Search results for: English discourse markers
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3548

Search results for: English discourse markers

578 Collaborative Online International Learning with Different Learning Goals: A Second Language Curriculum Perspective

Authors: Andrew Nowlan

Abstract:

During the Coronavirus pandemic, collaborative online international learning (COIL) emerged as an alternative to overseas sojourns. However, now that face-to-face classes have resumed and students are studying abroad, the rationale for doing COIL is not always clear amongst educators and students. Also, the logistics of COIL become increasingly complicated when participants involved in a potential collaboration have different second language (L2) learning goals. In this paper, the researcher will report on a study involving two bilingual, cross-cultural COIL courses between students at a university in Japan and those studying in North America, from April to December, 2022. The students in Japan were enrolled in an intercultural communication class in their L2 of English, while the students in Canada and the United States were studying intermediate Japanese as their L2. Based on a qualitative survey and journaling data received from 31 students in Japan, and employing a transcendental phenomenological research design, the researcher will highlight the students’ essence of experience during COIL. Essentially, students benefited from the experience through improved communicative competences and increased knowledge of the target culture, even when the L2 learning goals between institutions differed. Students also reported that the COIL experience was effective in preparation for actual study abroad, as opposed to a replacement for it, which challenges the existing literature. Both educators and administrators will be exposed to the perceptions of Japanese university students towards COIL, which could be generalized to other higher education contexts, including those in Southeast Asia. Readers will also be exposed to ideas for developing more effective pre-departure study abroad programs and domestic intercultural curriculum through COIL, even when L2 learning goals may differ between participants.

Keywords: collaborative online international learning, study abroad, phenomenology, EdTech, intercultural communication

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577 Residencial Inclusion Strategies for Homeless Immigrants: The Case of Spain

Authors: Raluca Cosmina Budian

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The homeless population in Spain, particularly among immigrants, has been a persistent and multifaceted issue. The government has implemented various housing public policies over the years to address homelessness, ranging from shelter programs to initiatives promoting permanent housing solutions. However, understanding the effectiveness of these policies requires insight from the very individuals and professionals directly impacted by or involved in their execution. This research sheds light on national strategies (The 2015-2020 Comprehensive National Strategy for the Homeless and National Strategy to Combat Homelessness in Spain 2023-2030) aimed at tackling homelessness in Spain, with a focus on the evolving landscape of housing public policies and their relationship with the homeless population. We investigate how these strategies have transformed over time and their impact on the inclusion of this vulnerable group. Furthermore, we explore the perspectives of homeless immigrants, distinguishing between those with an extended residency in Spain and those who have more recently arrived (less than 2 years); and distinguishing between women and men. Additionally, we incorporate insights from 13 interviews with professionals dedicated to serving the homeless population. These insights offer a deeper understanding of the intricacies of current homelessness service provision. Our findings reveal the complex dynamics of providing services to homeless individuals, and the importance of aligning these efforts with the broader national strategies for tackling homelessness. Drawing on a comprehensive dataset, we offer a nuanced view of the challenges and successes in implementing inclusive housing policies in the Spanish context. Our research highlights the importance of collaboration between policy makers, service providers and advocates to create a cohesive and effective approach. By fostering such collaboration, we aim to create a more inclusive and comprehensive strategy to address homelessness in Spain and possible affordable housing proposals for this vulnerable group. It´s only underscores the importance of tailored approaches but also contributes to the broader discourse on housing public policies' ability to address homelessness and foster integration. We suggest that a more comprehensive approach, considering the unique needs of immigrants and working in collaboration with professionals in the field, is essential for the development of effective strategies to combat homelessness and ensure the right to adequate housing for all.

Keywords: housing, homeless, public policy, Spain

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576 The Impact of a Lower Health Literacy in the Self-Management of Patients with a Multiple Sclerosis: A Literature Review

Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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575 Quest for Literary Past: A Study of Byatt’s Possession

Authors: Chen Jun

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Antonia Susan Byatt’s Possession: A Romance has been misread as a postmodern pastiche novel since its publication because there are epics, epigraphs, lyrics, fairy tales, epistles, and even critical articles swollen in this work. The word ‘pastiche’ suggests messy, disorganized, and chaotic, which buries its artistic excellence while overlooking its subtitle, A Romance. The center of romance is the quest that the hero sets forth to conquer the adversity, hardship, and danger to accomplish a task to prove his identity or social worth. This paper argues that Byatt’s Possession is not a postmodern pastiche novel but rather a postmodern romance in which the characters in the academic world set forth their quest into the Victorian literary past that is nostalgically identified by Byatt as the Golden Age of English literature. In doing so, these five following issues are addressed: first, the origin of the protagonist Roland, and consequently, the nature of his quest; second, the central image of the dragon created by the fictional Victorian poet Henry Ash; third, Melusine as an image of female serpent created by the fictional Victorian poet Christabel LaMotte; fourth, the images of the two ladies; last, the image of water that links the dragon and the serpent. In Possession, the past is reinvented not as an unfortunate fall but as a Golden Age presented in the imaginative academic adventure. The dragon, a stereotypical symbol of evil, becomes the symbol of life in Byatt’s work, which parallels with the image of the mythical phoenix that can resurrect from its own ash. At the same time, the phoenix symbolizes Byatt’s efforts to revive the Victorian poetic art that is supposed to be dead in the post-capitalism society when the novel is the dominating literary genre and poetry becomes the minority. The fictional Victorian poet Ash is in fact Byatt’s own poetic mask through which she breathes life into the lost poetic artistry in the postmodern era.

Keywords: Byatt, possession, postmodern romance, literary past

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574 Risk Factors for Determining Anti-HBcore to Hepatitis B Virus Among Blood Donors

Authors: Tatyana Savchuk, Yelena Grinvald, Mohamed Ali, Ramune Sepetiene, Dinara Sadvakassova, Saniya Saussakova, Kuralay Zhangazieva, Dulat Imashpayev

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Introduction. The problem of viral hepatitis B (HBV) takes a vital place in the global health system. The existing risk of HBV transmission through blood transfusions is associated with transfusion of blood taken from infected individuals during the “serological window” period or from patients with latent HBV infection, the marker of which is anti-HBcore. In the absence of information about other markers of hepatitis B, the presence of anti-HBcore suggests that a person may be actively infected or has suffered hepatitis B in the past and has immunity. Aim. To study the risk factors influencing the positive anti-HBcore indicators among the donor population. Materials and Methods. The study was conducted in 2021 in the Scientific and Production Center of Transfusiology of the Ministry of Healthcare in Kazakhstan. The samples taken from blood donors were tested for anti-HBcore, by CLIA on the Architect i2000SR (ABBOTT). A special questionnaire was developed for the blood donors’ socio-demographic characteristics. Statistical analysis was conducted by the R software (version 4.1.1, USA, 2021). Results.5709 people aged 18 to 66 years were included in the study, the proportion of men and women was 68.17% and 31.83%, respectively. The average age of the participants was 35.7 years. A weighted multivariable mixed effects logistic regression analysis showed that age (p<0.001), ethnicity (p<0.05), and marital status (p<0.05) were statistically associated with anti-HBcore positivity. In particular, analysis adjusting for gender, nationality, education, marital status, family history of hepatitis, blood transfusion, injections, and surgical interventions, with a one-year increase in age (adjOR=1.06, 95%CI:1.05-1.07), showed an 6% growth in odds of having anti-HBcore positive results. Those who were russian ethnicity (adjOR=0.65, 95%CI:0.46-0.93) and representatives of other nationality groups (adjOR=0.56, 95%CI:0.37-0.85) had lower odds of having anti-HBcore when compared to Kazakhs when controlling for other covariant variables. Among singles, the odds of having a positive anti-HBcore were lower by 29% (adjOR = 0.71, 95%CI:0.57-0.89) compared to married participants when adjusting for other variables. Conclusions.Kazakhstan is one of the countries with medium endemicity of HBV prevalence (2%-7%). Results of the study demonstrated the possibility to form a profile of risk factors (age, nationality, marital status). Taking into account the data, it is recommended to increase attention to donor questionnaires by adding leading questions and to improve preventive measures to prevent HBV. Funding. This research was supported by a grant from Abbott Laboratories.

Keywords: anti-HBcore, blood donor, donation, hepatitis B virus, occult hepatitis

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573 Prediction of Outcome after Endovascular Thrombectomy for Anterior and Posterior Ischemic Stroke: ASPECTS on CT

Authors: Angela T. H. Kwan, Wenjun Liang, Jack Wellington, Mohammad Mofatteh, Thanh N. Nguyen, Pingzhong Fu, Juanmei Chen, Zile Yan, Weijuan Wu, Yongting Zhou, Shuiquan Yang, Sijie Zhou, Yimin Chen

Abstract:

Background: Endovascular Therapy (EVT)—in the form of mechanical thrombectomy—following intravenous thrombolysis is the standard gold treatment for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It is well established that an ASPECTS ≥ 7 is associated with an increased likelihood of positive post-EVT outcomes, as compared to an ASPECTS < 7. There is also prognostic utility in coupling posterior circulation ASPECTS (pc-ASPECTS) with magnetic resonance imaging for evaluating the post-EVT functional outcome. However, the value of pc-ASPECTS applied to CT must be explored further to determine its usefulness in predicting functional outcomes following EVT. Objective: In this study, we aimed to determine whether pc-ASPECTS on CT can predict post-EVT functional outcomes among patients with AIS due to LVO. Methods: A total of 247 consecutive patients aged 18 and over receiving EVT for LVO-related AIS were recruited into a prospective database. The data were retrospectively analyzed between March 2019 to February 2022 from two comprehensive tertiary care stroke centers: Foshan Sanshui District People’s Hospital and First People's Hospital of Foshan in China. Patient parameters included EVT within 24hrs of symptom onset, premorbid modified Rankin Scale (mRS) ≤ 2, presence of distal and terminal cerebral blood vessel occlusion, and subsequent 24–72-hour post-stroke onset CT scan. Univariate comparisons were performed using the Fisher exact test or χ2 test for categorical variables and the Mann–Whitney U test for continuous variables. A p-value of ≤ 0.05 was statistically significant. Results: A total of 247 patients met the inclusion criteria; however, 3 were excluded due to the absence of post-CTs and 8 for pre-EVT ASPECTS < 7. Overall, 236 individuals were examined: 196 anterior circulation ischemic strokes and 40 posterior strokes of basilar artery occlusion. We found that both baseline post- and pc-ASPECTS ≥ 7 serve as strong positive markers of favorable outcomes at 90 days post-EVT. Moreover, lower rates of inpatient mortality/hospice discharge, 90-day mortality, and 90-day poor outcome were observed. Moreover, patients in the post-ASPECTS ≥ 7 anterior circulation group had shorter door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), and last known normal-to-puncture-time (LKNPT). Conclusion: Patients of anterior and posterior circulation ischemic strokes with baseline post- and pc-ASPECTS ≥ 7 may benefit from EVT.

Keywords: endovascular therapy, thrombectomy, large vessel occlusion, cerebral ischemic stroke, ASPECTS

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572 Understanding the Coping Experience of Mothers with Childhood Trauma Histories: A Qualitative Study

Authors: Chan Yan Nok

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The present study is a qualitative study based on the coping experiences of six Hong Kong Chinese mothers who had childhood trauma from their first-person perspective. Expanding the perspective beyond the dominant discourse of “inter-generation transmission of trauma”, this study explores the experiences and meanings of child trauma embedded in their narratives through the process of thematic analysis and narrative analysis. The interviewees painted a nuanced picture of their process of coping and trauma resolution. First, acknowledgement; second, feel safe and start to tell the story of trauma; third, feel the feelings and expression of emotions; fourth, clarifying and coping with the impacts of trauma; fifth, integration and transformation; and sixth, using their new understanding of experience to have a better life. It was seen that there was no “end” within the process of trauma resolution. Instead, this is an ongoing process with positive healing trajectory. Analysis of the stories of the mothers revealed recurrent themes around continuous self-reflective awareness in the process of trauma coping. Rather than being necessarily negative and detrimental, childhood trauma could highlight the meanings of being a mother and reveal opportunities for continuous personal growth and self-enhancement. Utilizing the sense of inadequacy as a core driver in the trauma recovery process while developing a heightened awareness of the unfinished business embedded in their “automatic pattern” of behaviors, emotions, and thoughts can help these mothers become more flexible to formulate new methods in facing future predicaments. Future social work and parent education practices should help mothers deal with unresolved trauma, make sense of their impacts of childhood trauma and discover the growth embedded in the past traumatic experience. They should be facilitated in “acknowledging the reality of the trauma”, including understanding their complicated emotions arising from the traumatic experiences and voicing their struggles. In addition, helping these mothers to be aware of short-term and long-term trauma impacts (i.e., secondary responses to the trauma) and explore their effective coping strategies in “overcoming secondary responses to the trauma” are crucial for their future positive adjustment and transformation. Through affirming their coping abilities and lessons learnt from past experiences, mothers can reduce feelings of shame and powerlessness and enhance their parental capacity.

Keywords: childhood trauma, coping, mothers, self-awareness, self-reflection, trauma resolution

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571 Generating a Multiplex Sensing Platform for the Accurate Diagnosis of Sepsis

Authors: N. Demertzis, J. L. Bowen

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Sepsis is a complex and rapidly evolving condition, resulting from uncontrolled prolonged activation of host immune system due to pathogenic insult. The aim of this study is the development of a multiplex electrochemical sensing platform, capable of detecting both pathogen associated and host immune markers to enable the rapid and definitive diagnosis of sepsis. A combination of aptamers and molecular imprinting approaches have been employed to generate sensing systems for lipopolysaccharide (LPS), c-reactive protein (CRP) and procalcitonin (PCT). Gold working electrodes were mechanically polished and electrochemically cleaned with 0.1 M sulphuric acid using cyclic voltammetry (CV). Following activation, a self-assembled monolayer (SAM) was generated, by incubating the electrodes with a thiolated anti-LPS aptamer / dithiodibutiric acid (DTBA) mixture (1:20). 3-aminophenylboronic acid (3-APBA) in combination with the anti-LPS aptamer was used for the development of the hybrid molecularly imprinted sensor (apta-MIP). Aptasensors, targeting PCT and CRP were also fabricated, following the same approach as in the case of LPS, with mercaptohexanol (MCH) replacing DTBA. In the case of the CRP aptasensor, the SAM was formed following incubation of a 1:1 aptamer: MCH mixture. However, in the case of PCT, the SAM was formed with the aptamer itself, with subsequent backfilling with 1 μM MCH. The binding performance of all systems has been evaluated using electrochemical impedance spectroscopy. The apta-MIP’s polymer thickness is controlled by varying the number of electropolymerisation cycles. In the ideal number of polymerisation cycles, the polymer must cover the electrode surface and create a binding pocket around LPS and its aptamer binding site. Less polymerisation cycles will create a hybrid system which resembles an aptasensor, while more cycles will be able to cover the complex and demonstrate a bulk polymer-like behaviour. Both aptasensor and apta-MIP were challenged with LPS and compared to conventional imprinted (absence of aptamer from the binding site, polymer formed in presence of LPS) and non-imprinted polymers (NIPS, absence of LPS whilst hybrid polymer is formed). A stable LPS aptasensor, capable of detecting down to 5 pg/ml of LPS was generated. The apparent Kd of the system was estimated at 17 pM, with a Bmax of approximately 50 pM. The aptasensor demonstrated high specificity to LPS. The apta-MIP demonstrated superior recognition properties with a limit of detection of 1 fg/ml and a Bmax of 100 pg/ml. The CRP and PCT aptasensors were both able to detect down to 5 pg/ml. Whilst full binding performance is currently being evaluated, there is none of the sensors demonstrate cross-reactivity towards LPS, CRP or PCT. In conclusion, stable aptasensors capable of detecting LPS, PCT and CRP at low concentrations have been generated. The realisation of a multiplex panel such as described herein, will effectively contribute to the rapid, personalised diagnosis of sepsis.

Keywords: aptamer, electrochemical impedance spectroscopy, molecularly imprinted polymers, sepsis

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570 Generative Pre-Trained Transformers (GPT-3) and Their Impact on Higher Education

Authors: Sheelagh Heugh, Michael Upton, Kriya Kalidas, Stephen Breen

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This article aims to create awareness of the opportunities and issues the artificial intelligence (AI) tool GPT-3 (Generative Pre-trained Transformer-3) brings to higher education. Technological disruptors have featured in higher education (HE) since Konrad Klaus developed the first functional programmable automatic digital computer. The flurry of technological advances, such as personal computers, smartphones, the world wide web, search engines, and artificial intelligence (AI), have regularly caused disruption and discourse across the educational landscape around harnessing the change for the good. Accepting AI influences are inevitable; we took mixed methods through participatory action research and evaluation approach. Joining HE communities, reviewing the literature, and conducting our own research around Chat GPT-3, we reviewed our institutional approach to changing our current practices and developing policy linked to assessments and the use of Chat GPT-3. We review the impact of GPT-3, a high-powered natural language processing (NLP) system first seen in 2020 on HE. Historically HE has flexed and adapted with each technological advancement, and the latest debates for educationalists are focusing on the issues around this version of AI which creates natural human language text from prompts and other forms that can generate code and images. This paper explores how Chat GPT-3 affects the current educational landscape: we debate current views around plagiarism, research misconduct, and the credibility of assessment and determine the tool's value in developing skills for the workplace and enhancing critical analysis skills. These questions led us to review our institutional policy and explore the effects on our current assessments and the development of new assessments. Conclusions: After exploring the pros and cons of Chat GTP-3, it is evident that this form of AI cannot be un-invented. Technology needs to be harnessed for positive outcomes in higher education. We have observed that materials developed through AI and potential effects on our development of future assessments and teaching methods. Materials developed through Chat GPT-3 can still aid student learning but lead to redeveloping our institutional policy around plagiarism and academic integrity.

Keywords: artificial intelligence, Chat GPT-3, intellectual property, plagiarism, research misconduct

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569 The Effects of Alpha-Lipoic Acid Supplementation on Post-Stroke Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

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Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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568 Investigating Introvert and Extrovert University Students’ Perception of the Use of Interactive Digital Tools in a Face-To-Face ESP Class

Authors: Eunice Tang

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The main focus of this study is investigating introvert and extrovert university students’ perception of the use of interactive digital tools (such as Padlet and Mentimeter) in a face-to-face English for Specific Purposes (ESP) class after all classes in the university had been switched to online mode for three semesters. The subjects of the study were business students from three ESP classes at The Hong Kong University of Science and Technology. The basic tool for data collection was an anonymous online survey, which included 3 required multiple-choice questions and 3 open questions (2 required; 1 optional) about the effects of interactive digital tools on their amount of contribution to the class discussions, their perception of the role of interactive digital tools to the sharing of ideas and whether the students considered themselves introvert or extrovert. The online survey will be emailed to all 54 students in the three ESP classes and subjected to a three-week data collection period. The survey results will then be analyzed qualitatively, particularly on the effect the use of interactive digital tools had on the amount of contribution to the class among introvert and extrovert students, their perception of a language class with and without digital tools and most importantly, the implication to educators about how interactive digital tools can be used (or not) to cater for the needs of the introvert and extrovert students. The pandemic has given educators various opportunities to use interactive digital tools in class, especially in an online environment. It is interesting for educators to explore the potential of such tools when classes are back face-to-face. This research thus offers the students’ perspective on using interactive digital tools in a face-to-face classroom. While a lot has been said about introverted students responding positively to digital learning online, the student's perception of their own personality collected in the survey and the digital impact tools have on their contribution to class may shed some light on the potential of interactive digital tools in a post-pandemic era.

Keywords: psychology for language learning, interactive digital tools, personality-based investigation, ESP

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567 Mammotome Vacuum-Assisted Breast Biopsy versus Conventional Open Surgery: A Meta-Analysis

Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

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Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

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566 Pregnant Women and Mothers in Prison, Mother and Baby Units and Mental Health

Authors: Rachel Dolan

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Background: Over two thirds of women in prison in England are mothers, and estimates suggest between 100 and 200 women per year give birth during imprisonment. There are currently six mother and baby units (MBUs) in prisons in England which admit women and babies up to the age of 18 months. Although there are only 65 places available, and despite positive impacts, they are rarely full. Mental illness may influence the number of admissions, as may interpretation of admission criteria. They are the only current alternative to separation for imprisoned mothers and their babies. Aims: To identify the factors that affect the decision to apply for/be offered a place in a prison MBU; to measure the impact of a placement upon maternal mental health and wellbeing; To measure the Initial outcomes for mother and child. Methods: A mixed methods approach - 100 pregnant women in English prisons are currently being recruited from prisons in England. Quantitative measures will establish the prevalence of mental disorder, personality disorder, substance misuse and quality of life. Qualitative interviews will document the experiences of pregnancy and motherhood in prison. Results: Preliminary quantitative findings suggest the most prevalent mental disorders are anxiety and depression and approximately half the participants meet the criteria for one or more personality disorders. The majority of participants to date have been offered a place in a prison MBU, and those in a prison with an MBU prior to applying are more likely to be admitted. Those with a previous history of childcare issues, who are known to social services are less likely to be offered a place. Qualitative findings suggest that many women are often hungry and uncomfortable during pregnancy, many have feelings of guilt about having a child in prison and that feelings of anxiety and worry are exacerbated by lack of information.

Keywords: mothers, prison, mother and baby units, mental health

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565 A Clinical Cutoff to Identify Metabolically Unhealthy Obese and Normal-Weight Phenotype in Young Adults

Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

Abstract:

Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

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564 A Study on Hierarchy and Popularity of Foreign TV Series with Different Origin Countries among Chinese Audiences from a Uses and Gratification Perspective

Authors: Terigele

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Cultural products are always shelved into different classes of a hierarchy that separates so-called highbrow and lowbrow cultures. This study illustrated that audiences might even construct a hierarchy according to the origin countries when consuming certain products. Chinese audiences now have access to TV series from all around the world thanks to the internet. TV series from different origin countries show some particular features in terms of length, theme, plots, accessibility, seriousness etc. Their audiences were therefore stereotyped because of what they watch. Based on in-depth interviews with 20 participants, this research has following findings: 1) Most popular origin countries of foreign TV series in China are Korea, the United States, the United Kingdom, Japan and European countries in a descending order. Korean TV series are most popular because they are less serious and more accessible compared to others. 2) In the hierarchy of the TV series, European TV series stand on the top followed by British and American TV series. Japanese TV series are also categorized into highbrow class. Korean TV series are at the bottom and always seen as lowbrow cultural products. 3) Most audiences consume TV series from more than one origin countries and have different needs when watching them. Participants reported that they watch European TV series because those TV series are more artistic than their counterparts and of great quality. They watch British and American TV series mainly to improve their English and to learn about the culture. They find Japanese TV series very enjoyable with a large variety of themes and impressive lines. Audiences watch Korean TV series mostly to entertain and kill time. 4) Audiences do care about cultural taste. Especially those who watch European, British and American TV series usually tend to consider audiences who watch nothing but Korean TV series to be shallow. On the other hand, Korean TV series’ audiences seem to care less about the hierarchy of the TV series. Even when they discuss the hierarchy, they tend to accept the judgments with ironies and jokes. Future studies can dig deeply into the genre and content of TV series with different origin countries and also investigate more about the psychology of audiences regarding the gender, age, education, socioeconomic status etc.

Keywords: foreign TV series, hierarchy, popularity, uses and gratification

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563 Transformation of the Institutionality of International Cooperation in Ecuador from 2007 to 2017: 2017: A Case of State Identity Affirmation through Role Performance

Authors: Natalia Carolina Encalada Castillo

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As part of an intended radical policy change compared to former administrations in Ecuador, the transformation of the institutionality of international cooperation during the period of President Rafael Correa was considered as a key element for the construction of the state of 'Good Living'. This intention led to several regulatory changes in the reception of cooperation for development, and even the departure of some foreign cooperation agencies. Moreover, Ecuador launched the initiative to become a donor of cooperation towards other developing countries through the ‘South-South Cooperation’ approach. All these changes were institutionalized through the Ecuadorian System of International Cooperation as a new framework to establish rules and policies that guarantee a sovereign management of foreign aid. Therefore, this research project has been guided by two questions: What were the factors that motivated the transformation of the institutionality of international cooperation in Ecuador from 2007 to 2017? and, what were the implications of this transformation in terms of the international role of the country? This paper seeks to answer these questions through Role Theory within a Constructivist meta-theoretical perspective, considering that in this case, changes at the institutional level in the field of cooperation, responded not only to material motivations but also to interests built on the basis of a specific state identity. The latter was only possible to affirm through specific roles such as ‘sovereign recipient of cooperation’ as well as ‘donor of international cooperation’. However, the performance of these roles was problematic as they were not easily accepted by the other actors in the international arena or in the domestic level. In terms of methodology, these dynamics are analyzed in a qualitative way mainly through interpretive analysis of the discourse of high-level decision-makers from Ecuador and other cooperation actors. Complementary to this, document-based research of relevant information as well as interviews have been conducted. Finally, it is concluded that even if material factors such as infrastructure needs, trade and investment interests, as well as reinforcement of state control and monitoring of cooperation flows, motivated the institutional transformation of international cooperation in Ecuador; the essential basis of these changes was the search for a new identity for the country to be projected in the international arena. This identity started to be built but continues to be unstable. Therefore, it is important to potentiate the achievements of the new international cooperation policies, and review their weaknesses, so that non-reimbursable cooperation funds received as well as ‘South-South cooperation’ actions, contribute effectively to national objectives.

Keywords: Ecuador, international cooperation, Role Theory, state identity

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562 Exploring Reading into Writing: A Corpus-Based Analysis of Postgraduate Students’ Literature Review Essays

Authors: Tanzeela Anbreen, Ammara Maqsood

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Reading into writing is one of university students' most required academic skills. The current study explored postgraduate university students’ writing quality using a corpus-based approach. Twelve postgraduate students’ literature review essays were chosen for the corpus-based analysis. These essays were chosen because students had to incorporate multiple reading sources in these essays, which was a new writing exercise for them. The students were provided feedback at least two times which comprised of the written comments by the tutor highlighting the areas of improvement and also by using the ‘track changes’ function. This exercise was repeated two times, and students submitted two drafts. This investigation included only the finally submitted work of the students. A corpus-based approach was adopted to analyse the essays because it promotes autonomous discovery and personalised learning. The aim of this analysis was to understand the existing level of students’ writing before the start of their postgraduate thesis. Text Inspector was used to analyse the quality of essays. With the help of the Text Inspector tool, the vocabulary used in the essays was compared to the English Vocabulary Profile (EVP), which describes what learners know and can do at each Common European Framework of Reference (CEFR) level. Writing quality was also measured for the Flesch reading ease score, which is a standard to describe the ease of understanding the writing content. The results reflected that students found writing essays using multiple sources challenging. In most essays, the vocabulary level achieved was between B1-B2 of the CEFL level. The study recommends that students need extensive training in developing academic writing skills, particularly in writing the literature review type assignment, which requires multiple sources citations.

Keywords: literature review essays, postgraduate students, corpus-based analysis, vocabulary proficiency

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561 Factors Influencing Violence Experienced by Medical Staff in Primary Health Care Centers, Taif City

Authors: Turki Adnan Kamal, Abdulmajeed Ahmad Alsofiany, Nemer Khidhran Husain Alghamdi, Ali Eissa Hassan Al-Rajhi

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Background:- Health care workers are ranked as one of the most vulnerable groups experiencing violence and aggressive behavior compared to other occupational groups. Objectives:- To estimate the prevalence rate and characteristics and assess the avoidance measures, and notification of the violence among medical staff working in primary health care centers in Taif city. Subject and methods:- A cross-sectional study design was applied among all physicians and a representative sample of nurses working in primary health care centers affiliated with the Ministry of Health (MOH) in Taif city. A predesigned Arabic/English validated self-administered questionnaire was used. Results:- In this study, 56 physicians and 145 nurses responded, giving a response rate of 77.6%. Their age ranged from 25 and 60 years (36.2±8.2), with 59.7% of them aged between 25 and 35 years. Males represent 55.7% of them. More than half of them (52.2%) were Saudis. The prevalence of workplace violence was 30.3%. Verbal abuse was the commonest reported type (86.9%). The absence of security, training on the procedures that must be followed and special uniforms at the workplace were significantly associated with workplace violence. We concluded that workplace violence is a significant problem facing a considerable proportion of HCWs in primary health care centers in Taif, Saudi Arabia. Most violence incidents were verbal. Conclusion:- Findings of this study revealed that HCWs who were dealing with male patients only were at high risk of workplace violence and the absence of measures to avoid workplace violence, particularly security, training on the procedures that must be followed and special uniform at the workplace was significantly associated with workplace violence.

Keywords: violence, workplace, primary health care, prevalence, avoidance

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560 Intelligent Scaffolding Diagnostic Tutoring Systems to Enhance Students’ Academic Reading Skills

Authors: A.Chayaporn Kaoropthai, B. Onjaree Natakuatoong, C. Nagul Cooharojananone

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The first year is usually the most critical year for university students. Generally, a considerable number of first-year students worldwide drop out of university every year. One of the major reasons for dropping out is failing. Although they are supposed to have mastered sufficient English proficiency upon completing their high school education, most first-year students are still novices in academic reading. Due to their lack of experience in academic reading, first-year students need significant support from teachers to help develop their academic reading skills. Reading strategies training is thus a necessity and plays a crucial role in classroom instruction. However, individual differences in both students, as well as teachers, are the main factors contributing to the failure in not responding to each individual student’s needs. For this reason, reading strategies training inevitably needs a diagnosis of students’ academic reading skills levels before, during, and after learning, in order to respond to their different needs. To further support reading strategies training, scaffolding is proposed to facilitate students in understanding and practicing using reading strategies under the teachers’ guidance. The use of the Intelligent Tutoring Systems (ITSs) as a tool for diagnosing students’ reading problems will be very beneficial to both students and their teachers. The ITSs consist of four major modules: the Expert module, the Student module, the Diagnostic module, and the User Interface module. The application of Artificial Intelligence (AI) enables the systems to perform diagnosis consistently and appropriately for each individual student. Thus, it is essential to develop the Intelligent Scaffolding Diagnostic Reading Strategies Tutoring Systems to enhance first-year students’ academic reading skills. The systems proposed will contribute to resolving classroom reading strategies training problems, developing students’ academic reading skills, and facilitating teachers.

Keywords: academic reading, intelligent tutoring systems, scaffolding, university students

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559 Lateral Retroperitoneal Transpsoas Approach: A Practical Minimal Invasive Surgery Option for Treating Pyogenic Spondylitis of the Lumbar Vertebra

Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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558 Literary Theatre and Embodied Theatre: A Practice-Based Research in Exploring the Authorship of a Performance

Authors: Rahul Bishnoi

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Theatre, as Ann Ubersfld calls it, is a paradox. At once, it is both a literary work and a physical representation. Theatre as a text is eternal, reproducible, and identical while as a performance, theatre is momentary and never identical to the previous performances. In this dual existence of theatre, who is the author? Is the author the playwright who writes the dramatic text, or the director who orchestrates the performance, or the actor who embodies the text? From the poststructuralist lens of Barthes, the author is dead. Barthes’ argument of discrete temporality, i.e. the author is the before, and the text is the after, does not hold true for theatre. A published literary work is written, edited, printed, distributed and then gets consumed by the reader. On the other hand, theatrical production is immediate; an actor performs and the audience witnesses it instantaneously. Time, so to speak, does not separate the author, the text, and the reader anymore. The question of authorship gets further complicated in Augusto Boal’s “Theatre of the Oppressed” movement where the audience is a direct participant like the actors in the performance. In this research, through an experimental performance, the duality of theatre is explored with the authorship discourse. And the conventional definition of authorship is subjected to additional complexity by erasing the distinction between an actor and the audience. The design/methodology of the experimental performance is as follows: The audience will be asked to produce a text under an anonymous virtual alias. The text, as it is being produced, will be read and performed by the actor. The audience who are also collectively “authoring” the text, will watch this performance and write further until everyone has contributed with one input each. The cycle of writing, reading, performing, witnessing, and writing will continue until the end. The intention is to create a dynamic system of writing/reading with the embodiment of the text through the actor. The actor is giving up the power to the audience to write the spoken word, stage instruction and direction while still keeping the agency of interpreting that input and performing in the chosen manner. This rapid conversation between the actor and the audience also creates a conversion of authorship. The main conclusion of this study is a perspective on the nature of dynamic authorship of theatre containing a critical enquiry of the collaboratively produced text, an individually performed act, and a collectively witnessed event. Using practice as a methodology, this paper contests the poststructuralist notion of the author as merely a ‘scriptor’ and breaks it further by involving the audience in the authorship as well.

Keywords: practice based research, performance studies, post-humanism, Avant-garde art, theatre

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557 Readability Facing the Irreducible Otherness: Translation as a Third Dimension toward a Multilingual Higher Education

Authors: Noury Bakrim

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From the point of view of language morphodynamics, interpretative Readability of the text-result (the stasis) is not the external hermeneutics of its various potential reading events but the paradigmatic, semantic immanence of its dynamics. In other words, interpretative Readability articulates the potential tension between projection (intentionality of the discursive event) and the result (Readability within the syntagmatic stasis). We then consider that translation represents much more a metalinguistic conversion of neurocognitive bilingual sub-routines and modular relations than a semantic equivalence. Furthermore, the actualizing Readability (the process of rewriting a target text within a target language/genre) builds upon the descriptive level between the generative syntax/semantic from and its paradigmatic potential translatability. Translation corpora reveal the evidence of a certain focusing on the positivist stasis of the source text at the expense of its interpretative Readability. For instance, Fluchere's brilliant translation of Miller's Tropic of cancer into French realizes unconsciously an inversion of the hierarchical relations between Life Thought and Fable: From Life Thought (fable) into Fable (Life Thought). We could regard the translation of Bernard Kreiss basing on Canetti's work die englischen Jahre (les annees anglaises) as another inversion of the historical scale from individual history into Hegelian history. In order to describe and test both translation process and result, we focus on the pedagogical practice which enables various principles grounding in interpretative/actualizing Readability. Henceforth, establishing the analytical uttering dynamics of the source text could be widened by other practices. The reversibility test (target - source text) or the comparison with a second translation in a third language (tertium comparationis A/B and A/C) point out the evidence of an impossible event. Therefore, it doesn't imply an uttering idealistic/absolute source but the irreducible/non-reproducible intentionality of its production event within the experience of world/discourse. The aim of this paper is to conceptualize translation as the tension between interpretative and actualizing Readability in a new approach grounding in morphodynamics of language and Translatability (mainly into French) within literary and non-literary texts articulating theoretical and described pedagogical corpora.

Keywords: readability, translation as deverbalization, translation as conversion, Tertium Comparationis, uttering actualization, translation pedagogy

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556 Systematic Review of the Efficacy of Traditional Chinese Medicine in Parkinson Disease

Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

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Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

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555 Gender and Language: Exploring Sociolinguistic Differences

Authors: Marvelyn F. Carolino, Charlene R. Cunanan, Gellien Faith O. Masongsong, Berlinda A. Ofrecio

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This study delves into the language usage differences among men, women, and individuals with other gender preferences. It specifically centers on the sociolinguistic aspects within the English majors at the College of Education of Rizal Technological University-Pasig, spanning from the first-year to fourth-year levels. The researchers employed a triangulation approach for data collection, utilizing a validated self-made questionnaire, interviews, and observations. The results revealed that language usage among different genders is influenced by a combination of cultural norms, social dynamics, and technological factors. Cultural norms significantly shape how respondents use language, as they conform to expected speech patterns based on their gender. Social factors, such as peer pressure, were found to impact language usage for individuals of all genders. This influence was viewed as constructive for personal development rather than inhibiting performance or communication. In terms of technological factors, respondents strongly agreed that the time spent on social media and educational applications influenced their language use. These platforms provided opportunities to expand and enhance their vocabulary. Additionally, the study employed hypothesis testing through the z-test formula to assess the impact of demographic profiles on language usage differences among genders. The results indicated that gender, economic status, locality, and ethnicity did not show statistically significant differences in language use. This lack of significant variation in findings was attributed to the relatively homogeneous demographic profile of respondents, primarily composed of females with low-income backgrounds and Tagalog ethnicity. This demographic similarity likely minimized the diversity of responses.

Keywords: gender, language, sociolinguistics, differences

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554 From Context to Text and Back Again: Teaching Toni Morrison Overseas

Authors: Helena Maragou

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Introducing Toni Morrison’s fiction to a classroom overseas entails a significant pedagogical investment, from monitoring students’ uncertain journey through Morrison’s shifty semantics to filling in the gaps of cultural knowledge and understanding for the students to be able to relate text to context. A rewarding process, as Morrison’s works present a tremendous opportunity for transnational dialogue, an opportunity that hinges upon Toni Morrison’s bringing to the fore the untold and unspeakable lives of racial ‘Others’, but also, crucially, upon her broader critique of Western ideological hegemony. This critique is a fundamental aspect of Toni Morrison’s politics and one that appeals to young readers of Toni Morrison in Greece at a time when the questioning of institutions and ideological traditions is precipitated by regional and global change. It is more or less self-evident that to help a class of international students get aboard a Morrison novel, an instructor should begin by providing them with cultural context. These days, students’ exposure to Hollywood representations of the African American past and present, as well as the use of documentaries, photography, music videos, etc., as supplementary class material, provide a starting point, a workable historical and cultural framework for textual comprehension. The true challenge, however, lies ahead: it is one thing for students to intellectually grasp the historical hardships and traumas of Morrison’s characters and to even engage in aesthetic appreciation of Morrison’s writing; quite another to relate to her works as articulations of experiences akin to their own. The great challenge, then, is in facilitating students’ discovery of the universal Morrison, the author who speaks across cultures while voicing the untold tales of her own people; this process of discovery entails, on a pedagogical level, that students be guided through the works’ historical context, to plunge into the intricacies of Morrison’s discourse, itself an elaborate linguistic booby trap, so as to be finally brought to reconsider their own historical experiences using the lens of Morrison’s fiction. The paper will be based on experience of teaching a Toni Morrison seminar to a class of Greek students at the American College of Greece and will draw from students’ exposure and responses to Toni Morrison’s “Nobel Prize Lecture,” as well as her novels Song of Solomon and Home.

Keywords: toni morrison, international classroom, pedagogy, African American literature

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553 Health Information Technology in Developing Countries: A Structured Literature Review with Reference to the Case of Libya

Authors: Haythem A. Nakkas, Philip J. Scott, Jim S. Briggs

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This paper reports a structured literature review of the application of Health Information Technology in developing countries, defined as the World Bank categories Low-income countries, Lower-middle-income, and Upper-middle-income countries. The aim was to identify and classify the various applications of health information technology to assess its current state in developing countries and explore potential areas of research. We offer specific analysis and application of HIT in Libya as one of the developing countries. Method: A structured literature review was conducted using the following online databases: IEEE, Science Direct, PubMed, and Google Scholar. Publication dates were set for 2000-2013. For the PubMed search, publications in English, French, and Arabic were specified. Using a content analysis approach, 159 papers were analyzed and a total number of 26 factors were identified that affect the adoption of health information technology. Results: Of the 2681 retrieved articles, 159 met the inclusion criteria which were carefully analyzed and classified. Conclusion: The implementation of health information technology across developing countries is varied. Whilst it was initially expected financial constraints would have severely limited health information technology implementation, some developing countries like India have nevertheless dominated the literature and taken the lead in conducting scientific research. Comparing the number of studies to the number of countries in each category, we found that Low-income countries and Lower-middle-income had more studies carried out than Upper-middle-income countries. However, whilst IT has been used in various sectors of the economy, the healthcare sector in developing countries is still failing to benefit fully from the potential advantages that IT can offer.

Keywords: developing countries, developed countries, factors, failure, health information technology, implementation, libya, success

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552 Developing a Shared Understanding of Wellbeing: An Exploratory Study in Irish Primary Schools Incorporating the Voices of Teachers

Authors: Fionnuala Tynan, Margaret Nohilly

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Wellbeing in not only a national priority in Ireland but in the international context. A review of the literature highlights the consistent efforts of researchers to define the concept of wellbeing. This study sought to explore the understating of Wellbeing in Irish primary schools. National Wellbeing Guidelines in the Irish context frame the concept of wellbeing through a mental health paradigm, which is but one aspect of wellbeing. This exploratory research sought the views of Irish primary-school teachers on their understanding of the concept of wellbeing and the practical application of strategies to promote wellbeing both in the classroom and across the school. Teacher participants from four counties in the West of Ireland were invited to participate in focus group discussion and workshops through the Education Centre Network. The purpose of this process was twofold; firstly to explore teachers’ understanding of wellbeing in the primary school context and, secondly, for teachers to be co-creators in the development of practical strategies for classroom and whole school implementation. The voice of the teacher participants was central to the research design. The findings of this study indicate that the definition of wellbeing in the Irish context is too abstract a definition for teachers and the focus on mental health dominates the discourse in relation to wellbeing. Few teachers felt that they were addressing wellbeing adequately in their classrooms and across the school. The findings from the focus groups highlighted that while teachers are incorporating a range of wellbeing strategies including mindfulness and positive psychology, there is a clear disconnect between the national definition and the implementation of national curricula which causes them concern. The teacher participants requested further practical strategies to promote wellbeing at whole school and classroom level within the framework of the Irish Primary School Curriculum and enable them to become professionally confident in developing a culture of wellbeing. In conclusion, considering wellbeing is a national priority in Ireland, this research promoted the timely discussion the wellbeing guidelines and the development of a conceptual framework to define wellbeing in concrete terms for practitioners. The centrality of teacher voices ensured the strategies proposed by this research is both practical and effective. The findings of this research have prompted the development of a national resource which will support the implementation of wellbeing in the primary school at both national and international level.

Keywords: primary education, shared understanding, teacher voice, wellbeing

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551 Teaching Practices for Subverting Significant Retentive Learner Errors in Arithmetic

Authors: Michael Lousis

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The systematic identification of the most conspicuous and significant errors made by learners during three-years of testing of their progress in learning Arithmetic throughout the development of the Kassel Project in England and Greece was accomplished. How much retentive these errors were over three-years in the officially provided school instruction of Arithmetic in these countries has also been shown. The learners’ errors in Arithmetic stemmed from a sample, which was comprised of two hundred (200) English students and one hundred and fifty (150) Greek students. The sample was purposefully selected according to the students’ participation in each testing session in the development of the three-year project, in both domains simultaneously in Arithmetic and Algebra. Specific teaching practices have been invented and are presented in this study for subverting these learners’ errors, which were found out to be retentive to the level of the nationally provided mathematical education of each country. The invention and the development of these proposed teaching practices were founded on the rationality of the theoretical accounts concerning the explanation, prediction and control of the errors, on the conceptual metaphor and on an analysis, which tried to identify the required cognitive components and skills of the specific tasks, in terms of Psychology and Cognitive Science as applied to information-processing. The aim of the implementation of these instructional practices is not only the subversion of these errors but the achievement of the mathematical competence, as this was defined to be constituted of three elements: appropriate representations - appropriate meaning - appropriately developed schemata. However, praxis is of paramount importance, because there is no independent of science ‘real-truth’ and because praxis serves as quality control when it takes the form of a cognitive method.

Keywords: arithmetic, cognitive science, cognitive psychology, information-processing paradigm, Kassel project, level of the nationally provided mathematical education, praxis, remedial mathematical teaching practices, retentiveness of errors

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550 E-Book Market In Vietnam: Great Potential, Many Barriers

Authors: Zakir Hossain

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Nowadays reading e-books on laptops, smartphones, and tablets have become a new leisure activity for Vietnamese youth. Since 2011 the copyrighted e-book market began to develop in Vietnam with the participation of five local enterprises. Over the last five years, thousands of e-books were published including the first online early education book series for children from 0 to 6 years old. Research shows that 61% Vietnamese find reading e-books is comfortable, and 45% feel convenient buying books online. More than half of the Vietnamese consider reading online far better than buying printed books, and surprisingly people over age 30 desire reading online while those under 18 prefer reading printed books. Hence with a market of more than 40 million regular internet users including 22 million smartphone users, Vietnam has ample opportunities to develop the e-book market and contribute a great deal to the diversity of the local reading culture which is essential for Building a Lifelong Learning Society, a state ambition of Vietnam by 2020. However, the e-book market in Vietnam is still in its infancy and is growing far too slowly than e-book producers had expected. All five e-book enterprises are facing numerous challenges. While the big profit that e-book technology can bring has been clearly recognised in other countries, e-books in Vietnam only make up less than 1% share of the book market. The objective of the study is to identify the difficulties and barriers to the development of the e-book market in Vietnam through an extensive literature review available in English. The study revealed that illegal e-books due to copyright infringement and an inconvenient payment system to purchase e-books are the major obstacles. The great potential of e-books in Vietnam is a reality but requires government enforcement of copyright protection laws, a new area of focus for the e-book market. Furthermore, Vietnamese readers should change their habits from using free and illegal e-books to develop the e-publishing industry in Vietnam.

Keywords: copyright, e-book, e-book reading, e-publishing, Vietnam

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549 Morphemic Analysis Awareness: A Boon or Bane on ESL Students’ Vocabulary Learning Strategy

Authors: Chandrakala Varatharajoo, Adelina Binti Asmawi, Nabeel Abdallah Mohammad Abedalaziz

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This study investigated the impact of inflectional and derivational morphemic analysis awareness on ESL secondary school students’ vocabulary learning strategy. The quasi-experimental study was conducted with 106 low proficiency secondary school students in two experimental groups (inflectional and derivational) and one control group. The students’ vocabulary acquisition was assessed through two measures: Morphemic Analysis Test and Vocabulary- Morphemic Test in the pretest and posttest before and after an intervention programme. Results of ANCOVA revealed that both the experimental groups achieved a significant score in Morphemic Analysis Test and Vocabulary-Morphemic Test. However, the inflectional group obtained a fairly higher score than the derivational group. Thus, the results indicated that ESL low proficiency secondary school students performed better on inflectional morphemic awareness as compared to derivatives. The results also showed that the awareness of inflectional morphology contributed more on the vocabulary acquisition. Importantly, learning inflectional morphology can help ESL low proficiency secondary school students to develop both morphemic awareness and vocabulary gain. Theoretically, these findings show that not all morphemes are equally useful to students for their language development. Practically, these findings indicate that morphological instruction should at least be included in remediation and instructional efforts with struggling learners across all grade levels, allowing them to focus on meaning within the word before they attempt the text in large for better comprehension. Also, by methodologically, by conducting individualized intervention and assessment this study provided fresh empirical evidence to support the existing literature on morphemic analysis awareness and vocabulary learning strategy. Thus, a major pedagogical implication of the study is that morphemic analysis awareness strategy is a definite boon for ESL secondary school students in learning English vocabulary.

Keywords: ESL, instruction, morphemic analysis, vocabulary

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