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Robotic surgery is limited by the lack of haptic feedback to the surgeon. The addition of tactile information may enable surgeons to feel tissue characteristics, appropriately tension sutures, and identify pathologic conditions. Tactile feedback may also enable expansion of minimally invasive surgery to other surgical procedures and decrease the learning curve associated with robotic surgery. This paper aims to explore a system to provide tactile feedback.

A pneumatic balloon‐based system has been developed to provide tactile feedback to the fingers of the surgeon during robotic surgery. The system features a polydimethyl siloxane actuator with a thin‐film silicone balloon membrane and a compact pneumatic control system. The 1.0 × 1.8 × 0.4 cm actuators designed for the da Vinci system feature a 3 × 2 array of 3 mm inflatable balloons.

The low‐profile pneumatic system and actuator have been mounted directly onto the da Vinci surgical system. Human perceptual tests have indicated that pneumatic balloon‐based tactile input is an effective means to provide tactile information to the fingers of the surgeon.

Application of a complete tactile feedback system is limited by current force sensing technologies.

The actuators have been designed such that they can be mounted directly onto the hand controls of the da Vinci robotic system, and are scalable such that they can be applied to various robotic applications.

The Mental Health of Children and Young People in England survey (National Health Service Digital, 2020) found that 1 in 6 children aged 5–16 have a probable mental health disorder. This represents 16% of children in that age group and is an increase from 1 in 9 in 2017 (Public Health England, 2021). Evidence suggests that some children and young people, particularly those who are economically disadvantaged, females and those with pre-existing mental health needs appear to have experienced greater negative impacts on their mental health and wellbeing during the COVID-19 pandemic (Public Health England, 2021) and schools and colleges therefore play an important role in continuing to support children and young people’s mental health. Evidence from the national charity, Education Support (2022), also indicates that the mental health of staff working in education has deteriorated, leading to adverse effects on job satisfaction, burnout and retention. This chapter explores the latest evidence relating to Children and Young People’s (CYP) mental health and the whole school approach to mental health, including the mental health of staff who work in the education sector. It makes a case for implementing a mental health curriculum in schools. It addresses the concept of mental health literacy and approaches for working in partnership with children and young people. It makes an argument for universal screening and outlines approaches for working in partnership with parents, carers and other agencies. Theoretical perspectives are considered and applied to school contexts.

This study aims to identify extensive and intensive margins in exports and imports and examine whether incoming foreign direct investments (FDI) benefit local firms in Indonesia through the export and import channels.

Using Heckman’s two-step selection model to consider the potential of bias of self-selection in export–import participation, this study uses the firm-level data from 2008 to 2015 collected from Statistik Industri and proximate both export and import spillovers.

The authors found that internal factors are critical for a firm to be an exporter, signaling self-selection in exports and imports. Spillover effects from FDI (spatial properties) support export but lower import propensity and intensity.

This study implies that improving human capital (absorptive capacity) is needed to accelerate export intensity and policies supporting FDI inflows in complementary sectors (noncompeting industries) can increase export propensity and intensity and reduce imports.

This study contributes to the literature in several ways. First, the proposed export spillovers model that accounts for impacts through a demonstration channel is applied to the import channel. Moreover, this study extends the model developed by Franco and Sasidharan (2010) and Yasin et al. (2022) by incorporating spatial spillover effects at the provincial level. Subsequently, the authors test whether a firm’s technological intensity determines export–import propensity and intensity. This can indicate whether specific sectors are more likely to participate in international activities based on their use of technology.

Coastal cities offer great ecological, cultural and economic benefits due to their tourism potential. The objective of this research is to (1) identify tourists' post-pandemic motivations, (2) establish a post-pandemic demand segmentation and (3) determine the relationship between post-pandemic segments and loyalty.

This study was carried out in Lima, Peru, a tourist destination on the Pacific Ocean coast. The sample was collected between June and July 2020, during the coronavirus disease 2019 (COVID-19) pandemic. In total, 354 valid questionnaires represented the sample size of this quantitative study. For data analysis, factor analysis and K-means non-hierarchical clustering were used.

The results show four post-pandemic motivational dimensions in coastal cities: “novelty and escape,” “learning and culture,” “destination safety” and “service safety.” Likewise, there are two post-pandemic segments in coastal cities: “safety seekers” who want to feel safe at the destination and with its services, and “multiple motives,” motivated by several reasons simultaneously, such as safety, novelty and escape, and learning and culture. The multiple motives group shows higher return intentions, making it a crucial post-pandemic segment in coastal cities.

The limitations of the present study were the online sampling and the timing when collecting the data since the demand can vary due to seasonal reasons.

Since coastal cities have natural and cultural attractions appealing to many travelers, they should adopt the necessary biosecurity measures to attract the safety seekers’ segment, who wants to feel safe at the destination and with its services. Similarly, the multiple motives’ segment favors safety over other recreational activities in the coastal area, so it is necessary that activities such as sports on the beach, walks, observation of flora and fauna, navigation and interaction with the community, meet the required biosecurity standards.

The results will be used to plan the following actions in coastal destinations and meet the tourists’ demands when this health crisis ends.

In this context, up to date, demand segmentation by motivations in coastal cities during the COVID-19 pandemic has not been investigated. Such a study will help to obtain post-pandemic results regarding the tourism demand for these destinations. To date, there are no studies in coastal cities that analyze demand segmentation and its motivations for the post-COVID-2019 pandemic.

Professional Identity Formation is the dynamic evolution to “think, act and feel” to become part of a professional community. This document presents the development and the study that aimed to assess the usability of a m-Learning Identity App (MLIA) focused on the formation of professional identity among undergraduate medical students.

MLIA development included four phases: Conceptual, prototype, pilot and implementation, before further deployment. The conceptual model was designed by eight faculty members from three Latin American universities. The prototype was developed and tested with stakeholders. The pilot was performed during 5 weeks before the implementation. Cross-sectional data collected during implementation from 138 medical students who completed a survey to assess the usability of MLIA are presented. During deployment, 977 posts were made on Professional Identity Formation, and examples of these posts are presented.

The prototype and pilot phases demanded improvements. The survey explored (1) Familiarity, (2) Perceived ease of use, (3) Perceived usefulness for Professional Identity Formation, (4) Satisfaction, (5) Intention to reuse (6) Digital aesthetics and (7) Safety. Results from the usability assessment suggest that students perceived MLIA as a secure space with positive aesthetics and ease of use.

Important limitations of the present study include, firstly, that it does not provide information on the effectiveness of the MLIA in shaping professional identity in medical students, it focuses exclusively on its development (conceptual model, prototype, pilot and implementation) and usability. Secondly, the study design did not consider a control group and, therefore, does not provide information on how the App compares with other strategies addressing self-reflection and sharing of meaningful experiences related to professional identity.

MLIA introduces a different approach to education, simulating a secure, easy-to-use, social media with a friendly interface in a safe environment to share academic and motivational moments, transitioning from being to becoming a professional.

The purpose of this paper is to analyse the evolution and characteristics of health education in schools in Spain during the dictatorship of General Franco (1939-1975).

The analysis of two kinds of sources has been performed. First, the reports from international organizations on health education in schools published in the 1950s and 1960s. Second, journals, books and official documents published by public health and education organizations in Franco’s Spain.

Health education in schools evolved in three stages under Franco’s dictatorship. In the first stage (1939-1953), Spanish schools maintained an outdated “school health” approach in the teaching programmes. In the second stage (1953-1965), the agreements with the USA in 1953 ended Spanish isolation, and the regime sought to follow the recommendations of international organizations. Efforts were made to “import” the WHO/UNESCO version of health education in schools but it failed to materialize. A programme that sought to enhance citizen participation and to acknowledge their idiosyncrasies was unlikely to prosper in a dictatorship. However, the less threatening food and nutrition education programme, encouraged by the FAO/UNICEF, did succeed. In the last stage (1965-1975), the Spanish education system entered a period of modernization in which the contents and methods of health education in schools were reformed in order to introduce the less conflictive aspects of the international recommendations.

The paper highlights the tensions between the aspirations to follow international programmes and the recommendations on health education in schools and the difficulties of implementing such schemes under a dictatorship.

The purpose of this study is to analyse the concept of dark tourism and apply it to the Valley of the Fallen in Spain, a controversial monument that is a symbol of the Spanish Civil War and the subsequent dictatorship.

First, the authors carried out a literature review to get an insight into the concept of “dark tourism”, the types of existing dark tourism and the methods that are applied to the main cases around the world. Then, the authors analysed the case through a content analysis of press articles and interviews.

The authors propose a way to change the current symbolism and connotations of the Valley of the Fallen towards a new symbolism engaging all the stakeholders involved, from a dark tourism point of view.

Applying this new symbolism requires attaining a difficult consensus that Spain has not yet been able to put into practice.

The dark tourism framework is an opportunity to link both economic and educational objectives, co-working on a model of consensus, but there is a gap in the literature on dark tourism in terms of Spain’s history. This strategy could be also applied to other controversial heritage with similar characteristics, according to different positioning classifications.

The purpose of this paper is twofold. First, it examines the communication strategies pursued by firms related to alcohol beverages in Spain during a decade with major changes in alcohol marketing regulations. Second, it analyzes the relationship between these strategies and underage alcohol consumption before and after 2007.

Panel data methodology is implemented using data from ESTUDES national survey (average sample size 26,000 interviews, 2004-2010) and INFOADEX (nationwide advertising expenditure, 1999-2013).

The results show that, under a restrictive alcohol marketing framework, firms related to alcohol beverages adapt their communication strategies: budget deviation from advertising to sponsorship. Regarding alcohol quantity and frequency models, the relationship between alcohol advertising expenditure and underage alcohol consumption after 2007 is very small but still positive and significant. However, contrary to expectations, in the case of alcohol sponsorship, the relationship between expenditure and underage alcohol consumption has not been affected by the observed budget deviation from advertising to sponsorship after 2007.

Changes in alcohol advertising and sponsorship regulation lead firms related to alcohol beverages to change their communication strategies to overcome new regulatory restrictions and to reach their target group. Overall, despite the relationships between both advertising and sponsorship expenditure and underage alcohol consumption diminish between periods, they still remain positive and significant. Closer and updated monitoring of alcohol communication strategies pursued by firm is needed to keep controlling the alcohol advertising and sponsorship exposure to under age people.

This is a pioneer study in analyzing communication strategies within the Spanish alcohol beverages sector and in proposing a model to analyze the dynamic effect of such strategies on underage alcohol consumption.

This paper addresses the evaluation of traditional wooden floors, based on (1) visual strength grading (VSG) techniques adopted for ancient wooden structures; (2) a new approach to biological damage and (3) structural safety analysis. This assessment includes complex concepts. Therefore, the study presents a highly needed practical tool to help technicians make a preliminary assessment whereby many of the timber elements in our heritage can be saved from removal.

A simple and effective procedure was developed for each step. An inspection and diagnosis datasheet was drawn up, and the structural analysis presented by the Eurocodes was summarized. This methodology was then applied in a case study to demonstrate the complete procedure. During the assessment of this sort of structures, the drilling technique was a relevant method utilized as it provided essential and clear information about the beams' conservation.

The case study results indicate that 70% of the beams of the analysed structure exceed strict minimum performance criteria. This shows that other similar buildings can have their wooden elements saved from demolition, which is not the current regular refurbishment approach.

The current reality shows that the technicians' lack of capacity for a pragmatic assessment of the timber members’ structural capacity promotes their disinterest in them. To avoid that, this text presents a process for evaluating wooden floors using a simple and clear approach. This will prevent the demolition of wooden elements and instead encourage their preservation.