Determinants of engagement in virtual social networks in Singapore

The use of virtual social networks (VSNs) has been prevalent among consumers worldwide. Numerous studies have investigated various aspects of VSNs. However, these studies have mainly focused on students and young adults as they were early adopters of these innovative networks. A search of the literature revealed there has been a paucity of research on adult consumers’ use of VSNs. This research study addressed this gap in the literature by examining the determinants of engagement in VSNs among adult consumers in Singapore. The objectives of this study are to empirically investigate the determinants of engagement in VSNs and to offer theoretical insights into consumers’ preference and usage of VSNs. This study tapped upon several theories developed in the discipline of technology and innovation adoption. These were Roger’s Diffusion of Innovation, Theory of Reasoned Action (TRA), Theory of Planned Behavior (TPB), Technology Acceptance Model (TAM), Conceptual Framework of Individual Innovation Adoption by Frambach and Schillewaert (2002), Enhanced Model of Innovation Adoption by Talukder (2011), Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) and the Information Systems (IS) Success Model. The proposed research model, named the Media Usage Model (MUM), is a framework rooted in innovation diffusion and IS theories. The MUM distilled the essence of these established models and thus provides an updated, lucid explanation of engagement in VSNs. A cross-sectional, online social survey was conducted to collect quantitative data to examine the validity of the proposed research model. Multivariate data analysis was carried out on a data set comprising 806 usable responses by utilizing SPSS, and for structural equation modeling AMOS and SmartPLS. The results indicate that consumer attitude towards VSNs is significantly and positively influenced by: three individual factors – hedonic motivation, incentives and experience; two system characteristics – system quality and information quality; and one social factor – social bonding. Consumer demographics were found to influence people’s attitudes towards VSNs. In addition, consumer experience and attitude towards VSNs significantly and positively influence their usage of VSNs. The empirical data supported the proposed research model, explaining 80% of variance in attitude towards VSNs and 45% of variance in usage of VSNs. Therefore, the MUM achieves a definite contribution to theoretical knowledge of consumer engagement in VSNs by deepening and broadening our appreciation of the intricacies related to use of VSNs in Singapore. This study’s findings have implications for customer service management, services marketing and consumer behavior. These findings also have strategic implications for maximizing efficient utilization and effective management of VSNs by businesses and operators. The contributions of this research are: firstly, shifting the boundaries of technology or innovation adoption theories from research on employees to consumers as well as the boundaries of Internet usage or adoption research from students to adults, which is also known as empirical generalization; secondly, highlighting the issues associated with lack of significance of social factors in adoption research; and thirdly, augmenting information systems research by integrating important antecedents for success in information systems.

Clinical Practice Guideline: irritable bowel syndrome with constipation and functional constipation in the adult

In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antidepressants, psychological therapy, acupuncture, enemas, sacral root neurostimulation, surgery) are discussed, and practical recommendations are made regarding each of them.

Reabilitação psicomotora em contexto da saúde mental de adultos no centro de atividades ocupacionais, Casa do Sol do Centro de Apoio Social do Pisão, Santa Casa da Misericórdia de Cascais

O presente relatório refere-se às atividades, do estágio inserido no Ramo de Aprofundamento de Competências Profissionais do Segundo Ciclo, desenvolvidas no âmbito da Reabilitação Psicomotora em Saúde Mental. Estas práticas de estágio foram realizadas no Centro de Atividades Ocupacionais (CAO) – Casa Do Sol e no Centro de Apoio Social do Pisão (CASP). A Intervenção no CAO e no CASP foi dirigida a indivíduos adultos com perturbação psiquiátrica, de ambos os sexos, residentes e/ou utentes destes centros. Esta intervenção foi constituída pelas seguintes quatro etapas: 1ª Observação informal das aulas de expressão corporal, dos momentos de refeições, dos ateliês de carpintaria, jardinagem, artes plásticas e culinária; 2ª Reabilitação / Intervenção psicomotora (duração aproximada de 6 meses); 3ª Avaliação formal de alguns casos utilizando instrumentos de avaliação nomeadamente a Bateria Psicomotora de Vítor da Fonseca (BPM) e a Escala do Comportamento Adaptativo Verão Portuguesa de Sofia Santos e Pedro Morato (ECAP). 4ª Elaboração e Ajustamento do Plano Terapêutico.

Terrenos de marinha: terras públicas com função social? um estudo da orla marítima de natal

This work has as its theme the social function of terrenos de marinha. Theresearch universe is the terrenos de marinha of Natal coastline, focusing on thefulfillment of its social function. Prescribed by law since the colonial period with thepurpose of protecting the coast and free movement of people and goods, theywere swathes of land not available to private use by individuals. With the transitionfrom the allotments system to the purchase and sale, regard to land access,crystallized with the creation of the Land Law in the nineteenth century, the land isheld as merchandise and terrenos de marinha, following this logic, also acquireexchange value and become capable of enjoyment by private individuals, with thecondition of tax payments to the state. This is seen until the twentieth century,when in 1988, primarily because of the Federal Constitution promulgation, begins anew cycle when is possible to use on terrenos de marinha the principle of thesocial function of property. From this perspective this study aims to identify thesocial function of terrenos de marinha in Natal, focusing on the public destinationand the use value of the city coastline. To this end, it was made a data collection inthe on-line information system of the Federal Heritage Department of Rio Grandedo Norte (SPU / RN) and in the terrenos de marinha areas, in order to find out ifthey had public or private use, or if they were empty lots, as well as if thepopulation access to the shore exist. Interviews with managers of the SPU weremade. The empirical study showed that the social function of terrenos de marinhain the city of Natal still didn´t happen, considering the constant existence of vacantlots in their areas, the lack of access in significant portions of the coastline and thereduced areas directed to common use along the coastline, minimizing its potentialof enjoyment by the population. It concludes by pointing to the existence of a newtransition phase on the terrenos de marinha, in witch, gradually, come up lawprovisions in the legal system and public policies to expand the purely taxcollection function attributed to this land for two centuries. In this direction, thesocial function of terrenos de marinha is embodied in concomitant adjustment ofthe tax collection function and the rescue of coastline use value, national heritageand a place for sociability and social relations development

Interesses da habitação social : políticas e processos no Rio Grande do Norte

En 2003, le gouvernement brésilien (gestion Lula) a initié une nouvelle phase dans son histoire de l habitation, en intensifiant les constructions de logements sociaux au Brésil. Un tel accroissement a eut des répercussions tant en ville comme à la campagne, et fût marqué dans le Rio Grande do Norte, par la production a grande échelle d ensembles d habitations, dans les programmes de Gouvernement. Afin de viabiliser ces transformations, des instruments politiques, financiers et de gestion ont étés articulés conjointement, utilisant la répétition d une typologie d édification, comme modèle, accompagnée de la reproduction d une morphologie dans les constructions de logements sociaux. Afin de comprendre ce processus nous introduisons une recherche urbanistique et socio-économique du problème du logement social au Brésil, en cherchant à mettre en relation les aspects techniques avec les questions historique, professionnelles et culturelles, éléments complémentaires. Notre analyse cherche a identifier comment les politiques de gestion et financement officielles (administrées dans sa grande majorité par la Caisse Économique Fédérale -CEF-), influencent le processus de conception de projets, en provoquant les répétitions de type/morphologiques, déjà citées. Basée sur l observation directe au cour de deux expériences différenciées pour du logement social en milieu rural, au Rio Grande do Norte, nous montrerons aussi certaines limitations et possibilités des acteurs sociaux, face aux agents et politiques officielles pour le logement social au Brésil, proposant des solutions alternatives standardisées qui caractérisent le résultat des projets financées et gérés par la CEF. Nos principales références théoriques et méthodologiques sont Nabil Bonduki (1998), David Harvey (2009,1982), Henry Lefèbvre (1970), Ermínia Maricato (2010, 2009, 2000, 1987) et Raquel Rolnik (2010, 2009, 2008, 1997)

Estrategias de intervención desde el trabajo social frente al suicidio en la adolescencia

La presente monografía; “Estrategias de intervención desde el Trabajo Social frente al suicidio en la adolescencia” aborda, entre otras, las siguientes temáticas; definiciones y tipos desuicidio; factores que influyen en el suicidio de la adolescencia y las causas que generan este problema de salud pública. El “sujeto” central de la investigación es la adolescencia, grupo etario donde el suicidio se ha convertido en la tercera causa de muerte. La conducta suicida,también es abordada; considerando los cambios y características psicológicas que es determinante para detectarestos comportamientos y poder prevenirlos e intervenir desde diferentes perspectivas profesionales, en donde el trabajo multidisciplinario es la base de la intervención especializada. En este escenario de multidisciplinariedad la tarea del Trabajador Social es caracterizada, en la monografía, como la del profesional que dinamiza armónicamente la acción de los profesionales involucrados, apoyándose en lopsicoeducativo y en la definición del escenario social. Finalmente se plantean estrategias y alternativas conceptuales y metodológicas, para prevenir el suicidio en la adolescencia y como intervenir con sus familias y allegados. La propuesta metodológica que se enfatiza como estrategia, para prevenir el suicidio, es el trabajo de equipo multidisciplinario,en dónde; psicólogos, médicos, psiquiatras, enfermeras, educadores, orientadores familiares y trabajadores sociales, aúnan esfuerzos para prevenir este flagelo y con la finalidad de relacionar lo conceptual y metodológico desde la práctica profesional se transcribe una entrevista a profundidad con un médico psiquiatra de uno de los hospitales de la localidad.

MIGRATION PATTERNS AMONG YOUNG ADULTS IN THE UNITED STATES: ENVIRONMENTAL, SOCIAL, AND ECONOMIC EXPLANATIONS

Young adult migration is a key factor in community development. The goal of this paper is to study what kinds of places attract young adults and what kinds are losing them. Linear regression is conducted to analyze what place-specific factors explain migration patterns among young adults. These factors include economic, social, and environmental variables. This study finds that social and environmental factors are just as important as economic ones. Specifically, employment in the arts increases young adult net migration. Environmental variables, for example, natural amenities and protected federal lands are particularly important in rural settings in attracting young adults. These findings suggest that policy makers interested in attracting and retaining young adults should pay closer attention to social and environmental factors and consider creating more opportunities for arts employment in general. For rural areas, improving the attractiveness of natural amenities and better protection of federal lands is also recommended.

The Impact of Social Comparison Processes on Hoped-For Possible Selves, Self-Regulatory Processes, and Mental Health Outcomes in Young Adults

In exploring the role of social influences in the development of the self, the current study evaluated whether young adults use social comparisons in developing their hoped-for possible selves and, if so, whether their developmental process correlates with self-regulatory processes and positive mental health outcomes. The current study found the following: (1) the domains of hoped-for possible selves among young adults were related to the gender of the social comparison target, (2) the direction of young adults’ social comparison processes (upward or downward) did not significantly influence self-regulatory processes (self-efficacy and outcome expectancy) toward achieving their hoped-for possible selves, (3) strong masculine gender identification related to greater outcome expectancy, while strong feminine gender identification related to both greater self-efficacy and outcome expectancy, and (4) self-efficacy related to less state anxiety, trait anxiety, and depression, while outcome expectancy related only to less trait anxiety. Males and females were found to use traditional gender role identification in forming their hoped-for possible selves.

Social Capital, HIV Risk Behavior and Substance Use among Recent Latino Immigrants in South Florida

Social capital, or social cohesion or group connectedness, can influence both HIV risk behavior and substance use. Because recent immigrants undergo a change in environment, one of the consequences can be a change in social capital. There may be an association among changes in social capital, and HIV risk behavior and substance use post immigration. The dissertation focused on the interface of these three variables among recent Latino immigrants (RLIs) in South Florida. The first manuscript is a systematic review of social capital and HIV risk behavior, and served as a partial background for the second and third manuscripts. Twelve papers with a measure of social capital as an independent variable and HIV risk as the dependent variable were included in the analysis. Eleven studies measured social capital at the individual level, and one study measured social capital at the group level. HIV risk was influenced by social capital, but the type of influence was dependent on the type of social capital and on the study population. Cognitive social capital, or levels of collective action, was protective against HIV in both men and women. The role of structural social capital, or levels of civic engagement/group participation, on HIV risk was dependent on the type of structural social capital and varied by gender. Microfinance programs and functional group participation were protective for women, while dysfunctional group participation and peer-level support may have increased HIV risk among men. The second manuscript was an original study assessing changes in social capital and HIV risk behavior pre to post immigration among RLIs in South Florida (n=527). HIV risk behavior was assessed through the frequency of vaginal-penile condom use, and the number of sexual partners. It was a longitudinal study using secondary data analysis to assess changes in social capital and HIV risk behavior pre immigration to two years post immigration, and to determine if there was a relationship between the two variables. There was an 8% decrease in total social capital (p ˂ .05). Reporting of ‘Never use’ of condoms in the past 90 days increased in all subcategories (p ˂ .05). Single men had a decrease in number of sexual partners (p ˂ .05). Lower social capital measured on the dimension of ‘friend and other’ was marginally associated with fewer sexual partners. The third manuscript was another original study looking at the association between social capital and substance use among RLIs in South Florida (n=527). Substance use with measured by frequency of hazardous alcoholic drinking, and illicit drug use. It was a longitudinal study of social capital and substance-use from pre to two years post immigration. Post-immigration, social capital, hazardous drinking and illicit drug use decreased (p˂.001). After adjusting for time, compared to males, females were less likely to engage in hazardous drinking (OR=.31, p˂.001), and less likely to engage in illicit drug use (OR=.67, p=.01). Documentation status was a moderator between social capital and illicit drug use. ‘Business’ and ‘Agency’ social capital were associated with changes in illicit drug use for documented immigrants. After adjusting for gender and marital status, on average, documented immigrants with a one-unit increase in ‘business’ social capital were 1.2 times more likely to engage in illicit drug use (p˂.01), and documented immigrants with one-unit increase in ‘agency’ social capital were 38% less likely to engage in illicit drug use (p˂.01). ‘Friend and other’ social capital was associated with a decrease in illicit drug use among undocumented immigrants. After adjusting for gender and marital status, on average, undocumented immigrants with a one-unit increase in ‘friend and other’ social capital were 45% less likely to engage in hazardous drinking and 44% less likely to use illicit drugs (p˂.01, p˂.05). Studying these three domains is relevant because HIV continues to be a public health issue, particularly in Miami-Dade County, which is ranked among other U.S. regions with high rates of HIV/AIDS prevalence. Substance use is associated with HIV risk behavior; in most studies, increased substance use is associated with increased chances of HIV risk behavior. Immigration, which is the hypothesized catalyst for the change in social capital, has an impact on the dynamic of a society. Greater immigration can be burdensome on the host country’s societal resources; however immigrants are also potentially a source of additional skilled labor for the workforce. Therefore, successful adaption of immigrants can have a positive influence on receiving communities. With Florida being a major receiver of immigrants to the U.S, this dissertation attempts to address an important public health issue for South Florida and the U.S. at large.

Prediction of adult height in girls: the Beunen-MalinaFreitas method

The purpose of this study was to validate and cross-validate the Beunen-Malina-Freitas method for non-invasive prediction of adult height in girls. A sample of 420 girls aged 10–15 years from the Madeira Growth Study were measured at yearly intervals and then 8 years later. Anthropometric dimensions (lengths, breadths, circumferences, and skinfolds) were measured; skeletal age was assessed using the Tanner-Whitehouse 3 method and menarcheal status (present or absent) was recorded. Adult height was measured and predicted using stepwise, forward, and maximum R2 regression techniques. Multiple correlations, mean differences, standard errors of prediction, and error boundaries were calculated. A sample of the Leuven Longitudinal Twin Study was used to cross-validate the regressions. Age-specific coefficients of determination (R2) between predicted and measured adult height varied between 0.57 and 0.96, while standard errors of prediction varied between 1.1 and 3.9 cm. The cross-validation confirmed the validity of the Beunen-Malina-Freitas method in girls aged 12–15 years, but at lower ages the cross-validation was less consistent. We conclude that the Beunen-Malina-Freitas method is valid for the prediction of adult height in girls aged 12–15 years. It is applicable to European populations or populations of European ancestry.

Diageo's 'Stop Out of Control Drinking' campaign in Ireland: an analysis

Background: It has been argued that the alcohol industry uses corporate social responsibility activities to influence policy and undermine public health, and that every opportunity should be taken to scrutinise such activities. This study analyses a controversial Diageo-funded ‘responsible drinking’ campaign (“Stop out of Control Drinking”, or SOOCD) in Ireland. The study aims to identify how the campaign and its advisory board members frame and define (i) alcohol-related harms, and their causes, and (ii) possible solutions. Methods: Documentary analysis of SOOCD campaign material. This includes newspaper articles (n = 9), media interviews (n = 11), Facebook posts (n = 92), and Tweets (n = 340) produced by the campaign and by board members. All material was coded inductively, and a thematic analysis undertaken, with codes aggregated into sub-themes. Results: The SOOCD campaign utilises vague or self-defined concepts of ‘out of control’ and ‘moderate’ drinking, tending to present alcohol problems as behavioural rather than health issues. These are also unquantified with respect to actual drinking levels. It emphasises alcohol-related antisocial behaviour among young people, particularly young women. In discussing solutions to alcohol-related problems, it focuses on public opinion rather than on scientific evidence, and on educational approaches and information provision, misrepresenting these as effective. “Moderate drinking” is presented as a behavioural issue (“negative drinking behaviours”), rather than as a health issue. Conclusions: The ‘Stop Out of Control Drinking’ campaign frames alcohol problems and solutions in ways unfavourable to public health, and closely reflects other Diageo Corporate Social Responsibility (CSR) activity, as well as alcohol and tobacco industry strategies more generally. This framing, and in particular the framing of alcohol harms as a behavioural issue, with the implication that consumption should be guided only by self-defined limits, may not have been recognised by all board members. It suggests a need for awareness-raising efforts among the public, third sector and policymakers about alcohol industry strategies

‘‘Model age-based” and ‘‘copy when uncertain” biases in children’s social learning of a novel task

Theoretical models of social learning predict that individuals can benefit from using strategies that specify when and whom to copy. Here the interaction of two social learning strategies, model age-based biased copying and copy when uncertain, was investigated. Uncertainty was created via a systematic manipulation of demonstration efficacy (completeness) and efficiency (causal relevance of some actions). The participants, 4- to 6-year-old children (N = 140), viewed both an adult model and a child model, each of whom used a different tool on a novel task. They did so in a complete condition, a near-complete condition, a partial demonstration condition, or a no-demonstration condition. Half of the demonstrations in each condition incorporated causally irrelevant actions by the models. Social transmission was assessed by first responses but also through children’s continued fidelity, the hallmark of social traditions. Results revealed a bias to copy the child model both on first response and in continued interactions. Demonstration efficacy and efficiency did not affect choice of model at first response but did influence solution exploration across trials, with demonstrations containing causally irrelevant actions decreasing exploration of alternative methods. These results imply that uncertain environments can result in canalized social learning from specific classes of mode

Prediction of adult height in girls: the Beunen-MalinaFreitas method

The purpose of this study was to validate and cross-validate the Beunen-Malina-Freitas method for non-invasive prediction of adult height in girls. A sample of 420 girls aged 10–15 years from the Madeira Growth Study were measured at yearly intervals and then 8 years later. Anthropometric dimensions (lengths, breadths, circumferences, and skinfolds) were measured; skeletal age was assessed using the Tanner-Whitehouse 3 method and menarcheal status (present or absent) was recorded. Adult height was measured and predicted using stepwise, forward, and maximum R2 regression techniques. Multiple correlations, mean differences, standard errors of prediction, and error boundaries were calculated. A sample of the Leuven Longitudinal Twin Study was used to cross-validate the regressions. Age-specific coefficients of determination (R2) between predicted and measured adult height varied between 0.57 and 0.96, while standard errors of prediction varied between 1.1 and 3.9 cm. The cross-validation confirmed the validity of the Beunen-Malina-Freitas method in girls aged 12–15 years, but at lower ages the cross-validation was less consistent. We conclude that the Beunen-Malina-Freitas method is valid for the prediction of adult height in girls aged 12–15 years. It is applicable to European populations or populations of European ancestry.

Prevalencia y factores asociados al consumo de bebidas azucaradas en escolares de 9 a 17 años de Bogotá, Colombia: Estudio FUPRECOL

Objetivo: Determinar la prevalencia y los factores asociados al consumo de bebidas azucaradas en una población escolar de Bogotá, Colombia, pertenecientes al estudio FUPRECOL. Métodos: Estudio descriptivo y transversal, realizado en 8136 niños y adolescentes en edad escolar entre 9 y 17 años de Bogotá, Colombia. El peso, la estatura, el índice de masa corporal (IMC), la circunferencia de cintura y el porcentaje de grasa, se recogieron como marcadores antropométricos y de composición corporal. El consumo de bebidas azucaradas (bebidas carbonatadas, jugos ultra-procesados y/o Té), y los factores asociados (sexo, edad, obesidad abdominal, clasificación del IMC, grado de estudios de la madre/padre, y nivel nutricional por cuestionario “Krece plus”), se recogieron por encuesta estructurada. Se establecieron asociaciones mediante la construcción de modelos de regresión logística simple. Resultados: De la población general, el 58,4% eran mujeres. En función al sexo, los varones acusaron la mayor ingesta de “bebidas carbonatadas” con una frecuencia semanal y diaria de 70,9% y 21,0%, respectivamente, seguido de “jugos ultra- procesados” (64,4% semanal vs. 11,3% diario). En ambos sexos, la prevalencia de obesidad abdominal fue mayor en los escolares que respondieron consumir diariamente “bebidas carbonatadas” (23,3%), “jugos ultra-procesados” (13,2%) y “bebidas Té” (9,7%). La edad, el grado de educación de los padres y el nivel nutricional, se asociaron como factores predisponentes al consumo diario de “bebidas carbonatadas”. Conclusión: El consumo de bebidas azucaradas cambia por los factores analizados. Se recomiendan intervenciones integrales en las que estén involucrados los componentes nutricional y educativo entre los niños y adolescentes de Bogotá, Colombia.

Conceptos y prácticas de la actividad física que se reproducen en las clases sociales: aproximación desde el enfoque determinantes/ determinación social de la salud

El concepto de actividad física es concebido de diferentes formas. Mostrando que existen varios factores que afectan de manera directa e indirecta la percepción que los sujetos construyen entorno a él, generando así una aproximación a diferentes definiciones de la actividad física desde varias perspectivas y dimensiones, donde predomina una noción netamente biológica. Este estudio pretende analizar, como desde las clases sociales se concibe la actividad física en sus conceptos y prácticas considerando los modelos de determinantes y determinación social para la salud. Con fin de comprender como los autores de la literatura científica conciben la actividad física y la relación con las clases sociales, desde una perspectiva teórica de los determinantes sociales de la salud y la teoría de la determinación social, se realizó una revisión documental y análisis de contenido de los conceptos y prácticas de la actividad física que se han considerado en los últimos 10 años. Para ello se seleccionaron las bases de datos PubMed y BVS (Biblioteca Virtual de Salud) por sus énfasis en publicaciones de salud mundialmente. Mostrando que la actividad física es concebida dominantemente desde una perspectiva biológica que ejerce una mirada reduccionista. Las relaciones entre actividad física y las clases sociales están claramente establecidas, sin embargo, estas relaciones pueden discrepar teniendo en cuenta el concepto de clase social, el contexto y la orientación de los autores y las poblaciones objetos de estudio. Obteniendo como resultado que los estudios documentados, revisados y analizados muestran una clara tendencia al modelo de determinantes; no obstante, algunos estudios en sus análisis se orientan hacia el modelo de determinación social. En cuanto al concepto de clases sociales los autores consideran una combinación de factores culturales y económicos sin atreverse a adoptar un concepto específico.