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This paper presents an analysis of Isolde Amante’s Eve, a 21st century Philippine fiction to reveal a contemporary worldview of motherhood. Despite the success of feminist movements in society, motherhood remains fraught with romantic ideals that stem from the essentialist notions of gender and sex. This results in ‘othering’--oppressing and alienating women in the 21st century. The paper argued that the entire notion of motherhood has entered a postmodern framing—one that challenges traditional notions of motherhood and mothering. To characterize this worldview, the paper used the theories of cognitive stylistics, such as conceptual metaphor theory, to describe the mind style of the text’s focalizer, the narrator in Eve. This theory granted access to the intricate mental processes which helped explain why a character behaves a certain why, what dispositions s/he hold in life, as well as what motivations form his/her thoughts, language and action. Further, the mind style is drawn from the communicative force that make up the ‘maternal discourse’ in the text, using Searle’s Speech Act theory. The result is an unorthodox but liberating view of motherhood and mothering. The study argues the need to mainstream mind style analysis in 21st century fiction literary analysis to discover evolving and liberating ideals related to the constructions of gender, and in particular, motherhood.

With the sudden transition to online instruction in most educational institutions caused by the COVID-19 pandemic, it can be assumed that there is paucity in research as regards the teaching of writing online during this crisis moment. To address this niche, 13 Filipino university English language teachers were asked to participate in both online semi-structured and follow-up email interviews to describe their experiences in teaching writing online during the pandemic, particularly the challenges they faced, their coping strategies to address these challenges, and the opportunities in online teaching they valued. The interview responses revealed three major challenges in teaching writing online: technological concerns and equity issues, vague response of schools to emergency remote teaching, and problems in assessment. Three key strategies to cope with these challenges were found: flexibility in communicating with students and in accommodating their concerns, initiatives for professional development, and gaining support from colleagues and students. Despite the challenges of online instruction, two opportunities for development in online writing instruction were identified: optimizing the use of online-teaching platforms and resources, and enhancing one's reflective practice. Implications for teaching writing online in particular and for online learning and teacher education in general are discussed in the paper.

Pedagogical content knowledge (PCK) in language teaching has received attention from educators and researchers alike from the late 1900s until the present. While this pedagogical framework has been employed and reconceptualized in hundreds of published studies, it has been a challenge to concretize PCK for specific subject matters such as language teaching. Drawing explicit PCK principles from language teacher educator (LTE) perspectives and practices is a practicable attempt to capture a contextualized PCK in language teacher preparation. Thus, this study explored PCK through developing lesson exemplars that are informed by LTEs perceived effective instructional practices in the teaching methodology courses. The practitioner-driven inquiry is situated in a Philippine teacher education institution particularly in the preservice English teacher education program. Open-ended questionnaires, classroom observations, and focus group discussions were used to survey and examine LTEs instructional practices in teaching methods courses. Coding of discussion annotations, observation notes, and questionnaire responses identified the following perceived effective practices: (1) providing support through modeling, preparatory tasks, and input on critical issues in teaching methodology; (2) promoting collaboration through activities and assessment tasks; (3) employing experiential learning through demonstration teaching; and (4) fostering creativity through innovative strategies in lesson planning. The identified practices informed a ten-component lesson exemplar for teaching PCK. These lesson components included: setting up the context, identifying objectives, highlighting the PCK focus, modeling the concept, conducting the workshop, evaluating the teaching methodology, reflecting on implications to language teaching practice, synthesizing learning, and reflecting on current issues and practices. [ABSTRACT FROM AUTHOR]

This research analyzes the role of green accounting and carbon emission disclosure in determining firm value. The population in the study consisted of companies that participated in the Company Performance Assessment Program in Environmental Management (PROPER) organized by the Ministry of Environment and Forestry (KLHK) during the 2020-2023 period. This research uses a purposive sampling technique in determining the sample with a sample size of 20 companies each year and is processed with the help of SPSS 25. This research uses multiple linear regression analysis to test the effect of green accounting and carbon emission disclosure on firm value. The research results indicate that green accounting significantly impacts firm value, and foreign ownership as a moderating variable strengthens the substantial and positive relationship between green accounting and firm value. Meanwhile, the carbon emission disclosure variable indicates that the results are insignificant to firm value.

Wildlife trade, both legal and illegal, is increasingly recognized as a key factor in the rise of emerging viral infectious diseases, and this is especially apparent in Asia, where large numbers of wildlife are openly offered for sale in bird markets. We here focus on the risk of Psittacosis becoming a zoonotic disease in the wildlife markets of Java and Bali, Indonesia. Psittacosis is particularly prevalent in parrots (hence the name), and the trade in parrots was instrumental in the Great Parrot Fever Pandemic in 1929/1930. Between 2014 and 2023, we conducted 176 surveys of 14 bird markets, during which we recorded 4446 largely wild-caught parrots for sale. On average, each market had nine genera on offer, and the diversity of genera increased with the increasing presence of parrots (up to 16 genera). For most of the bird markets during each survey, parrots from different genera and originating from different parts of the world, were offered for sale alongside each other. Genera offered for sale together did not cluster into natural (geographic) groups. We found no temporal difference in the sale of parrots. We conclude that the omnipresence of wild-caught parrots from various geographic regions in large numbers within the same bird markets increases the risk that psittacosis is present and that this poses a real risk for the zoonotic spread of avian chlamydiosis to humans.

ABSTRACT Insecticides are used to reduce the number of Aedes aegypti mosquitoes, a vector of the dengue virus that causes dengue hemorrhagic fever in Indonesia, including in Bali. However, in recent years, the resistance of the Ae. aegypti mosquito to insecticides has been reported in Bali. In addition, Ae. aegypti is also identified to be resistant to several types of insecticides whose resistance mechanism is not yet clear. Several studies have stated that the KDR genes are one of the causes of resistance to pyrethroid insecticides. Therefore, a study was conducted to determine the frequency of the KDR genes in the Ae. aegypti population in Denpasar, Bali which had been previously shown resistance to permethrin (type of pyrethroid). Forty-three females Ae. aegypti specimens from bioassay testing using permethrin stored in tubes containing 100% ethanol were used in this study. Each mosquito is put in a different tube. The mosquito DNA was then extracted. Three KDR genes, V1016G, V410L, and F1534C, were analyzed using the quantitative-PCR melt curve method at the Biomolecular Laboratory, FKIK Unwar. In this study, the mutation frequency of 1016G was 98%, 410L was 50%, and 1534C was 3.4%. The 410L mutant gene was shared by all specimens, although only in one allele (heterozygous). Of the 43 specimens, 39 had homozygous mutant V1016G, heterozygous V410L, and wild typehomozygous F1534C. It indicated that the frequency of the 1016G and 410L mutant genes is quite high, while the 1534C gene is low. The combination of the KDR 1016G and 410L genes was the most dominant found in permethrin-resistant Ae. aegypti specimens. Therefore, it is assumed that these two KDR genes play a role in forming permethrin resistance in Ae. aegypti. ABSTRAK Insektisida digunakan untuk menurunkan jumlah nyamuk Aedes aegypti yang merupakan vektor virus dengue penyebab penyakit demam berdarah dengue di Indonesia, termasuk di Bali. Namun, dalam beberapa tahun terakhir, resistensi nyamuk Ae. aegypti terhadap insektisida dilaporkan sudah terjadi di Bali. Selain itu, Ae. aegypti juga dilaporkan resisten terhadap beberapa jenis insektisida yang mekanisme terjadinya resistensi belum diketahui. Beberapa penelitian menyebutkan bahwa gen KDR menjadi salah satu penyebab terjadinya mekanisme resistensi terhadap insektisida golongan peritroid. Oleh sebab itu, dilakukan penelitian untuk mengetahui frekuensi gen KDR pada populasi Ae. aegypti di Denpasar, Bali yang sebelumnya telah terbukti memiliki resistensi permetrin (insektisida golongan peritroid). Sebanyak 43 spesimen Ae. aegypti betina hasil dari pengujian bioassay yang tersimpan dalam tabung yang berisi etanol 100% digunakan dalam penelitian ini. Tiap nyamuk dimasukkan dalam tabung yang berbeda. Selanjutnya dilakukan ekstraksi DNA nyamuk. Tiga jenis gen KDR, yaitu V1016G, V410L, and F1534C, dianalisis dengan metode quantitative-PCR melt curve di Laboratorium Biomolekuler FKIK Unwar. Dalam penelitian ini ditemukan frekuensi mutasi 1016G sebesar 98%, 410L 50%, dan 1534C sebesar 3,4%. gen mutan 410L dimiliki oleh seluruh spesimen walaupun hanya pada salah satu alel (heterozigot). Dari 43 spesimen yang diteliti, terdapat 39 spesimen yang memiliki profil genotip V1016G homosigot mutan, V410L heterosigot, dan F1534C homosigot wild type. Sehingga dapat disimpulkan bahwa frekuensi gen mutan 1016G dan 410L cukup tinggi, sedangkan gen 1534C rendah. Kombinasi gen KDR 1016G dan 410L paling dominan ditemukan pada spesimen Ae. aegypti resisten permetrin. Kedua gen KDR diasumsikan berperan dalam pembentukan resistensi permetrin pada Ae. aegypti.

Rural environments in the United States present challenges to wellness, but there is a lack of tools with which to categorize rurality at the subcounty level. The most common tool, the Food and Drug Administration's 2010 Rural-Urban Commuting Area (RUCA) codes, uses data that are over a decade old and cannot accommodate regional differences in rurality. The purpose of this study was to develop a census-tract classification system of rurality and demonstrate its use in describing HIV outcomes. We transformed census-tract measures (population density, natural resource workforce, walkability index, household type, and air quality) into local scales of rurality using factor analysis. We surveyed public health practitioners to determine cutpoints and compared the resulting categorization with RUCA codes. We characterized the incidence of HIV in Washington State according to rurality category. Our classification system categorized 25% of census tracts as rural, 19% as periurban, and 56% as urban. Our survey yielded cutoffs that were more conservative in categorizing urban areas than RUCA codes. The rate of HIV diagnosis was substantially higher in urban areas. Our rural-urban classification system offers an alternative to RUCA codes that is more responsive to regional differences., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: AIDS Drug Assistance Programs (ADAPs) are state-administered programs that pay for medical care and medication for people living with HIV (PLWH) in the United States. In October 2021, the federal policy requiring that clients recertify for the program every 6 months was repealed, giving states the authority to set their own recertification policies. However, little data exist on the costs and health effects of alternative recertification schedules. We assessed the cost of changing the legacy 6-month recertification to a 12-month schedule in Washington State to inform policy decisions on recertification., Methods: We used a Markov model to simulate the population of PLWH in Washington State who are eligible or enrolled in ADAP. We obtained model inputs and validation data from the Washington State Ryan White database. We estimated the cost of 12-month and 6-month criteria over a 5-year time horizon. Model outputs included annual program costs, population sizes, and number of people virally suppressed, by scenario., Results: Under a continuation of the legacy 6-month recertification criteria, the annual cost of Washington ADAP would be $37 663 000 (95% CI, $34 570 000-$41 686 000) during the next 5 years, with a per-client cost of $7966 (95% CI, $7478-$8494). Under 12-month criteria, the annual cost would be $40 217 000 (95% CI, $36 243 000-$44 401 000) and the per-client cost would be $7543 (95% CI, $7084-$8042). Under the 12-month scenario, 245 more people will have been virally suppressed by the end of 2025., Conclusions: Switching to a less frequent recertification process may improve health outcomes at a modest increase in cost in Washington State., Competing Interests: Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: J.C.D. has conducted research with supplies donated from Hologic, Cepheid, and Mayne Pharmaceuticals. C.M.K. has received donations of research supplies from Hologic, Inc. for activities outside of the submitted work.

Adverse childhood experiences (ACEs) have been linked to numerous negative health outcomes in adulthood and have been recognized as a hurdle to participating in HIV care. However, few studies have examined the cumulative impact that different types of childhood trauma have on HIV care engagement and HIV outcomes. This study characterized the relationship between ACEs, viral suppression, and health-related quality of life (HRQOL) among persons living with HIV (PLWH). We used HIV surveillance data and self-reported information on ACEs and HRQOL from PLWH in Washington State from 2018-2020. Logistic regression was used to assess the relationship between the quantity and type of ACEs and viral suppression. We used Poisson regression to examine the relationship between ACEs and HRQOL as measured by unhealthy days. The majority of PLWH experienced ≥1 ACE (86.8%). ACEs were not significantly associated with the likelihood of viral suppression (OR ≥4 vs 0 ACEs: 0.49, 95% CI: 0.12-2.09), but ACEs were associated with more unhealthy days experienced in a 30-day period (RR ≥4 vs 0 ACEs: 3.19, 95% CI: 1.59-6.40). These findings provide support that trauma is common among PLWH, and efforts to address the impact of childhood trauma may work to improve quality of life.

Background: The COVID-19 pandemic disrupted global economic and healthcare systems. People living with HIV (PLWH) represent a marginalized and stigmatized population who may have been particularly impacted. The purpose of this analysis was to describe the impact of the COVID-19 pandemic on PLWH in the United States., Setting: United States., Methods: We analyzed surveys of behavioral and clinical characteristics of PLWH residing in 5 states that participated in the Medical Monitoring Project between 2020 and 2022. We described the impact of COVID-19 illness, testing, and diagnoses; receipt of medical care; social service access; employment; and preventive measures by project site and demographic characteristics., Results: Unweighted data from 1715 PLWH were analyzed. A high proportion of PLWH had medical care disrupted by the pandemic; 31% of PLWH missed medical appointments, 26% missed routine laboratory test results, and 7% missed antiretroviral therapy doses. In total, 30% of PLWH reported losing wages and 19% reported difficulty in accessing social services. Overall, 88% reported receiving at least 1 dose of COVID-19 vaccine, but vaccine uptake was low among younger, Black, and Hispanic or Latina/o/x PLWH., Conclusions: This descriptive analysis reinforces previous findings that show that COVID-19 negatively impacted PLWH and their ability to obtain medical care. Additional efforts will be critical to ameliorating the longer-term impacts of COVID-19 on the health of PLWH and supporting PLWH through future pandemics and healthcare system disruptions., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: People living with HIV (PLWH) who have not achieved or maintained viral suppression post-diagnosis likely face multiple barriers to HIV care. To identify these barriers a universally accepted definition of viral suppression is needed. The most common definition, the Center for Disease Control and Prevention (CDC) definition, contains simplifying assumptions that may misclassify individuals and attenuate associations. In this study, we evaluated alternative definitions of viral suppression on their ability to identify barriers to care., Design and Methods: We used HIV surveillance data to classify participants of the 2015-2019 Washington Medical Monitoring Project (MMP) as virally suppressed or not using the CDC definition and two definitions that assess viral suppression over a longer period ("Enriched" and "Durable"). We identified barriers to suppression from literature (unstable housing, illicit drug use, poor mental health, heavy drinking, recent incarceration, racism, and poverty) and measured them using interview questions from MMP. We compared the rate ratios (RR) of being not virally suppressed using each definition for each barrier., Results: There were 858 PLWH in our study. All viral suppression definitions classified a similar proportion of people as suppressed (85%-89%). The durable viral suppression definition consistently yielded the largest rate ratios (e.g. unstable housing: CDC RR = 1.3, 95% CI 0.9-1.8; Enriched 1.5, 95% CI 1.0-2.2; Durable 2.2, 95% CI 1.6-3.1) and reclassified 10% of the population relative to the CDC definition., Conclusions: Longitudinal definitions for viral suppression may yield less misclassification and serve as superior tools for identifying and curtailing barriers to HIV care., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Introduction: AIDS Drug Assistance Programs (ADAPs) provide financial support for medical care for people living with HIV (PLWH) in the United States. Federal policy requires that clients recertify for the program every 6 months, which has been described as a barrier to care access. Our objective was to describe the prevalence of and factors associated with ADAP disenrollment in Washington State., Methods: Between 2017 and 2019, we categorized ADAP clients by the success of their recertification applications as follows: (1) continuously enrolled, (2) ruled ineligible, or (3) disenrolled if they failed to recertify. We compared individuals who were disenrolled with those who were continuously enrolled by demographic and socioeconomic characteristics and engagement with case management using data from the Washington State HIV Surveillance and Ryan White data systems., Results: From 2017 to 2019, 5480 clients were enrolled in ADAP, of whom 1423 (26%) were disenrolled and 984 (18%) were ruled ineligible at least once. Compared with those who were continuously enrolled, disenrolled PLWH were more likely to be Black [unadjusted prevalence ratio (PR) vs White 1.31, 95% confidence interval (CI): 1.17 to 1.46], uninsured (PR vs private insurance 1.24, 95% CI: 1.10 to 1.40), and younger (PR 25-34 vs 35-44 years 1.23, 95% CI: 1.08 to 1.41). The median time to return after disenrollment was 12 months (95% CI: 8 to 19 months)., Conclusions: Disenrollment after failure to recertify was the most common reason why PLWH lost ADAP coverage in Washington State. ADAP recertification procedures disproportionately affect Black, young, and uninsured PLWH and may contribute to disparities in HIV outcomes., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

To examine the relationship between African birth and HIV outcomes and comorbidities among individuals accessing care at the University of Washington. Patients who received a diagnosis of HIV at the University of Washington from 1995 to 2018 were identified. African-born patients were defined as those with recorded birthplace or primary language belonging to an African country. This cohort was compared to all non-African-born patients for initial CD4 count < 200 cells/mL, time from diagnosis to viral suppression, and prevalence of comorbid conditions. We identified 357 African-born and 3710 non-African-born patients. Over the time period, African-born patients were more likely to present with initial CD4 counts < 200 cells/mL (31% vs 19%, p < 0.01), but had shorter time to viral suppression (HR 1.31, [95% CI: 1.14-1.56]). African-born patients had higher rates of hepatitis B and tuberculosis (12% vs. 7% p < 0.01 and 13% vs. 3% p < 0.01). African-born patients living in the Seattle area have better HIV outcomes, but low initial CD4 counts suggest that they are presenting to care late. Increased efforts to engage this population in HIV, hepatitis B, and tuberculosis screening are warranted., (© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Despite progress made in the last decades, malaria persists as a pressing health issue in sub-Saharan Africa. Pregnant women are particularly vulnerable to infection and serious health outcomes for themselves and their unborn child. Risk can be mitigated through appropriate use of control measures such as insecticide-treated bed nets. Although social networks can influence uptake of preventive strategies, the role of social influence on bed net ownership has not been explored. During an evaluation of a bed net distribution programme, the influence of non-health care advisors on ownership and use of bed nets by pregnant women in Kumasi, Ghana was examined., Methods: Data were collected through in-person interviews with 300 pregnant women seeking antenatal care in an urban hospital in Kumasi, Ghana. Participants were asked about their bed net ownership, bed net use, and information about three personal contacts that they go to for pregnancy advice. Information about these advisors was combined into an influence score. Logistic regression models were used to determine the association between the score and bed net ownership. Those who owned a bed net were further assessed to determine if interpersonal influence was associated with self-reported sleeping under the bed net the previous night., Results: Of the 294 women in the analysis, 229 (78%) reported owning bed nets. Of these bed net owners, 139 (61%) reported using a bed net the previous night. A dose response relationship was observed between the interpersonal influence score and bed net ownership and use. Compared to the lowest influence score, those with the highest influence score (>1 SD above the mean) were marginally more likely to own a bed net [OR = 2.37, 95% CI (0.87, 6.39)] and much more likely to use their bed net [5.38, 95% CI (1.89, 15.25)] after adjusting for other factors., Conclusions: Interpersonal influence appears to have modest impact on ownership and use of bed nets by pregnant women in an urban area of Ghana. Further investigations would need to be conducted to determine if the relationship is causal or if individuals who associate are simply more likely to have similar practices.