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The institutional conditions of primary care provision remain understudied in low- and middle-income countries. This study analyzes how primary care doctors cope with medical uncertainty in municipal clinics in urban India. As street-level bureaucrats, the municipal doctors occupy two roles simultaneously: medical professional and state agent. They operate under conditions that characterize health systems in low-resource contexts globally: inadequate state investment, weak regulation and low societal trust. The study investigates how, in these conditions, the doctors respond to clinical risk, specifically related to noncommunicable diseases (NCDs).

The analysis draws on year-long ethnographic fieldwork in Pune (2013–14), a city of three million, including 30 semi-structured interviews with municipal doctors.

Interpreting their municipal mandate to exclude NCDs and reasoning their medical expertise as insufficient to treat NCDs, the doctors routinely referred NCD cases. They expressed concerns about violence from patients, negative media attention and unsupportive municipal authorities should anything go wrong clinically.

The study contextualizes street-level service-delivery in weak institutional conditions. Whereas street-level workers may commonly standardize practices to reduce workload, here the doctors routinized NCD care to avoid the sociopolitical consequences of clinical uncertainty. Modalities of the welfare state and medical care in India – manifest in weak municipal capacity and healthcare regulation – appear to compel restraint in service-delivery. The analysis highlights how norms and social relations may shape primary care provision and quality.

This conceptual article presents a schematic of rat maternal behavior and niche stress epigenetic effects as a case study that is then aligned with current evolutionary concepts, which raises new questions regarding immigrant assimilation and niche dynamics.

The necessary background material for rat maternal and niche(s) stress factors are incorporated into a recursive, test-operate-test (rTOT), information-only-transfer, schematic (Patterson, 2023), which is an extension and refinement of the test-operate-test-exit (TOTE) schematic of Miller et al. (1960).

The generated epigenetic rTOT demonstrates the fundamental evolutionary unit of the flexible organism within its niche(s). The rTOT also confirms that epigenetic processes, epigenetic inheritance and phenotype plasticity are significant conceptual tools for understanding evolution. The teleology of rat adaptations for niche fitness via maternal behavior has been demonstrated. Sterling's (2011) allostasis, or predictive homeostasis, is extended to include species-niche(s) interaction(s) that are governed by recursive information feedback loops that function via self-organized criticality (SOC) for species and niche(s). Use of a rat model for biosocial issues in humans is strengthened.

Epigenetic rTOT only covers the species side of the evolutionary unit. Niche(s) require(s) a separate rTOT schematic. The information modeled does not include the entire system producing epigenetic effects but models a substantial portion of it.

Epigenetic rTOT demonstrates the utility of phenotypic plasticity, epigenetics and epigenetic inheritance as explanations for inheritable behavior patterns. rTOT is a useful computational model for evolutionary issues. The issues involved in niche modeling using an rTOT schematic are briefly reviewed.

When the demonstrated epigenetic model of rat genetics and inherited behavior are applied to the issues of immigrant enclaves, epigenetic complications for the difficulties of assimilation into the culture within which the enclaves are embedded become apparent. However, the questions raised must be addressed with extreme care to avoid cultural imperialism. Such cultural issues must be modeled with an rTOT application that covers the materials involved. The limitations of human Learning III restrictions when attempting to model Learning IV issues are addressed. Research into the means by which abuse and trauma are maintained by epigenetic means is urgently needed.

The rTOT schematic visualizes rat maternal behavior and stress epigenetic effects that produce inheritable behavior patterns, which answers Jablonka's (2017) request for new computational modeling representations. The concept of allostasis, or predictive homeostasis, (Sterling, 2011) is extended to the niche(s) of the organism under study so that allostasis becomes a fully cybernetic concept governed by SOC for both the organism and its niche(s). This new case study confirmed evolutionary effects of epigenetics, epigenetic inheritance and phenotypic plasticity. Niche control of organism evolution is presented. Epigenetic applications for immigrant assimilation issues have been suggested and niche dynamic questions have been raised.

The purpose of this study is to stabilize the rotating speed of the permanent magnet direct current (PMDC) motor driven by a DC-DC boost converter under mismatched disturbances (i.e.) under varying load circumstances like constant, frictional, fan type, propeller and undefined torques.

This manuscript proposes a higher order sliding mode control to elevate the dynamic behavior of the speed controller and the robustness of the PMDC motor. A second order classical sliding surface and proportional-integral-derivative sliding surface (PIDSS) are designed and compared.

For the boost converter with PMDC motor, both simulation and experimentation are exploited. The prototype is built for an 18 W PMDC motor with field programmable gate arrays. The suggested sliding mode with second order improves the robustness of the arrangement under disturbances with a wide range of control. Both the simulation and experimental setup shows satisfactory results.

According to software-generated mathematical design and experimental findings, PIDSS exhibits excellent performance with respect to settling speed, steady-state error and peak overshoot.

The widespread uptake of digital technology tools for online teaching and learning reached its peak during the nationwide lockdown triggered by the COVID-19 pandemic. It transformed the higher education institutions (HEIs) marketplace both in developed and developing countries. However, in this process of digital transformation, several HEIs, specifically from developing countries, faced major challenges. That threatened to affect their sustainability and performance. In this vein, this study conducts a bibliometric review to map the challenges during the COVID-19 pandemic and suggest strategies for HEIs to cope with post-pandemic situations in the future.

This comprehensive review encompasses 343 papers published between 2020 and 2023, employing a systematic approach that combines bibliometrics and content analysis to thoroughly evaluate the articles.

The investigation revealed a lack of published work addressing the specific challenges faced by the faculty members affecting their well-being. The study underscores the importance of e-learning technology adoption for higher education sustainability by compelling both students and teachers to rely heavily on social media platforms to maintain social presence and facilitate remote learning. The reduced interpersonal interaction during the pandemic has had negative consequences for academic engagement and professional advancement for both educators and students.

This has implications for policymakers and the management of HEIs, as it may prove useful in reenvisioning and redesigning future curricula. The paper concludes by developing a sustainable learning framework using a blended approach. Additionally, we also provide directions for future research to scholars.

This study has implications for policymakers and HEI management to rethink the delivery of future courses with a focus on education and institute sustainability. Finally, the research also proposes a hybrid learning framework for sustainability and forms a robust foundation for scholars in future research.

This study aims to make the case for real-time rights-based recordkeeping governance as a new foundation for the regulation and systemisation of multiple rights in recordkeeping for the Alternative Care of children and young people.

This article aims to make the case for real-time rights-based recordkeeping governance as a new foundation for the regulation and systemisation of multiple rights in recordkeeping for the Alternative Care of children and young people. It investigates this concept using the Australian context as a critical case study to highlight some of the current limitations in Australian Alternative Care systems in the way recordkeeping rights are represented in existing regulatory frameworks and monitored in practice. This paper will argue for the need for systemic transformations in child protection and information legislation and regulatory systems to better represent and enact alternative care recordkeeping rights.

This analysis of the legislative provisions for participation in recordkeeping and access to records of Care experiences against the Australian Charter of Lifelong Rights in Childhood Recordkeeping in Out-of-Home Care reveals a number of limitations. While the direct provision of rights to access records and the strengthening of principles of participation in some of the jurisdictions are welcome, it illustrates how the risk-oriented focus of the legislation on child protection investigations and substantiations encodes opaque recordkeeping practices and works against the provision of the full suite of childhood recordkeeping rights envisaged by the charter. Furthermore, without provisions for systemic and dynamic oversight, those with Care experiences are left to pursue individual outcomes against significant bureaucratic odds.

In line with international recognition that active participation and proactive provision of rights are a protective factor, this article contends that governance frameworks need to be proactively designed to respect and enact recordkeeping rights, along with requiring mechanisms for real-time monitoring and oversight if the records problems of the past are not to be perpetuated.

The study’s proposal for the need for a real-time, rights-based recordkeeping governance seeks to address the systemic recordkeeping problems that have been identified in research and public inquiry related to Alternative Care systems in Australia as well as in the UK.

Adopting a governance model that prioritises real-time, rights-based principles will ultimately impact how the Alternative Care system approaches records and their value in the processes of care.

Placing real-time rights-based governance at the foundation of a reimagining of the Alternative Care recordkeeping model offers the potential to create a system that places rights in recordkeeping and ethics of care at its core. This has highly transformative potential for the overall Alternative Care system and its relationship with children in out-of-home care.

This study aims to analyze the way Indonesian and the US laws regulate the reality and implications of legal issues regarding telemedicine, including the protection of citizens in using telemedicine.

This normative legal study used secondary data comprising primary and secondary legal materials based on the law as a norm. The normative legal method was used because the data were based on laws and regulations, reports, journals and research governing telemedicine in Indonesia and the USA.

The results showed similarities between Indonesia and the USA regarding health services as part of protecting human rights. The differences in implementing telemedicine are from a legal aspect. The legal comparison of telemedicine implementation between the two countries resulted in differences in regulation, informed consent, medical records, practice licenses and medical prescriptions.

This study discussed telemedicine’s legal aspects in Indonesia and the USA.

This study aimed to determine the implementation and guidelines used by the USA to be considered for adoption by Indonesia for legal certainty.

The results showed that legal threats could be a weakness of law in Indonesia. Therefore, the government should develop guidelines about telemedicine to accommodate citizens’ legal protection and certainty.

This study is original and could be used as a reference for policymakers in Indonesia and the USA in protecting citizens using telemedicine services. The findings provide a perspective based on Health Law in Indonesia.

Regarding how the public regulation of human services is perceived within welfare organizations and how the latter cope with it, the role of emotions (as mediators between structure and agency) proves highly relevant while often being hidden beneath the surface. This article shows how a specific approach to such regulation – here: managerialism – may impact on “emotional regimes” at the organizational and individual level, affecting the attainment of organizational goals and workers' health.

The article primarily draws on multiple qualitative case studies across two welfare sectors (four organizations) in Germany (continuing education/active inclusion; long-term care). The study research was conducted between 2020 and 2022 and based on 36 interviews with caseworkers and managers, focus group interviews and expert dialogues at industry level.

The results suggest that the managerialist regulation of welfare services breeds complex and ambiguous emotional regimes. Business-like management techniques elicit various emotions, affecting the motivational basis of human service work. While the experience of hard challenges may raise positive feelings, coping patterns often put strain on organizations and staff alike. In the short run, related emotional regimes tend to make service delivery proceed smoothly, yet in the long run they may have corrosive effects and problematic repercussions on macro-level developments.

The study highlights the role of emotions in publicly regulated human service settings by intermingling macro- and micro-level processes and thereby broadens the perspective of welfare state research as it reveals the impact of (managerialist) regulation on the dynamic organizational chemistry of such settings.

This study aims to analyse in the health access of Indonesian illegal migrant workers in Malaysia, during which time they were not covered by Indonesia’s national social health insurance.

This study adopted a sociolegal approach, the research approach is conducted to understand the effect of a law, policy and regulation on access to health-care access among Indonesian migrant workers working illegally in Malaysia. This research involved 110 respondents who work illegally in Malaysia. The research explored the perceptions of respondents concerning to health access services of illegal migrant workers.

The study demonstrated the weakness of provisions intended to guarantee the health access to health care of migrant workers from Indonesia illegally working in Malaysia. A decline in health status was observed, but it was not significant. Bilateral cooperation between Indonesia and Malaysia is necessary to provide a framework for Indonesia providing health care to its citizens working in Malaysia, regardless of their legal status.

This paper concerns on the Indonesia illegal migrant workers experiencing illness and the access to the health service in Malaysia, and also the implementation of international regulation to protect Indonesian illegal migrant workers in Malaysia under ASEAN Consensus on the Protection and Promotion of the Rights of Migrant Workers.

This study aims to understand the progressive marketization of health data collection and use, through a study of its historical development in France, from the 1930s to the present day.

The authors collected a set of legal, institutional, political and media data. These came from the INA (National Audiovisual Institute), the French national newspaper websites and the websites legifrance.gouv.fr and vie-publique.fr. The authors then conducted a thematic content analysis.

The study results highlight the changes in the health-care system related to the increased use of data in France over three major periods. The first period – 1930s to 1980s – is marked by the creation of the French social security system to collect large sets of data to better manager people’s health care. The second period – 1980s to 2000s – is characterized by the adoption and assimilation of tools to manage patient data through several national and European regulations. The last period – 2000s to the present – saw the introduction of measures in favor of the digitalization of health care, and consequently of data, in parallel with the advancement of digital technologies in general. The institutional dynamics in healthcare have evolved with the nature of the actors and their practices, in connection with new perceptions about health data.

This research sheds light on the historical transformation of health data collection and use in France, revealing the involvement of diverse stakeholders, the discourses driving data development and the need for regulation. It exposes the dual nature of health data collection and use, initially sanctioned by the state and public entities but later exploited for private interests.

This paper aims to identify the reasons why cases of leakage of patient personal data often occur in the health sector. This paper also analyzes personal data protection regulations in the health sector from a comparative legal perspective between Indonesia, Singapore and the European Union (EU).

This type of research is legal research. The research approach used is the statute approach and conceptual approach. The focus of this study in this research is Indonesia with a comparative study in Singapore and the EU.

Cases of leakage of patient personal data in Indonesia often occur. In 2021, the data for 230,000 COVID-19 patients was leaked and sold on the Rapid Forums dark web forum. A patient’s personal data is a human right that must be protected. Compared to Singapore and the EU, Indonesia is a country that does not yet have a law on the protection of personal data. This condition causes cases of leakage of patients’ personal data to occur frequently.

This study analyzes the regulation and protection of patients’ personal data in Indonesia, Singapore and the EU to construct a regulatory design for the protection of patients’ personal data.

The results of this study are useful for constructing regulations governing the protection of patients’ personal data. The regulation is to protect the patient’s personal data like a patient’s human right.

The ideal regulatory design can prevent data breaches. Based on the results of comparative studies, in Singapore and the EU, cases of personal data leakage are rare because they have a regulatory framework regarding the protection of patients’ personal data.

Legal strategies that can be taken to prevent and overcome patient data breaches include the establishment of an Act on Personal Data Protection; the Personal Data Protection Commission; and management of patients’ personal data.