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Considering the evolving and unpredictable job market, adaptability is an important skill for young adults. Such adaptability implies that schools need to teach key social competences, like communication, collaboration, or problem-solving. In this area, a gender gap has consistently been found, showing that boys display social competences less than girls. A large-scale nationwide multilab longitudinal experiment--the ProFAN project--was conducted in France among more than 10,000 vocational high-school students. Its primary goal was to develop and test an intervention promoting a range of psychological and psychosocial variables in vocational high schools, including social competences. This 2-year long, three-wave field experiment compared the effects of a cooperative learning method--the jigsaw classroom, that entails positive goal and resource interdependence--to two control conditions: one that involves cooperation with resource independence, and the other that remains business-as-usual. This article focuses on the differential development of perceived social competences of adolescent boys and girls over time, comparing the three pedagogical methods. Results of longitudinal multilevel modeling replicate the gender gap in perceived social competences and show that this gap widens with time. However, and most importantly, the analyses revealed that such widening of the gender gap was greater in the two control conditions than in the jigsaw condition, in which the evolution of boys' and girls' perceptions of social competences remained similar over time. Contributions to the understanding of the development and teaching of social competences in education settings are discussed.

This research addresses the problem of the imposition of educational spaces in multicultural contexts. The research is of qualitative nature, based on an interpretative hermeneutic paradigm. It uses collective case study design. The selection of participants was non-probabilistic and intentional, and snowball sampling was used, selecting 15 teachers and 24 students. It is concluded that Chilean schools in multicultural contexts show a lack of social and cultural relevance in the construction and organization of spaces. In addition, it is concluded that educational establishments should consider the implementation of pedagogical and didactic strategies in contact with nature, given that, as has already been demonstrated, children often prefer outdoor experiences as ideal spaces for learning.

Abstract Background Vitamin C plays key roles in cellular homeostasis, functioning as a potent antioxidant and a positive regulator of cell differentiation. In skeletal muscle, the vitamin C/sodium co-transporter SVCT2 is preferentially expressed in oxidative slow fibers. SVCT2 is up-regulated during the early fusion of primary myoblasts and decreases during initial myotube growth, indicating the relevance of vitamin C uptake via SVCT2 for early skeletal muscle differentiation and fiber-type definition. However, our understanding of SVCT2 expression and function in adult skeletal muscles is still limited. Results In this study, we demonstrate that SVCT2 exhibits an intracellular distribution in chicken slow skeletal muscles, following a highly organized striated pattern. A similar distribution was observed in human muscle samples, chicken cultured myotubes, and isolated mouse myofibers. Immunohistochemical analyses, combined with biochemical cell fractionation experiments, reveal a strong co-localization of SVCT2 with intracellular detergent-soluble membrane fractions at the central sarcomeric M-band, where it co-solubilizes with sarcoplasmic reticulum proteins. Remarkably, electrical stimulation of cultured myofibers induces the redistribution of SVCT2 into a vesicular pattern. Conclusions Our results provide novel insights into the dynamic roles of SVCT2 in different intracellular compartments in response to functional demands.

The widespread use of social media has fundamentally transformed how people communicate, collaborate, and interact, leading to significant shifts in social structure and contemporary cultural order. This study aims to analyze the role of social media in revolutionizing public service implementation in the digital era. The research uses a qualitative approach, utilizing Google Collab and Nvivo as analytical tools. Key findings reveal that internet usage is dominated by adolescents and adults, which accelerates the adoption of public services through social media, primarily due to the high level of technological literacy among users. The results of this study contribute to the literature by highlighting the role of social media as an effective tool to overcome the limitations of conventional communication in public services. The practical implications of this study indicate the potential for improving public service standards at the international level through the optimization of social media to reach the community more broadly and efficiently. Keywords: social media, e-government, e-governance, innovation division, web 2.0 Abstrak Penggunaan media sosial yang luas telah secara mendasar mengubah cara orang berkomunikasi, berkolaborasi, dan berinteraksi, serta menyebabkan pergeseran signifikan dalam struktur sosial dan tatanan budaya kontemporer. Penelitian ini bertujuan untuk menganalisis peran media sosial dalam merevolusi implementasi pelayanan publik di era digital. Metode yang digunakan adalah pendekatan kualitatif dengan memanfaatkan alat analisis Google Collab dan Nvivo. Temuan utama menunjukkan bahwa penggunaan internet didominasi oleh remaja dan orang dewasa, yang mempercepat adopsi layanan publik melalui media sosial, terutama karena tingginya tingkat literasi teknologi di kalangan pengguna. Hasil penelitian ini berkontribusi pada literatur dengan menekankan peran media sosial sebagai alat efektif untuk mengatasi keterbatasan komunikasi konvensional dalam pelayanan publik. Implikasi praktis dari penelitian ini menunjukkan potensi peningkatan standar pelayanan publik di tingkat internasional melalui optimalisasi media sosial untuk menjangkau masyarakat secara lebih luas dan efisien. Kata Kunci: media sosial, e-government, e-governance, divisi inovasi, web 2.0

Abstract Background Hearing loss in older adults affects general, generic health-related and disease-specific quality of life (QoL). The conventional strategy to address it is through hearing aids, which have been shown to improve disease-specific QoL. However, the long-term results regarding general quality of life are unknown, and communication problems and stigma associated with hearing loss may persist. An effective intervention strategy to address these problems is group communication programs, most notably Active Communication Education (ACE). This program has been shown to increase communication strategies and reduce communication activity limitations and participation restrictions. These precedents allow us to hypothesize that this program could improve general QoL. Methods A randomized clinical trial was conducted on 114 older adult hearing aid users. Fifty-four subjects composed the intervention group that received the ACE program, while 60 subjects composed the control group that received an informational-lectures type intervention. The WHOQOL-BREF questionnaire was used to measure general QoL. Measurements were taken before and right after the intervention, with follow-ups at 6 and 12 months. Multilevel linear mixed models were estimated, considering the WHOQOL-BREF dimension scores and total score as the outcomes, and an interaction term between time since intervention and group as the predictor. Within- and between-group comparisons were made. Results Compared to the baseline time-point, the ACE group showed significant improvements right after the intervention, and at the 6-month and 12-month follow-ups for the dimensions of psychological health, social relationships, environment, and total score. Compared to the control group, the ACE group exhibited significantly greater improvements in the social dimension at all postintervention assessments, as well as in the environment dimension and total score at the 12-month follow-up. Conclusions The ACE program improved general QoL in terms of social relationships and environment dimensions, which lasted up to 12 months after the intervention. Therefore, ACE is positioned as an effective complement for HA users, enhancing and delivering new benefits related to broader aspects of QoL not necessarily tied to health. Trial registration ISRCTN54021189 (retrospectively registered on 18/07/2023).

Objective. To evaluate whether use of a culturally adapted mobile application (app) for adolescents with type 1 diabetes is associated with improved metabolic control. Methods. The Dominican Republic’s National Institute of Diabetes, Endocrinology, and Nutrition and the Learning to Live clinic recruited 23 pediatric participants for the study. Blood tests were performed before and after use of the app for a period of 3 months. Based on the user profile, participants were encouraged to use the app’s bolus insulin calculator after each meal. The app included a list of regionally and culturally specific foods, color-coded to indicate a high glycemic index (GI) as red; medium GI as yellow; and low GI as green. The color-coding was designed to assist participants in making healthier eating choices. Results. There were statistically significant improvements in lipid profile. Mean high-density lipoprotein values rose to acceptable levels, while low-density lipoproteins and triglyceride levels fell to the recommended values. The overall quality of life increased, although glycated hemoglobin levels showed no statistically significant changes. Conclusion. The findings of this study suggest that using this culturally tailored app can help young patients with type 1 diabetes to improve metabolic health.

Abstract Cytomegalovirus (CMV) infection poses risks to newborns, necessitating effective therapies. Given that the damage includes both viral infection of brain cells and immune system-related damage, here we investigate the involvement of cellular prion protein (PrP), which plays vital roles in neuroprotection and immune regulation. Using a murine model, we show the role of PrP in tempering neonatal T cell immunity during CMV infection. PrP-null mice exhibit enhanced viral control through elevated virus-specific CD8 T cell responses, leading to reduced viral titers and pathology. We further unravel the molecular mechanisms by showing CMV-induced upregulation followed by release of PrP via the metalloproteinase ADAM10, impairing CD8 T cell response specifically in neonates. Additionally, we confirm PrP downregulation in human CMV (HCMV)-infected fibroblasts, underscoring the broader relevance of our observations beyond the murine model. Furthermore, our study highlights how PrP, under the stress of viral pathogenesis, reveals its impact on neonatal immune modulation.

The use of the Spanish pronouns of address "tú" and "usted" is an intricate matter for L2 learners due to the many factors that influence their selection at the discourse and interactional level. Although the literature has traditionally focused on the challenges experienced by L1-English learners of L2-Spanish in learning these forms, less is known about speakers whose L1s also present similar (but not identical) pronouns of address. This study thus analyzes the use of "tú" and "usted" by L1-French and L1-European Portuguese learners who learn Spanish either in their home countries (i.e., France and Portugal) or in Spain as part of a study-abroad experience. Results indicate that learners in both L1 groups used "tú" more often while in Spain than in their home country. Additionally, students in immersion started adopting more similar criteria to those of L1-Spanish speakers in determining whether "tú" or "usted" would be appropriate in certain contexts.

Under climate change, species are expected to migrate along with their climate envelope. However, many species’ distribution models do not include the human footprint, thus overestimating distributional zones with high probabilities of occurrence. Species inhabiting sky islands (high-elevation landscapes that differ from landscapes in intermediate valleys) are particularly sensitive to climate and land-use change, given their limited ability to migrate. We aimed to assess the suitability of the climatic conditions for a sky island lizard under different climate scenarios and how that could affect its distribution based on (i) its climate envelope and (ii) the human footprint (croplands and buildings). Using climatic variables to develop a species distribution model and the indicator Human Footprint, we predicted the presence probabilities of Liolaemus nigroviridis Müller & Hellmich, 1932 populations under climate change scenarios (current, year 2040, and year 2080). We analyzed the relevant variables for L. nigroviridis’s climate envelope, which we projected to decrease and shift southward by 2080. The species could track its climate envelope in the Andes, but not in the Coastal mountains, given the strong human footprint. We propose assisted migration as a possible adaptive strategy, and show that conservation of sky islands species can be enhanced by integrating climatic and anthropogenic factors.

Cheryl Lin,1 Alejandra Mella-Velazquez,1 Wendy E Braund,2 Pikuei Tu1 1Policy and Organizational Management Program, Duke University, Durham, NC, USA; 2Pennsylvania Department of Health, Harrisburg, PA, USACorrespondence: Pikuei Tu, Email Pikuei.tu@duke.eduPurpose: Hispanics, the largest minority in America, have increased risk of several medical issues and face noteworthy health disparities. This study compares care-seeking behaviors and choice experience among Hispanics, Asians, Blacks, and Whites, considering SES (income, education, and insurance status) and across five healthcare provider (HCP) types. Concurrent analysis provides a comprehensive view of how and where inequity manifests in healthcare.Methods: A cross-sectional online survey assessed 1485 adults (Hispanic=314, Asian=313, Black=316, White=542, recruited through a panel agency) of the frequency of visiting primary care providers, dentists, optometrists, gynecologists, and specialists for chronic conditions. Participants also rated the importance of self-selecting a HCP and difficulty in finding one.Results: Whites visited each HCP most regularly. Compared to Asians, more Hispanics saw specialists regularly (45.1% vs 56.5%, p=0.042), and Blacks saw dentists less (47.0% vs 38.3%, p=0.028) and gynecologists more often (21.2% vs 33.1%, p=0.024). No other frequency differences were observed among minorities. Low-income participants across four races saw dentists and gynecologists with comparable infrequency. Hispanics and Asians assigned similarly significantly lower self-choice importance and experienced more difficulty relative to Whites or Blacks. Participants with lower income or education visited HCPs less regularly yet perceived the same choice importance as higher-SES peers (p> 0.05). Notably, discrepancies in visit frequency between Whites and minorities were more pronounced in higher-SES than lower-SES group. Differences in experiencing care-seeking difficulty were associated with income (p=0.029) and insurance type (p=0.009) but not education (p> 0.05).Conclusion: Higher income and education increase healthcare utilization; however, racial disparities persist, particularly among higher-SES groups. Despite similarities among minorities, the extent of disparities varied by SES and provider type. The findings help explain evident inequity in healthcare access and health outcomes. Tailored patient education, culturally-specific navigation support, and more inclusive services are needed to address barriers faced by minorities and disadvantaged populations.Keywords: healthcare access, minority, equity, health behavior, patient preference, decision-making

Abstract Cholinergic striatal interneurons (ChIs) express the vesicular glutamate transporter 3 (VGLUT3) which allows them to regulate the striatal network with glutamate and acetylcholine (ACh). In addition, VGLUT3-dependent glutamate increases ACh vesicular stores through vesicular synergy. A missense polymorphism, VGLUT3-p.T8I, was identified in patients with substance use disorders (SUDs) and eating disorders (EDs). A mouse line was generated to understand the neurochemical and behavioral impact of the p.T8I variant. In VGLUT3T8I/T8I male mice, glutamate signaling was unchanged but vesicular synergy and ACh release were blunted. Mutant male mice exhibited a reduced DA release in the dorsomedial striatum but not in the dorsolateral striatum, facilitating habit formation and exacerbating maladaptive use of drug or food. Increasing ACh tone with donepezil reversed the self-starvation phenotype observed in VGLUT3T8I/T8I male mice. Our study suggests that unbalanced dopaminergic transmission in the dorsal striatum could be a common mechanism between SUDs and EDs.

This research analyses the efficiency of pre-and-post-merger Bank Syariah Indonesia (BSI). This research used a descriptive quantitative analysis method. The population in this research is Islamic banks, which were merged into BSI. The sampling technique was carried out using saturated samples, resulting in the merged of three Islamic Banks, namely Bank Syariah Mandiri (BSM), Bank Negara Indonesia Syariah (BNIS), Bank Rakyat Indonesia Syariah (BRIS), to become BSI. The data used is secondary data in the form of quarterly financial reports for 2019-2022. The research focused on input variables such as total fixed assets, third-party funds, operating costs, and financing. The data analysis techniques used to measure the efficiency of Islamic banks are the Econometric Model (Single Equation Model), Stochastic Frontier Analysis (SFA), and Independent Sample t-test. The result showed that pre-merger, the total fixed asset, total third-party funds, and operating cost as the input variables of the three Islamic Banks were optimal for generating financing. Therefore, the total assets, total third-party funds, and operating costs produced a more optimal impact on the distribution of total financing. It is shown that BSI, both pre-and-post-merger, has generally been efficient in its operational activities. The results of this research complement the theory related to the efficiency level of Islamic banks in terms of the amount of financing as measured by fixed assets, total third-party funds, and operational costs. Practically, the results of this research can be a reference for banks, especially Islamic banks, that will carry out mergers to measure their efficiency level.

The focus and concern of researchers on the theme of bioethics and its relationship with science learning is highly expected, as evidenced by publications in reputable journals. The purpose of this systematic literature review (SLR) was to review and compare investigations of researches on article published by scopus indexed journals. We used the phrase "bioethics+learning+science" in the search menu of the scopus database, and found 138 articles. Furthermore, 15 articles met the criteria to be analyzed. The inclusion and exclusion model used is PRISMA. The publication of "bioethics" in the scopus database is likely to increase in 2012. Although in 2013-2022 there were fluctuations. This theme can be approached through qualitative or quantitative and even mix-method. Almost all types of populations/samples have been used as subjects, showing that this theme is broad in dimension and involves all parties. Leonora Kaldaras is the most dominant researcher in reference. Bioethics specs are related to artificial intelligence. The keyword artificial intelligence is related to student, teaching, engineering education, computer science education, education computing, and education. Interesting things on the theme of artificial intelligence related to learning systems and computer aided instruction. The theme of "bioethics" is the focus of researchers from all continents and is generally written in groups. There are four institutions in the world that fund research and publications on bioethics, while the others are not mentioned. Most publications have fulfilled one of the ethics in publication, which is to clearly mention the name of the institution / institution that funds their research and publication. We formulate and discuss all aspects of the trend. The alignment of researchers continues to increase regarding "bioethics", which can be seen based on distribution year, research types / methods, instruments, aspects of study, author, keywords, author's internationality, and collaboration. This information or findings gives us new insights to think clearly about research and the relationship between bioethics, science learning and artificial intelligence.

IntroductionSelf-regulation of learning is an essential variable in university students’ educational process and integral development, especially in the first semesters. Given its relevance, significant, valid, and reliable instruments are required for its measurement. Therefore, this study aimed to determine the psychometric properties of the SRLI-U scale that assesses Self-Regulation of Learning in Undergraduates.MethodsAn instrumental design was used, and the questionnaire was administered to 348 Chilean first-year university students (59.5% female) aged between 18 and 21 years (M = 18.85; SD = 0.773).ResultsAdequate adjustment indexes of the second order model were evidenced considering three dimensions theoretically coherent with Zimmerman’s model (1) Learning Disposition, Ω = 0.861, (2) Learning Performance, Ω = 0.842, and (3) Learning Self-evaluation, Ω = 0.887; and a general factor Ω = 0.936.ConclusionIt is a valid and reliable instrument for evaluating levels of self-regulation in Chilean university students.DiscussionThe SRLI-U constitutes a valuable tool for educational practice because it allows for evaluating, monitoring, and intervening the self-regulation of learning levels. Theoretical and practical implications are discussed, as well as the study’s limitations.

IntroductionThe intention to dropout and dropout is a problem still unresolved in higher education institutions.ObjectiveTo estimate the differences in the levels of engagement, motivation and academic satisfaction according to (a) intention to dropout and (b) students who remained with those who dropped out. Method: non-experimental designs were used. Two studies are reported, study 1 involved 3,256 students and study 2 involved 2,110 students. The Utrecht Work Engagement Scale Student Test, the Academic Self-Regulation Scale and the Academic Satisfaction Scale were used. The intention to dropout was measured with 3 items and the final dropout data was taken from the official register of students who dropped out of university.ResultsThere are significant differences in the levels of engagement, autonomous motivation and satisfaction between the students who remained and those who dropped out of the university.DiscussionStudents who dropped out in the 3rd semester presented lower levels of academic engagement, motivation and academic satisfaction than those who remained. The intention to dropout and lower levels of these cognitive-motivational variables may contribute to the identification of students at high risk of dropping out. These results contribute to unveiling key variables for the educational transformation of Higher Education in the 21st century.

PT Cupa-Cupa Snack is a company in Pangandaran that processes fishery products into snack products, one of which is crispy squid. The number of crispy squid producers in Indonesia is a challenge for companies to develop products to produce innovations that suit market needs and maintain competitiveness. The purpose of this study was to analyze the product development carried out by the cupa-cupa snack company. The study was conducted from August to October 2024. The research method used was the survey method, with interview techniques and observations of crispy squid products that were analyzed descriptively and qualitatively. The results showed that the company has developed in various aspects, such as the addition of raw material suppliers from various regions, the use of faster and more modern production equipment and processes, changing the formulation of non-msg additives that are safe for consumption, using quality aluminum foil packaging, increasing flavor variants, and business-to-business marketing that maintains good and consistent digital presence techniques on various social media, such as Instagram, Facebook, and TikTok, to increase market share and company competitiveness.

The importance of socioemotional teaching skills has been highlighted for its link with better academic, social, emotional, and behavioral results of students, as well as for its contribution to the work wellbeing, mental health, and prosperity of teachers. However, there are few instruments that measure these skills in teachers in the context of their professional practice. The purpose of this research was to analyze the psychometric properties of the socioemotional Skills Instrument for Teachers (SEMS-IT). An instrumental design and a sample of 853 Chilean secondary school teachers were used. To evaluate the dimensional structure of the instrument, a portion of the sample (n = 468) underwent a network estimation method with exploratory graph analysis (EGA) using a Gaussian GLASSO model. Then, in order to confirm the structural consistency and stability of the items, the analysis was replicated in a second sample (n = 385), where these results were additionally contrasted with those of the confirmatory factor analysis (CFA). The EGA findings confirmed a structure of four dimensions and 19 items in total: (a) cognitive management of teacher emotion (four items), (b) teacher empathic concern (four items), (c) teacher–student relationship (four items), and (d) adverse classroom climate (seven items), with a 7-point Likert scale response format. The CFA showed good and acceptable fit indicators, X2(171) = 354.546 (p

We used the Markov switching regression model to establish a relationship between the conditional stock market returns and macroeconomic volatilities. Monthly data from thirteen (13) African stock markets and macroeconomic variables (exchange rate, inflation, interest rate, money supply, and crude oil price) from 2003 to 2022 were employed. We confirmed the existence of two distinct regimes: An economic expansion or a "tranquil" state with less volatility and an economic decline or a "crisis" state with high volatility. Our findings indicated that macroeconomic variables significantly affect both expansion and crisis periods. However, the estimated coefficients were more significant in a tranquil than in a crisis state. The findings of the study were consistent with macroeconomic theory and pointed out policy implications.

Abstract External signs of disease are frequently used as indicators of disease susceptibility. However, immune profiling can be a more effective indicator to understand how host responses to infection may be shaped by host, pathogen and environmental factors. To better inform wildlife health assessment and research directions, we investigated the utility of a novel multivariate immunophenotyping approach examining innate and adaptive immune responses in differing climatic, pathogen co-infection and demographic contexts across two koala (Phascolarctos cinereus) populations in New South Wales: the Liverpool Plains (LP), and Southern Highlands to South-west Sydney (SHSWS). Relative to the comparatively healthy SHSWS, the LP had greater and more variable innate immune gene expression (IL-1β, IL-6), and KoRV transcription. During extreme heat and drought, koalas from the LP displayed upregulation of a stress pathway gene and reduced adaptive immune genes expression, haematocrit and plasma protein, suggesting the possibility of environmental impacts through multiple pathways. In those koalas, KoRV transcription status, Chlamydia pecorum infection loads, and visible urogenital inflammation were not associated with immune variation, suggesting that immune markers were more sensitive indicators of real-time impacts than observed disease outcomes.

Microservices gained momentum in enterprise IT, as they enable building cloud-native applications. At the same time, they come with new security challenges, including security smells, viz., symptoms of bad (though often unintentional) design decisions that might affect application security. This study aims to explore the impacts of microservice security smells –and of the refactorings known to mitigate their effects– beyond security. In particular, we systematically elicit possible impacts of smells and refactorings on applications’ maintainability, performance efficiency, and adherence to microservices’ key design principles. We then validate the elicited impacts through an online survey targeting experienced practitioners and researchers. Our main contributions include 35 validated impacts and a discussion of the survey results geared towards analyzing the (mis)alignment between practitioners and researchers. Finally, we also provide a holistic view of these impacts, through Softgoal Interdependency Graphs (SIGs).

Aims To review compliance with current blood monitoring guidelines of Older Adult Community Mental Health (OACMHT) patients who are on clozapine within the community teams of Herefordshire and Worcestershire Health and Care NHS Trust. This is for full blood count, prolactin, glycated haemoglobin (HbA1C), liver function, renal function, lipid profile, glucose, and clozapine assay. Methods Our trust guidelines state the following blood parameters should be monitored every 6 months: 1.Full Blood Count (FBC) 2.Glucose (fasting if possible) 3.Prolactin 4.Urea & electrolytes (U&E) 5.Lipid profile (fasting if possible) 6.Liver Function Tests (LFT) 7.HbA1c (annually) 8.Clozapine plasma assay (annually) We reached out to the medical secretaries of the following OACMHTs: Wyre Forest, Malvern Evesham & Pershore, Worcester & Droitwich, Redditch & Bromsgrove to collate a list of patients on clozapine. We then retrospectively looked at blood test results in the past 1 year from 31.12.22 to 31.12.23 and assessed compliance of the 8 haematological parameters. Results In total, 7 patients were identified across the 4 OACMHTs caseloads who were on clozapine. In the past 1 year, we would expect 2 episodes of monitoring for FBC, Glucose, U&E, Prolactin, Lipid profile, and LFT, as well as 1 episode of HbA1C and clozapine drug levels. Compliance for FBC monitoring for 2 episodes was achieved for 100% (n = 7) of the patients. Compliance for 2 episodes of glucose and prolactin monitoring were 0%. Compliance for 2 episodes of renal profile monitoring was 57% (n = 4), but 86% (n = 6) of the patients had at least 1 episode of renal profile monitoring. Compliance for 2 episodes of Lipid profile monitoring was 0%, however 43% (n = 3) of the patients had at least 1 test. In terms of LFTs, 71% (n = 5) of the patients achieved the expected 2 episodes of monitoring, and 100% of them at least 1 episode of monitoring. For HbA1C monitoring, 100% of the patients had the expected 1 episode of monitoring annually. For clozapine plasma levels, 43% (n = 3) of the patients achieved their expected annual episode of monitoring. An interesting observation of note was that a number of blood parameter investigations were performed by GPs/hospitals as part of another investigation, not exclusively for the sole purpose of clozapine monitoring. For example, 50% of the U&Es, 33% of lipid profiles, 71% of LFTs, and 43% of HbA1c tests were done by the GP/hospital. Conclusion The OACMHTs within our trust achieved 100% compliance with FBC and HbA1c monitoring in the past 1 year. 71% compliance was achieved with LFT monitoring, 57% was achieved with U&E monitoring and 43% compliance was achieved with the annual clozapine monitoring. With regards to tests done by GP/hospitals, on one hand, repeated phlebotomy of patients would come with increased direct medical (equipment, facilities) and non-medical (time) cost to service and intangible costs (pain) to patients. It would also not be cost effective to repeat these tests if done recently. Hence one could use recent test results as part of their monitoring routine. However, if these patients do not happen to see their GPs or have a hospital admission for unrelated issues, would they have missed their ideal monitoring targets? This unpredictability of timely monitoring raises the question of whether there is a need for the creation/standardisation of clozapine clinics within the OACMHTs, especially if the clozapine patient caseloads continue to grow.

The military plays a key role in Indonesia’s fight against armed separatist -insurgent groups. Not only that is it mandated by law, the military’s involvement in counterinsurgency is also necessitated by practical demands and the nature of the conflict where separatist insurgents would often utilize guerilla warfare attacks such as exploitation of terrain to ambush security force positions. Other than the ability to inflict lethal force, the military also possess “soft” capabilities needed to win hearts & minds and facilitate the implementation of government policies. This study aims to analyze the operational application of military capabilities in counterinsurgency within an MOOTW framework in Papua. This article utilized a qualitative research design with a deductive analysis method where the researcher seeks to deductively analyze the data collected by understanding and studying theories from various literatures related to the research topic and then critically analyzing the data to answer the research questions as it pertains to the utilization Indonesia’s military capabilities as means within an operational plan to implement the counterinsurgency strategy, as well as the challenges in conducting such operations & the relative limitations of the capabilities of the Indonesian military that can be utilized. The results of this study found that the military capabilities are applied in territorial, intelligence, and combat/ enforcement operations. The challenges to the operational application include lack of cultural competence, actionable intelligence, unified command, as well as suitable metrics. In conclusion, the military supports the implementation of government policy in Papua via territorial, intelligence, and combat/ enforcement operations with significant impediments including lack of intelligence, cultural/ linguistic competence, metrics, and a unified command. To improve this, the military needs to provide cultural/ linguistic training, enable point persistent surveillance, stand up a unified structure to coordinate intelligence, and implement viable metrics to assess progress.