Open Access. Powered by Scholars. Published by Universities.®

Social and Behavioral Sciences Commons

Open Access. Powered by Scholars. Published by Universities.®

Medicine and Health Sciences

Institution
Keyword
Publication Year
Publication
Publication Type
File Type

Articles 6151 - 6180 of 38797

Full-Text Articles in Social and Behavioral Sciences

Analisis Efisiensi Relatif Di Unit Pelaksana Teknis Badan Pengawas Obat Dan Makanan Tahun 2019, Pantri Widyastuti, Atik Nurwahyuni Dec 2021

Analisis Efisiensi Relatif Di Unit Pelaksana Teknis Badan Pengawas Obat Dan Makanan Tahun 2019, Pantri Widyastuti, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

The challenge of drug and food supervision requires the BPOM Technical Implementation Unit (UPT) to work optimally in the midst of limited resources. The analysis of the relative efficiency of the BPOM Technical Implementation Unit in 2019 was carried out with the aim of improving BPOM's planning, budgeting, and strategic policies in an effort to improve performance at each UPT. Calculation of relative efficiency using the DEA (Data Envelopment Analysis) method. This study uses a mixed method with a cross sectional research design. The research sample was 31 UPT BPOM that met the requirements as DMU (Decision Making Unit), 10 …


Estimasi Biaya Dan Evaluasi Program Intervensi Pemberian Pangan Olahan Untuk Keperluan Medis Khusus (Pkmk) Untuk Perbaikan Status Gizi Di Banyumas, Jawa Tengah, Hanifah Hasnur, Febyolla Presilawati Dec 2021

Estimasi Biaya Dan Evaluasi Program Intervensi Pemberian Pangan Olahan Untuk Keperluan Medis Khusus (Pkmk) Untuk Perbaikan Status Gizi Di Banyumas, Jawa Tengah, Hanifah Hasnur, Febyolla Presilawati

Jurnal Ekonomi Kesehatan Indonesia

The Government of Banyumas has implemented an intervention in the Provision of Processed Food for Special Medical Purposes (FSMP) with nutritional supplementation of 1.5 kcal/mL in 2019. However, there is no evaluation has been carried out, both of outcome and the cost of the intervention. So that, it is necessary to provide an initial picture of the resources needed for the formulation of future intervention plans. This study aims to determine the estimated cost required for FSMP intervention and to determine the outcome of the intervention. The economic evaluation was carried out partially by calculating costs from the perspective of …


The Health Status Of Labor Force In East Kalimantan Province: Effect Of Individual Characteristics And Household Conditions, Jaka Eben Heizer Dec 2021

The Health Status Of Labor Force In East Kalimantan Province: Effect Of Individual Characteristics And Household Conditions, Jaka Eben Heizer

Jurnal Ekonomi Kesehatan Indonesia

The aims of this research are first, to explore the factors that are associated with health status. Second, to address the individual characteristics and household conditions that affect the health status of labor force, taking into account the urban-rural differences. This research utilized data from SUSENAS Cor 2018, and employed a cross sectional - multinomial logistic regression analysis method. The dependent variable is the health conditions of the labor force. The findings show that, age and number of household members were significant for both sick and very sick health status in all two type of areas analyzed. In urban and …


Evaluasi Capaian Peta Jalan Jkn Di Provinsi Bengkulu Studi Kasus Sectio Caesarea Tahun 2014 Sampai 2019, Susilo Wulan Dec 2021

Evaluasi Capaian Peta Jalan Jkn Di Provinsi Bengkulu Studi Kasus Sectio Caesarea Tahun 2014 Sampai 2019, Susilo Wulan

Jurnal Ekonomi Kesehatan Indonesia

Bengkulu is one of the provinces in Indonesia where SC rate has increased significantly over the last five years after the implementation of JKN. Previous studies into SC trend in Indonesia indicate that both overutilization and underutilization of SC exist reflected inequality. SC is a public health concern since it absorbs a huge amount of JKN funds and is indicated to contribute to the BPJS deficit. This study evaluates the achievement of the SC case equity target in Bengkulu Province based on the 2014- 2019 JKN roadmap. Combining qualitative and quantitative approaches, analyzing secondary data from the BPJS routine data …


Physicians’ Behavior In Referring National Health Insurance Patients To Hospital, Natalia Natalia Dec 2021

Physicians’ Behavior In Referring National Health Insurance Patients To Hospital, Natalia Natalia

Jurnal Ekonomi Kesehatan Indonesia

Physicians’ decision to refer patients in primary health care is vital in supporting the referral system. The increase of referral cases impacted the claims cost and hospital workload. This study aimed to analyze the physicians’ behavior in referring National Health Insurance (NHI) patients to hospitals. This study employed a qualitative method; 18 informants were selected using purposive sampling and analyzed using content analysis. The data were validated by triangulating method, source, and data. Physicians referred patients when the cases could not be handled; there were indications of severe disease and required further examination. The obstacles in the referral system were …


Patient Perceptions Of Trauma-Focused Telemental Health Services Using The Telehealth Satisfaction Questionnaire (Tsq), Bianca T. Villalobos, Aubrey R. Dueweke, Rosaura Orengo-Aguayo, Regan W. Stewart Dec 2021

Patient Perceptions Of Trauma-Focused Telemental Health Services Using The Telehealth Satisfaction Questionnaire (Tsq), Bianca T. Villalobos, Aubrey R. Dueweke, Rosaura Orengo-Aguayo, Regan W. Stewart

Psychological Science Faculty Publications and Presentations

Telehealth services can address many barriers to traditional office-based mental health services. Few studies have assessed youth and caregiver perceptions of and satisfaction with trauma-focused interventions delivered via telemental health. The current study presents data collected using the Telehealth Satisfaction Questionnaire (TSQ), which was developed to measure child and caregiver satisfaction with services, comfort with the telehealth equipment, and barriers to traditional office-based services. Thirteen clinicians delivered home- and school-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) via videoconferencing on tablets and computers to 60 child patients (71.7% Latinx, 18.3% Black, and 10.0% non-Hispanic White). Patients and caregivers completed the TSQ at …


An Investigation Into Caffeine Consumption And Self-Reported Dependency In The Republic Of Ireland, Gavin Buckley, Ciara Murphy, Nora O'Sullivan, Róisín Spriggs Dec 2021

An Investigation Into Caffeine Consumption And Self-Reported Dependency In The Republic Of Ireland, Gavin Buckley, Ciara Murphy, Nora O'Sullivan, Róisín Spriggs

International Undergraduate Journal of Health Sciences

Objectives: To explore the consumption of caffeine containing beverages by the Irish population and to investigate their self-perceived dependency on such products.

Methodology: An online survey was distributed with national access to Irish adults which was open to responses from 25th February to 7th March 2021 inclusive. A total of 417 responses from participants over 18 years of age were validated and analysed using Microsoft Excel.

Results: Tea was the most commonly consumed caffeinated product among the Irish population, with the majority of respondents stating their consumption began before 10 years old. The majority of respondents did not …


An Investigation Into College Induced Stress & Coping Mechanisms And Its Effect On Mental Health, Gráinne Morgan, Madeleine Quinn, Clíodhna Ní Shúilleabháin Dec 2021

An Investigation Into College Induced Stress & Coping Mechanisms And Its Effect On Mental Health, Gráinne Morgan, Madeleine Quinn, Clíodhna Ní Shúilleabháin

International Undergraduate Journal of Health Sciences

No abstract provided.


An Investigation Into The Prevalence Of Use And Availability Of Information On Contraception For Female Third Level Students Aged 18-24, Barbara Dymet, Jane Hyde, Chloe Madden, Ciara Walsh Dec 2021

An Investigation Into The Prevalence Of Use And Availability Of Information On Contraception For Female Third Level Students Aged 18-24, Barbara Dymet, Jane Hyde, Chloe Madden, Ciara Walsh

International Undergraduate Journal of Health Sciences

Introduction:

The purpose of this investigation was to find out the amount of female students in third level institutions who use contraception as well as their attitude towards the availability of information about female birth control options in these institutions.

Materials and methods:

An online survey was created using Google Docs which was then sent out to undergraduate third level female students over the age of 18. All gathered data was analysed using Microsoft Excel.

Results:

The vast majority of the surveyed population was sexually active and used contraception with the most common form being a combination of the contraceptive …


Technology Of Physical Training Of Students Specializing In Sports Gymnastics, Anvar Kurganovich Eshtaev Dec 2021

Technology Of Physical Training Of Students Specializing In Sports Gymnastics, Anvar Kurganovich Eshtaev

Eurasian Journal of Sport Science

Purpose: To identify the most significant factors affecting the level of physical fitness of students in the course of training sessions of the course “Sports and pedagogical skills”.

Methods: Analysis of educational and methodological literature, pedagogical testing, pedagogical observation, pedagogical experiment, methods of mathematical statistics.

Results: Consist in the following: our proposed program for the development of motor qualities is confirmed by the progressive dynamics of the increase in the indicators of the “school” of movements and physical qualities, the means of preparation used and timely monitoring of the process of “utilization” of basic gymnastics exercises in the qualities studied …


Maintaining A Stable Body Balance During Rotational Movements And Its Influence On The Indicators Of The Throwing Workability Of Wrestlers, Bakhrom Bakhtiyorovich Odilov Dec 2021

Maintaining A Stable Body Balance During Rotational Movements And Its Influence On The Indicators Of The Throwing Workability Of Wrestlers, Bakhrom Bakhtiyorovich Odilov

Eurasian Journal of Sport Science

Purpose: The purpose of this research is to study the influence of vestibulosomatic stability on the efficiency of throwing workability of belt wrestlers, when they perform techniques on the right and on the left.

Methods: The studies used pedagogical tests specially developed and approved by the Belt Wrestling Federation of Uzbekistan. The research was conducted in September 2017 and June 2018 and involved qualified belt wrestlers-students in the weight categories of 61-66 and 67-73 kg, the number of which was distributed to 15 people in each weight category.

Results: Actual level of volume and intensity of dummy throws over the …


Application Of Competitive Intelligence For Insular Territories: Automatic Analysis Of Scientific And Technology Trends To Fight The Negative Effects Of Climate Change, Henri Dou, Pierre Fournie Dec 2021

Application Of Competitive Intelligence For Insular Territories: Automatic Analysis Of Scientific And Technology Trends To Fight The Negative Effects Of Climate Change, Henri Dou, Pierre Fournie

International Journal of Islands Research

Islands are fragile territories because of their geographical position. As a result, climate impacts can have serious consequences, of which some are irreversible. Therefore, it is necessary to allow insular territories to benefit from the latest scientific and technological advances in combating climate effects. The current article shows how to deal with automatic analysis of scientific information on the one hand, but also its applications via patents. We will analyse the latest scientific results as well as their possible applications using patent analysis. We will also focus on experts, laboratories, and leading companies, that are active on the field. The …


The Problem Of Training Loads Rationing Of Young Hockey Players At The Stage Of In-Depth Specialization In Annual Training Cycle, Abdukhamid Abdumannabovich Karimov Dec 2021

The Problem Of Training Loads Rationing Of Young Hockey Players At The Stage Of In-Depth Specialization In Annual Training Cycle, Abdukhamid Abdumannabovich Karimov

Eurasian Journal of Sport Science

Purpose: to ration the training load of young hockey players in the preparatory period based on the programs of hockey clubs.

Methods: The following pedagogical research methods were used to solve the tasks set: analysis of scientific and methodological literature. Generalization of practical experience, which was carried out during the observation of the training sessions of the hockey teams “Binokor” and “Humo”. The documentation related to the planning of the training process of young hockey players in the preparatory period was also studied, after which the means used, the volumes and their ratios were discussed and evaluated with the team …


Ongoing Genocides And The Need For Healing: The Cases Of Native And African Americans, Benjamin P. Bowser, Carl O. Word, Kate Shaw Dec 2021

Ongoing Genocides And The Need For Healing: The Cases Of Native And African Americans, Benjamin P. Bowser, Carl O. Word, Kate Shaw

Genocide Studies and Prevention: An International Journal

The elimination of Native peoples and the enslavement of Africans in the U.S. more than qualify as acts of historical state sponsored genocide. A feature of both genocides is that they ended as institutional practices but have continued culturally and psychologically. The primary contemporary legacy of these genocides is racism which reinforces historical trauma and grief. Suggestions are made for how healing for Native and African Americans can begin despite ongoing racism. This includes psychological counseling for White Americans with beliefs in White supremacy. Suggestions are also made for how reconciliation can begin at the county-level between descendants of slave …


Measuring The Quality Of Postgraduate Physician Assistant Fellowship/Residency Programs With A Surgical Focus, Lesley Davies, Jacqueline Guarino, Caitlin Justus, Cassandra Mueller Pa-C, Ryan Krasnosky, Jordan Rodriguez, Angelo P. Giardino Dec 2021

Measuring The Quality Of Postgraduate Physician Assistant Fellowship/Residency Programs With A Surgical Focus, Lesley Davies, Jacqueline Guarino, Caitlin Justus, Cassandra Mueller Pa-C, Ryan Krasnosky, Jordan Rodriguez, Angelo P. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction

Postgraduate programs for PAs provide formal postgraduate training for clinical specialty areas. These programs are intended to provide intense specialty training in various fields, as well as to standardize education beyond the entry level. The purpose of this descriptive study was to determine if there are consistent trends or clear differences in program length, approach to training, validation of learning, and accreditation through the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) for postgraduate programs with a surgical focus in the United States.

Methods

This study is a non-experimental and descriptive research design. Program directors were mailed …


Health Care Capacity Surge Strategies, Jennifer L. Wenhold Dec 2021

Health Care Capacity Surge Strategies, Jennifer L. Wenhold

Florida Public Health Review

While streamlining emergency powers might offer some advantages, recent events demonstrate how Florida’s Department of Health worked collaboratively to address the Novel Coronavirus Disease 2019 (COVID-19) pandemic. As Florida began experiencing a need for increased health care capacity, Division of Medical Quality Assurance (MQA) officials reviewed health care practitioners’ licensing and regulatory framework to identify mitigation strategies to boost staffing of front-line responders where needed. Florida officials responded quickly to the spread of COVID-19 and adopted health care workforce strategies that were grouped into three categories: (1) those involving licensed practitioners, (2) those involving soon-to-be licensed practitioners, and (3) those …


A Note From The Co-Editors, Jada C. Johnson Dec 2021

A Note From The Co-Editors, Jada C. Johnson

Ideas: Exhibit Catalog for the Honors College Visiting Scholars Series

An introduction to the second issue of the third volume of Ideas Magazine, concerning the research and work of M. Adam Howard.


2021 - The Second Annual Fall Symposium Of Student Scholars Dec 2021

2021 - The Second Annual Fall Symposium Of Student Scholars

Symposium of Student Scholars Program Books

The full program book from the Fall 2021 Symposium of Student Scholars, held on November 18, 2021. Includes abstracts from the presentations and posters.


Dear Maliha,, Na-Eela Djemil Dec 2021

Dear Maliha,, Na-Eela Djemil

Capstones

Dear Maliha is a short documentary film exploring the complexities of spiritual abuse through Maliha Fairooz. Spiritual abuse is a form of abuse that uses spiritual or religious beliefs to control or manipulate others. In some cases, spiritual abuse can be used to describe a religious leader who abuses their platform. But in Maliha’s story, we explore the concept of parental spiritual abuse. However, we learn more about this through Maliha Fairooz and the creative use of her journal.

For Maliha journaling is a form of therapy she uses to process her feelings and days. She also uses it as …


Reducing Opioid Related Deaths And Improving Rehabilitation Access Through The Elk Grove Village Cares Program: A Program Evaluation, Rebecca Barron Dec 2021

Reducing Opioid Related Deaths And Improving Rehabilitation Access Through The Elk Grove Village Cares Program: A Program Evaluation, Rebecca Barron

Doctor of Nursing Practice (DNP) Manuscripts

Abstract The goal of the Elk Grove Village Cares program is to decrease the deaths and overdoses of those who abuse opioids through harm reduction strategies and provide access to treatment. The article is a program evaluation of the Elk Grove Village Cares program. Surveys, interviews and the synthesis of program data is used to evaluate the efficacy of program activities. Results: The rate of death from opioid use has decreased an average of 1.7 deaths since program implementation in 2018. Law enforcement officers (LEO) and the community responded similarly to many survey questions regarding attitudes surrounding addiction. Within the …


Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji Dec 2021

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …


The Necessity Of Implementing A Wellness Curriculum Into Physician Assistant Programs, Jessica K. Erim, Darryl Bines Jr. Dec 2021

The Necessity Of Implementing A Wellness Curriculum Into Physician Assistant Programs, Jessica K. Erim, Darryl Bines Jr.

Physician Assistant Capstones, 2020-current

Purpose: In response to the decline of mental health and wellness of students within medical school programs, recent research has been exploring the effects of implementation of wellness curriculums. The purpose of this review is to highlight the research that has been conducted in the medical school environment and to establish the need for further research. This review will specifically discuss the implementation of a student-led wellness curriculum at James Madison University’s Physician Assistant Program and its impact on students. Methods: A thorough search was conducted using Google Scholar using specific inclusion and exclusion criteria (see Table 1). …


Factors Associated With Omani’S Schoolteachers’ Reporting Behavior Of Suspected Cases Of Child Abuse And Neglect, Zeinab N. Alazri Dec 2021

Factors Associated With Omani’S Schoolteachers’ Reporting Behavior Of Suspected Cases Of Child Abuse And Neglect, Zeinab N. Alazri

Theses & Dissertations

Child abuse and neglect is a global problem that can result in severe negative consequences for victims and their societies. Numerous initiatives have been launched by the United Nations Children's Fund (UNICEF) to combat this problem. Recently, Sultanate Oman, an Arab country, has mandated schoolteachers to report suspected abuse and neglect cases to comply with UNICEF's recommendations. As schoolteachers spend a great deal of their time with children, they are in a good position to recognize and report suspected abuse and neglect cases so the victims can get the needed help and treatment. There is a dearth of information about …


A Call To Create: Poetry As Healing And One Nurse’S Self-Discovery, Kim Cornett Henry, Kim Cornett Henry Dec 2021

A Call To Create: Poetry As Healing And One Nurse’S Self-Discovery, Kim Cornett Henry, Kim Cornett Henry

English Theses

Florence Nightingale’s vision for nursing has changed greatly in the past one hundred and fifty years, with nursing’s identity replaced with an emphasis on science over caring. The fast-paced, technologically sophisticated environments, designed to meet the declining health of an American public, have resulted in nurses who are being pulled away from nurse-to-patient caring acts and the reasons they felt called to become nurses. These changes have had detrimental psychological and emotional effects on nurses and are especially evident in Intensive Care nurses. Expressive writing as poetry, autoethnography, and participation in vibrant writing communities offer nurses experiences for healing, voice, …


Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown Dec 2021

Intention To Breastfeed: Breastfeeding Attitudes, Norms, Self-Efficacy, Social Support Network And Community Resources Of African American, Low-Income, Emerging Adult Women, Pregnant For The First Time, Sara E. Brown

Theses & Dissertations

African American (AA) women continue to have the lowest rates of breastfeeding. This continues to create a health disparity even though breastfeeding is extensively recognized in the scientific and health care communities as the optimal feeding choice for infants. This study examined the relationship between the external variables (social support network and community resources) and the explanatory variables (attitudes, norms, and perceived self-efficacy) and intention to breastfeed, for the AA, first time, low-income, emerging adult pregnant woman. The Integrated Behavior Model (IBM) was used as the theoretical framework to guide this study in better understanding the variables influencing breastfeeding intention. …


Improving Developing Countries’ Health Information Systems Capacity For Infectious Disease Pandemic Responses: A Case Study Of The Ebola Virus Disease And The Coronavirus Disease Pandemics, Uche Ikenyei Dec 2021

Improving Developing Countries’ Health Information Systems Capacity For Infectious Disease Pandemic Responses: A Case Study Of The Ebola Virus Disease And The Coronavirus Disease Pandemics, Uche Ikenyei

Electronic Thesis and Dissertation Repository

There is increasing evidence to demonstrate that current information system theoretical models meant to assess the success of the health information systems (HIS) lack the applicable theoretical underpinning suitable for developing countries. This stems partly from a theory-evidence gap where theoretical models developed in the West are applied in developing country contexts but lack tailoring to localized, contextual realities. Therefore, this study addresses this gap by enhancing the DeLeon and McLean's information system success model with six contextual factors peculiar to the infectious disease HISs in a developing country context.

This study took place in two developing countries, Liberia and …


The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe Dec 2021

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …


The Importance Of Studying The Social Portrait Of A Modern Manager For The Formation Of A Methodology For Preparing Future Specialists For Managerial Activities In The Field Of Physical Culture And Sports, Azizbek Ulugbekovich Rashidov Dec 2021

The Importance Of Studying The Social Portrait Of A Modern Manager For The Formation Of A Methodology For Preparing Future Specialists For Managerial Activities In The Field Of Physical Culture And Sports, Azizbek Ulugbekovich Rashidov

Eurasian Journal of Sport Science

Purpose: It consists in studying the social portrait of a modern manager in order to form a methodology for preparing future specialists for managerial activities in the field of physical culture and sports. It is necessary to identify the modern demands of society to managers in the field of physical culture and sports, for the subsequent formation of appropriate qualities in future specialists.

Methods: In the course of the research, the following methods were used: pedagogical observation, the method of sociological research (questionnaire), methods of mathematical statistics. The survey was conducted in an online format, after which the data of …


University Of Maine Athletics_University Of Maine System Updates Indoor Gathering Attendance Requirements For Children Email, University Of Maine Athletics Dec 2021

University Of Maine Athletics_University Of Maine System Updates Indoor Gathering Attendance Requirements For Children Email, University Of Maine Athletics

Athletics Department

UMaine Athletic News email regarding the fact that starting Jan. 4, 2022 the University of Maine System required anyone five years of age or older attending an indoor event with more than 250 people to be vaccinated against COVID-19 or receive a negative test within 72 hours of the gathering. Proof of vaccination or a negative test was also needed.


Does Digital Literacy Empower Adolescent Girls In Low- And Middle-Income Countries: A Systematic Review, Salima Meherali, Komal Abdul Rahim, Sandra Campbell, Zohra S. Lassi Dec 2021

Does Digital Literacy Empower Adolescent Girls In Low- And Middle-Income Countries: A Systematic Review, Salima Meherali, Komal Abdul Rahim, Sandra Campbell, Zohra S. Lassi

School of Nursing & Midwifery

Background: The vast majority (90%) of the world's adolescents aged 10-19 live in low- and middle-income countries (LMICs); and in those resource-limited settings, girls face distinct challenges across multiple health, social, and economic domains. Gender equality and girls' empowerment are key goals in their own right and are central to all other development goals. Digital literacy is a great enabler for the empowerment of young girls. This systematic review aims to assess the range and nature of digital literacy interventions implemented to empower adolescent girls in LMICs and identify evidence about adolescent girls' access and use of digital technologies in …