics that interest them (dad wiki), and a portal to book sessions with coaches who specialize in different topics (dad coaching space). The evidence-based logic model proposes that if fatherli is successfully implemented, important outcomes such as increased parental efficacy and mental health help-seeking behaviors may be observed. We documented the co-design and development process of fatherli, which confirmed that it is possible to use input from end users and experts, integrated with theory and research evidence, to create suitable digital well-being interventions for fathers. In general, the key findings suggest that an app that facilitates connection, communication, and psychoeducation may appeal to fathers. Further studies will now focus on acceptability, feasibility, and effectiveness. Feedback gathered during pilot-testing will inform any further developments in the app to increase its applicability to fathers and its usability.

School Excellence and Acceleration Policy: A Review of Theory and Implementation

This research aims to describe the advantages, disadvantages, and ideal picture of superior schools and acceleration programs. The research method used is descriptive qualitative with literature study. The results of the theoretical review present concepts and definitions of excellent schools and acceleration programs. The advantages of excellent schools include a quality learning environment, skilled teachers, and a curriculum focused on critical skills. Disadvantages of excellent schools include high competition and lack of involvement in non-academic aspects. The strengths of accelerated programs are that the academic challenges match the abilities of gifted and bright students. Disadvantages of accelerated programs include social and emotional gaps and a lack of focus on non-academic skills. The ideal picture of excellent schools and accelerated programs includes a balanced approach between academic and non-academic needs, emotional and social support for students, and flexibility in the curriculum. In conjunction with the curriculum reform in Curriculum 2013 (K13), a school policy with an SKS (Satuan Kredit Semester) system was created that emphasizes students' independent and collaborative learning abilities based on Independent Learning Activity Units (UKBM).

Against the ‘Control Argument’: Assessing the State’s Authority in the State-Commissioned Qur’ān Translation

Indonesia is one of a few countries that has an official Qur’ān translation, namely Al-Qur’an dan Terjemahnya (QT). As a country that has always been preoccupied with issues of religious regulation, there is a general consensus among the current scholarship on QT, namely that QT is the state's instrument for creating a standardized Islamic discourse in Indonesia. My paper questions this argument through an analysis of three interpretive cases in QT: the creation verse (Q 4:1), akābīra mujrimīhā in Q 6:123, and awliyāʾ in Q 5:51, focusing on the extent to which the interpretive outcome of QT is closely controlled by the state. In contrast to the 'control argument,' this study demonstrates that the renderings of QT in these three cases reflect the state's lack of involvement in the actual translation process. Despite the fact that QT is a state-commissioned and authorized Qur’ān translation, the ulama continue to be the masters of QT interpretive authority. While the entire process of producing QT may imply the obvious presence of the state, when we consider the genealogical nature of tafsīr, the religious authority of QT returns to the ulama rather than the state.

Assessment of Knowledge and Rate of Service Uptake of Community Based Health Insurance among Traders in Akpan Andem Market, Uyo, Akwa Ibom State, Nigeria

Community Based Health Insurance (CBHI) is a form of micro health insurance, which is a health insurance targeting low-income people. The specific feature of CBHI is the community involvement in driving its setup and in its management. Traditional CBHI models are small, voluntary, and often include the pooling of health risks and funds within a community. In Nigeria, many CBHI schemes have had limited success, suffering from low membership levels, and having issues such as regressive financing, poor or lack of involvement amongst scheme members amongst others. The study assessed the level of CBHI knowledge and rate of service uptake of CBHI among the traders. 300 Questionnaires were administered to the traders by face-to-face interview which gave the respondents the opportunity to respond to both the structured and open-ended questions. Inferential statistical tests were used to test the various research hypothesis that arose from the research questions in the study. Various statistical tests such as Chi-square, comparison of column proportions, correlational tests, and multiple regression were used. The result shows a mean knowledge score of 33.79 ± 3.22 with their scores ranging from 25 – 42. 2%. There was no significant relationship between knowledge level and service uptake (p = 0.351). Findings from this study noted that although awareness is poor, a good quota of the participants (79%) still have overall good knowledge of CBHI schemes. Hence, it will be beneficial to leverage on this concretize more efforts towards encouraging people to enrol with the CBHI schemes. Keywords: Community Based Health Insurance, Community Involvement, Voluntary, Health Risk, Regressive Financing, Inferential Statistics, Knowledge Level, Service Uptake.

Dinamika Hubungan Sponsorship dalam Narcotics Anonymous (NA) sebagai Strategi Pemulihan Adiksi Narkoba

Indonesia still has a fairly high rate of drug abuse. Some limitations in drug management strategies in Indonesia, such as obstacles to intervention in prisons and lack of involvement in recovery from addicts, can be overcome by the existence of alternative drug treatment strategies. One of the recommended rehabilitation methods is sponsorship from Narcotics Anonymous. This method allows the involvement of the addict in the recovery process from drug addiction and can trigger the desire of the addict to continue the recovery process with social support provided through sponsorship relationships. This study aims to understand the dynamics of the experiences of individuals undergoing sponsorship in the Narcotics Anonymous community for drug addiction recovery. A single case study with an in-depth interview method was conducted on 42-year-old individuals undergoing drug recovery, as well as having experience participating in Narcotics Anonymous and having sponsorship relationships, both as sponsors and sponsors. In-depth interviews referred to four themes emerging from participants' experiences: (1) the main problem of addiction is behavior that forms with drug use, (2) opening the ears and expressing the heart can have therapeutic effects during recovery, (3) learning from sponsors during recovery, and (4) sharing experiences as sponsors is a form of recovery. The results of the study found that the dynamics of sponsorship relationships in NA become a social support that has therapeutic value for its members, facilitates abstinence, and raises positive expectations in recovery. As sponsors, participants who provide support also find it helpful in undergoing recovery through helper therapy principles. It can be said that the sponsorship relationship as one of the social supports in drug handling is felt to provide many benefits and can effectively help the recovery process of drug addiction so that it can be considered for mental health practitioners as an alternative therapy in handling drug addiction.

Ethnically diverse communities and their priorities for cancer research.

e18602 Background: Ethnic minorities in the UK tend to have poorer access to healthcare, outcomes and experiences than the majority population. They are often underrepresented in health research. Experiencing disparities compounded by the lack of involvement in research widens the inequalities gap. Methods: Targeted community engagement was implemented in the highest areas of deprivation in the South West. The project team designed a series of questions and data was collected during outreach health checks and community events by members of the team based in the community. Information was collected from individuals and from groups. Results: Forty people, from culturally and linguistically diverse communities participated. We sought help from interpreters to ensure inclusivity and information was gathered in a cultural sensitive way. This was especially important due to the sensitivity in this topic area. Demographic information was collected from those that participated. The majority were women (n = 33), men (n = 7). In terms of ethnicity the majority described themselves as Black African/Caribbean (n = 31), Arab (n = 9) and Asian (n = 3). The age range was 25 - 64 years. Twelve people identified that their actual age was different to their recorded age on the NHS system. Fourteen people had been in the UK for less than 5 years and included those identifying themselves as refugees and asylum seekers. We conducted content analysis to identify and categorise the cancer research needs identified. Key themes identified included: Easier access to screening programmes; earlier diagnosis and how to initiate onward referral; research into cancer prevention and a more holistic approach to cancer care. Only one patient had clinical trials discussed. Conclusions: Community engagement offers the opportunity to identify cancer research priorities and discuss access to cancer prevention, cancer screening programmes, therapies and clinical trials. Through actively listening to our communities and the voices seldom heard about their experience of health and cancer care, we raise awareness and provide ongoing education to health care teams, on the delivery of care that is culturally sensitive, inclusive and more tailored to an individual. Increasing the diversity of the workforce may increase representation and greater advocacy of the communities. Engaging patients more in their own cancer care and decision-making may empower them to be more involved in their health. Our findings suggest that community engagement with people from diverse communities identify areas for improvement in their cancer care and experience. This includes how we might better engage with people from diverse backgrounds on clinical trials. Addressing the priorities identified from these communities is a first step in addressing the existing inequalities. Organisations need to actively engage, listen to and empower the communities that we serve.

Adult sibling-related experiences while caring for a parent diagnosed with a blood cancer.

An older parent's blood cancer diagnosis impacts the entire family system, including adult siblings, an often overlooked subsystem of the family. Yet, adult siblings are typically involved in their parents' care needs. We explored sibling-related experiences adult child caregivers identify while caring for a parent diagnosed with a blood cancer to capture information useful for caregiving intervention development. Fifteen adult child caregivers with at least 1 sibling participated in an in-depth, semistructured interview. Participants were 87% white and 80% daughters. A majority of caregivers were in midlife (M age = 44), with parents diagnosed between age 56 and 90. A thematic analysis was conducted on transcripts using the constant comparative method. Caregivers described 3 types of sibling-related experiences that centered on (a) caregiving responsibilities (e.g., sharing/not sharing tasks; challenging feelings about lack of involvement); (b) expectations about the caregiver role (e.g., gender, family status, and birth order expectations); and (c) coping together and apart (e.g., receiving information together, enhanced relationships, divergent maladaptive coping). Findings illustrate how a parent's blood cancer diagnosis can enhance the sibling bond and family system as well as contribute to tension, particularly regarding the experiences of not sharing caregiving tasks or having divergent approaches to coping. Findings also provide insight into areas in which supportive interventions or resources are needed (e.g., helping siblings talk about caregiving involvement) to promote healthy family functioning after a blood cancer diagnosis. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Integrating metacognitive strategies impact in virtual science experiments for undergraduate students’ HOTS

Higher Order Thinking Skills (HOTS) are essential variables that support the achievement of science learning objectives. However, distance learning during the Covid-19 Pandemic was the cause of the lack of maximum HOTS for undergraduate science students due to their lack of involvement in experiments. Therefore, this study aims to apply a metacognition-integrated science virtual experiment model and examine its impact on students' HOTS science. A quasi-experiment was involved with a randomized pretest-posttest comparison group design to see the impact of the implementation of this model. Participants in the two treatment groups were randomly selected from two private universities in Indonesia. The HOTS of participants were assessed using multiple-choice questions. Observation sheets were used to measure the implementation of the learning model being developed. A general linear model with MANOVA was used to test the effect of the model, while Partial Eta Squared was used to measure the effect size of the model on HOTS. The results showed that the virtual science experimental model integrated with metacognition strategies significantly affected students' HOTS. The effect size measurement shows a high effect in the experimental group. Researchers recommend that universities apply a similar model to encourage students' achievement of HOTS.

Pola Asuh Permisif dan Dampaknya Kepada Anak Usia Dini (Teori dan Problematika)

Basically every parent has the hope of having a child who is good, useful in terms of religion and education. This is of course inseparable from the parenting style adopted by parents, because the initial formation of character and children's education comes from the family environment. However, the current reality is that many parents do not understand their rights and obligations as parents, one of which is not upgrading knowledge about proper parenting or child development, causing parents to lack understanding of how to apply good parenting styles for children. This study aims to obtain information about permissive parenting and its impact on early childhood. The type of research used is descriptive qualitative research with data collection techniques in the form of observation, interviews and documentation. The source of data in this study is parents who are the object of research. The results of the study show that parenting styles in each family are different, this is caused by several factors, namely: parental education, economy, culture and environment. The parenting style applied in this study is permissive parenting. The permissive parenting style applied by parents has a great impact on children, causing children to be difficult to advise and teach good things, selfish, have no manners and manners, have no respect for parents, often fight and yell at parents in daily interactions, being lazy and impatient. This is due to the parenting style applied by parents and the lack of giving a good example or example to children. The characteristics of parents practicing permissive parenting are: 1. There are no clear rules; 2. Not consistent in giving punishments; 3. Giving excessive gifts; 4. Lack of involvement; 5. Does not provide clear consequences; 6. Avoid conflict; 7. Do not limit access to dangerous things; 8. Become a friend rather than an authority.&#x0D; &#x0D; Keywords: Permissive Parenting, Early Childhood.

Massive Influx of Victims: Staff Preparedness and Facility Readiness of Tunisian General University Hospitals.

Introduction:Hospital preparedness for a massive influx of victims relies, to a certain extent, on actions, programs, and systems that are created and executed ahead of time, but also on the knowledge, skills, and professional competences of the hospital's staff. This study aims to understand the factors influencing the preparedness of Tunisian University Hospital staff in facing a massive influx of victims.Method:This is a multi-method qualitative descriptive study, conducted in nine general University Hospitals (UH) in Tunisia; the first component was a phenomenological design via open-ended interviews; the second component was a qualitative observational non-participatory design via field observations.Results:17 participants were recruited, in an intentional non-probabilistic way. Participants to this study discussed issues related to the material and financial resources of their hospitals; the psychological impact of managing an influx of victims; their training, their involvement in the process, and the norm versus the circumstances in the field. Which led to the conclusion that: "For multiple reasons, the Tunisian University Hospitals are not ready to properly manage a massive influx of victims"Conclusion:This multi-method qualitative study discussed the factors that affected the preparedness of staff and readiness of UHs included. Factors were mainly resources (material and financial), psychological burden, lack of training, lack of involvement in the process and issues related to evidence-based practice. Data collected supports the idea that more research and more practical interventions need to be performed to increase the preparedness level of Tunisian UHs and their staff.