Multifaceted Research Research Articles

Strengthening Research and Practice in Community Health Systems: A Research Agenda and Manifesto.

While there have been increased calls for strengthening community health systems (CHSs), key priorities for this field have not been fully articulated. This paper seeks to fill this gap, presenting a collaboratively defined research agenda, accompanied by a ‘manifesto’ on strengthening research and practice in the CHS. The CHS research agenda domains were developed through a modified concept mapping process with a team of 33 experts on the CHS including policy-makers, implementers and researchers from institutions in six countries: Uganda, Guatemala, South Africa, Sweden, Tanzania and Zambia. The process began remotely with brainstorming research priorities and concluded in a one-week workshop that was held in Zambia where priorities for strengthening CHS were discussed, grouped into domains, interpreted, and drafted into a collective declaration. Eight domains of research priorities for CHSs were identified: clarifying the purpose and values of the CHS, ensure inclusivity; design, implementation and monitoring of strategies to strengthen the CHS; social, political and historical contexts of CHS; community health workers (CHWs); social accountability; the interface between the CHS and the broader health system; governance and stewardship; and finally, the ethical methodologies for researching the CHS. By harnessing a set of diverse and rich experiences and perspectives on CHS through a structured process, a multifaceted research agenda and manifesto that transcend context, disciplines and time were developed. We posit this as an entry into greater debate and diversity in the field as we continue to find ways to strengthen research and practice in the CHS.

The Disappearance of Coal Seams Recorded in Associated Gangue Rocks in the SW Part of the Upper Silesian Coal Basin, Poland

Coal seams in the Upper Silesian Coal Basin vanish within the Carboniferous Upper Silesian Sandstone Series and below an unconformity marking the Carboniferous top surface. Changes in the geochemical, mineralogical, petrological and palynological characteristics of gangue rocks associated with the vanished seams record what happened. The observed changes could have been caused by (1) coal-seam paleofire, (2) peat combustion, (3) igneous intrusion, (4) metasomatism and/or (5) weathering. Multifaceted research on samples collected at the Jas-Mos mining area, a part of the operating Jastrzębie-Bzie Coal Mine that are representative of different geological settings in the northern and southern parts of the mining area, point to intra-deposit paleofire as the most plausible reason for the disappearance. Biomarkers enabled recognition of differences in heating duration and oxygen access. Coal seams in the south burned quickly with abundant oxygen supply. Seams in the north pyrolyzed for an extended time under conditions of limited oxygen. Though other methods used proved less sensitive, all confirmed low (100–150 °C) paleotemperature heating. Overall, the reason for the local disappearance of the coal seams, making their exploitation difficult and unprofitable, can be assigned to a variety of different processes in a complex overlapping history of variable weathering, heating due to local endogenic fires and, probably, earlier peat combustion.

DIGITAL JOURNALISM: multifaceted research in the development of didactics and production processes

The internet is the main source of news for Brazilians, the smartphone is the preferred device to reach them and social media have overtaken television as the hegemonic journalistic medium. Fragmented journalism in cyberspace demands new narratives, new media formats, production and distribution processes. Algorithms and artificial intelligence (AI) systems already perform many tasks, the profession reshapes itself and the teaching of digital journalism needs to keep up with the transformations. This article proposes multifaceted applied research as a way to develop narratives, apparatuses, production management systems and didactics capable of keeping up with technological evolutions and train journalists capable of researching and working in mutant environments.

Visual Mapping Sentence: A Methodological Approach to Multifaceted Research Design and Analyses

The declarative mapping sentence is both a research methodology within qualitative social science and humanities research, and a way of thinking about such scholarship. In essence, declarative mapping sentences are hypothesised statements of an area of enquiry that guide a researcher’s thoughts, plans and designs, investigations, analyses and interpretations. In this brief essay I consider the often neglected considerations of the philosophical status of the components of the declarative mapping sentence. I suggest that considering the relationship between the parts of a declarative mapping sentence may facilitate a greater understanding of the investigated phenomena.

2400 years of climate and human-induced environmental change recorded in sediments of Lake Młynek in northern Poland

Abstract. In the densely forested Warmia and Masuria region (northern Poland) there are many small endorheic lakes characterized by their low sedimentation rate, which makes them excellent archives of Holocene environmental and palaeoclimatic change. Lake Młynek, located near the village of Janiki Wielkie, was selected for multi-faceted palaeoenvironmental research supported with radiocarbon dates. Sediments from this lake also contain unique information about human impact on the environment, because a stronghold has been operating on its northern shore since the early Iron Age to the early Medieval period, giving the opportunity to correlate palaeoenvironmental data with the phases of human activity over the last 2400 years. During the second and third centuries BCE the lake was surrounded by a dense deciduous forest. From the first century BCE to second century CE the forest around the lake was much reduced, which can be associated with the first pre-Roman (La Tène) and Roman occupation phase evidenced by the construction of the stronghold located close to the lake. From the second up to ninth century CE gradual restoration of the forest and a decline in human activity took place, along with lake deepening and the onset of a colder and humid climatic phase which corresponded to the global cooling episode known as the Bond 1 event (1.5 ka BP). The next intensive phase of forest clearing around the lake occurred between the 9th–13th century CE as result of human activity (Middle Age settlement phase of the stronghold). Whilst this period is marked by a warming, the human impact which has transformed the landscape likely overprints any signals of climate-driven environmental changes.

Comment on: seismic hazard and probability assessment of Kashmir valley, northwest Himalaya, India by Chandra et al. 2018

Chandra et al. (2018) have conducted seismic hazard and probability assessment of the Kashmir valley by following multifaceted research methodologies that have mainly used the earthquake data from the United States Geological Survey, which ranges from 1902–2017. These data are supplemented by the lithological, geomorphological, geotechnical, hydrogeological and socio-economic datasets. However, the results are conflicting, contradictory, and questionable, because the authors have used scientifically invalid research methods. Therefore, the comment aims to highlight the major concerns with a motivation to offer solutions that could help the authors to refine the science on the earthquake hazards in the region.

Teoria/Literatura as a Mise en Abyme of Digital Research on Literary Studies. The Corpus of Polish Literary Theory Between Mathematical Intuitionism and Formalism

In this paper, I present theoretical assumptions behind Teoria/Literatura, a multifaceted digital research and publishing project on 20th-century Polish literary thought. The point of departure is the conjecture that the tensions between the digital and the humanistic in present-day DH help bring out in full relief the cardinal conflict line in Polish literary theory – between formalism/structuralism on the one hand and phenomenology on the other. Conversely, the order of concepts in the corpus of Polish literary theory enables the researcher to pinpoint the relation of the humanistic and the digital (or formalist) within DH so that it might be challenged and/or upgraded. In the first section, I provide an overview of the project's strata and its wide-ranging goal, i.e., a corpus of Polish literary theory. In section two, I examine the way in which the structure of the corpus can help elucidate the general problem of the relation between the digital and the humanistic in DH. Specifically, I relate this issue to the quarrel in constructive mathematics between mathematical intuitionism and formalism. The third section is devoted to a synecdochal representation of the general problem of the duality of intuitionism and formalism – the visualisation of narrative temporality.

Reply: Screening Instruments and Prevalence of Impulse Control Disorders.

We appreciate the opportunity to respond to the comments on our recently published study1 and thank Jaakkola and Joutsa2 for their constructive discussion. We agree that the methodology used to detect impulse control disorders (ICDs) is crucial to estimate their prevalence. Overall, most studies included in our review used a screening tool to detect ICDs, thus increasing the sensitivity and yielding higher prevalence rates. We acknowledged this relevant caveat in our study and reported the methodology used in each of the studies selected. A previous study showed that the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) and the Minnesota Impulse Disorders Interview (MIDI), the 2 most used screening tools in our sample, yielded overall comparable results.3 Only a minority of studies, both from Western and Eastern countries, relied on clinical interviews to detect ICDs, as we reported.1 Jaakkola and Joutsa2 also raised their concerns about another important issue regarding impulse control behaviors (ICBs), which we did not fully address in our review. As we explained, we chose not to address the prevalence of the different subtypes of ICBs as these data were more inconsistently reported than ICDs. However, as our colleagues pertinently point out, the QUIP assesses both ICDs and ICBs.4 For our review, we used the total prevalence of any ICD as reported in each study, and considering that none of the articles using QUIP specifically states the exclusion of ICBs from the assessment, we should assume that ICBs may be included in the total prevalence reported. In the perfect scenario, all studies would have specified clearly if ICBs were included in the total prevalence reported and subtracted this data from it, but this was not the case for all of them. We accept that this is an important limitation of our study, for ICDs as a whole could be overestimated in several studies included in our analysis, and we appreciate the pertinent observation of Jaakkola and Joutsa. However, this limitation does not affect our data regarding the frequency of each subtype of ICD separately, on which we also based our results. In our study, we acknowledged that the variability in patient populations and methodological differences among the included studies make them difficult to compare directly, and we agree with Jaakkola and Joutsa2 that our results should be interpreted with caution. Even so, our review puts together a large number of studies, showing the huge heterogeneity currently existing in the literature, and points out the relevance of considering geographical differences in the assessment of ICDs in patients with Parkinson's disease. Our research may help to set the basis of more specific studies conducting this complex and multifaceted research. (1) Research Project: A. Conception, B. Organization, C. Execution; (2) Manuscript Preparation: A. Writing of the First Draft, B. Review and Critique. P.P.-D.: 1A, 1B, 1C, 2A, 2B A.A.-C.: 1A, 1B, 2A, 2B Ethical Compliance Statement: The authors confirm that the approval of an institutional review board and informed patient consent were not required for this work. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this work is consistent with those guidelines. Funding Sources and Conflict of Interest: This research did not receive any funding. The authors declare that there is no conflict of interest. Financial Disclosures for the Previous 12 Months: Paloma Parra-Díaz declares no financial disclosures. Araceli Alonso-Cánovas has received honoraria as a speaker from AbbVie, Zambon, Alter, Krka, and Lundbeck. She has participated in the advisory boards of AbbVie, Zambon, and Bial. She has received travel grants from AbbVie and Zambon and funding for scientific research from Italfarmaco.

095 Bioengineering a complex skin equivalent for skin care applications

Bioengineered skin constructs provide a physiologically relevant platform for fundamental and translational research. We have developed a complex, robust and reproducible full thickness skin equivalent, which has been validated against in vivo skin using in-depth analyses. To mimic the dermis in vitro, primary fibroblasts were cultured within the Alvetex® Scaffold to produce endogenous extracellular matrix proteins. The robust dermal compartment supports the generation of an organised, stratified and keratinised epidermis. Additional cell types have also been incorporated, such as melanocytes and immune cells, to increase the skin equivalent complexity. The human skin equivalent recapitulates the organised structure of human skin in vitro. Skin constructs that represent different ages have been developed using neonatal, young or ageing cells. The use of ageing and senescent cells recreates the ageing skin phenotype in vitro, with regards to epidermal thinning, decreased keratinocyte proliferation and reduced extracellular matrix synthesis. Pigmented skin equivalents include melanocytes, which localise to the basal layer and transfer melanin to neighbouring keratinocytes to form a protective supranuclear cap. The pigmented skin equivalents are functional, and exposure to ultraviolet radiation induces a tanning effect. Langerhans cells have also been incorporated into the epidermis to produce an immune-competent skin equivalent, which is responsive to topical allergens and irritants. We have developed advanced, robust and reproducible skin constructs that resemble the structure of human skin. These skin equivalents have multifaceted research applications such as investigating the underpinning mechanisms of skin ageing, assessing the effect of exogenous stressors and evaluating cosmetic formulations.

Can the SARS-CoV-2 virus damage human hearing and balance?

In 2019, COVID-19, the disease caused by the SARS-CoV-2 virus, evolved into a pandemic which is still going on. The basic clinical symptoms of the SARS-CoV-2 infection are: fever, dry cough, fatigue, muscle pain, respiratory problems, and the loss of smell or taste. Other symptoms, including those related to hearing and balance organs (hearing loss, tinnitus, dizziness), are reported less frequently by patients. They are especially rarely reported as the first symptoms of this infection. In order to answer the question of whether SARS-CoV-2 can cause hearing and balance damage, the authors reviewed the literature sources from 2019-2020 included in EMBASE and PubMed, entering the following words: "hearing loss," "COVID-19," "coronavirus," "sensorineural hearing loss," "vertigo," and "dizziness." Ultimately, 9 studies on the possible relationship between hearing impairment and SARS-CoV-2, and 4 studies on the possible relationship between damage to the balance and SARS-CoV-2, were qualified for the study. The results of the analysis suggest a possible relationship between COVID-19 and hearing loss, with no evidence of a similar relationship between this virus and the balance system. The possible existence of such a relationship should be especially remembered by hospital emergency room doctors, otolaryngologists and audiologists, especially as regards the possibility of a sudden sensironeural hearing loss as the first symptom of COVID-19. This also applies to doctors of other specialties. The authors indicate the need for further, intensive and multifaceted research on this issue. Med Pr. 2021;72(3):321-5.

The ACTION Quality Improvement Collaborative: 2020 Annual Report

Purpose ACTION (Advanced Cardiac Therapies Improving Outcomes Network) is a multi-faceted quality improvement (QI) and research network with the goal of improving pediatric and congenital heart disease VAD and heart failure (HF) outcomes. This report describes ACTION initiatives. Methods ACTION includes QI, educational activities, and a data registry. Stakeholders include providers, patients and families, and industry partners. The core values of ACTION include collaboration and transparency. ACTION started in 2017, with data collection beginning in April 2018. This report utilizes ACTION data and describes selected completed and ongoing initiatives. Results The ACTION registry report is shared with sites as an interactive dashboard (refreshed monthly). A comprehensive data quality strategy includes data queries and adjudication of critical events. There are 50 US/Canadian sites in the network and 34 of the sites contribute data. There are additional international sites that participate in all activities except patient-level data collection. The registry includes 388 patients implanted with 511 devices with 51,411 device days. DCM (203) and CHD (143) are the major underlying diagnoses. EXCOR (148), HVAD (97), and HM3 (70), are the most common end devices. Survival is 91% (including ongoing support, transplant and wean). AE rates are: stroke 11%, bleeding 21%, and infection 26%. The dashboard allows intuitive examination of subgroups, e.g., stroke/bleeding rate in patients less than 10 kg/on a specific device. Initial QI projects include an initiative (ABC of stroke), that used a bundle of interventions to reduce stroke during VAD support; a discharge planning project; a telehealth support project; and a harmonization initiative to reduce burden of protocol development for sites. Additionally, a patient-facing education website about VAD/HF care is being deployed and a HF project is collecting baseline data for acute decompensated HF. ACTION data have been used to support regulatory (FDA) approval of selected devices. Conclusion ACTION, a collaborative, multi-stakeholder network, has undertaken numerous approaches to improve outcomes for children with HF and VADs. In keeping with the values of transparency and collaboration, the ACTION annual reports will be made available in their entirety in a patient-facing version, via the ACTION website.

Student Meaning-Making of an Allegorical Picturebook in Social Studies

Participation in a classroom-based study provided Grade 4 students with multiple opportunities to develop their visual meaning-making skills and competences, as well as their aesthetic understanding of and critical thinking about multimodal ensembles. Intentionally-designed instruction during the multifaceted research included a variety of activities focused on a selection of elements of visual art and design. Student participants read and discussed, and wrote about picturebooks during Language Arts, Science and Social Studies. The Rabbits, a picturebook that has been interpreted as a powerful and unsettling allegory of colonization, industrializaiton, and ecological destruction, was one selection of literature featured during a Social Studies unit on European exploration. The content analysis of the students’ responses to The Rabbits revealed how the students identified, described, and interpreted Shaun Tan’s use of color, visual point of view, and typography as fulfilling multiple, and often simultaneous, meaning-making purposes. The responses provided evidence of student engagement in sophisticated visual analysis and symbolic interpretation that deepened their critical understanding and appreciation of The Rabbits, as well as enhanced their understanding of curriculum. Overall, the findings extend the limited research on how student knowledge about and interpretation of elements of visual art and design in the artwork in picturebooks used for Social Studies pedagogy can simultaneously develop students’ visual reading skills, enhance their comprehension of curricular content, and build their higher-order thinking skills.

Disclosure Practices of Information in the Field of Financial Instruments: Evidence from Polish Companies Listed in the Warsaw Stock Exchange

Purpose: The aim of the work is to investigate the practices of disclosing information about financial instruments in the financial statements due to the fulfillment of disclosure obligations and voluntary presentation of information under the accounting policy of financial instruments of companies listed in the Warsaw Stock Exchange. Design/Methodology/Approach: The research aimed at achieving the assumed goal was conducted based on annual, separate financial statements of listed companies for 2016 and 2017. The selection of entities for the audit covered 66 companies and was deliberate selection. In the study, the content of financial statements was analyzed. Findings: The analysis shows that the requirements for disclosing information about financial instruments in accordance with the accounting principles are very liberal. The scope of disclosures about financial instruments among Polish companies is varied and their transparency is low. Overall results show that companies are complying with their accounting policy disclosures, although there are a few requirements that companies ignore. The main problem with information transparency about financial instruments is that companies comply with their disclosure obligations by copying the guidelines and not by presenting important principles to the usefulness of the information. Practical Implications: The information obtained will constitute the basis for multifaceted research on accounting for financial instruments, especially in the field of identifying mandatory and voluntary disclosures of information about the accounting policy of financial instruments, as well as comparing and assessing the application of specific accounting principles of financial instruments from individual periods of application of the guidelines. Originality/Value: The study joins the current literature dealing with disclosure practices about financial instruments that are still missing. The study enriches the existing knowledge in the field of financial instruments and IFRS by identifying attributes that increase the level of information related to financial instruments provided by non-financial enterprises.

Conceptual Modeling of Construction Industry Enterprises Management Under Conditions of Economic Instability

The present article addresses the problems of effective management of building contractors under conditions of economic instability. The issue of sustainable development of enterprises is of particular relevance in the aftermath of the global financial and economic crisis, that has hit the world economy and has led to a significant deterioration of the key indicators o global economy, to declining trust in markets sustainable, in solvency of enterprises or even in suitability of economic systems around the world. One of the main reasons for this situation was the inefficient activities of the large enterprises, which assumed excessive risks in core activities, and after that they have hidden their failed results. The transition of the Russian Federation to a market economy has demanded from domestic economic science to review basic provisions of the concept of construction industry enterprises management. This is due to the fact that the unpredictability of rapid changes in the economic environment appeared and is growing at both micro and macro-level of fast-growing market. This resulted in an objective need to develop appropriate management methods for construction companies in conditions of instability and uncertainty engendered by the unpredictable changes of modern market. Complexity and uncertainty of the given problem have led to multifaceted research associated with development of management methods for the complex for socio-economic facilities in conditions of uncertainty of global economics.

Introduction: Migration and Unequal Positions in a Transnational Perspective

How does spatial mobility influence social mobility and vice versa? Often, the ‘objective’ structural positions on the one hand, and the ‘subjective’ definition of social positions on the other hand, are not considered together. Yet this is necessary in order to gauge the consequences of mobility trajectories reaching across borders. This framing editorial asks how we can study the interplay of perceptions of one’s own social position and one’s objective social position to better understand how spatial mobility influences social mobility and vice versa. In short, this means an exploration of the nexus of spatial mobility and social mobility. Exploring that nexus requires attention to objective social positions, subjective social positioning strategies, transnational approaches to the study of social positions and self-positioning, and social boundary theory. Overall, the complexity of the nexus between social and spatial mobilities calls for a multifaceted research approach that covers various levels of analysis. Some of the contributions feature a mixed-methods approach that allows drawing a multifaceted picture of the interrelation between the perceptions of social positions and their structural features.

Regional Farmers’ Perception and Societal Issues in Vineyards Affected by High Erosion Rates

We explore the current situation in a viticultural region in Eastern Spain from a holistic and multifaceted research approach, which allowed us to understand the biophysical conditions, economic cost, social impact, and perception of the farmers’ community to the use of catch crops. A survey of the perception of the farmers, and an assessment of the biophysical impact of catch crops (CC) and tillage (C = Control plot) on soil organic matter, bulk density, infiltration capacity (single ring infiltrometer), and runoff generation and soil erosion (rainfall simulation experiments) was carried out. Two representative fields as study sites were selected in Les Alcusses valley, within Els Alforins wine production region. The results show that the use of CC increased soil organic matter, favored higher infiltration rates and runoff generation was delayed. Moreover, runoff rates and soil erosion were lowered. The perception of the farmers was mainly against the use of catch crops due to their view as it being ‘dirty’, their cost, and the loss of their reputation and respect by other farmers. Our survey proves that the farmers would accept the catch crops if a subsidy of 76.56 € ha−1 on average would be paid. Farmers see the use of a catch crop more as a benefit for the health of the Planet than for themselves. To achieve land degradation neutrality, education and dissemination programs should be developed to teach and inform the farmers of their key role in the proper management of vineyards.

Research on the Application of Big Data Technology in Food Safety Management

When we think of the term food, we think of all kinds of eating and drinking related to our health. Of course, what we should think of most is the health of the body. In the form of today’s data, computer technology plays a very distinct role in the safety management of some well-known food companies at home and abroad[1]. Since the establishment of the food industry, foreign food safety management technologies have been synthesized by computers. As far as my country’s food technology is concerned, we still use a combination of manual and electronic machinery for food safety management. There is no doubt that the efficiency of this management method is very low. In order to greatly improve this efficiency, we should use big data technology in food safety management to conduct multi-faceted research.

Decorating rare-earth fluoride upconversion nanoparticles on AuNRs@Ag core–shell structure for NIR light-mediated photothermal therapy and bioimaging

Photothermal therapy (PTT) has presented its inherent application value in cancer treatment. Nevertheless, single-functional photothermal materials cannot meet the precise diagnosis and treatment of cancer. Therefore, it is important to design a nanocomposite that has both high therapeutic efficiency and multimodal imaging capabilities. In our work, a new nanostructure of gold nanorods (AuNRs) with silver shells decorated by BaGdF5:Yb3+,Er3+ nanoparticle was synthesized by a simple way. The biostability of AuNRs is increased by coating with silver shells, and the AuNR@Ag nanoparticles can be used as excellent surface enhanced Raman scattering (SERS) probe. Moreover, the modification of BaGdF5:Yb3+,Er3+ nanoparticles provides the possibility of real-time optical imaging of the tumor area. Under the irradiation of NIR laser, the AuNR@Ag/BaGdF5:Yb3+,Er3+ nanocomposites (NCs) have strong upconversion emission and excellent photothermal conversion efficiency. Meanwhile, the NCs show low cytotoxicity and good biocompatibility in MTT cytotoxicity test. Moreover, the NCs are also exceptional contrast agents for CT imaging. For invitro photothermal therapy test, NCs show excellent killing efficiency on tumor cells. Therefore, the multifaceted research of AuNR@Ag/BaGdF5:Yb3+,Er3+ multifunctional nanomaterials provides a break for high-efficiency tumor photothermal therapy and multimodal imaging.

Multifaceted Research from the Design Perspective of Subconscious <i>Kansei</i> and Desires

Multifaceted Research from the Design Perspective of Subconscious <i>Kansei</i> and Desires

Psychosocial Challenges in Palliative Care: Bridging the Gaps Using Digital Health.

Psychosocial health is a major palliative care concern globally. Patients and caregivers engaged in palliative care may experience deteriorated mental and social health conditions. Global evidence informs a high burden of depression, anxiety, psychological distress and other mental health problems among the palliative care populations. Those challenges aggravate the preexisting palliative care issues, such as lack of access and suboptimal quality of care. Palliative caregiving, both in the institutional and community settings, should be strengthened, incorporating psychosocial support for the patients and their caregivers. The recent advancements in digital health technologies have shown promising impacts in facilitating health communication, decision-making and delivering psychosocial interventions using digital devices and platforms. Adopting evidence-based interventions can help the users to access mental health resources and communicate with each other to promote shared decision-making and management of health problems. Health-care organisations and systems may explore opportunities to advance psychosocial care using digital technologies. Leveraging advanced technologies in palliative caregiving may require multifaceted research exploring potential barriers and opportunities at the user, institutional and systems levels. Nonetheless, palliative care policies and health systems measures should be strengthened to develop and implement digital support systems that may improve psychosocial health and overall palliative care outcome.