Perspective Of Makers Research Articles

Discourse Markers in the Students’ Individual Presentation in Indonesian Classroom

Individual presentation is one of common presentations used by students to present certain topic given by the lecturers in the class. This kind of presentation may take place in a range of setting such as in the classroom by providing question-and-answer session. Individual presentation might also invite classroom interaction among the students. One specific aspect of individual presentation which may contribute to the effective classroom interaction is the use of discourse markers by the students. This paper focuses to investigate the functions of discourse markers used by the students in the individual presentation as well as the students’ interaction during the presentation. Using data from an English class, this study describes the occurrences of discourse markers (DMs) used by the students in their individual presentations. To collect data, the researchers recorded individual presentations of the students in the class. Two long recording and transcription of the individual presentations was sampled and analyzed using discourse analysis approach. The discourse markers used by the students were analyzed using Schiffrin’s perspective of discourse markers (1987). Findings show that the students’ most common use of discourse markers function as pause filler, delaying tactic, hesitation device, to order the sequence of what the speaker says. Findings of this study are relevant to improve students’ English language proficiency and serves as a beneficial input for teachers and students to create effective classroom interaction.Keywords: Individual Presentation, Discourse Markers, Discourse Analysis, Scriffin’s discourse makers (DMs) perspective

Who decided the new energy vehicles policy in China? From the perspective of policy objects and policy makers

The new energy automobile industry is a comprehensive system that contains Exploration and Manufacture, Consumption and Promotion, Infrastructure Construction and Supporting Industries, which coordinate and supplement with each other. Accordingly, from the perspective of policy object, NEVs policies since 1991 to 2022 could be divided into four fields in China. With policy bibliometric analysis and social network analysis, in each field of policies, its policy networks can be drawn, with statistic of policies released separately, in order to comprehensively analyse the features of NEVs policy making. It is found that: (1) The structure of policy system is balanced among four fields of NEVs policies in China, though with a bias towards Consumption & Promotion, Exploration & Manufacture. (2) Policy makers in all four fields of NEVs policies preferred slightly to formulate policies jointly, rather than acting alone. While policies made by sole actors are part of policy system. (3) GOOSC, MIIT and MOT, as sole actor, played more significant roles in industry-wide, supply-side and demand-side of NEVs industry respectively. (4) Policy networks of all four fields started with the “iron four” (MIIT, NDRC, MOF, MOST), ultimately forming two different ways of development, specialization and sociability. (5) In addition to the government departments, social organizations and enterprises also influenced the policy network, at the edge of network. This paper is of positive significance for understanding the current status and characteristics of policy making in different fields of the NEV industry, beneficial to distinguish potential effective ways to impact on NEVs policy system in China.

Subjective complexity under uncertainty

Complexity of the problem of choosing among uncertain acts is a salient feature of many of the environments in which departures from expected utility theory are observed. I study a class of Generalized Simple Bounds preferences in which acts that are complex from the perspective of the decision maker are bracketed by “simple” acts to which they are related by statewise dominance. I then study a refinement of the model in which the size of the partition with respect to which an act is measurable arises endogenously as a measure of subjective complexity. Finally, I consider choice behavior characterized by a “cautious completion” of Simple Bounds preferences, and discuss the relationship between this model and models of ambiguity aversion. I develop general comparative statics results, and explore applications to portfolio choice and insurance choice.

Community pharmacy services during the COVID-19 pandemic: Insights from providers and policy makers

BackgroundReadily accessible to the public, community pharmacies (CPs) were placed under increased pressure during the COVID-19 pandemic. In England, dispensing volume increased by 25% between February and March 2020. This followed a decade of stagnant government funding, which has been attributed to CP closures. If another pandemic emerged, the reduced number of CPs may face increased pressures. ObjectiveTo explore CP service provision in England throughout the COVID-19 pandemic from the perspectives of providers and policy makers, including what can be learned in preparation for any future pandemic. MethodsCP providers (n = 10) and policy makers (n = 6) were interviewed via telephone between June and September 2021. Interviews were transcribed and then analysed thematically using NVivo. ResultsPandemic specific pressures were identified, as well as long-term issues which preceded the pandemic. Increased workload was recognised by both providers and policy makers due to changes in prescribing habits and was exacerbated by staff shortages. CP staff safety was a major concern, with limited personal protective equipment provided despite being open to the public. General Practitioner (GP) surgeries received more protective equipment than CP and still referred patients to pharmacy e.g., for a blood pressure check. ConclusionsThe pandemic re-confirmed CPs role of providing accessible healthcare, particularly medicines provision, but also highlighted the demand for in-person clinical services. Improved communication channels between CP and GP surgeries are required, as is pandemic prescribing guidance to ensure appropriate prescribing to safeguard the medicines supply chain. To ensure the health of all providers is fairly protected, activities which require in-person contact or can be undertaken remotely by CP, GP surgeries and other providers should be reviewed. For pandemic preparation, legislative changes are required which empower pharmacy to fully contribute to patient care. A review of pharmacy funding and staffing is also needed to ensure services are sustainable.

The Impact of Affective Gastronomy Experience on Satisfaction and Revisit Intention: Evidence from Turkey

The number of people traveling for food continues to increase day by day. This situation supports the development of gastronomy tourism. In this respect, it has become more important to understand the gastronomy experiences of food lovers. In this study, affective gastronomy experience, which is a new topic in the literature, is addressed. The aim of the study is to understand the impact of tourists' affective gastronomy experiences on satisfaction and revisit intention. The research was conducted in a southern region of Turkey. Data were collected online via Google form between 06.06.2023-05.07.2023. In total, 667 acceptable questionnaires were obtained. The data were analyzed using SPSS software. The results of the analysis showed that the affective gastronomy experience had significant and strong effects on satisfaction and revisit intention. Satisfaction and revisit intention are explained by affective gastronomy intention at a rate of 64% and 36%, respectively. In other words, positive perceptions of the affective gastronomy experience increase both satisfaction and revisit intention. These results emphasize the importance of affective gastronomy experience in the literature. This study offers a new perspective for both decision makers and managers of tourism businesses.

Preventing and developmental factors of sustainability in healthcare organisations from the perspective of decision makers: an exploratory factor analysis

BackgroundUN Sustainable Development Goals are part of the political agenda of most developed countries. Being a developing country, Albania has only recently adhered to this trend. Prior research at national level has sporadically focused on environmental sustainability, neglecting a holistic view of the phenomenon. To fill this gap, this study aims to explore preventing and developmental factors of sustainability in healthcare organisations from the perspective of decision makers by relying to a Triple Bottom Line approach.MethodsData were collected through a questionnaire administered to healthcare facilities and analysed through the Exploratory Factor Analysis. Findings revealed that the factors influencing the sustainability of the national healthcare system were five: Barriers of Organisational Sustainability; Stakeholders Pressure (regarding sustainable issues); Awareness (knowledge and measures taken for sustainability); Institutional Engagement; and Personal Interest and Involvement. The underlying factors included 19 items suitable for this sample, representing 64.371% of the total variance.ResultsThe findings show the existence of 4 factors: Barriers of Organisational Sustainability, Stakeholders Pressure regarding Sustainable issues, Awareness/knowledge and measures taken for sustainability, Personal Interest and Involvement.ConclusionsIt is evident that national health organisations should continuously improve its strategies to be consistent with the sustainable development goals of international organisations, so that their initiatives could reflect the integration of sustainability approaches at the organisational level.

Perspectives of key decision makers on out-of-pocket payments for medicines in the Ethiopian healthcare system: a qualitative interview study

ObjectiveThis study aimed to explore the perspectives of key decision makers on out-of-pocket (OOP) payment for medicines and its implications in the Ethiopian healthcare system.DesignA qualitative design that employed audiorecorded...

Barriers to and Facilitators of the Implementation of Digital Mental Health Interventions as Perceived by Primary Care Decision Makers: Content Analysis of Structured Open-Ended Survey Data.

Digital mental health represents a way to increase access to evidence-based psychological support. However, the implementation of digital mental health in routine health care practice is limited, with few studies focusing on implementation. Accordingly, there is a need to better understand the barriers to and facilitators of implementing digital mental health. Existing studies have mainly focused on the viewpoints of patients and health professionals. Currently, there are few studies about barriers and facilitators from the perspective of primary care decision makers, that is, the persons responsible for deciding whether a given digital mental health intervention should be implemented in a primary care organization. The objectives were to identify and describe barriers to and facilitators of the implementation of digital mental health as perceived by primary care decision makers, evaluate the relative importance of different barriers and facilitators, and compare barriers and facilitators reported by primary care decision makers who have versus have not implemented digital mental health interventions. A web-based self-report survey was conducted with primary care decision makers responsible for the implementation of digital mental health in primary care organizations in Sweden. Answers to 2 open-ended questions about barriers and facilitators were analyzed through summative and deductive content analysis. The survey was completed by 284 primary care decision makers-59 (20.8%) decision makers representing implementers (ie, organizations that offered digital mental health interventions) and 225 (79.2%) respondents representing nonimplementers (ie, organizations that did not offer digital mental health interventions). Overall, 90% (53/59) of the implementers and 98.7% (222/225) of the nonimplementers identified barriers, and 97% (57/59) of the implementers and 93.3% (210/225) of the nonimplementers identified facilitators. Altogether, 29 barriers and 20 facilitators of implementation were identified related to guidelines; patients; health professionals; incentives and resources; capacity for organizational change; and social, political, and legal factors. The most prevalent barriers were related to incentives and resources, whereas the most prevalent facilitators were related to the capacity for organizational change. A number of barriers and facilitators were identified that could influence the implementation of digital mental health from the perspective of primary care decision makers. Implementers and nonimplementers identified many common barriers and facilitators, but they differ in terms of certain barriers and facilitators. Common and differing barriers and facilitators identified by implementers and nonimplementers may be important to address when planning for the implementation of digital mental health interventions. For instance, financial incentives and disincentives (eg, increased costs) are the most frequently mentioned barrier and facilitator, respectively, by nonimplementers, but not by implementers. One way to facilitate implementation could be to provide more information to nonimplementers about the actual costs related to the implementation of digital mental health.

Diverse policy maker perspectives on the mental health of pregnant and parenting adolescent girls in Kenya: Considerations for comprehensive, adolescent-centered policies and programs.

The pregnancy rate in Kenya among adolescent girls is among the highest in the world. Adolescent girls experience increased risk of anxiety and depression during pregnancy and postpartum which can result in poor health outcomes for both mother and baby, and negatively influence their life course. Mental health is often given low priority in health policy planning, particularly in Sub-Saharan Africa (SSA). There is an urgent need to address the treatment gap and provide timely mental health promotion and preventative services, there is a need to focus on the shifting demographic of SSA-the young people. To understand perspectives on policymakers on the mental health prevention and promotion needs of pregnant and parenting adolescent girls, we carried out a series of interviews as part of UNICEF funded helping pregnant and parenting adolescents thrive project in Kenya. We interviewed 13 diverse health and social policy makers in Kenya to understand their perspectives on the mental health experiences of pregnant and parenting adolescent girls and their ideas for optimizing mental health promotion. Six principal themes emerged including the mental health situation for adolescent girls, risk factors for poor mental health and barriers to accessing services for adolescent girls, health seeking behavior effect on maternal and child health outcomes, mental health promotion, protective factors for good mental health, and policy level issues. Examination of existing policies is required to determine how they can fully and effectively be implemented to support the mental health of pregnant and parenting adolescent girls.

Landscape Strategies for Terraced Landscapes in the European Alpine Region Using a Mixed-Method Analysis Tool

Terraced landscapes are anthropic landscapes that need continuous management. Future planning policies need to develop bottom-up approaches in order to be able to take into consideration the perspectives of decision makers (DMs) and civil society stakeholders (CSs). Using a participatory mixed-method approach, this research work identified and prioritized the strengths, weaknesses, opportunities, and threats (SWOT analysis) perceived as key factors for setting future landscape strategies. The aims were (i) to develop a methodological framework for the enhancement of the terraced landscapes using a bottom-up approach, (ii) to identify and rank the favorable and unfavorable factors affecting their management in the European Alpine Region, and (iii) to develop alternative and future landscape strategies. The methodology was applied in nine Italian and Swiss cross-border terraced landscapes. An online focus group was organized together with a decision maker from each study area in order to identify the SWOT items for their enhancement. Subsequently, a focus group for each study area was organized with civil society stakeholders. They prioritized the SWOT items based on the local context and territorial issues using a cumulative voting method. The results were normalized, and these allowed for the development of local and supralocal landscape strategies that were both common to the cross-border terraced landscapes and specific to the main land uses characterizing them.

Patients' Perceptions on Community Pharmacy Services of a Ward (10) of Kathmandu Metropolitan.

Community pharmacists' role is shifting from product-oriented function towards patient-centered care. The patient-centered role of pharmacists is undervalued, as the public is unaware of pharmacists' role. This study aims to identify patients' perceptions and satisfaction with pharmaceutical care services and factors affecting their preferences for community pharmacy services. A quantitative cross-sectional study was conducted for three months on patients visiting registered community pharmacies in Kathmandu metropolitan ward number 10. Out of 406 participants, 30.5% perceive pharmacists to have a balance between business and health aspects of pharmacy practices; 29.1% view them as drug experts; and 11.8% consider pharmacists to be more concerned with business. 43.8% of participants were found to discuss their drug-related queries with pharmacists, possibly due to low treatment costs. Approximately 77% of respondents had no hesitancy when contacting pharmacists for health-related information because they believed pharmacists were sufficiently qualified to address drug-related questions. Around 88% of respondents agreed that the role of pharmacists is to counsel the patient about the directions for the use of medications. The level of satisfaction indicated that 72.4% are highly satisfied with pharmacy services. In addition, patients feel comfortable discussing their health with pharmacists due to their ability to protect the privacy of their medical records. In contrast, more trust in doctors seems to be the most common barrier for patients visiting pharmacists. Overall, pharmacists were regarded as the most trusted health care personnel to contact. However, to facilitate the expansion of pharmaceutical care services, the public should be aware of their distinctive professional talents. It is recommended for future researchers to understand the subjective perspective of pharmacy staff, managers, and pharmaceutical policy makers.

OBILJEŽJA NEFORMALNOG RIZIČNOG KAPITALA U ČEŠKOJ: KVANTITATIVNO ISTRAŽIVANJE

In this paper, the demographic and investment profiles of business angels operating in the Czech Republic are evaluated based on a sample of 78 angel investors. This is the first attempt to use data on investor activities from the Pitchbook database, which has become increasingly popular in academic research. Beyond the framework of descriptive statistical analysis, a multidimensional statistical investigation using cluster analysis was conducted. The results show that there are two groups of angel investors in the Czech Republic. The first group is represented by investors who predominantly have a large active portfolio, as well as the number of total completed investments. On the other hand, the second cluster is made up of investors who conduct a smaller number of investments and are also in the position of the founder of a start-up. Not surprisingly, there are two main locations of angel investors in the Czech Republic, Brno and Prague. Both categories of typical investors are united by some demographic characteristics; for example, the market is dominated by middle-aged men with a completed Master’s degree in Economics who invest in start-ups in the field of information and communication technologies. The main contribution of the paper consists in evaluating the demographic and investment profiles of angel investors operating in the Czech business environment. The results of the research have implications for upcoming research, the informal venture capital industry, and public policy beyond the Czech business environment, while developing tools for fostering an angel ecosystem. In today’s globalized world, the boundaries of angel investors are often blurred. Just as start-ups have ambitions to expand internationally, informal venture capitalists are increasingly making cross-border deals. From the perspective of both investee firms and policy makers, it is thus important to know the profiles of not only domestic but also foreign business angels, e.g. with regard to the setting of public support for foreign capital inflows.

Practice efficiency of treatment with epcoritamab versus glofitamab in relapsed/refractory diffuse large B-cell lymphoma.

e18919 Background: Bispecific antibodies are an emerging class of immunotherapies with demonstrated efficacy in the treatment of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). Since epcoritamab is administered subcutaneously, it provides an opportunity for reduced healthcare provider (HCP) and patient burden compared to intravenous (IV) glofitamab. This study assessed HCP and chair time saved treating R/R DLBCL patients with epcoritamab versus glofitamab. Methods: An efficiency model was developed to comprehensively capture time and resources utilized in the administration of epcoritamab and glofitamab from the perspective of institutional decision makers in the United States. The model was informed by the administration process and dosing schedules outlined in the pivotal publications as well as published literature examining HCP’s tasks and the time required to complete these tasks. A 6-month time horizon as was adopted as the base case due to its relevance in the Enhancing Oncology Model, and scenario analyses were performed examining various time horizons. Results: Treating patients with SC epcoritamab compared to IV glofitamab was estimated to reduce HCP time by 29% (45.4 hours for 19 doses of epcoritamab vs. 63.9 hours for 10 doses of glofitamab) and chair time by 38% (55.8 vs. 90.6 hours) per patient over a 6-month time horizon. Time saved for epcoritamab was mainly driven by glofitamab’s infusion time and required pre-treatment with obinutuzumab. For 100 hypothetical patients treated with SC epcoritamab vs. IV glofitamab, a savings of 3,478 chair hours was generated, which could free up capacity to treat 62 additional patients. In the scenario analyses examining different time horizons, the capacity savings advantage of epcoritamab over glofitamab remained. Conclusions: In this model, the use of SC epcoritamab improved practice efficiency compared to IV glofitamab. For institutional decision makers, reduced chair time may increase the total number of treated patients and lead to reduced waiting lists.

An integrated sustainable bio-fuel and bio-energy supply chain: A novel approach based on DEMATEL and fuzzy-random robust flexible programming with [formula omitted] measure

The viability of the Indian government’s green initiative to blend 20% fuel grade ethanol with gasoline is investigated by modelling a sustainable integrated bio-fuel and bio-energy supply chain with multiple echelons in order to address the dual crisis of fossil fuels, i.e., environmental as well as gradually diminishing reserves. In order to find the best strategic and planning decisions, a multi-objective mixed integer programming model is developed that analyses the supply chain from a technological, economic, environmental, and social standpoints while handling various feedstocks, supply zones, products, and multiple periods. The drawbacks in addressing the uncertainty in the parameter as well as risk in decision making are overcome by introducing a novel fuzzy-random robust flexible programming approach based on Me measure and probabilistic programming. The presented model incorporates hybrid uncertainty, flexible constraints and a convex mixture of optimistic-pessimistic perspective of decision maker. A hybrid strategy combining the fuzzy Decision Making Trial and Evaluation Laboratory (DEMATEL) method and the multi-choice reference point goal programming with S-shaped utility function is presented to solve the generated multi-objective model. A case study in West Bengal, India is then performed that envisages the economic, environmental and social aspects of a bio-fuel and bio-energy supply chain.

Use of big data from health insurance for assessment of cardiovascular outcomes.

Outcome research that supports guideline recommendations for primary and secondary preventions largely depends on the data obtained from clinical trials or selected hospital populations. The exponentially growing amount of real-world medical data could enable fundamental improvements in cardiovascular disease (CVD) prediction, prevention, and care. In this review we summarize how data from health insurance claims (HIC) may improve our understanding of current health provision and identify challenges of patient care by implementing the perspective of patients (providing data and contributing to society), physicians (identifying at-risk patients, optimizing diagnosis and therapy), health insurers (preventive education and economic aspects), and policy makers (data-driven legislation). HIC data has the potential to inform relevant aspects of the healthcare systems. Although HIC data inherit limitations, large sample sizes and long-term follow-up provides enormous predictive power. Herein, we highlight the benefits and limitations of HIC data and provide examples from the cardiovascular field, i.e. how HIC data is supporting healthcare, focusing on the demographical and epidemiological differences, pharmacotherapy, healthcare utilization, cost-effectiveness and outcomes of different treatments. As an outlook we discuss the potential of using HIC-based big data and modern artificial intelligence (AI) algorithms to guide patient education and care, which could lead to the development of a learning healthcare system and support a medically relevant legislation in the future.

Tin Mining in Bangka Belitung Islands and Its Impact on the Reputation of Geographical Indication: A Policymakers Perspective

The Bangka Belitung Islands are known as one of the best white pepper producing areas in the world which is normatively recognized as a geographical indication. One of the factors in the recognition of white pepper as a geographical indication is the environmental factor in this area which causes the taste to be distinctive and different from white pepper from other regions. On the other hand, tin mining is happening massively, one of which is turning pepper plantations into mining areas. This study uses empirical juridical methods, linking the consequences of tin mining to the reputation of white pepper as a geographical indication from the perspective of policy makers in the mining sector. The data used are primary data obtained from interviews as well as secondary data obtained from literature study data on a number of documents. From the results of the study conducted, it was found that most policy makers were of the opinion that uncontrolled tin mining had an effect on the reputation of white pepper, because many pepper plantations had turned into mining areas. Juridically, if this condition is allowed, it will threaten the reputation of white pepper as a geographical indication.

A qualitative study

A qualitative study

Cost-Effectiveness of Sequential Abaloparatide/Alendronate in Men at High Risk of Fractures in the United States

Abaloparatide (ABL) significantly increases bone mineral density in men with osteoporosis similar to what was reported in postmenopausal women with osteoporosis. The cost effectiveness of sequential treatment with ABL followed by alendronate (ALN) in men at high fracture risk was compared to relevant alternative treatments. A Markov-based microsimulation model based on a lifetime US healthcare decision maker perspective was developed to evaluate the cost (expressed in US$2021) per quality-adjusted life-years (QALYs) gained of sequential ABL/ALN. Comparators were sequential treatment unbranded teriparatide (TPTD)/ALN, generic ALN monotherapy, and no treatment. Discount rates of 3% were used. Consistent with practice guidelines, patients received 18 months of ABL or TPTD followed by ALN for 5 years, or 5 years of ALN monotherapy. Analyses were conducted in high-risk men aged over 50 years defined as having a bone mineral density T-score ≤-2.5 and a recent fracture. Time-specific risk of subsequent fracture after a recent fracture, incremental costs up to 5 years following fractures, real-world medication adherence, and mostly US men-specific data were included in the model. One-way and probabilistic sensitivity analyses were conducted to assess the robustness of results. Over the full age range, sequential ABL/ALN led to more QALYs for lower costs than sequential unbranded TPTD/ALN, while no treatment was dominated (more QALYs, lower costs) by ALN monotherapy. The costs per QALY gained of sequential ABL/ALN were lower than the US threshold of US$150,000 versus generic ALN monotherapy. The probabilities that sequential ABL/ALN was cost effective compared to ALN monotherapy were estimated at 51% in men aged 50 years and between 88 and 90% in those aged ≥ 60 years. Sequential therapy using ABL/ALN may be cost effective compared with genericALN monotherapy in US men aged ≥ 50 years at high fracture risk, especially in those aged ≥ 60 years. Unbranded TPTD/ALN and no treatment were dominated interventions (less QALY, more costs) compared with ABL/ALN or ALN monotherapy.

Social identity based motivation to engage in collective action supporting the redistribution of street space

Reallocation of street space to active travel modes remains contested, despite the need for a sustainable mobility transition. Citizen engagement plays a crucial role in pushing city councils to take action and provide safe infrastructure for cyclists and pedestrians. In this study, we assess what drives active support for policies redistributing street space, focusing on transport user groups and their social identities that may influence active engagement in favor (or in opposition) to these transport policies. We draw on the Social Identity Model of Collective Action to investigate processes influencing active policy support as a form of collective action. Based on a representative sample of German citizens (N = 615), we observe a medium–low willingness to get actively engaged. Findings suggest that people identifying with minority groups (e.g. cyclists) profiting from changes to the status quo are most willing to support policies redistributing street space. A sense of collective efficacy and perceived social pressure within the group through social norms seem particularly important. As social identity processes appear to influence people’s policy support more so than their mode choice itself, there are widespread implications for the mobility transition. We discuss the benefits of considering social identities from the perspective of policy makers as well as citizen initiatives.

DEA model for partial centralization resource allocation among independent subset of DMUs

This paper proposes the concept of partial centralization in view of the problem of partition and group governance in management practice, and based on this, an optimization model of independent subset incentive resource allocation is constructed. From the perspective of the decision makers of each independent subset, the model takes into account the different attributes of resources and incorporates the homogeneous decision-making units outside the subset into the reference set to allocate resources based on the principle of efficiency first and fairness. The purpose is to improve the output of each decision-making unit in the subset and reduce the myopia effect by rationally optimizing the allocation of resources. The constructed model can directly compute resource optimization results without model retransformation. Numerical examples show that by applying this model, the efficiency value of each decision-making unit after optimizing resource allocation is greater than or equal to the original efficiency value. Finally, it is applied to analyze the optimal allocation of resources of 30 banks in Taiwan. The results show that this method can better realize the optimal allocation of bank resources and stimulate the resource allocation of non-effective decision-making units, which has important application significance.