bluuebunny/crossref_metadata_2025 huggingface dataset:
Wykorzystanie ochrony środowiska w działalności promocyjnej, informacyjnej, administracyjnej na podstawie badań przeprowadzonych w Gminie Świętajno
Authors: Grott Edward
Published: January 2021

W ciągu ostatnich kilku lat znacznie zmienił się obraz polskiej wsi. Rolnik poza umiejętnościami typowo gospodarskimi w wielu wypadkach posiadł wiedzę z marketingu i turystyki. W szczególności dotyczy to obszarów atrakcyjnych turystycznie. Dzięki promocji swojego gospodarstwa, czy tez całej gminy jako obszaru na którym dbałość o środowisko naturalne jest priorytetem, rolnicy uzyskali dodatkowe źródło dochodu a samorządy środki własne, np. na dalszą promocję gminy czy rozwój infrastruktury. Wzrost popularności agroturystyki jest szansą dla biednych regionów Polski o minimalnym stopniu degradacji środowiska naturalnego, na których w wyniku przekształceń polityczno-społecznych w latach 90tych XXw. zostało zlikwidowanych wiele PGR-ów a bezrobocie sięga 40%. Z tej szansy warto skorzystać a gmina Świętajno wie jak to zrobić.
Traktat o kobiecie
Authors: Ruszczyński Jacek
Published: January 2021

Streszczenie nie jest dostępne.
Łemkowska architektura sakralna na przykładzie cerkwi greckokatolickiej w Łosiu - ikonostas
Authors: Wójtowicz Bernadetta
Published: January 2021

Strzeszczenie nie jest dostępne.
Środowisko naturalne oraz inne atrakcje turystyczne w działalności promocyjno-informacyjnej prowadzonej przez administrację samorządową rejonie Bartoszyc
Authors: Grott Edward
Published: January 2021

Streszczenie nie jest dostępne.
Szanse rozwoju spółdzielczości wiejskiej jako formy organizowania się rolników w Polsce w odniesieniu do warunków społecznych i gospodarczych w Unii Europejskiej
Authors: Adamczyk Beata
Published: January 2021

Strzeszczenie nie jest dostępne.
Wpływ działalności promocyjno-informacyjnej administracji państwowej i samorządowej na rozwój regionu na podstawie badań przeprowadzonych w Ełku
Authors: Grott Edward
Published: January 2021

Współczesna turystyka nie może istnieć bez promocji. Władze miasta Ełk i okolic upatrują szansę rozwoju gospodarczego w turystyce przy wykorzystaniu ogromnego potencjału jakim jest środowisko naturalne. W tej sytuacji oczywiste jest, że nie dbając o środowisko naturalne sami pozbawiamy się naszego głównego atutu w konkurencyjnej walce o turystę. Działalność promocyjno-informacyjna służy nie tylko indywidualnym turystom, ale również organizatorom wypoczynku grupowego, restauratorom, branży hotelarskiej jak również pojedynczym gospodarstwom agroturystycznym. Im większa jest świadomość społeczeństwa o stanie obecnym środowiska naturalnego w ich najbliższej okolicy, tym łatwiej jest zaplanować działania mające na celu jego ochronę, jak też organizację kampanii reklamowych regionu.Bardzo szeroki wachlarz dostępnych narzędzi w dziedzinie gromadzenia, przetwarzania i udostępniania informacji może być w pełni wykorzystywany w turystyce z pełnym uwzględnieniem grup odbiorców, rynków czy poszczególnych produktów. Takimi odbiorcami są m.in.: samorząd lokalny i gospodarczy, przewoźnicy, piloci, przewodnicy, twórcy produktów turystycznych, animatorzy wydarzeń kulturalnych, firmy poszukujące usług turystycznych, turyści indywidualni oraz grupy zorganizowane, lokalne społeczności, media, szkoły turystyczne.Region Polski Północno-Wschodniej jest wolny od ciężkiego przemysłu. Bogactwo fauny i flory oraz wyjątkowe walory krajobrazowe przez wiele organizacji międzynarodowych zastały uznane za przyrodnicze dziedzictwo Europy. Celem  mieszkańców tych regionów powinno byc zachowanie i umacnianie tego wizerunku. Wiele jest przykładów państwa i regionów, które pogodziły rozwój gospodarczy z dbałością o środowisko naturalne. Warto dołączyć do tego elitarnego grona.
Rozważania nad świadomością ekologiczną
Authors: Klimski Marcin
Published: January 2021

Forming ecological awareness of children, young people and adults is one of the most important challenges of the contemporary world. This process is of great importance, as it leads to forming a pro-ecological behaviour, resulting in proper attitudes of people to the environment. This article shows the ways of understanding ecological attitude. We consider its wide versus narrow meaning. We also present types of ecological attitudes and the values belonging to its development and to making it work in everyday live.
Sposoby ujmowania edukacji ekologicznej
Authors: Bernadkiewicz Agnieszka
Published: January 2021

Recently, relation between human being and nature is mainly that environmental resources are gained by people to assurance themselves worthy living conditions. People’s actions are often not very well motivated, leading to serious consequences such as degradation of environmental components. The way of making use of biosphere components are undoubtedly depend on degree of ecological awareness and on people’s responsibility for environment. A creation of pro-ecological attitudes is one of main goals of ecological education. This article shows the ways of understanding ecological education, the areas of its interest, its essence, and the most important trends and values in the contemporary world.
Anthropological Perspective on the Decision-Making Process in Environmental Protection
Authors: Embros Grzegorz
Published: January 2021

The systemic perspective on environmental action adopted in the paper, allows in this thematic area, issues related to the decision-making process. Due to the current crisis affecting human-environment relationships, these issues call for special attention and specific solutions. Against this backdrop, the paper draws on selected patterns, which constitute a point of reference in the formulation of the decision-making process, namely, the Deming Cycle, and the control system worked out by Marian Mazur. Among the manifold determinants of the decision-making process, special emphasis is put on the anthropological one, with reference to the approach proposed by Michał Gierycz. In turn, the idea of oikophilia, as presented by Roger Scruton, has been used as an exemplification of the discussed issues. More specifically, an attempt has been made to determine the influence of the adopted anthropological perspective on the shape and course of the decision-making process, which is the aim of the study. The paper analyses further how a defined profile of the performer, influences the structure and course of the decision-making process in environmental protection. The conducted analyses enable the formulation of a postulate, in order that the adopted vision of the decision-maker, should be treated as a point of reference in the design and construction of a methodology for environmental protection.
Man’s Attitude Towards Nature and Animal Respect Questionnaire (AniRe-Que)
Authors: Kaliský Ján , Kaliská Lada
Published: January 2021

The psychometric properties of the author´s original tool named Questionnaire of the Relations between a Man and Animals (further on AniRe-Que) was constructed to assess the relations between a man and animals as natural beings; calculated in the form of an R-score (R as respect). The questionnaire is based on the theoretical outcomes of an egalitarian zoocentric, ecoethical position attributing moral statues to all beings, and measures the level of respect expression to nonhuman beings. The aim of this study was to verify its validity and reliability in a research sample of future primary and secondary teachers (N = 500, 62% of females, Mage=22.3; SD=4.1) at Matej Bel University in Banská  Bystrica, Slovakia. Various statistical procedures were used to verify its construct validity (exploratory factor analysis /EFA/) and its convergent/discriminating character, criterion validity, and reliability (test-retest, parallel-forms, internal consistency) to establish satisfactory psychometric properties for the AniRe-Que questionnaire. The questionnaire has possible usage for the animal relation estimation by researchers, practitioners and teachers´ ethical and environmental education intervention effectivitiveness, and also as a form of future international cooperation and verification based on this new instrument.
Environmental Protection in Strategic Instruments of Spatial Policy in Poland
Authors: Nowak Maciej J.
Published: January 2021

Ensuring environmental protection requires the use of various instruments, including spatial policy ones. Appropriate integration of environmental issues in spatial policy is still a major challenge. The aim of this article is to determine the direction of optimal environmental protection in strategic tools of spatial policy. The article indicates optimal expectations for spatial policy instruments, from an environmental perspective. Then, it verifies the extent to which these expectations are, or can be, included in the current system. The research part verifies studies of conditions and directions of the spatial development of voivode cities, in terms of using key elements from an environmental perspective. The analyses and research show that, especially in strategic instruments at the local level, consideration should be given to determining the importance of protected areas in shaping the environment, indicating potential solutions to environmental threats, and the social context of environmental protection. However, attempts at such activities are undertaken, largely, to a very limited extent.
Disturbances in the Mechanism of Apoptosis as One of the Causes of the Development of Cancer Diseases
Authors: Rusin Paweł , Jabłońska Karolina
Published: January 2021

Apoptosis is a genetically programmed process that affects all multicellular organisms. This mechanism of programmed cell death is designed to protect the body against uncontrolled proliferation of cells with impaired functions. Apoptosis can occur through two major pathways. The extrinsic, initiated by signals from the death receptor, and the intrinsic one, resulting from a change in the permeability of the external mitochondrial membrane due to stress factors promoting the initiation of programmed cell death. Apoptosis may be influenced by many factors that may lead to suppressing the initiation of apoptotic pathways, and the damaged cell will develop, divide, and over time transform into a cancerous cell. As a result, cancer cells will be resistant to the applied chemo- and radiotherapy. The mechanisms responsible for apoptosis regulation are impaired, what eliminates the effects of therapies aimed at initiating this type of cell death. New types of molecular therapies provide an opportunity to increase the effectiveness of anticancer treatment, aiming at deficient proteins and suppressing or eliminating their antiapoptotic effects.
Contribution to the Study of the European Ground Squirrel’s Population (Spermophilus citellus Linnaeus, 1766) in Rila National Park, Bulgaria
Authors: Mitrevichin Emanuil , Sakelarieva Lidia
Published: January 2021

Although there are still some large and stable populations of the European Ground Squirrel, there has been a serious decline in the number and density of most of the species populations throughout its range, including in Bulgaria. The aim of the study is to supplement the scientific data about the population of the European Ground Squirrel and its habitat in Rila National Park, Southwestern Bulgaria. The research was carried out in 2017-2019 in two study areas, each divided into 20 (21) transects (every 100 m long and 5 m wide). The results have shown that the relative population density based on the number of holes tends to decrease in the period of study. The most likely reason for this, and the most significant identified threat to the population of the species in the research area in general, is the observed deterioration of the habitat status.
Bulky Vehicles Recycling. Part 1 - Conditions for Recycling
Authors: Matuszewska Anna , Wieczorek Piotr , Samson-Bręk Izabela
Published: January 2021

Recycling of end-of-life passenger vehicles is a well-known topic, and there are many literary reports in this regard. However, little information is available on the recycling of bulky vehicles, which determines the authors’ intention to present this issue. This article describes the loopholes that have prevented end-of-life vehicles from currently being recycled.  The forms of recycling of these types of vehicles has been shown, and they are analogous to those for passenger cars. Also being presented are the causes of design changes in passenger cars and trucks, with the reasons for these changes being slightly different in bulky vehicles, than in passenger cars, and the article will discuss how these changes translate into recycling. Examples of actions taken by large vehicle manufacturers to meet the changes taking place in the economy, and implement the principles of the circular economy, in the field of recycling large-size vehicles, are also outlined.
Faktor-faktor Yang Mempengaruhi Preferensi Masyarakat Dalam Menggunakan Moda Mass Rapid Transit (MRT) Kota Jakarta
Authors:   Jurusan Perencanaan Wilayah dan Kota, Sembada Mochamad Trias , Hariyani Septiana , setyono deni agus
Published: January 2021

DKI Jakarta selain merupakan Ibukota Negara Indonesia juga menjadi pusat bisnis dan pemerintahan dengan jumlah penduduk mencapai 10.374.235 jiwa dan kepadatan penduduk mencapai 15.663 orang per . Dinamika kota-kota besar dengan karakter pertumbuhan penduduk dan kepadatan lalu lintas yang tinggi membuat kebutuhan terhadap pengembangan sistem transportasi terutama transportasi massal cepat (Mass Rapid Transportation-MRT) menjadi cukup besar. Selain itu, pengembangan sistem transportasi ini juga untuk mengimbangi pertumbuhan kendaraan pribadi yang terus mengalami peningkatan sedangkan sistem moda shares angkutan umum cenderung mengalami penurunan hingga 3% sejak tahun 2002. Saat ini, terdapat upaya pengembangan sistem angkutan umum massal berbasis jalan dan berbasis rel berdasarkan RTRW DKI Jakarta 2010-2030. Berkaitan dengan kondisi tersebut perlu adanya kajian terhadap penilaian pelayanan transportasi umum guna menarik masyarakat dalam menggunakannya agar permasalahan lalu lintas yang ada dapat terselesaikan. Tujuan penelitian ini antara lain adalah mengetahui karakteristik masyarakat yang memiliki preferensi dalam menggunakan moda MRT dan faktor-faktor yang mempengaruhi preferensi masyarakat dalam menggunakan moda MRT. Penelitian ini menggunakan metode analisis statistic deskriptif dan analisis faktor. Berdasarkan hasil analisa diketahui masyarakat yang memiliki preferensi untuk menggunakan moda MRT sebesar 98% dengan karakter sebagian besar berjenis kelamin Laki-laki, rentang usia 25-35 Tahun, jenis pekerjaan pegawai swasta, dan tingkat penghasilan ≥Rp.4.000.000. Tujuan perjalanan menuju perkantoran, dan memiliki keperluan perjalanan untuk bekerja. Selanjutnya dari analisis faktor dihasilkan 17 kelompok faktor yang mempengaruhi preferensi masyarakat dalam menggunakan moda MRT, dengan kelompok faktor nomor 1 yang memiliki tingkat variasi eigen value tertinggi.
Persepsi Wisatawan terhadap Aspek Penawaran Wisata Pantai Lariti Kabupaten Bima
Authors:   Jurusan Perencanaan Wilayah dan Kota, Fakultas Teknik, UB, Furqon Arif , Wijayanti Wawargita Permata , Subagiyo Aris
Published: January 2021

Pantai Lariti merupakan salah satu obyek wisata paling potensial di Kabupaten Bima, Provinsi Nusa Tenggara Barat. Meski Lariti memiliki daya tarik wisata yang indah, namun pantai tersebut memiliki masalah yang cukup serius terkait dengan lokasinya yang dekat dengan tambak ikan. Kondisi ini membuat wisatawan tidak nyaman dengan bau dan limbah dari kolam. Selain itu minimnya infrastruktur membuat jumlah pengunjung ke pantai ini juga semakin berkurang dalam kurun waktu tiga tahun. Penelitian ini bertujuan untuk mengetahui bagaimana persepsi wisatawan terhadap pasokan pariwisata di Pantai Lariti dan mengetahui faktor-faktor yang mempengaruhi peningkatan kondisi Lariti. Kami menggunakan analisis deskriptif dengan IPA dan analisis faktor untuk menentukan faktor yang berpengaruh terkait dengan penawaran wisata. Hasil penelitian menunjukkan bahwa hampir 50% wisatawan tidak puas terkait dengan aspek penawaran pariwisata yag ditawarkan pada Pantai Lariti. Sehingga, 12 dari 20 atribut penelitian menjadi prioritas pemerintah untuk meningkatkan pasokan pariwisata di Pantai Lariti.Atribut-atribut inilah yang akan diprioritaskan penanganannya guna peningkatan kualitas aspek penawaran di Pantai Lariti. Dengan harapan, jumlah kunjungan wisatawan ke Pantai Lariti akan semakin meningkat dan dapat meningkatkan pendapatan daerah Kabupaten Bima
Pemetaan Perubahan Kondisi Sosial Ekonomi Masyarakat Pasca Gempa Bumi di Kecamatan Tanjung, Kabupaten Lombok Utara
Authors:   Program Studi PWK Universitas Teknologi Yogyakarta, Dewi Baiq Vidy Tiara
Published: January 2021

Indonesia rentan terhadap bencana gempa bumi karena terletak pada garis Ring of Fire Samudera Pasifik. Gempa beruntun yang terjadi sejak 29 Juli 2018 menyebabkan banyak kerugian bagi masyarakat di Pulau Lombok. Gempa bumi dengan main shock berkekuatan 7,0 SR yang terjadi pada 5 Agustus 2018 memberi dampak kerusakan besar bagi Kabupaten Lombok Utara karena menjadi pusat gempa. Penelitian berlokasi di Kecamatan Tanjung karena mengalami dampak kerusakan terbesar serta merupakan salah satu pusat pemerintahan di Kabupaten Lombok Utara. Gempa bumi memberi dampak signifikan bagi aspek sosial dan ekonomi. Penelitian bertujuan untuk menilai dampak akibat bencana gempa bumi berdasarkan aspek sosial dan ekonomi di Kecamatan Tanjung Kabupaten Lombok Utara. Penelitian menggunakan metode penelitian kuantitatif dengan teknik analisis deskriptif kuantitatif dan pemetaan untuk menujukkan sebaran spasial daerah kerusakan. Pengumpulan data menggunakan metode observasi, wawancara, kuesioner, dan telaah dokumen. Jumlah sampel penelitian sebanyak 100 reponden dengan nilai error 10% dengan teknik Proportionate Sampling yang disebar ke tujuh desa di Kecamatan Tanjung. Penelitian menunjukkan bahwa terdapat perubahan signifikan kondisi sosial ekonomi masyarakat sebelum dan setelah gempa bumi di Kecamatan Tanjung. Desa Jenggala menjadi desa dengan perubahan sosial ekonomi tertinggi atau paling rentan terdahap bencana gempa bumi. Perubahan sosial ekonomi diakibatkan oleh tingginya tingkat ancaman di desa tersebut. Selain itu, juga disebabkan oleh kerusakan infrastruktur, lamanya proses evakuasi, banyaknya korban, perubahan fisik lingkungan, serta karakteristik sosial ekonomi penduduk. Penelitian ini dapat menjadi acuan pemerintah daerah dalam menentukan upaya mitigasi terhadap bencana gempa bumi di Kecamatan Tanjung Kabupaten Lombok Utara.
Conceptual Design of COD-E Humanoid Robots
Authors: Anwar Rusmadiah , Vermol Verly Veto , Kamaruzaman Muhamad Fairus
Published: January 2021

The conceptualizing process plays an important role in assisting designers’ creativity in form and styling development. It contributes to representing the cultural elements before product transformation, which has a limited investigation. This research aims to identify the metaphorical form element that conveys the brain impaired as factors of selection and defining form development of the humanoid robot embodiment. Design Protocol Analysis obtains to into design linguistic interpretations and synthesizing design based on perceptual product experience. Findings have outlined the theory of metaphorical form element selection and identification that could represent brain impaired product in assisting humanoid robotic acceptance among autism.
Keywords: Design-Inspire; Humanoid Robot; Children with Autism; Design Protocol Analysis.
eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bsby e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v5iSI3.2534
Design Feature of Local Traditional Pelangi Cloth
Authors: Samin Mohd Azhar
Published: January 2021

This paper is a discussion on how the design features of local traditional Pelangi cloth. The investigation is to determine the characteristic of the cloth that was designed. Most of this kind of textile artefacts were sustained and preserved at a few local museums. This study established the selected Pelangi cloths from several examples so that the analysis was conducted. The design illustrated certain similarity from the other type of local traditional cloth. Most of the design features were mainly derived from local elements. The combination of the designs significantly represented the identity of local traditional Pelangi cloth for this country.
Keywords: Design; Feature; Local Pelangi Cloth; Motifs
eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v5iSI3.2535
Design Focus Group as a Controlled-Experiment Setting
Authors: P. Toyong Natrina Mariane , Zainal Abidin Shahriman , Mokhtar S’harin , Anwar Rusmadiah
Published: January 2021

This paper argues the flexibility of focus group in Design research as a controlled-experiment setting to study Designerly Intuition at concept-stage decision making. This paper outlines the focus group design in terms of the types and structure considerations and the moderator factor. Finally, the focus-group result gathers dual-mode input from novice Industrial Designers (1) 'as a group' and the intuitive attributes as (2) ‘individual participants’. Therefore, the focus group design for the data collection setting is established through the research layout and space design that accommodates both modes of inquiry.
Keywords: Focus Group Study, Design Intuition, Design Research, Controlled Experiment
eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bsby e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
DOI: https://doi.org/10.21834/ebpj.v5iSI3.2536
Investigating the Food and Drug Administration Biotherapeutics Review and Approval Process: Narrative Review
Authors: Bonet Olivencia Samuel , Sasangohar Farzan
Published: January 2021

Background

The development, review, and approval process of therapeutic biological products in the United States presents two primary challenges: time and cost. Advancing a biotherapeutic from concept to market may take an average of 12 years, with costs exceeding US $1 billion, and the product may still fail the US Food and Drug Administration (FDA) approval process. Despite the FDA’s practices to expedite the approval of new therapies, seeking FDA approval remains a long, costly, and risky process.

Objective

The objective of this paper is to explore the factors and gaps related to the FDA review and approval process that contribute to process inefficiencies and complexities as well as proposed methods and solutions to address such gaps. This paper also aims to investigate the available modeling efforts for the FDA approval process of therapeutic biological products.

Methods

A narrative review of literature was conducted to understand the scope of published knowledge about challenges, opportunities, and specific methods to address the factors and gaps related to the review and approval of new drugs, including therapeutic biological products. Relevant peer-reviewed journal articles, conference proceedings, book chapters, official reports from public policy professional centers, and official reports and guidelines from the FDA were reviewed.

Results

Of the 23 articles identified in this narrative literature review, none modeled the current FDA review and approval process structure to address issues related to the robustness, reliability, and efficiency of its operations from an external point of view. Although several studies summarize the FDA approval process with clarity, in addition to bringing to light the problems and challenges faced by the regulatory agency, only a few attempts have been made to provide solutions for the problems and challenges identified. In addition, although several reform models have been discussed, these models lack the application of scientific methodologies and modeling techniques in understanding FDA as a complex sociotechnical system. Furthermore, tools and methods to assess the efficacy of the models before implementation are largely absent.

Conclusions

The findings suggest the efficacy of model-based systems engineering approaches for identifying opportunities for significant improvements to the FDA review and approval process. Using this holistic approach will serve several investigative purposes: identify influential sources of variability that cause major delays, including individual, team, and organizational decision making; identify the human-system bottlenecks; identify areas of opportunity for design-driven improvements; study the effect of induced changes in the system; and assess the robustness of the structure of the FDA approval process in terms of enforcement and information symmetry.
Mind Your Data: Privacy and Legal Matters in eHealth
Authors: Zegers Catharina M L , Witteveen Annemieke , Schulte Mieke H J , Henrich Julia F , Vermeij Anouk , Klever Brigit , Dekker Andre
Published: January 2021

The health care sector can benefit considerably from developments in digital technology. Consequently, eHealth applications are rapidly increasing in number and sophistication. For successful development and implementation of eHealth, it is paramount to guarantee the privacy and safety of patients and their collected data. At the same time, anonymized data that are collected through eHealth could be used in the development of innovative and personalized diagnostic, prognostic, and treatment tools. To address the needs of researchers, health care providers, and eHealth developers for more information and practical tools to handle privacy and legal matters in eHealth, the Dutch national Digital Society Research Programme organized the “Mind Your Data: Privacy and Legal Matters in eHealth” conference. In this paper, we share the key take home messages from the conference based on the following five tradeoffs: (1) privacy versus independence, (2) informed consent versus convenience, (3) clinical research versus clinical routine data, (4) responsibility and standardization, and (5) privacy versus solidarity.
A Rest Quality Metric Using a Cluster-Based Analysis of Accelerometer Data and Correlation With Digital Medicine Ingestion Data: Algorithm Development
Authors: Heidary Zahra , Cochran Jeffrey M , Peters-Strickland Timothy , Knights Jonathan
Published: January 2021

Background

Adherence to medication regimens and patient rest are two important factors in the well-being of patients with serious mental illness. Both of these behaviors are traditionally difficult to record objectively in unsupervised populations.

Objective

A digital medicine system that provides objective time-stamped medication ingestion records was used by patients with serious mental illness. Accelerometer data from the digital medicine system was used to assess rest quality and thus allow for investigation into correlations between rest and medication ingestion.

Methods

Longest daily rest periods were identified and then evaluated using a k-means clustering algorithm and distance metric to quantify the relative quality of patient rest during these periods. This accelerometer-derived quality-of-rest metric, along with other accepted metrics of rest quality, such as duration and start time of the longest rest periods, was compared to the objective medication ingestion records. Overall medication adherence classification based on rest features was not performed due to a lack of patients with poor adherence in the sample population.

Results

Explorations of the relationship between these rest metrics and ingestion did seem to indicate that patients with poor adherence experienced relatively low quality of rest; however, patients with better adherence did not necessarily exhibit consistent rest quality. This sample did not contain sufficient patients with poor adherence to draw more robust correlations between rest quality and ingestion behavior. The correlation of temporal outliers in these rest metrics with daily outliers in ingestion time was also explored.

Conclusions

This result demonstrates the ability of digital medicine systems to quantify patient rest quality, providing a framework for further work to expand the participant population, compare these rest metrics to gold-standard sleep measurements, and correlate these digital medicine biomarkers with objective medication ingestion data.
Automated Identification of Common Disease-Specific Outcomes for Comparative Effectiveness Research Using ClinicalTrials.gov: Algorithm Development and Validation Study
Authors: Elghafari Anas , Finkelstein Joseph
Published: January 2021

Background

Common disease-specific outcomes are vital for ensuring comparability of clinical trial data and enabling meta analyses and interstudy comparisons. Traditionally, the process of deciding which outcomes should be recommended as common for a particular disease relied on assembling and surveying panels of subject-matter experts. This is usually a time-consuming and laborious process.

Objective

The objectives of this work were to develop and evaluate a generalized pipeline that can automatically identify common outcomes specific to any given disease by finding, downloading, and analyzing data of previous clinical trials relevant to that disease.

Methods

An automated pipeline to interface with ClinicalTrials.gov’s application programming interface and download the relevant trials for the input condition was designed. The primary and secondary outcomes of those trials were parsed and grouped based on text similarity and ranked based on frequency. The quality and usefulness of the pipeline’s output were assessed by comparing the top outcomes identified by it for chronic obstructive pulmonary disease (COPD) to a list of 80 outcomes manually abstracted from the most frequently cited and comprehensive reviews delineating clinical outcomes for COPD.

Results

The common disease-specific outcome pipeline successfully downloaded and processed 3876 studies related to COPD. Manual verification indicated that the pipeline was downloading and processing the same number of trials as were obtained from the self-service ClinicalTrials.gov portal. Evaluating the automatically identified outcomes against the manually abstracted ones showed that the pipeline achieved a recall of 92% and precision of 79%. The precision number indicated that the pipeline was identifying many outcomes that were not covered in the literature reviews. Assessment of those outcomes indicated that they are relevant to COPD and could be considered in future research.

Conclusions

An automated evidence-based pipeline can identify common clinical trial outcomes of comparable breadth and quality as the outcomes identified in comprehensive literature reviews. Moreover, such an approach can highlight relevant outcomes for further consideration.
Rural Residents’ Perspectives on an mHealth or Personalized Health Coaching Intervention: Qualitative Study With Focus Groups and Key Informant Interviews
Authors: Schoenberg Nancy , Dunfee Madeline , Yeager Hannah , Rutledge Matthew , Pfammatter Angela , Spring Bonnie
Published: January 2021

Background

Compared with national averages, rural Appalachians experience extremely elevated rates of premature morbidity and mortality. New opportunities, including approaches incorporating personal technology, may help improve lifestyles and overcome health inequities.

Objective

This study aims to gather perspectives on whether a healthy lifestyle intervention, specifically an app originally designed for urban users, may be feasible and acceptable to rural residents. In addition to a smartphone app, this program—Make Better Choices 2—consists of personalized health coaching, accelerometer use, and financial incentives.

Methods

We convened 4 focus groups and 16 key informant interviews with diverse community stakeholders to assess perspectives on this novel, evidence-based diet and physical activity intervention. Participants were shown a slide presentation and asked open-ended follow-up questions. The focus group and key informant interview sessions were audiotaped, transcribed, and subjected to thematic analysis.

Results

We identified 3 main themes regarding Appalachian residents’ perspectives on this mobile health (mHealth) intervention: personal technology is feasible and desirable; challenges persist in implementing mHealth lifestyle interventions in Appalachian communities; and successful mHealth interventions should include personal connections, local coaches, and educational opportunities. Although viewed as feasible and acceptable overall, lack of healthy lifestyle awareness, habitual behavior, and financial constraints may challenge the success of mHealth lifestyle interventions in Appalachia. Finally, participants described several minor elements that require modification, including expanding the upper age inclusion, providing extra coaching on technology use, emphasizing personal and supportive connections, employing local coaches, and ensuring adequate educational content for the program.

Conclusions

Blending new technologies, health coaching, and other features is not only acceptable but may be essential to reach vulnerable rural residents.
Facebook Ads Manager as a Recruitment Tool for a Health and Safety Survey of Farm Mothers: Pilot Study
Authors: Burke Richard R , Weichelt Bryan P , Namkoong Kang
Published: January 2021

Background

Social media platforms have experienced unprecedented levels of growth and usage over the past decade, with Facebook hosting 2.7 billion active users worldwide, including over 200 million users in the United States. Facebook users have been underutilized and understudied by the academic community as a resource for participant recruitment.

Objective

We performed a pilot study to explore the efficacy and cost-effectiveness of Facebook advertisements for the recruitment of an online agricultural health and safety survey.

Methods

We undertook a 1-week advertising campaign utilizing the integrated, targeted advertising platform of Facebook Ads Manager with a target-spending limit of US $294. We created and posted three advertisements depicting varying levels of agricultural safety adoption leading to a brief survey on farm demographics and safety attitudes. We targeted our advertisements toward farm mothers aged 21-50 years in the United States and determined cost-effectiveness and potential biases. No participant incentive was offered.

Results

We reached 40,024 users and gathered 318 advertisement clicks. Twenty-nine participants consented to the survey with 24 completions. Including personnel costs, the cost per completed survey was US $17.42. Compared to the distribution of female producers in the United States, our advertisements were unexpectedly overrepresented in the eastern United States and were underrepresented in the western United States.

Conclusions

Facebook Ads Manager represents a potentially cost-effective and timely method to recruit participants for online health and safety research when targeting a specific population. However, social media recruitment mirrors traditional recruitment methods in its limitations, exhibiting geographic, response, and self-selection biases that need to be addressed.
Measuring Public Reaction to Violence Against Doctors in China: Interrupted Time Series Analysis of Media Reports
Authors: Yang Qian , Tai-Seale Ming , Liu Stephanie , Shen Yi , Zhang Xiaobin , Xiao Xiaohua , Zhang Kejun
Published: January 2021

Background

Violence against doctors in China is a serious problem that has attracted attention from both domestic and international media.

Objective

This study investigates readers’ responses to media reports on violence against doctors to identify attitudes toward perpetrators and physicians and examine if such trends are influenced by national policies.

Methods

We searched 17 Chinese violence against doctors reports in international media sources from 2011 to 2020. We then tracked back the original reports and web crawled the 19,220 comments in China. To ascertain the possible turning point of public opinion, we searched violence against doctors–related policies from Tsinghua University ipolicy database from 2011 to 2020, and found 19 policies enacted by the Chinese central government aimed at alleviating the intense patient–physician relationship. We then conducted a series of interrupted time series analyses to examine the influence of these policies on public sentiment toward violence against doctors over time.

Results

The interrupted time series analysis (ITSA) showed that the change in public sentiment toward violence against doctors reports was temporally associated with government interventions. The declarations of 10 of the public policies were followed by increases in the proportion of online public opinion in support of doctors (average slope changes of 0.010, P<.05). A decline in the proportion of online public opinion that blamed doctors (average level change of –0.784, P<.05) followed the declaration of 3 policies.

Conclusions

The government’s administrative interventions effectively shaped public opinion but only temporarily. Continued public policy interventions are needed to sustain the reduction of hostility toward medical doctors.
Combining Web-Based Gamification and Physical Nudges With an App (MoveMore) to Promote Walking Breaks and Reduce Sedentary Behavior of Office Workers: Field Study
Authors: Mamede André , Noordzij Gera , Jongerling Joran , Snijders Merlijn , Schop-Etman Astrid , Denktas Semiha
Published: January 2021

Background

Sedentary behavior (SB) and lack of physical activity (PA) have been associated with poorer health outcomes and are increasingly prevalent in individuals working in sedentary occupations such as office jobs. Gamification and nudges have attracted attention as promising strategies to promote changes in health behavior. However, most effectiveness studies thus far lacked active controls, and few studies have tested interventions combining these strategies.

Objective

This study investigates the effectiveness of combining a gamified digital app with physical nudges to increase PA and reduce SB in Dutch office workers.

Methods

Employees in the municipality of Rotterdam (N=298) from two office locations were randomized at the location level to either a 10-week intervention, combining a 5-week gamification phase encompassing a gamified digital app with social support features and a 5-week physical nudges phase, or to an active control (ie, basic digital app with self-monitoring and goal setting). The primary outcome was the daily step count, objectively measured via accelerometers. Secondary outcomes were self-reported PA and SB measured at baseline and at 5, 10, and 14 weeks. Mixed effects models were used to analyze the effects of the intervention on the outcome measures.

Results

A total of 78.5% (234/298) of participants completed the study and provided accelerometer data, whereas 36.9% (110/298) participants completed the self-report measures at 14 weeks. In the gamification phase, step count data were missing for 13.5% (473/3492) of observations in the control and 11.4% (445/3888) in the intervention condition; however, these percentages increased to 39.6% (1154/2910) and 59.6% (1932/3492) at follow-up, respectively. During the gamification phase, intervention participants increased their number of daily steps by 634 (95% CI 154.2-1113.8; P=.01) more than participants in the control group, after controlling for relevant factors. Improvements were not sustained during the physical nudges phase (P=.76) or follow-up (P=.88).

Conclusions

A digital intervention with gamification and social support features significantly increased the step count of office workers compared with an active control. Physical nudges in the workplace were insufficient to promote the maintenance of behavioral changes achieved in the gamification phase. Future research should explore the long-term effectiveness of similar gamified digital interventions.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN) 49129401; https://www.isrctn.com/ISRCTN14881571
Evaluating a Hybrid Web-Based Training Program for Panic Disorder and Agoraphobia: Randomized Controlled Trial
Authors: Ebenfeld Lara , Lehr Dirk , Ebert David Daniel , Kleine Stegemann Stefan , Riper Heleen , Funk Burkhardt , Berking Matthias
Published: January 2021

Background

Previous studies provide evidence for the effectiveness of web-based interventions for panic disorder with and without agoraphobia. Smartphone-based technologies hold significant potential for further enhancing the accessibility and efficacy of such interventions.

Objective

This randomized controlled trial aims to evaluate the efficacy of a guided, hybrid web-based training program based on cognitive behavioral therapy for adults with symptoms of panic disorder.

Methods

Participants (N=92) with total scores in the Panic and Agoraphobia Scale ranging from 9 to 28 were recruited from the general population and allocated either to a hybrid intervention (GET.ON Panic) or to a wait-list control group. The primary outcome was the reduction in panic symptoms, as self-assessed using a web-based version of the Panic and Agoraphobia Scale.

Results

Analysis of covariance-based intention-to-treat analyses revealed a significantly stronger decrease in panic symptoms posttreatment (F=9.77; P=.002; Cohen d=0.66; 95% CI 0.24-1.08) in the intervention group than in the wait-list control group. Comparisons between groups of the follow-up measures at 3 and 6 months yielded even stronger effects (3-month follow-up: F=17.40, P<.001, Cohen d=0.89, 95% CI 0.46-1.31; 6-month follow-up: F=14.63, P<.001, Cohen d=0.81, 95% CI 0.38-1.24).

Conclusions

Hybrid web-based training programs may help reduce the symptoms of panic disorder and hence play an important role in improving health care for patients with this debilitating disorder.

Trial Registration

German Clinical Trial Register DRKS00005223; https://tinyurl.com/f4zt5ran

International Registered Report Identifier (IRRID)

RR2-10.1186/1745-6215-15-427
COVID-19–Related Knowledge and Practices Among Health Care Workers in Saudi Arabia: Cross-sectional Questionnaire Study
Authors: Shaikhain Talal Ahmad , Al-Husayni Faisal Abdulmohsen , Alhejaili Essam Awadh , Al-Harbi Maha Nawaf , Bogari Anas Abdullah , Baghlaf Bayan Abdulaziz , Alzahrani Mohammed Saeed
Published: January 2021

Background

Health care workers are at the front line against COVID-19. The risk of transmission decreases with adequate knowledge of infection prevention methods. However, health care workers reportedly lack a proper attitude and knowledge of different viral outbreaks.

Objective

This study aimed to assess the knowledge and attitude of health care workers in Saudi Arabia toward COVID-19. Assessment of these parameters may help researchers focus on areas that require improvement.

Methods

A cross-sectional questionnaire study was conducted among 563 participants recruited from multiple cities in Saudi Arabia. An online questionnaire was shared via social media applications, which contained questions to health care workers about general information regarding COVID-19 and standard practices.

Results

The mean age of the study population was 30.7 (SD 8) years. Approximately 8.3% (47/563) of the health care workers were isolated as suspected cases of COVID-19, and 0.9% (n=5) were found positive. The majority agreed that social distancing, face masks, and hand washing are effective methods for preventing disease transmission. However, only 63.7% (n=359) knew the correct duration of hand washing. Almost 70% (n=394) strictly adhered to hand hygiene practices, but less than half complied with the practice of wearing a face mask. Significant differences in health care workers' attitudes were observed on the basis of their city of residence, their adherence to COVID-19 practices, and their compliance with the use of a face mask. Among the health care workers, 27.2% (n=153) declared that they will isolate themselves at home and take influenza medication if they experience COVID-19 symptoms.

Conclusions

The majority of health care workers in Saudi Arabia presented acceptable levels of general knowledge on COVID-19, but they lack awareness in some crucial details that may prevent disease spread. Intense courses and competency assessments are highly recommended. Prevention of disease progression is the only option for the time being.
Detection of Bulbar Involvement in Patients With Amyotrophic Lateral Sclerosis by Machine Learning Voice Analysis: Diagnostic Decision Support Development Study
Authors: Tena Alberto , Claria Francec , Solsona Francesc , Meister Einar , Povedano Monica
Published: January 2021

Background

Bulbar involvement is a term used in amyotrophic lateral sclerosis (ALS) that refers to motor neuron impairment in the corticobulbar area of the brainstem, which produces a dysfunction of speech and swallowing. One of the earliest symptoms of bulbar involvement is voice deterioration characterized by grossly defective articulation; extremely slow, laborious speech; marked hypernasality; and severe harshness. Bulbar involvement requires well-timed and carefully coordinated interventions. Therefore, early detection is crucial to improving the quality of life and lengthening the life expectancy of patients with ALS who present with this dysfunction. Recent research efforts have focused on voice analysis to capture bulbar involvement.

Objective

The main objective of this paper was (1) to design a methodology for diagnosing bulbar involvement efficiently through the acoustic parameters of uttered vowels in Spanish, and (2) to demonstrate that the performance of the automated diagnosis of bulbar involvement is superior to human diagnosis.

Methods

The study focused on the extraction of features from the phonatory subsystem—jitter, shimmer, harmonics-to-noise ratio, and pitch—from the utterance of the five Spanish vowels. Then, we used various supervised classification algorithms, preceded by principal component analysis of the features obtained.

Results

To date, support vector machines have performed better (accuracy 95.8%) than the models analyzed in the related work. We also show how the model can improve human diagnosis, which can often misdiagnose bulbar involvement.

Conclusions

The results obtained are very encouraging and demonstrate the efficiency and applicability of the automated model presented in this paper. It may be an appropriate tool to help in the diagnosis of ALS by multidisciplinary clinical teams, in particular to improve the diagnosis of bulbar involvement.