Search results for: hearing impaired children
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3639

Search results for: hearing impaired children

639 Under the 'Umbrella' Project: A Volunteer-Mentoring Approach for Socially Disadvantaged University Students

Authors: Evridiki Zachopoulou, Vasilis Grammatikopoulos, Michail Vitoulis, Athanasios Gregoriadis

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In the last ten years, the recent economic crisis in Greece has decreased the financial ability and strength of several families when it comes to supporting their children’s studies. As a result, the number of students who are significantly delaying or even dropping out of their university studies is constantly increasing. The students who are at greater risk for academic failure are those who are facing various problems and social disadvantages, like health problems, special needs, family poverty or unemployment, single-parent students, immigrant students, etc. The ‘Umbrella’ project is a volunteer-based initiative to tackle this problem at International Hellenic University. The main purpose of the project is to provide support to disadvantaged students at a socio-emotional, academic, and practical level in order to help them complete their undergraduate studies. More specifically, the ‘Umbrella’ project has the following goals: (a) to develop a consulting-supporting network based on volunteering senior students, called ‘i-mentors’. (b) to train the volunteering i-mentors and create a systematic and consistent support procedure for students at-risk, (c), to develop a service that, parallel to the i-mentor network will be ensuring opportunities for at-risk students to find a job, (d) to support students who are coping with accessibility difficulties, (e) to secure the sustainability of the ‘Umbrella’ project after the completion of the funding of the project. The innovation of the Umbrella project is in its holistic-person-centered approach that will be providing individualized support -via the i-mentors network- to any disadvantaged student that will come ‘under the Umbrella.’

Keywords: peer mentoring, student support, socially disadvantaged students, volunteerism in higher education

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638 Comparative Evaluation of Weaning Knowledge, Attitudes and Feeding Practices among Mothers in Benue and Zamfara States of Nigeria

Authors: Apityan Tume, Sefater Gbashi, Stephanie Dillon

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The present study was aimed at investigating the weaning knowledge, attitudes and practices among mothers with infants in Benue and Zamfara States, Nigeria. A questionnaire consisting of both open and close-ended questions was adopted for this study. Socio-demographic information was captured with this questionnaire. This is in addition to capturing data linked to respondents' knowledge and attitude to weaning and the weaning practice itself. 400 questionnaires were distributed, and 329 was filled and returned. Results obtained from the study revealed that the mother's location; mother's level of education, her occupation, her age; and her level of education would have an effect on her practice of and attitude to weaning. Essentially, mothers based in Zamfara who were full-time housewives, tailor or trader were more likely to start weaning at a later age than mothers who have the same occupation but based in Benue. Furthermore, the results revealed mothers who were uneducated and based in Zamfara were more likely to wean their babies later than the uneducated mothers, mothers educated to primary, secondary or tertiary level based in Benue. It was also evident that mothers who were low-income earners and based in Zamfara were more likely to start weaning later than the low, average or high-income earning mothers in Benue. Moreover, younger mothers in Zamfara age 20-25 years were more likely to start weaning later than mothers of other age groups. In overall, mothers had a good understanding of best practices with regards to weaning. Notwithstanding, mothers could be further encouraged and educated about the advantages of exclusive breastfeeding and complementary feeding practices as well as the benefits therein to enhance the healthy growth of the children.

Keywords: breastfeeding, complementary feeding, socio-demographic, weaning

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637 Predictive Analytics Algorithms: Mitigating Elementary School Drop Out Rates

Authors: Bongs Lainjo

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Educational institutions and authorities that are mandated to run education systems in various countries need to implement a curriculum that considers the possibility and existence of elementary school dropouts. This research focuses on elementary school dropout rates and the ability to replicate various predictive models carried out globally on selected Elementary Schools. The study was carried out by comparing the classical case studies in Africa, North America, South America, Asia and Europe. Some of the reasons put forward for children dropping out include the notion of being successful in life without necessarily going through the education process. Such mentality is coupled with a tough curriculum that does not take care of all students. The system has completely led to poor school attendance - truancy which continuously leads to dropouts. In this study, the focus is on developing a model that can systematically be implemented by school administrations to prevent possible dropout scenarios. At the elementary level, especially the lower grades, a child's perception of education can be easily changed so that they focus on the better future that their parents desire. To deal effectively with the elementary school dropout problem, strategies that are put in place need to be studied and predictive models are installed in every educational system with a view to helping prevent an imminent school dropout just before it happens. In a competency-based curriculum that most advanced nations are trying to implement, the education systems have wholesome ideas of learning that reduce the rate of dropout.

Keywords: elementary school, predictive models, machine learning, risk factors, data mining, classifiers, dropout rates, education system, competency-based curriculum

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636 The Relation between Sports Practice and the Academic Performance

Authors: Albert Perez-Bellmunt, Eila Rivera, Aida Valls, Berta Estragues, Sara Ortiz, Roberto Seijas, Pedro Alvarez

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INTRODUCTION: Physical and sports activity on a regular basis present numerous health benefits such as the prevention of cardiovascular and metabolic diseases. Also, there is a relation between sport and the psychological or the cognitive process of children and young people. The objective of the present study is to know if the sports practice has any positive influence on the university academic performance. MATERIALS AND METHODS: The level of the physical activity of 220 students of different degrees in health science was evaluated and compared with the academic results (grades). To assess the level of physical and sports activity, the Global Physical Activity Questionnaire (to calculate the sporting level in a general way) and the International Physical Activity Questionnaire (to estimate the physical activity carried out during the days leading up to the academic exams) were used. RESULTS: The students that realized an average level of sports activity the days before the exam obtained better grades than the rest of their classmate and the result was statistically significant. Controversially, if the sports level was analyzed in a general way, no relationship was observed between academic performance and the level of sport realized. CONCLUSION: A moderate physical activity, on the days leading up to an assessment, can be a positive factor for the university academic performance. Despite the fact that a regular sports activity improves many cognitive and physiological processes, the present study did not observe a direct relationship between sport/physical activity and academic performance.

Keywords: academic performance, academic results, global physical activity questionnaire, physical activity questionnaire, sport, sport practice

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635 Extra Skeletal Manifestations of Histocytosis in Pediatrics

Authors: Ayda Youssef, Mohammed Ali Khalaf, Tarek Rafaat

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Background: Langerhans cell histiocytosis (LCH) is a rare multi-systemic disease that shows an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the lung, liver, spleen, lymph nodes, brain, mucocutaneous, soft tissue (head and neck), and salivary glands. Evaluation of the extent of disease is one of the major predictors of patient outcome. Objectives: To recognize the pathogenesis of Langerhans cell histiocytosis (LCH), describe the radiologic criteria that are suggestive of LCH in different organs rather than the bones and to illustrate the appropriate differential diagnoses for LCH in each of the common extra-osseous sites. Material and methods: A retrospective study was done on 150 biopsy-proven LCH patients from 2007 to 2012. All patients underwent imaging studies, mostly US, CT, and MRI. These patients were reviewed to assess the extra-skeletal manifestations of LCH. Results: In 150 patients with biopsy-proven LCH, There were 33 patients with liver affection, 5 patients with splenic lesions, 55 patients with enlarged lymph nodes, 9 patient with CNS disease and 11 patients with lung involvement. Conclusions: Because of the frequent LCH children and evaluation of the extent of disease is one of the major predictors of patient outcome. Radiologist need to be familiar with its presentation in different organs and regions of body outside the commonest site of affection (bones). A high-index suspicion should be raised a biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality.

Keywords: langerhans cell histiocytosis, extra-skeletal, pediatrics, radiology

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634 Social Consequences of Male Migration on Women: An Evidence from Gujrat-Pakistan

Authors: Shahid Iqbal

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It is observed that international migration is increased over a time period in all over the world counties and Pakistan is not escaped. It played a pivotal role in household economy and affecting the gender roles both positive and negative in the developing countries. A vast majority of males from Pakistan migrate to other countries in search of employment and income generating activities and their families left behind, particularly nuclear families are subjected to different social problems. In this scenario, most of the responsibilities lie on the female partners as they have to play the role of male as well as female for their children and household chores. Wives of some males feel loneliness, isolation and a sense of insecurity. Keeping in mind, these realities, this study aims to explore the social impact of husbands’ absentee ship on the lives of families left behind. Particularly, wives’ own experiences will be analyzed. This study will be carried out in the District Gujrat of Punjab Pakistan. Since this study will focus on observing the social impact of male’s migration on families, so, all the households that had at least one member abroad will be the potential respondents of the study. Purposes sampling technique will be used as method to locate the respondents. A focus group discussion will be conducted as a tool for the collection of data. Those women will be approached who are taking care of their families in the absence of their husbands for last three years. For the sake of analysis Interpretative Phenomenological Analysis (IPA) will be applied and researcher will explore how participants make sense of their personal experience and social world.

Keywords: social consequences, male migration, left behind, absentee ship, Pakistan

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633 High Prevalence of Multi-drug Resistant Diarrheagenic Escherichia coli among Hospitalised Diarrheal Patients in Kolkata, India

Authors: Debjani Ghosh, Goutam Chowdhury, Prosenjit Samanta, Asish Kumar Mukhopadhyay

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Acute diarrhoea caused by diarrheagenic Escherichia coli (DEC) is one of the major public health problem in developing countries, mainly in Asia and Africa. DEC consists of six pathogroups, but the majority of the cases were associated with the three pathogropus, enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC), and enteropathogenic E. coli (EPEC). Hence, we studied the prevalence and antimicrobial resistance of these three major DEC pathogroups in hospitalized diarrheal patients in Kolkata, India, during 2012-2019 with a large sample size. 8,891 stool samples were processed, and 7.8% of them was identified as DEC infection screened by multiplex PCR, in which ETEC was most common (47.7%) followed by EAEC (38.4%) and EPEC (13.9%). Clinical patient history suggested that children <5 years of age were mostly affected with ETEC and EAEC, whereas people within >5-14 years of age were significantly associated with EPEC and ETEC infections. Antibiogram profile showed a high prevalence of multidrug resistant (MDR) isolates among DEC (56.9%), in which 9% were resistant to antibiotics of six different antimicrobial classes. Screening of the antibiotic resistance conferring genes in DEC showed the presence of blaCTX-M (30.2%) in highest number followed by blaTEM (27.5%), tetB (18%), sul2 (12.6%), strA (11.8%), aadA1 (9.8%), blaOXA-1 (9%), dfrA1 (1.6%) and blaSHV (1.2%) which indicates the existence of mobile genetic elements in those isolates. Therefore, the presence of MDR DEC strains in higher number alarms the public health authorities to take preventive measures before the upsurge of the DEC caused diarrhea cases in near future.

Keywords: diarrheagenic escherichia coli, ETEC, EAEC, EPEC

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632 Spiritual Warriors: Christian Testimony and Psychotherapy in Ritual Abuse Memoir

Authors: Jocelyn Cohen

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This paper identifies a powerful synchronicity of two traditions of life-story writing in the autobiographies of ritual abuse (RA) survivors, the Christian conversion narrative and the memoir of healing from childhood sexual trauma. Using methodologies from literary studies, history, and psychology, a close reading of three RA memoirs sheds light on a taboo and deeply suspect form of violence. Treatment of RA survivors and the unique role of psychotherapists, in particular, deserve far greater attention from multi-disciplinary scholars. Each story reflects salient characteristics of the Christian conversion narrative, a genre which originated in the US in the early 19th century with the serendipitous confluence of the simultaneous emergence of print culture and the basic structures of evangelicalism during the Second Great Awakening. The impulse of writing is thus to give testimony against the sin they witnessed and endured as young children during ritual violence perpetrated within the church. Importantly, RA is seen as an inherent if obscure aspect of Christian discourse itself, not in opposition to it, and not as an aberration. In RA's memoir, healing comes in part from the Christian narrative praxis of personal redemption, framed as prevailing in a war between good and evil. In other words, storytelling itself affects the healing, much as it does by means of each writer’s 'talking cure,' in the relationship with a psychotherapist who guides her through a repair of the life-story through the excavation of traumatic memories and their integration into the writer’s psyche. Integrating literary techniques into the psychotherapeutic relationship, therapists leverage the deep linguistic structures that clients possess as a resource to aid in their healing.

Keywords: memoir, psychotherapy, religion, trauma

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631 Attracting European Youths to STEM Education and Careers: A Pedagogical Approach to a Hybrid Learning Environment

Authors: M. Assaad, J. Mäkiö, T. Mäkelä, M. Kankaanranta, N. Fachantidis, V. Dagdilelis, A. Reid, C. R. del Rio, E. V. Pavlysh, S. V. Piashkun

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To bring science and society together in Europe, thus increasing the continent’s international competitiveness, STEM (science, technology, engineering and mathematics) education must be more relatable to European youths in their everyday life. STIMEY (Science, Technology, Innovation, Mathematics, Engineering for the Young) project researches and develops a hybrid educational environment with multi-level components that is being designed and developed based on a well-researched pedagogical framework, aiming to make STEM education more attractive to young people aged 10 to 18 years in this digital era. This environment combines social media components, robotic artefacts, and radio to educate, engage and increase students’ interest in STEM education and careers from a young age. Additionally, it offers educators the necessary modern tools to deliver STEM education in an attractive and engaging manner in or out of class. Moreover, it enables parents to keep track of their children’s education, and collaborate with their teachers on their development. Finally, the open platform allows businesses to invest in the growth of the youths’ talents and skills in line with the economic and labour market needs through entrepreneurial tools. Thus, universities, schools, teachers, students, parents, and businesses come together to complete a circle in which STEM becomes part of the daily life of youths through a hybrid educational environment that also prepares them for future careers.

Keywords: e-learning, entrepreneurship, pedagogy, robotics, serious gaming, social media, STEM education

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630 The Effect of Gender Differences on Mate Selection in Private University

Authors: Hui Min Kong, Rajalakshmi A/P Ganesan

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The present study was conducted to investigate the effect of gender differences in mate selection in a private university. Mate selection is an important process and decision to the people around the world, especially for single people. The future partner we have chosen could be our lifetime friend, supporter, and lover. Mate selection is important to us, but we have never fully understood the evolution of gender differences in mate selection. Besides, there was an insufficient empirical finding of gender differences in mate selection in Malaysia. Hence, the research would allow us to understand our feelings and thoughts about our future partners. The research null hypotheses have stated that there was no significant difference on 18 mate selections characteristics between males and females. A quantitative method was performed to test the hypotheses through independent t-test. There was a total of 373 heterosexual participants with the age range of 18 to 35 in the study. The instrument used was Factors in choosing a mate developed by Buss and Barnes (1986). Results indicated that females (M= 26.69) were found to be highly valued on refinement and neatness, good financial prospect, dependable character, emotional stability and maturity, desire for home and children, favorable social status or rating, similar religious background, ambition and industriousness, mutual attraction, good health and education and intelligence than males (M= 23.25). These results demonstrated that there were 61.11% significant gender differences in mate selections characteristics. Findings of this research have highlighted the importance of human mate selections in Malaysia. Further research is needed to identify the factors that could have a possible moderating effect of gender differences in mate selection.

Keywords: gender differences, mate selections, evolution, future partner

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629 The Impact of Social Interaction, Wellbeing and Mental Health on Student Achievement During COVID-19 Lockdown in Saudi Arabia

Authors: Shatha Ahmad Alharthi

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Prior research suggests that reduced social interaction can negatively affect well-being and impair mental health (e.g., depression and anxiety), resulting in lower academic performance. The COVID-19 pandemic has significantly limited social interaction among Saudi Arabian school children since the government closed schools and implemented lockdown restrictions to reduce the spread of the disease. These restrictions have resulted in prolonged remote learning for middle school students with unknown consequences for perceived academic performance, mental health, and well-being. This research project explores how middle school Saudi students’ current remote learning practices affect their mental health (e.g., depression and anxiety) and well-being during the lockdown. Furthermore, the study will examine the association between social interaction, mental health, and well-being pertaining to students’ perceptions of their academic achievement. Research findings could lead to a better understanding of the role of lockdown on depression, anxiety, well-being and perceived academic performance. Research findings may also inform policy-makers or practitioners (e.g., teachers and school leaders) about the importance of facilitating increased social interactions in remote learning situations and help to identify important factors to consider when seeking to re-integrate students into a face-to-face classroom setting. Potential implications for future educational research include exploring remote learning interventions targeted at bolstering students’ mental health and academic achievement during periods of remote learning.

Keywords: depression, anxiety, academic performance, social interaction

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628 A Retrospective Study to Evaluate Verbal Scores of Autistic Children Who Received Hyperbaric Oxygen Therapy

Authors: Tami Peterson

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Hyperbaric oxygen therapy (HBOT) has been hypothesized as an effective treatment for increasing verbal language skills in individuals on the autism spectrum. A child’s ability to effectively communicate with peers, parents, and caregivers impacts their level of independence and quality of personal relationships. This retrospective study will compare the speech development of participants aged 2-17 years that received 40 sessions of HBOT at 2.0 ATA to those who had not. Both groups will have a verbal assessment every six months. There were 31 subjects in the HBO group and 32 subjects in the non-HBO group. The statistical analysis will focus on whether hyperbaric oxygen therapy made a significant difference in Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) or Assessment of Basic Language and Learning Skills (ABLLS) results. The evidence demonstrates a strong correlation between HBOT and an increased change from baseline verbal scores compared to the control group, even in difficult to grasp areas such as spontaneous vocalization. We suggest this is due to the anti-inflammatory effects of hyperbaric oxygen therapy. Neuroinflammation causes hypoperfusion of critical central nervous system areas responsible for the symptoms described within the autism spectrum, such as problems with thought processing, memory, and speech. Decreasing the inflammation allows the brain to function properly, which results in improved verbal scores for the participants that underwent HBOT.

Keywords: assessment of basic language and learning skills, autism spectrum disorder, hyperbaric oxygen therapy, verbal behavior milestones assessment and placement program

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627 Islamic Perspective on Autism Spectrum Disorder: Lived Experience of Muslim Families of Children with Autism Spectrum Disorder in a City in the UK

Authors: Hawa Khan

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Autism is a complex disorder related to abnormalities in the development of brain structure and neurological function and a new phenomenon which is epidemically on the increase. The Muslim community, with its profound commitment to the all-encompassing Islamic precedence, views all phenomena in the light of religious imperatives. How autism is understood and treated in these communities is key to successful inclusive services. Moreover, parents mentioned their Islamic faith as a coping mechanism for the challenges they faced while caring for their child. This study utilises interpretative phenomenology analysis as a methodology that seeks to interpret the meaning the participants make of their experiences, which extends descriptive analysis. Semi-structured interviews were conducted with 5 family units that included fathers, mothers, grandparents, and siblings. In the preliminary stage, this study found families give high importance of accessible Islamic education for their child and questioning the accountability of the child who might not be able to follow the Islamic way of life entirely or understand the concept of Allah. Moreover, the families expressed their beliefs in traditional and religious treatment as an effective way to treat and cure autism. This poses a major barrier between families seeking support and professionals providing services. Consequentially, it can also result in a low uptake of mainstream services from the Muslim community. Exploring the lived experiences of parents from the Muslim community and how ASD is conceptualised in this community could have implications for improved and effective home, community, and service collaboration.

Keywords: autism spectrum disorder, Islamic education, religious beliefs, mainstream services

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626 Frequency and Factors Associated with Thyroid Dysfunction: A Descriptive Cross-Sectional Study from a Tertiary Care Center in Kabul, Afghanistan

Authors: Mohammad Naeem Lakanwall, Jamshid Abdul-Ghafar

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Background: Endocrinopathies are a commonly occurring entity, particularly those of the thyroid gland; however, there is a lack of scientific literature from Afghanistan, a country with very limited health care facilities and resources. To our best knowledge, this is the first study aimed to describe the frequency of occurrence and factors associated with thyroid dysfunction in the Afghan population. The aim of this study is to estimate the frequency and to identify factors associated with thyroid dysfunction among individuals coming to a tertiary care facility in Kabul, Afghanistan. Methods: A cross-sectional study was conducted from July to Sep 2018 at the Department of Clinical Pathology, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan. Blood samples were obtained, serum TSH levels were analyzed, and the patients were divided into three diagnostic categories according to their serum TSH concentrations: 1) hypothyroidism, 2) hyperthyroidism, 3) normal. Results: A total of 127 individuals were included in the final analysis. The majority of study participants (77%) were females. A large number of the participants (92%) did not have a family history of thyroid dysfunction. 74% of the participants in the study had normal TSH levels classified as normal thyroid function, (14%) had lower TSH levels, and (12%) higher TSH levels, classified as hyper and hypothyroid, respectively. Conclusions: The findings of the current study showed a high frequency of thyroid dysfunctions from a single center. Further large-scale studies are needed to find out the prevalence and document this entity for better health outcomes in the country.

Keywords: Afghanistan, factors, frequency, hypothyroid, hyperthyroid, thyroid, thyroid stimulating hormone

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625 Non-Communicable Diseases: Knowledge, Attitudes and Practices of Risk Factors among Secondary School Students in Sharjah, UAE

Authors: A. Al-Wandi, A. Al-Ali, R. Dali, Y. Al-Karaghouli

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Background: Non-communicable diseases (NCDs) have become an alarming health problem across the globe. The risk of developing those diseases begins in childhood and develops gradually under the influence of risk factors including obesity, hypertension, dyslipidemia, cigarette smoking and decreased physical activity. Therefore, this study aims to determine the level of knowledge, attitudes, and practices of the risk factors of lifestyle induced chronic diseases (non-communicable diseases) among secondary school students in Sharjah city. Methods: Five hundred and ninety-one school children, from grades 10 to 12, formed the study sample, using the multistage stratified cluster sampling method. Four governmental schools were chosen, for each gender. Data was collected through a pretested, close-ended questionnaire consisting of five sections; demographics, physical activity, diet, smoking and sleeping patterns. Frequencies and descriptive statistics were used to analyze data through SPSS 23. Results: The data showed 64.6% of students had low knowledge of risk factors of non-communicable diseases. Concerning physical activity, 58.2 % were physically inactive and females being less active than males. More than 2/3 of students didn’t fulfill the recommended daily intake of fruits and vegetables (75.9%). 8% reported to be smokers with cigarettes being the most encountered tobacco product. Conclusion: Our study has demonstrated a low level of knowledge and practices yet, positive attitudes towards risk factors of chronic diseases. We recommend implementation of thorough awareness campaigns through public health education about the risk factors of non-communicable diseases.

Keywords: non-communicable diseases, physical activity, diet, knowledge, attitudes, practices, smoking

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624 Randomized Controlled Study of the Antipyretic Efficacy of Oral Paracetamol, Intravenous Paracetamol, and Intramuscular Diclofenac

Authors: Firjeeth C. Paramba, Vamanjore A. Naushad, Nishan K. Purayil, Osama H. Mohammed, Prem Chandra

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Background: Fever is a common problem in adults visiting the emergency department. Extensive studies have been done in children comparing the efficacy of various antipyretics. However, studies on the efficacy of antipyretic drugs in adults are very scarce. To the best of our knowledge, no controlled trial has been carried out comparing the antipyretic efficacy of paracetamol (oral and intravenous) and intramuscular diclofenac in adults. Methods: In this parallel-group, open-label trial, participants aged 14–75 years presenting with fever who had a temperature of more than 38.5°C were enrolled and treated. Participants were randomly allocated to receive treatment with 1,000 mg oral paracetamol (n=145), 1,000 mg intravenous paracetamol (n=139), or 75 mg intramuscular diclofenac (n=150). The primary outcome was degree of reduction in mean oral temperature at 90 minutes. The efficacy of diclofenac versus oral and intravenous paracetamol was assessed by superiority comparison. Analysis was done using intention to treat principles. Results: After 90 minutes, all three groups showed a significant reduction in mean temperature, with intramuscular diclofenac showing the greatest reduction (−1.44 ± 0.43, 95% confidence interval [CI] −1.4 to −2.5) and oral paracetamol the least (−1.08 ± 0.51, 95% CI −0.99 to −2.2). After 120 minutes, there was a significant difference observed in the mean change from baseline temperature between the three treatment groups (P, 0.0001). Significant changes in temperature were observed in favor of intramuscular diclofenac over oral and intravenous paracetamol at each time point from 60 minutes through 120 minutes inclusive. Conclusion: Both intramuscular diclofenac and intravenous paracetamol showed superior antipyretic activity than oral paracetamol. However, in view of its ease of administration, intramuscular diclofenac can be used as a first-choice antipyretic in febrile adults in the emergency department.

Keywords: antipyretic, intramuscular, intravenous, paracetamol, diclofenac, emergency department

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623 Incidence, Risk Factors and Impact of Major Adverse Events Following Paediatric Cardiac Surgery

Authors: Sandipika Gupta

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Objective: Due to admirably low 30-day mortality rates for paediatric cardiac surgery, it is now pertinent to turn towards more intermediate-length outcomes such as morbidities closely associated with these surgeries. One such morbidity, major adverse events (MAE) comprises a group of adverse outcomes associated with paediatric cardiac surgery (e.g. cardiac arrest, major haemorrhage). Methods: This is a retrospective study that analysed the incidence and impact of MAE which was the primary outcome in the UK population. The data was collected in 5 centres between October 2015 and June 2017, amassing 3090 surgical episodes. The incidence and risk factors for MAE, were assessed through descriptive statistical analyses and multivariate logistic regression. The secondary outcomes of life status at 6 months and the length of hospital stay were also evaluated to understand the impact of MAE on patients. Results: Out of 3090 episodes, 134 (4.3%) had a postoperative MAE. The majority of the episodes were in: neonates (47%, P<0.001), high-risk cardiac diagnosis groups (20.1%, P<0.001), episodes with longer 5mes on the bypass (72.4%, P<0.001) and urgent surgeries (57.9%, P<0.001). Episodes reporting MAE also reported longer lengths of stay in hospital (29 days vs 9 days, P<0.001). Furthermore, patients experiencing MAE were at a higher risk of mortality at the 6-month life status check (mortality rates: 29.2% vs 2%, P<0.001).Conclusions: Key risk factors were identified. An important negative impact of MAE was found for patients. The identified risk factors could be used to profile and flag at-risk patients. Monitoring of MAE rates and closer investigation into the care pathway before and after individual MAEs in children’s heart units may lead to a reduction in these terrible events.

Keywords:

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622 Measuring the Effect of Continuous Performance Test-3 Administration on Regional Cerebral Blood Flow with Single-Photon Emission Computed Tomography in Adult ADHD

Authors: Claire Stafford, Charles Golden, Daniel Amen, Kristen Willeumier

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The aim of this study is to investigate the effect of the administration of the Conners Continuous Performance Test (CPT-3) on cerebral blood flow (CBF) in adults with ADHD. The data for this study was derived from a large SPECT database. Participants in the ADHD group (n=81, Mage=37.97) were similar to those in the healthy control group (n=8503, Mage=41.86). All participants were assessed for cerebral blood flow levels before and after CPT-3 administration. Both age and gender were considered covariates. Multiple 2-by-2 ANCOVAs with repeated measures were conducted with sphericity assumed. The main effects of CPT-3 administration on CBF levels were significant in the left and right side of the frontal and occipital, and right temporal lobe. The main effects of ADHD diagnosis were significant in all brain areas assessed. The interaction between CPT-3 administration and ADHD diagnosis was significant in the left and right side of the limbic system, basal ganglia, the frontal lobe, and occipital lobe. Post hoc tests with a Bonferroni adjustment revealed that CBF levels increased following CPT-3 administration but less so in the ADHD group. Individuals had higher levels of CBF following the administration of CPT-3. Due to a significant interaction, we can infer that ADHD diagnosis changes the effect of CPT-3 administration on CBF levels. This is consistent with our hypothesis considering that CPT-3 is a test of sustained attention, a common challenge for children with ADHD. The aforementioned interaction was not found to be significant in the parietal lobe. This may be due to the nature of CPT- 3 which does not require an integration of sensory information.

Keywords: SPECT, ADHD, conners continuous performance test, cerebral blood flow

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621 Women in Violent Conflicts and the Challenges of Food Security in Northeast Nigeria: The Case of Boko Haram Insurgency

Authors: Grace Modupe Adebo, Ayodeji Oluwamuyiwa Adedapo

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Women are key actors in ensuring food security in terms of food availability, food access, and food utilization in the developing economy, however, they suffer mostly during violent conflicts due to their feminist nature of rearing and caring for their children and relatives. The study was embarked upon to access the effects of violent conflicts posed by Boko Haram insurgency on women and food security in the Northeast of Nigeria. The study made use of secondary data. A time series data collected over a 22 years period were used. The data collected were subjected to descriptive statistics and t-test analysis. The findings of the study established a significant difference in food production (availability) before and after the Boko Haram insurgency at the 1% level of significance. The high level of Internally Displaced Person (IDP) with a high proportion of women depicts a very low level of food accessibility as the men and women has fled and uninhabited their place of abode for over a period of four to five years, thus diminishing their economic power, and the means of acquiring food which invariably endanger food stability and utilization. The study confirmed the abduction and changing roles of women as cooks, porters, spies, partners, and sex slaves to Boko Haram troop members, thus affecting their livelihoods and food security. The study recommends hands-on interventions by the governmental, non-governmental and international agencies to terminate the activities of Boko Haram in the area and restore the food production for enhanced food security.

Keywords: Boko Haram insurgency, food accessibility, food production, food utilization, women’s livelihoods

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620 Associations between Parental Divorce Process Variables and Parent-Child Relationships Quality in Young Adulthood

Authors: Klara Smith-Etxeberria

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main goal of this study was to analyze the predictive ability of some variables associated with the parental divorce process alongside attachment history with parents on both, mother-child and father-child relationship quality. Our sample consisted of 173 undergraduate and vocational school students from the Autonomous Community of the Basque Country. All of them belonged to a divorced family. Results showed that adequate maternal strategies during the divorce process (e.g.: stable, continuous and positive role as a mother) was the variable with greater predictive ability on mother-child relationships quality. In addition, secure attachment history with mother also predicted positive mother-child relationships. On the other hand, father-child relationship quality was predicted by adequate paternal strategies during the divorce process, such as his stable, continuous and positive role as a father, along with not badmouthing the mother and promoting good mother-child relationships. Furthermore, paternal negative emotional state due to divorce was positively associated with father-child relationships quality, and both, history of attachment with mother and with father predicted father-child relationships quality. In conclusion, our data indicate that both, paternal and maternal strategies for children´s adequate adjustment during the divorce process influence on mother-child and father-child relationships quality. However, these results suggest that paternal strategies during the divorce process have a greater predictive ability on father-child relationships quality, whereas maternal positive strategies during divorce determine positive mother-child relationships among young adults.

Keywords: father-child relationships quality, mother-child relationships quality, parental divorce process, young adulthood

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619 The Increase of Adolescent Obesity Rates after the COVID-19 Pandemic and Possible Obesity Prevention Programs for Implementation

Authors: Tatiana Pratt, Benyamin Hanasabzadeh, Panayiota Courelli

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The COVID-19 pandemic is one of the largest global public health issues of this current century. COVID-19 puts people diagnosed with obesity at higher risk of not only contracting the virus but also being hospitalized and dying, making this a vital time to implement obesity prevention programs. However, COVID-19 is predicted to rapidly increase the obesity rate in the United States due to the mandatory sedentary lifestyle the pandemic demands; this is especially harmful to adolescent-aged children because it creates lifelong unhealthy habits and behaviors. Adolescent obesity prevention programs have been rigorously implemented throughout the last century to help diminish the ever-increasing adolescent obesity rate. Since the pandemic kept adolescents inside and away from in-person school, many programs have now become ineffective due to their in-person participation. Examples of in-person participation programs include school lunch programs, OSNAP and New Moves. Therefore, online programs or remote intervention measures are now more essential. This leads to programs such as Time2bHealthy, HEALTH[e]TEEN, and SWITCH should be looked at with more vitality. Adolescents have intertwined their lives with technology and screen usage. Therefore, online and remote prevention programs will continue to play a large role in the post-pandemic era. This literature review will be reviewing past and current adolescent obesity prevention programs and their effectiveness with the new remote, sedentary lifestyle adolescents. Furthermore, it will suggest new ways to more productively decrease adolescent obesity rates by analyzing the harmful factors that COVID-19 introduced into their lifestyles.

Keywords: adolescent, obesity, overweight, COVID-19, preventative care, public health, public policy, obesity prevention programs, online programs

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618 The Amorphousness of the Exposure Sphere

Authors: Nipun Ansal

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People guard their beliefs and opinions with their lives. Beliefs that they’ve formed over a period of time, and can go to any lengths to defy, desist from, resist and negate any outward stimulus that has the potential to shake them. Cognitive dissonance is term used to describe it in theory. And every human being, in order to defend himself from cognitive dissonance applies 4 rings of defense viz. Selective Exposure, Selective Perception, Selective Attention, and Selective Retention. This paper is a discursive analysis on how the onslaught of social media, complete with its intrusive weaponry, has amorphized the external ring of defense: the selective exposure. The stimulus-response model of communication is one of the most inherent model that encompasses communication behaviours of children and elderly, individual and masses, humans and animals alike. The paper deliberates on how information bombardment through the uncontrollable channels of the social media, Facebook and Twitter in particular, have dismantled our outer sphere of exposure, leading users online to a state of constant dissonance, and thus feeding impulsive action-taking. It applies case study method citing an example to corroborate how knowledge generation has given in to the information overload and the effect it has on decision making. With stimulus increasing in number of encounters, opinion formation precedes knowledge because of the increased demand of participation and decrease in time for the information to permeate from the outer sphere of exposure to the sphere of retention, which of course, is through perception and attention. This paper discusses the challenge posed by this fleeting, stimulus rich, peer-dominated media on the traditional models of communication and meaning-generation.

Keywords: communication, discretion, exposure, social media, stimulus

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617 Nalanda ‘School of Joy’: Teaching Learning Strategies and Support System, for Implementing Child-Friendly Education in Bangladesh

Authors: Sufia Ferdousi

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Child-friendly education (CFE) is very important for the children, especially the early year’s students, because it fosters the holistic development of a child. Teacher plays a key role in creating child-friendly education. This study intends to learn about child-friendly education in Bangladesh. The purpose of the study is to explore how CFE is being practiced in Bangladesh. The study attempted to fulfill the purpose through case study investigation. One school, named Nalanda, was selected for the study as it claims to run the school through CFE approach. The objective of the study was to identify, how this school is different from the other schools in Bangladesh, to explore overall teaching learning system like, curriculum, teaching strategies, assessments and to investigate the support system for Child Friendly Education provided to the teachers through training or mentoring. The nature of the case study was qualitative method to get maximum information from the students, parents, teachers and school authorities. The findings were based on 3 classroom observations, interviews with 1 teacher, 1 head teacher and 1 trainer, FGD with 10 students and 6 parents, were used to collect the data. It has been found that Nalanda is different than the other schools in Bangladesh in terms of, parents’ motivation about school curriculum, and sufficiency of teachers’ knowledge on joyful learning/child-friendly learning. The students took part in the extracurricular activities alongside the national curriculum. Teachers showed particular strength in the teaching learning strategies, using materials and assessment. And Nalanda gives strong support for teacher’s training. In conclusion, The Nalanda School in Dhaka was found appropriate for the requirements of Child-friendly education.

Keywords: child friendly education, overall teaching learning system, the requirements of child-friendly education, the alternative education approach

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616 An Ethnobotanical Survey of Medicinal Plants for the Treatment of Infantile Diarrhea in the Eastern Cape Province of South Africa

Authors: Anela Lupuwana

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The main objective of this paper is to develop an ethnobotanical survey that documents medicinal plants used to treat diarrhea among infants in the Eastern Cape province of South Africa. In South Africa’s pluralistic healthcare system, medicinal plants are an integral part of healing and treating an array of diseases. This is also the case in rural areas of South Africa, where healthcare facilities are hard to access. There is a lack of literature on the use of medicinal plants to cure ailments common to children, and this paper fills this gap. A total of 18 participants were interviewed using semi-structured interviews. A purposive approach was used to sample the study cohorts. A total of 28 medicinal plants representing 19 different families were recorded, with the family Asteraceae (11%) having the most medicinal plants. The remaining plants (82%) were distributed equally among the following families: Rubiaceae, Canellaceae, Aloaceae, Rutaceae, Thymeleaceae, Myrinaceae, Olinaceae, Iradeceae, Zingiberaceae, Capparaceae, Aizoaceae, Fabaceae, Geraniaceae, Cornaceae, Monimiaceae, Talinaceae, Chrysobalanaceae, and Icacinaceae. Oral administration was the most common mode of administration, with 82% of plants taken orally. Healing was proven to be holistic; it was more than just treating physical ailments as such; infants were protected from evil spirits that made them vulnerable to illnesses. There was also evidence of the assimilation of Dutch medicine and animal products into traditional healing methods. In order to mitigate the prevalence of disease and illness in South Africa, I recommend that diversity in healing practices should be acknowledged and appreciated.

Keywords: infants, traditional healers, primary care givers, traditional medicine

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615 Community Education Leadership and Organizational Culture: Perceptions of Empowerment

Authors: Aisha M. Khairat

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Community education in the Arab Republic of Egypt is a model that provides education to remote, underprivileged villages and hamlets where children have no access to public education. The community education model is based on the philosophy of transforming individuals to reach their full potential and on instilling the seeds of empowerment and citizenship to induce societal transformation. This research aims at investigating the degree to which the leadership style and organizational culture of the Egyptian community schools demonstrates an empowering approach. Nile Valley NGO, an Egyptian Non-Governmental Organization (NGO) leading hundreds of Egyptian community schools was studied to investigate the perceptions of empowerment amongst its leadership. This in turn will have serious implications on the level of empowerment the communities managed by Nile Valley NGO are experiencing, and will serve as an indicator to the degree to which community schools are achieving their goals in transforming individuals and empowering communities and reforming Egyptian education – and not just a tool to reach literacy. This mixed-methods research utilized surveys and semi-structured interviews to capture the perceptions of empowerment in the views of a sample of 380 community schools facilitators (teachers) spanning 8 Egyptian governorates and Nile Valley NGO’s community education project team and leadership. The findings demonstrate interesting leadership approaches with traits from transformational and servant leadership theoretical models. The organizational culture at Nile Valley NGO reflects the universal dichotomy between market-oriented and humanitarian orientations. The perceptions of empowerment were positive, and several success stories were uncovered in spite of the many challenges faced on the national level and despite the scarcity or resources.

Keywords: community education, community schools in Egypt, empowerment, organizational culture, leadership

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614 Processes of Identity Construction for Generation 1.5 Students in Canada

Authors: Timothy Mossman

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The number of adolescent children accompanying their immigrant parents to Canada has steadily increased since the 1990s. Much of the applied linguistics literature on these so-called ‘Generation 1.5’ youth has focused on their deficiencies as academic writers in US Rhetoric and Composition and ESL contexts in higher education and the stigma of ESL in US K-12 contexts. However, the literature on Generation 1.5 students and identity in Canadian higher education is limited. This qualitative study investigates the processes of identity construction of three Generation 1.5 students studying at a university in Metro Vancouver to find out what types of identities and representations of self and other they make relevant, the meanings they attribute to their identities, and what motivates them to construct these identities. The study analyzes the accounts and experiences of the participants in interviews, focus groups, and texts and as ‘culture-in-action,’ positing that they constructed identities as social categories associated with the languages and social practices of their countries of birth, in liminal spaces among a continuum between Canada and their countries of birth, and a spectrum of related cultural representations. Ideas and beliefs associated with broader ‘macro’ social structures in Canadian society related to language, culture, legitimacy, immigration, power, distinction, and racism were shown to be transcended in and through their representations of themselves and others. Data suggest that moving to Canada caused participants to experience discontinuities between their cultures, languages, and social practices, and in some cases a conflicting sense of self. The study brings implications for finding ways to understand the complexity of immigrant students, avoid reifying and generalizing about them, and not see them as stuck-in-between or lacking.

Keywords: culture-in-action, generation 1.5, identity, membership categorization analysis

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613 Voices of the Grown-Ups: Transnational Rearing among Chinese Families

Authors: Laura Lamas Abraira

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Large-scale Chinese immigration in Spain emerged in the 80's. Engaged in their own businesses or working for other Chinese migrants with long schedules, young couples had to choose between contracting or transnationalising the care labour as they were unable to combine productive and reproductive tasks. In most cases, they decided to transnationalize the care labour embodied on grandparents or children migratory paths. Either the grandparents go to Spain to take care of their grandchildren or the kids were left behind or sent to China after being born in Spain in order to be raised with their extended family members. Very little is known about how the people who have been raised in a transnational context relates their own experience and agency as care managers within the family care cycle. In order to fill this gap, this paper aims to inquire into these transnationally-reared Chinese young adults’ narratives about their own experience and expectations (past, present and future) by adopting care circulation and care cycle approach within life course framework. Drawing upon a qualitative study resulting from a multi-sited ethnography (Spain-China), we argue that young adults raised in transnational context build their narratives as a result of an otherness process related to their parents and an essentialization of their Chinese roots to use selectively among different contexts. In doing so, these family narratives constitute a part of their social identity that interact with other dimensions such as the ethnic one. We suggest when building their parent's otherness they also build their sameness among pairs, as members of the same club, marked by transnational care on a double time basis: the practices of their parents as wrong past, and their own as an amendable future.

Keywords: Chinese families, narratives, transnational care, young adults

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612 Exploring the Number, Type and Level of Disability among Victims of Nepal Earthquake 2015

Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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611 A Multiple Case Study of How Bilingual-Bicultural Teachers' Language Shame and Loss Affects Teaching English Language Learners

Authors: Lisa Winstead, Penny Congcong Wang

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This two-year multiple case study of eight Spanish-English speaking teachers explores bilingual-bicultural Latino teachers’ lived experiences as English Language Learners and, more recently, as adult teachers who work with English Language Learners in mainstream schools. Research questions explored include: How do bilingual-bicultural teachers perceive their native language use and sense of self within society from childhood to adulthood? Correspondingly, what are bilingual teachers’ perceptions of how their own language learning experience might affect teaching students of similar linguistic and cultural backgrounds? This study took place in an urban area in the Pacific Southwest of the United States. Participants were K-8 teachers and enrolled in a Spanish-English bilingual authorization program. Data were collected from journals, focus group interviews, field notes, and class artifacts. Within case and cross-case analysis revealed that the participants were shamed about their language use as children which contributed to their primary language loss. They similarly reported how experiences of mainstream educator and administrator language shaming invalidated their ability to provide support for Latino heritage ELLs, despite their bilingual-bicultural expertise. However, participants reported that counter-narratives from the bilingual authorization program, parents, community and church organizations, and cultural responsive teachers were effective in promoting their language retention, pride, and feelings of well-being.

Keywords: teacher education, bilingual education, English language learners, emergent bilinguals, social justice, language shame, language loss, translanguaging

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610 Impact of a Novel Technique of S-Shaped Tracheostoma in Pediatric Tracheostomy in Intensive Care Unit on Success and Procedure Related Complications

Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

Abstract:

Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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