Methodological and Technological Support for the Coordination of Smart Networks of SMEs

Part 2: Behaviour and Coordination

Exploring the relationship between educational mismatch, earnings and job satisfaction in the tourism industry

This article analyses the interrelationship between educational mismatch, wages and job satisfaction in the Spanish tourism sector in the first years of the global economic crisis. It is shown that there is a much higher incidence of over-education among workers in the Spanish tourism sector than in the rest of the economy despite this sector recording lower educational levels. This study estimates two models to analyse the influence of the educational mismatch on wages and job satisfaction for workers in the tourism industry and for the Spanish economy as a whole. The first model shows that in the tourism sector, the wage penalty associated with over-education is approximately 10%. The second reveals that in the tourism sector the levels of satisfaction of over-educated workers are considerably lower than those corresponding to workers well assigned. With respect to the differences between tourism and the overall economy in both aspects, the wage penalty is substantially lower in the case of tourism industries and the effect of over-education on job satisfaction is very similar to that of the economy as a whole in a context where both wages and the private returns to education are considerably lower in the tourism sector.

Preserving and interpreting the mining company office : landscape, space and technological change in the management of the copper industry

The purpose of this research is to examine the role of the mining company office in the management of the copper industry in Michigan’s Keweenaw Peninsula between 1901 and 1946. Two of the largest and most influential companies were examined – the Calumet & Hecla Mining Company and the Quincy Mining Company. Both companies operated for more than forty years under general managers who were arguably the most influential people in the management of each company. James MacNaughton, general manager at Calumet and Hecla, worked from 1901 through 1941; Charles Lawton, general manager at Quincy Mining Company, worked from 1905 through 1946. In this case, both of these managers were college-educated engineers and adopted scientific management techniques to operate their respective companies. This research focused on two main goals. The first goal of this project was to address the managerial changes in Michigan’s copper mining offices of the early twentieth century. This included the work of MacNaughton and Lawton, along with analysis of the office structures themselves and what changes occurred through time. The second goal of the project was to create a prototype virtual exhibit for use at the Quincy Mining Company office. A virtual exhibit will allow visitors the opportunity to visit the office virtually, experiencing the office as an office worker would have in the early twentieth century. To meet both goals, this project used various research materials, including archival sources, oral histories, and material culture to recreate the history of mining company management in the Copper Country.

Characterization and Technological Features of Autochthonous Coagulase-Negative Staphylococci as Potential Starters for Portuguese Dry Fermented Sausages

The manufacture of dry fermented sausages is an important part of the meat industry in Southern Europeancountries. These products are usually produced in small shops from a mixture of pork, fat, salt, and condiments andare stuffed into natural casings. Meat sausages are slowly cured through spontaneous fermentation by autochthonousmicrobiota present in the raw materials or introduced during manufacturing. The aim of this work was to evaluate thetechnological and safety features of coagulase-negative staphylococci (CNS) isolated from Portuguese dry fermented meatsausages in order to select autochthonous starters. Isolates (n = 104) obtained from 2 small manufacturers were identifiedas Staphylococcus xylosus, Staphylococcus equorum, Staphylococcus saprophyticus,andStaphylococcus carnosus. Genomically diverseisolates (n = 82) were selected for further analysis to determine the ability to produce enzymes (for example, nitrate-reductases, proteases, lipases) and antibiotic susceptibility. Autochthonous CNS producing a wide range of enzymes andshowing low antibioresistance were selected as potential starters for future use in the production of dry fermented meatsausages.

Provenance and technological analysis of selected cuneiform tablets from the late second millennium BC

The aim of the present study is to examine a group of clay tablets by thin-section petrography and thermogravimetric analysis in order to assess specific problems related to their provenance and manufacture technology. Two sets of documents dating to the fourteenth-thirteenth centuries BC will be considered separately throughout the thesis, with different research questions in mind for each case study. The petrographic data will be compared when possible with the chemical composition of the tablets, determined by pXRF and/or INAA in previous studies. On the whole, this dissertation is an attempt to combine textual, archaeological, petrographic, chemical and thermogravimetric information in order to get a better understanding of the materiality and the historical implications of the objects under examination; Resumo: O objetivo do presente estudo é examinar um grupo de tabuletas de argila por petrografia e análise termogravimétrica, a fim de avaliar problemas específicos relacionados com a sua proveniência e tecnologia de fabricação. Dois conjuntos de documentos que datam dos séculos XIV-XIII a.C. serão considerados separadamente ao longo da tese, com diferentes questões de pesquisa em mente para cada estudo de caso. Os dados petrográficos serão comparados quando possível com a composição química das tabuletas, determinada por pXRF e/ou INAA em estudos anteriores. No seu conjunto, esta dissertação é uma tentativa de combinar informação textual, arqueológica, petrográfica, química e termogravimétrica a fim de obter uma melhor compreensão da composição material e das implicações históricas dos objetos em análise.

La pratique d’infirmières ayant participé à une mission humanitaire en Haïti suite au séisme de 2010 au sein d’une organisation non-gouvernementale

Les vies de millions de personnes sont dévastées par des désastres naturels à travers le monde. Les écrits scientifiques relatifs aux efforts humanitaires dans ces contextes ciblent les travailleurs humanitaires sans toutefois les différencier quant à leur appartenance disciplinaire ou à l’organisation qui les emploie. Les connaissances liées à la pratique des infirmières dans le contexte d’urgence humanitaire sont limitées, malgré qu’elles jouent un rôle vital auprès des populations touchées. Cette ethnographie focalisée, guidée par la théorie du caring bureaucratique de Ray (1989) répond à la question de recherche: Comment des infirmières ayant participé à une mission humanitaire d’urgence suite au séisme à Haïti en janvier 2010 au sein de l’organisation Médecins Sans Frontières décrivent-elles leur pratique dans les contextes légal, politique, économique, éducationnel, socioculturel, physique et technologique de cette expérience? Des entrevues semi-structurées en profondeur de 90 minutes ont été menées auprès de quatre participantes qui ont également échangé à propos de photographies prises durant leurs missions. Les participantes ont discuté de leur préparation, de leurs objectifs, des rôles qu’elles assumaient, ainsi que des défis rencontrés au retour de leurs missions. Des facteurs inhérents à l’infirmière et à l’organisation ont émergé comme importants pour l’articulation et la délimitation de leur pratique. Cette étude révèle également que des facteurs contextuels importants, soit l’équipe, le temps, l’environnement physique, la médiatisation, la sécurité, ainsi que les conditions de travail et les contextes sociopolitique et culturel avaient une influence sur la pratique. Les participantes, selon leur évaluation de ces contextes et des besoins immédiats, devaient constamment ajuster leur pratique. Cette recherche permet une meilleure compréhension de la pratique d’infirmières dans un contexte d’urgence humanitaire de laquelle découlent des implications pour la pratique, la formation et la recherche.

Bibliographies on nursing; books, pamphlets, articles, audio-visual materials.

A replacement for, rather than an addition to, the bibliographies of the former National Organization for Public Health Nursing, the National League of Nursing Education, 1952, and the National League for Nursing, 1954-55.

Educational pathways of minority youth in Norway: intersections of gender, ethnicity and social class

Educational aspirations during lower secondary school and choice of upper secondary education are important for young people’s future trajectories into higher education and labour market positions. In line with ideas about reflexive, autonomous individuals (Giddens, 1991), choice of education is often represented as a young person’ individual decision, and educational guidance as aimed at discovering what ‘fits’ an individual’s personality, interests and abilities. Educational aspirations and choices are also social patterns that are reproduced. Some population categories represent exceptions from expected patterns of social reproduction of educational level and professions. In several countries, one such category is young people from families with migration experiences (Lauglo, 2000; Modood, 2004). In Norway, students have a legal right to non-compulsory upper secondary schooling and 96 percent of the students continue from lower to upper secondary school. In spite of positive developments regarding minority youths’ completion of upper secondary and higher education in later years, studies still persistently show lower educational attainment among minority youth, particularly among boys (Fekjaer, 2006). However, in lower secondary school, minor ity youth tend to have markedly higher educational aspirations and stronger learning motivation than their majority peers, as well as greater effort in school and strong adherence to school values (Lauglo, 2000) despite lower educational attainment or lower socio-economic backgrounds. In addition, gender differences in educational aspirations seem to be smaller among minority youth. The principal objective of the study in progress that will be presented in this paper, is to describe how processes relating to gendered, ethnic and class-based identities influence young people’s educational choices. The study is undertaken as a PhD project in social anthropology. The methodological approach is ethnographic longitudinal fieldwork in two multicultural lower secondary schools in Oslo. The study is part of a larger project that also include quantitative analyses of longitudinal data covering 9th graders in Oslo 2006 through four data collections during lower and upper secondary school.

Immigrant Families and the School in Spain: Dynamics and Factors that Influence their Relations

In Spain, academic debate and school administrations have evolved to the extent that relations between the school, the family and the surrounding environment are now considered as crucial to student achievement at school and to the good functioning of the educational system as a whole. Despite this development, change is slow in practice and often complicated due to the emerging resistance of families and schools, given that they have always maintained relations marked by an imbalance of power. Our theoretical and especially our empirical work has focused on the relations between immigrant families and the school system in Spain. In view of the above, the creation of what we call positive relational dynamics and communication in schools is conditioned by the attitudes and behaviour of the school administration, professionals and families. However, the physical space in which these relations take place must also be taken into consideration. Regarding school organisation, we have emphasised the role of the school’s administration. By differentiating the range of management models, we note the ones that facilitate more relations and communication with and among families (especially the one we have called the horizontal participative model) and those that discourage them. However, the multiple and complex range of attitudes among teachers and families must always be taken into account.

Cultural and Educational Society of Muslims "Narodna Uzdanica" /"National Hope"/ 1923-1941

Ibrahim Kemura. The Muslim Cultural-Educational Society Narodna uzdanica from 1923/4 to 1941 One of the features of the cultural history of the Bosniacs between the two world wars (1918-1941) was a cultural and educational society named Narodna uzdanica, which was a significant institutional and cultural-intellectual centre of the Bosniac people in Bosnia and Herzegovina. Narodna uzdanica expressed the aspirations and needs of the Bosniac citizens who were its main support and axis and was aimed at fulfilling their interests. This was reflected in an ideological-cultural orientation towards the West and the adoption of positive western achievements while at the same time stressing its Slavic origins and individuality, the education of young people and the formation of a European-type civic intelligentsia, adaptation to life in capitalist society, the development of modern trade and crafts, the emancipation of women, and cultural education based on European values. Thus conceived, the programme enjoyed the support of a wider circle of members, the reading public and the cultural consumers of those particular elements such as education and economic prosperity which it sought to achieve. The political involvement of Narodna uzdanica and its use as a platform for the leading Bosniac political party Jugoslovenska muslimanska organizacija (JMO - Yugoslav Muslim Organisation) which had founded the society, played a significant role in the socio-political life and development of Bosniacs. The opposition to the ruling regime, often expressed through close cooperation with similar Croat organisations and through the pro-Croat attitude of some of the society's leading figures, offered both the regime and Narodna uzdanica's political adversaries grounds for describing it as separatist and Croat and served as a pretext for repressive measures to hinder its normal operations. This research proved these accusations to be groundless, showing that the pro-Croat orientation was primarily political and cultural and that throughout its existence Narodna uzdanica was active in the cultural and educational renaissance of Bosniacs, helping to strengthen their national identity.

A technological framework based on automatic messaging for improving adherence of diabetic patients

En todo el mundo se ha observado un crecimiento exponencial en la incidencia de enfermedades crónicas como la hipertensión y enfermedades cardiovasculares y respiratorias, así como la diabetes mellitus, que causa un número de muertes cada vez mayor en todo el mundo (Beaglehole et al., 2008). En concreto, la prevalencia de diabetes mellitus (DM) está aumentando de manera considerable en todas las edades y representa un serio problema de salud mundial. La diabetes fue la responsable directa de 1,5 millones de muertes en 2012 y 89 millones de años de vida ajustados por discapacidad (AVAD) (OMS, 2014). Uno de los principales dilemas que suelen asociarse a la gestión de EC es la adherencia de los pacientes a los tratamientos, que representa un aspecto multifactorial que necesita asistencia en lo relativo a: educación, autogestión, interacción entre los pacientes y cuidadores y compromiso de los pacientes. Medir la adherencia del tratamiento es complicado y, aunque se ha hablado ampliamente de ello, aún no hay soluciones “de oro” (Reviews, 2002). El compromiso de los pacientes, a través de la participación, colaboración, negociación y a veces del compromiso firme, aumentan las oportunidades para una terapia óptima en la que los pacientes se responsabilizan de su parte en la ecuación de adherencia. Comprometer e involucrar a los pacientes diabéticos en las decisiones de su tratamiento, junto con expertos profesionales, puede ayudar a favorecer un enfoque centrado en el paciente hacia la atención a la diabetes (Martin et al., 2005). La motivación y atribución de poder de los pacientes son quizás los dos factores interventores más relevantes que afectan directamente a la autogestión de la atención a la diabetes. Se ha demostrado que estos dos factores desempeñan un papel fundamental en la adherencia a la prescripción, así como en el fomento exitoso de un estilo de vida sana y otros cambios de conducta (Heneghan et al., 2013). Un plan de educación personalizada es indispensable para proporcionarle al paciente las herramientas adecuadas que necesita para la autogestión efectiva de la enfermedad (El-Gayar et al. 2013). La comunicación efectiva es fundamental para proporcionar una atención centrada en el paciente puesto que influye en las conductas y actitudes hacia un problema de salud ((Frampton et al. 2008). En este sentido, la interactividad, la frecuencia, la temporalización y la adaptación de los mensajes de texto pueden promover la adherencia a un régimen de medicación. Como consecuencia, adaptar los mensajes de texto a los pacientes puede resultar ser una manera de hacer que las sugerencias y la información sean más relevantes y efectivas (Nundy et al. 2013). En este contexto, las tecnologías móviles en el ámbito de la salud (mHealth) están desempeñando un papel importante al conectar con pacientes para mejorar la adherencia a medicamentos recetados (Krishna et al., 2009). La adaptación de los mensajes de texto específicos de diabetes sigue siendo un área de oportunidad para mejorar la adherencia a la medicación y ofrecer motivación a adultos con diabetes. Sin embargo, se necesita más investigación para entender totalmente su eficacia. Los consejos de texto personalizados han demostrado causar un impacto positivo en la atribución de poder a los pacientes, su autogestión y su adherencia a la prescripción (Gatwood et al., 2014). mHealth se puede utilizar para ofrecer programas de asistencia de autogestión a los pacientes con diabetes y, al mismo tiempo, superar las dificultades técnicas y financieras que supone el tratamiento de la diabetes (Free at al., 2013). El objetivo principal de este trabajo de investigación es demostrar que un marco tecnológico basado en las teorías de cambios de conducta, aplicado al campo de la mHealth, permite una mejora de la adherencia al tratamiento en pacientes diabéticos. Como método de definición de una solución tecnológica, se han adoptado un conjunto de diferentes técnicas de conducta validadas denominado marco de compromiso de retroacción conductual (EBF, por sus siglas en inglés) para formular los mensajes, guiar el contenido y evaluar los resultados. Los estudios incorporan elementos del modelo transteórico (TTM, por sus siglas en inglés), la teoría de la fijación de objetivos (GST, por sus siglas en inglés) y los principios de comunicación sanitaria persuasiva y eficaz. Como concepto general, el modelo TTM ayuda a los pacientes a progresar a su próxima fase de conducta a través de mensajes de texto motivados específicos y permite que el médico identifique la fase actual y adapte sus estrategias individualmente. Además, se adoptan las directrices del TTM para fijar objetivos personalizados a un nivel apropiado a la fase de cambio del paciente. La GST encierra normas que van a ponerse en práctica para promover la intervención educativa y objetivos de pérdida de peso. Finalmente, los principios de comunicación sanitaria persuasiva y eficaz aplicados a la aparición de los mensajes se han puesto en marcha para aumentar la efectividad. El EBF tiene como objetivo ayudar a los pacientes a mejorar su adherencia a la prescripción y encaminarlos a una mejora general en la autogestión de la diabetes mediante mensajes de texto personalizados denominados mensajes de retroacción automáticos (AFM, por sus siglas en inglés). Después de una primera revisión del perfil, consistente en identificar características significativas del paciente basadas en las necesidades de tratamiento, actitudes y conductas de atención sanitaria, el sistema elige los AFM personalizados, los aprueba el médico y al final se transfieren a la interfaz del paciente. Durante el tratamiento, el usuario recopila los datos en dispositivos de monitorización de pacientes (PMD, por sus siglas en inglés) de una serie de dispositivos médicos y registros manuales. Los registros consisten en la toma de medicación, dieta y actividad física y tareas de aprendizaje y control de la medida del metabolismo. El compromiso general del paciente se comprueba al estimar el uso del sistema y la adherencia del tratamiento y el estado de los objetivos del paciente a corto y largo plazo. El módulo de análisis conductual, que consiste en una serie de reglas y ecuaciones, calcula la conducta del paciente. Tras lograr el análisis conductual, el módulo de gestión de AFM actualiza la lista de AFM y la configuración de los envíos. Las actualizaciones incluyen el número, el tipo y la frecuencia de mensajes. Los AFM los revisa periódicamente el médico que también participa en el perfeccionamiento del tratamiento, adaptado a la fase transteórica actual. Los AFM se segmentan en distintas categorías y niveles y los pacientes pueden ajustar la entrega del mensaje de acuerdo con sus necesidades personales. El EBF se ha puesto en marcha integrado dentro del sistema METABO, diseñado para facilitar al paciente diabético que controle sus condiciones relevantes de una manera menos intrusiva. El dispositivo del paciente se vincula en una plataforma móvil, mientras que una interfaz de panel médico permite que los profesionales controlen la evolución del tratamiento. Herramientas específicas posibilitan que los profesionales comprueben la adherencia del paciente y actualicen la gestión de envíos de AFM. El EBF fue probado en un proyecto piloto controlado de manera aleatoria. El principal objetivo era examinar la viabilidad y aceptación del sistema. Los objetivos secundarios eran también la evaluación de la eficacia del sistema en lo referente a la mejora de la adherencia, el control glucémico y la calidad de vida. Se reclutaron participantes de cuatro centros clínicos distintos en Europa. La evaluación del punto de referencia incluía datos demográficos, estado de la diabetes, información del perfil, conocimiento de la diabetes en general, uso de las plataformas TIC, opinión y experiencia con dispositivos electrónicos y adopción de buenas prácticas con la diabetes. La aceptación y eficacia de los criterios de evaluación se aplicaron para valorar el funcionamiento del marco tecnológico. El principal objetivo era la valoración de la eficacia del sistema en lo referente a la mejora de la adherencia. En las pruebas participaron 54 pacientes. 26 fueron asignados al grupo de intervención y equipados con tecnología móvil donde estaba instalado el EBF: 14 pacientes tenían T1DM y 12 tenían T2DM. El grupo de control estaba compuesto por 25 pa cientes que fueron tratados con atención estándar, sin el empleo del EBF. La intervención profesional tanto de los grupos de control como de intervención corrió a cargo de 24 cuidadores, entre los que incluían diabetólogos, nutricionistas y enfermeras. Para evaluar la aceptabilidad del sistema y analizar la satisfacción de los usuarios, a través de LimeSurvey, se creó una encuesta multilingüe tanto para los pacientes como para los profesionales. Los resultados también se recopilaron de los archivos de registro generados en los PMD, el panel médico profesional y las entradas de la base de datos. Los mensajes enviados hacia y desde el EBF y los archivos de registro del sistema y los servicios de comunicación se grabaron durante las cinco semanas del estudio. Se entregaron un total de 2795 mensajes, lo que supuso una media de 107,50 mensajes por paciente. Como se muestra, los mensajes disminuyen con el tiempo, indicando una mejora global de la adherencia al plan de tratamiento. Como se esperaba, los pacientes con T1DM recibieron más consejos a corto plazo, en relación a su estado. Del mismo modo, al ser el centro de T2DM en cambios de estilo de vida sostenible a largo plazo, los pacientes con T2DM recibieron más consejos de recomendación, en cuanto a dietas y actividad física. También se ha llevado a cabo una comparación de la adherencia e índices de uso para pacientes con T1DM y T2DM, entre la primera y la segunda mitad de la prueba. Se han observado resultados favorables para el uso. En lo relativo a la adherencia, los resultados denotaron una mejora general en cada dimensión del plan de tratamiento, como la nutrición y las mediciones de inserción de glucosa en la sangre. Se han llevado a cabo más estudios acerca del cambio a nivel educativo antes y después de la prueba, medidos tanto para grupos de control como de intervención. Los resultados indicaron que el grupo de intervención había mejorado su nivel de conocimientos mientras que el grupo de control mostró una leve disminución. El análisis de correlación entre el nivel de adherencia y las AFM ha mostrado una mejora en la adherencia de uso para los pacientes que recibieron los mensajes de tipo alertas, y unos resultados no significativos aunque positivos relacionados con la adherencia tanto al tratamiento que al uso correlacionado con los recordatorios. Por otra parte, los AFM parecían ayudar a los pacientes que no tomaban suficientemente en serio su tratamiento en el principio y que sí estaban dispuestos a responder a los mensajes recibidos. Aun así, los pacientes que recibieron demasiadas advertencias, comenzaron a considerar el envío de mensajes un poco estresante. El trabajo de investigación llevado a cabo al desarrollar este proyecto ofrece respuestas a las cuatro hipótesis de investigación que fueron la motivación para el trabajo. • Hipótesis 1 : es posible definir una serie de criterios para medir la adherencia en pacientes diabéticos. • Hipótesis 2: es posible diseñar un marco tecnológico basado en los criterios y teorías de cambio de conducta mencionados con anterioridad para hacer que los pacientes diabéticos se comprometan a controlar su enfermedad y adherirse a planes de atención. • Hipótesis 3: es posible poner en marcha el marco tecnológico en el sector de la salud móvil. • Hipótesis 4: es posible utilizar el marco tecnológico como solución de salud móvil en un contexto real y tener efectos positivos en lo referente a indicadores de control de diabetes. La verificación de cada hipótesis permite ofrecer respuesta a la hipótesis principal: La hipótesis principal es: es posible mejorar la adherencia diabética a través de un marco tecnológico mHealth basado en teorías de cambio de conducta. El trabajo llevado a cabo para responder estas preguntas se explica en este trabajo de investigación. El marco fue desarrollado y puesto en práctica en el Proyecto METABO. METABO es un Proyecto I+D, cofinanciado por la Comisión Europea (METABO 2008) que integra infraestructura móvil para ayudar al control, gestión y tratamiento de los pacientes con diabetes mellitus de tipo 1 (T1DM) y los que padecen diabetes mellitus de tipo 2 (T2DM). ABSTRACT Worldwide there is an exponential growth in the incidence of Chronic Diseases (CDs), such as: hypertension, cardiovascular and respiratory diseases, as well as diabetes mellitus, leading to rising numbers of deaths worldwide (Beaglehole et al. 2008). In particular, the prevalence of diabetes mellitus (DM) is largely increasing among all ages and constitutes a major worldwide health problem. Diabetes was directly responsible for 1,5 million deaths in 2012 and 89 million Disability-adjusted life year (DALYs) (WHO 2014). One of the key dilemmas often associated to CD management is the patients’ adherence to treatments, representing a multi-factorial aspect that requires support in terms of: education, self-management, interaction between patients and caregivers, and patients’ engagement. Measuring adherence is complex and, even if widely discussed, there are still no “gold” standards ((Giardini et al. 2015), (Costa et al. 2015). Patient’s engagement, through participation, collaboration, negotiation, and sometimes compromise, enhance opportunities for optimal therapy in which patients take responsibility for their part of the adherence equation. Engaging and involving diabetic patients in treatment decisions, along with professional expertise, can help foster a patient-centered approach to diabetes care (Martin et al. 2005). Patients’ motivation and empowerment are perhaps the two most relevant intervening factors that directly affect self-management of diabetes care. It has been demonstrated that these two factors play an essential role in prescription adherence, as well as for the successful encouragement of a healthy life-style and other behavioural changes (Heneghan et al. 2013). A personalised education plan is indispensable in order to provide the patient with the appropriate tools needed for the effective self-management of the disease (El-Gayar et al. 2013). Effective communication is at the core of providing patient-centred care since it influences behaviours and attitudes towards a health problem (Frampton et al. 2008). In this regard, interactivity, frequency, timing, and tailoring of text messages may promote adherence to a medication regimen. As a consequence, tailoring text messages to patients can constitute a way of making suggestions and information more relevant and effective (Nundy et al. 2013). In this context, mobile health technologies (mHealth) are playing significant roles in improving adherence to prescribed medications (Krishna et al. 2009). The tailoring of diabetes-specific text messages remains an area of opportunity to improve medication adherence and provide motivation to adults with diabetes but further research is needed to fully understand their effectiveness. Personalized text advices have proven to produce a positive impact on patients’ empowerment, self-management, and adherence to prescriptions (Gatwood et al. 2014). mHealth can be used for offering self-management support programs to diabetes patients and at the same time surmounting the technical and financial difficulties involved in diabetes treatment (Free et al. 2013). The main objective of this research work is to demonstrate that a technological framework, based on behavioural change theories, applied to mHealth domain, allows improving adherence treatment in diabetic patients. The framework, named Engagement Behavioural Feedback Framework (EBF), is built on top of validated behavioural techniques to frame messages, guide the definition of contents and assess outcomes: elements from the Transtheoretical Model (TTM), the Goal-Setting Theory (GST), Effective Health Communication (EHC) guidelines and Principles of Persuasive Technology (PPT) were incorporated. The TTM helps patients to progress to a next behavioural stage, through specific motivated text messages, and allow clinician’s identifying the current stage and tailor its strategies individually. Moreover, TTM guidelines are adopted to set customised goals at a level appropriate to the patient’s stage of change. The GST was used to build rules to be applied for enhancing educational intervention and weight loss objectives. Finally, the EHC guidelines and the PPT were applied to increase the effectiveness of messages. The EBF aims to support patients on improving their prescription adherence and persuade them towards a general improvement in diabetes self-management, by means of personalised text messages, named Automatic Feedback Messages (AFM). After a first profile screening, consisting in identifying meaningful patient characteristics based on treatment needs, attitudes and health care behaviours, customised AFMs are selected by the system, approved by the professional, and finally transferred into the patient interface. During the treatment, the user collects the data into a Patient Monitoring Device (PMD) from a set of medical devices and from manual inputs. Inputs consist in medication intake, diet and physical activity, metabolic measurement monitoring and learning tasks. Patient general engagement is checked by estimating the usage of the system and the adherence of treatment and patient goals status in the short and the long term period. The Behavioural Analysis Module, consisting in a set of rules and equations, calculates the patient’s behaviour. After behavioural analysis is accomplished, the AFM library and the dispatch setting are updated by the AFM Manager module. Updates include the number, the type and the frequency of messages. The AFMs are periodically supervised by the professional who also participates to the refinement of the treatment, adapted to the current transtheoretical stage. The AFMs are segmented in different categories and levels and patients can adjust message delivery in accordance with their personal needs. The EBF was integrated to the METABO system, designed to facilitate diabetic patients in managing their disease in a less intrusive approach. Patient device corresponds in a mobile platform, while a medical panel interface allows professionals to monitoring the treatment evolution. Specific tools allow professional to check patient adherence and to update the AFMs dispatch management. The EBF was tested in a randomised controlled pilot. The main objective was to examine the feasibility and acceptance of the system. Secondary objectives were also the assessment of the effectiveness of system in terms of adherence improvement, glycaemic control, and quality of life. Participants were recruited from four different clinical centres in Europe. The baseline assessment included demographics, diabetes status, profile information, knowledge about diabetes in general, usage of ICT platforms, opinion and experience about electronic devices and adoption of good practices with diabetes. Acceptance and the effectiveness evaluation criteria were applied to evaluate the performance of the technological framework. The main objective was the assessment of the effectiveness of system in terms of adherence improvement. Fifty-four patients participated on the trials. Twenty-six patients were assigned in the intervention group and equipped with mobile where the EBF was installed: 14 patients were T1DM and 12 were T2DM. The control group was composed of 25 patients that were treated through a standard care, without the usage of the EBF. Professional’s intervention for both intervention and control groups was carried out by 24 care providers, including endocrinologists, nutritionists, and nurses. In order to evaluate the system acceptability and analyse the users’ satisfaction, an online multi-language survey, using LimeSurvey, was produced for both patients and professionals. Results were also collected from the log-files generated in the PMDs, the professional medical panel and the entries of the data base. The messages sent to and from the EBF and the log-files of the system and communication services were recorded over 5 weeks of the study. A total of 2795 messages were submitted, representing an average of 107,50 messages per patient. As demonstrated, messages decrease over time indicating an overall improvement of the care plan’s adherence. As expected, T1DM patients were more loaded with short-term advices, in accordance with their condition. Similarly, being the focus of T2DM on long-term sustainable lifestyle changes, T2DM received more reminders advices, as for diet and physical activity. Favourable outcomes were observed for treatment and usage adherences of the intervention group: for both the adherence indices, results denoted a general improvement on each care plan’s dimension, such as on nutrition and blood glucose input measurements. Further studies were conducted on the change on educational level before and after the trial, measured for both control and intervention groups. The outcomes indicated the intervention group has improved its level of knowledge, while the control group denoted a low decrease. The correlation analysis between the level of adherences and the AFMs showed an improvement in usage adherence for patients who received warnings message, while non-significantly yet even positive indicators related to both treatment and usage adherence correlated with the Reminders. Moreover, the AFMs seemed to help those patients who did not take their treatment seriously enough in the beginning and who were willing to respond to the messages they received. Even though, patients who received too many Warnings, started to consider the message dispatch to be a bit stressful. The research work carried out in developing this research work provides responses to the four research hypothesis that were the motivation for the work: •Hypothesis 1: It is possible to define a set of criteria to measure adherence in diabetic patients. •Hypothesis 2: It is possible to design a technological framework, based on the aforementioned criteria and behavioural change theories, to engage diabetic patients in managing their disease and adhere to care plans. •Hypothesis 3: It is possible to implement the technological framework in the mobile health domain. •Hypothesis 4: It is possible to use the technological framework as a mobile health solution in a real context and have positive effects in terms of diabetes management indicators. The verification of each hypothesis allowed us to provide a response to the main hypothesis: The Main Hypothesis is: It is possible to improve diabetic adherence through a mHealth technological framework based on behavioural change theories. The work carried out to answer these questions is explained in this research work. The framework was developed and applied in the METABO project. METABO is an R&D project, co-funded by the European Commission (METABO 2008) that integrates mobile infrastructure for supporting the monitoring, management, and treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients.

The effects of cultural distance on student socialization and departure decisions

Organizational socialization theory and university student retention literature support the concept that social integration influences new recruits' level of satisfaction with the organization and their decision to remain. This three-phase study proposes and tests a Cultural Distance Model of student retention based on Tinto's (1975) Student Integration Model, Louis' (1980) Model of Newcomer Experience, and Kuh and Love's (2000) theory relating cultural distance to departure from the organization. ^ The main proposition tested in this study was that the greater the cultural distance, the greater the likelihood of early departure from the organization. Accordingly, it was inferred that new recruits entering the university culture experience some degree of social and psychological distance. The extent of the distance correspondingly influences satisfaction with the institution and intent to remain for subsequent years. ^ The model was tested through two freshman student surveys designed to examine the effects of cultural distance on non-Hispanics at a predominantly Hispanic, urban, public university. The first survey was administered eight weeks into their first Fall semester and the second at the end of their first year. Student retention was determined through their re-enrollment for the second Fall semester. Path analysis tested the viability of the hypothesis relating cultural distance to satisfaction and retention as suggested in the model. Logistic regression tested the model's predictive power. ^ Correlations among variables were significant, accounting for 54% of variance in students' decisions to return for the second year with 96% prediction accuracy. Initial feelings of high cultural distance were related to increased dissatisfaction with social interactions and institutional choice at the end of the first year and students' intention not to re-enroll. Path analysis results supported the view that the construct of culture distance incorporates both social and psychological distance, and is composed of beliefs of institutional fit with one's cultural expectations, individual comfort with the fit, and the consequent sense of “belonging” or identifying with the institution. ^

Globalization and the public provision of higher education: Empirical evidence from selected countries

This research study was designed to examine the relationship between globalization as measured by the KOF index, its related forces (economic, political, cultural and technological) and the public provision of higher education. This study is important since globalization is increasingly being associated with changes in critical aspects of higher education. The public provision of education was measured by government expenditure and educational outcomes; that is participation, gender equity and attainment. The study utilized a non-experimental quantitative research design. Data collected from secondary sources for 139 selected countries was analyzed. The countries were geographically distributed and included both developed and developing countries. The choice of countries for inclusion in the study was based on data availability. The data, which was sourced from international organizations such as the United Nations and the World Bank, were examined for different time periods using five year averages. The period covered was 1970 to 2009.^ The relationship between globalization and the higher education variables was examined using cross sectional regression analysis while controlling for economic, political and demographic factors. The major findings of the study are as follows. For the two spending models, only one revealed a significant relationship between globalization and education with the R 2 s ranging from .222 to .448 over the period. This relationship was however negative indicating that as globalization increased, spending on higher education declined. However, for the education outcomes models, this relationship was not significant. For the sub-indices of globalization, only the political dimension showed significance as shown in the spending model. Political globalization was significant for six periods with R2 s ranging from .31 to .52.^ The study concluded that the results are mixed for both the spending and outcome models. It also found no robust effects of globalization on government education provision. This finding is not surprising given the existing literature which sees mixed results on the social impact of globalization.^

Authentic Experiences Assessment Instrument: The Case of Millennial Students and Cultural Attractions in Central Florida

Three types of authenticity were chosen to analyze cultural attractions—they were: staged or real authenticity, sensory authenticity, and existential authenticity. A group of millennium students that visited Orlando’s cultural attractions from the University of Central Florida were part of this study. Results show that the term “culture” is unclear among students. Also gender might play a role in determining what is perceived as “authenticity.” In general the focus group discussion had a consensus that these three types of authenticity were the right ones to measured cultural attractions, people, and behaviors.