Search results for: patient engagement

Authors: P. W. G. D. P. Samarasekara, S. M. K. S. Seneviratne, D. Munidasa, S. S. Williams

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Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.

Keywords: content analysis, coping strategies, rehabilitation, spinal cord injury

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Authors: Usha Dinakaran, Richa Ganguly

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Gastronomic tourism has evolved into a prominent niche within the travel industry, with tourists increasingly seeking unique culinary experiences as a primary motivation for their journeys. This research explores the intricate relationship between gastronomic tourism and its profound influence on the overall image of travel destinations. It delves into the multifaceted aspects of culinary experiences, tourists' perceptions, and the preservation of cultural identity, all of which play pivotal roles in shaping a destination's image. The primary aim of this study is to comprehensively examine the interplay between gastronomy and tourism, specifically focusing on its impact on destination image. The research seeks to achieve the following objectives: (1) Investigate how tourists perceive and engage with gastronomic tourism experiences. (2) Understand the significance of food in shaping the tourism image. (3.) Explore the connection between gastronomy and the destination's cultural identity Quantify the relationship between tourists' engagement in co-creation activities related to gastronomic tourism and their overall satisfaction with the quality of their culinary experiences. To achieve these objectives, a mixed-method research approach will be employed, including surveys, interviews, and content analysis. Data will be collected from tourists visiting diverse destinations known for their culinary offerings. This research anticipates uncovering valuable insights into the nexus between gastronomic tourism and destination image. It is expected to shed light on how tourists' perceptions of culinary experiences impact their overall perception of a destination. Additionally, the study aims to identify factors influencing tourist satisfaction and how cultural identity is preserved and promoted through gastronomic tourism. The findings of this research hold practical implications for destination marketers and stakeholders. Understanding the symbiotic relationship between gastronomy and tourism can guide the development of more targeted marketing strategies. Furthermore, promoting co-creation activities can enhance tourists' culinary experiences and contribute to the positive image of destinations.This study contributes to the growing body of knowledge regarding gastronomic tourism by consolidating insights from various studies and offering a comprehensive perspective on its impact on destination image. It offers a platform for future research in this domain and underscores the importance of culinary experiences in contemporary travel. In conclusion, this research endeavors to illuminate the dynamic interplay between gastronomic tourism and destination image, providing valuable insights for both academia and industry stakeholders in the field of tourism and hospitality.

Keywords: gastronomy, tourism, destination image, culinary

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Authors: Amanda Watson

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The goal of this project is to create the conditions wherein every teacher, especially subjectarea experts, sees themselves as a teacher of language and vocabulary. Assessment and observational data suggest that students are not getting the support they need in vocabulary and reading comprehension, and secondary teachers do not currently have the confidence or expertise to provide this support. This study seeks to examine the impact of 10-20 minutes of daily, targeted instruction around orthography and vocabulary on student competence with the navigation of complex vocabulary and comprehension of subject-specific concepts and texts. The first phase of the pilot included 6 participating classroom teachers of grades 9 and 10 English (95 students in total) who administered an initial reading comprehension assessment. The results of this assessment indicated that the vast majority of students were reading below grade level. Teachers were then provided with a slide deck of complete lessons on orthography, vocabulary (etymology, roots and affixes) and reading comprehension strategies. For five weeks, teachers delivered lessons with their students, implementing the recommended evidence-based teaching strategies. Students and teachers completed surveys to provide feedback on the value and impact of the method. The results confirmed that this was new learning for the students and that the teaching strategies improved engagement. The lessons succeeded in providing equitable access to challenge by simultaneously offering theoretical learning to proficient readers, and exposure and practice to weaker readers. A second reading comprehension was administered after 5 weeks of daily instruction. Average scores increased by 41%, and almost every student experienced progress. The first phase was not long enough to measure the impact of the method on vocabulary acquisition or reading comprehension of subject-specific texts, however. The project will use the results of the first phase to design the second phase, and new teaching and learning strategies will be added. The goals of the second phases are to increase motivation, and to grow the daily practice beyond English class and into science and / or math. This team will continue to document a continuation of the daily lessons, Commented [E1]: Please do not use rhetorical questions in the abstract. measure the impact of the strategies, and address questions about the correlation between daily practice and improvements in the skills students need for vocabulary acquisition and disciplinary reading comprehension.

Keywords: adolescent, comprehension, orthography, reading, vocabulary, etymology, word study, disciplinary, teaching strategies

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Authors: Xin Qi Dong, Melissa Simon

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Aims: Elder mistreatment and suicidal ideation are important public health concerns among aging populations. This study will examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the USA. Methods: Guided by a community-based participatory research approach, in this study we conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago area from 2011 to 2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results: Overall, 3,159 Chinese older adults participated in this study, and their mean age was 72.8 years. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with 2-week suicidal ideation (OR 2.46, 95% CI 1.52--4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62--3.73). With respect to gender differences, the study found that the association remained significant for older women but not for older men after adjusting for all confounding factors. Conclusion: As the largest epidemiology study conducted among Chinese older adults in the USA, this study suggests that elder mistreatment is significantly associated with 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation.

Keywords: suicidal ideation, elder abuse, family violence, Asian health equity

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Authors: Ritwik Dutta, Marylin Wolf

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This paper describes the trade-offs and the design from scratch of a self-contained, easy-to-use health dashboard software system that provides customizable data tracking for patients in smart homes. The system is made up of different software modules and comprises a front-end and a back-end component. Built with HTML, CSS, and JavaScript, the front-end allows adding users, logging into the system, selecting metrics, and specifying health goals. The back-end consists of a NoSQL Mongo database, a Python script, and a SimpleHTTPServer written in Python. The database stores user profiles and health data in JSON format. The Python script makes use of the PyMongo driver library to query the database and displays formatted data as a daily snapshot of user health metrics against target goals. Any number of standard and custom metrics can be added to the system, and corresponding health data can be fed automatically, via sensor APIs or manually, as text or picture data files. A real-time METAR request API permits correlating weather data with patient health, and an advanced query system is implemented to allow trend analysis of selected health metrics over custom time intervals. Available on the GitHub repository system, the project is free to use for academic purposes of learning and experimenting, or practical purposes by building on it.

Keywords: flask, Java, JavaScript, health monitoring, long-term care, Mongo, Python, smart home, software engineering, webserver

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Authors: Saeideh Lotfi Nikoo, Azadeh Ghaheri, Reza Omani Samani

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Context: In most cultures around the globe, infertility is recognized as a crisis and exposed infertile couples are under psychosocial pressure. Indeed, the quality of life (QoL) for infertile women is lower in comparison with fertile control. Objective, The purpose of this study, was to investigate the impact of social support and hope on QoL in women undergoing infertility treatment. Methods: A cross-sectional study. Patient(s): In this cross-sectional study, 350 infertile women were recruited who were referred to an infertility clinic for the first time and had no history of Assisted Reproductive Techniques (ART) failure. Intervention(s): Questionnaires on the Fertility Quality of Life (FertiQoL), Multi-dimensional Scale of Perceived Social Support (family and friends), and Snyder Hope Scale (pathway and agency) were used to collect data. Data analysis was done by univariate and multivariate analysis. P value <0.05 was considered statistically significant. Result(s): Multivariate analysis indicated that infertile women with a higher score of social support (by family & friends) (b= 0.59 (CI 95%: 0.03, 1.15) (P = 0.040), b= 0.61 (CI 95%: 0.17, 1.04) (P = 0.006)) and hope (pathway & agency) (b= 0.94 (CI 95%: 0.29, 1.59) (P = 0.005), b= 1.13 (CI 95%: 0.45, 1.82) (P = 0.001) respectively) have significantly better Core FertiQoL. The result revealed that social support and hope are significantly and positively associated with other subscales of FertiQoL as well. Conclusions: According to the results, lifestyle interventions such as receiving social support, building a sound family with effective communication, and providing appropriate health education are of crucial importance to address psychological distress and improve the fertility QoL of women experiencing fertility problems.

Keywords: inertility, social support, infertile women, hope

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Authors: Nahela Nowshin, Rafia Sultana, Farzana Misha, Sabina F. Rashid

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Sexual and reproductive health and rights (SRHR) are currently an area of neglect for males (aged 15-24 years) in Bangladesh. The lack of focus on the male youth population has consequences not only for their own health and wellbeing, but the patriarchal structure of Bangladeshi society and socio-cultural norms mean that the male population’s SRH behavior can severely impact the lives of their female counterparts. A majority of sexual and reproductive health and rights-related research and interventions in the country are female-centric. Although the Government of Bangladesh has taken many initiatives to improve the SRHR of the general population, the male youth segment has not been prioritized in most of these interventions. There is an urgent need for male-youth-focused SRHR interventions in Bangladesh, but due to a lack of evidence-based research on this issue, there exist data gaps on how such interventions could be better designed and implemented. Therefore, to ascertain strategies for better program design and smoother implementation of male-youth-focused sexual and reproductive health and rights interventions, we carried out 25 key informant interviews with experts as well as focal persons involved in more than 20 ongoing and recently-ended SRHR-related interventions of national and international non-government organizations in which male youth were targeted or engaged. The results show that program implementers face several challenges at the field, organizational and policy levels. Some of the most common field challenges include high sensitivity to SRHR topics due to cultural reasons, difficulties in acquiring access to boys and young men due to their high mobility and engagement in labor for commercial purposes, as well as accessing them in hard-to-reach areas due to transportation and communication issues. Common organizational-level challenges include a lack of skilled manpower. Policy-level challenges include the prohibition of SRH service provision to unmarried adolescents and youth and lack of readiness of local governments to implement existing action plans. Some ways in which male-youth-focused SRHR interventions can be made more effective are through sensitization of service providers, awareness-raising at the community level to engage parents, advocacy to increase donor interest, and generating data on SRHR of male youth.

Keywords: Bangladesh, intervention, male, SRHR

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Authors: Qi En Han, Si En Wai, Eugene Quek

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As one of the two Academic Medical Centres (AMCs) in Singapore, SingHealth Duke-NUS AMC strives to improve patients’ lives through excellent clinical care, research and education. These efforts are enhanced with the establishment of Academic Clinical Programmes (ACPs). Each ACP brings together specialists in a particular discipline from different institutions to maximize the power of shared knowledge and resources. Initiated by Surgery ACP, the student research mentorship programme is a programme designed to facilitate engagement between medical students and the surgical faculty. The programme offers mentors not only the opportunity to supervise research but also to nurture future clinician scientists. In turn, medical students acquire valuable research experience which may be useful in their future careers. The programme typically lasts one year, depending on the students’ commitment. Surgery ACP matches students’ research interests with the mentor's area of expertise whenever possible. Surgery ACP organizes informal tea sessions to bring students and prospective mentors together. Once a match is made, the pair is required to submit a project proposal which includes the title, proposed start and end dates, ethical and biosafety considerations and project details. The mentees either think of their own research question with guidance from the mentors or join an existing project. The mentees may participate in data collection, data analysis, manuscript writing and conference presentation. The progress of each research project is monitored through half-yearly progress report. The mentees report problems encountered or changes made to existing proposal on top of the progress made. A total of 18 mentors were successfully paired with 36 mentees since 2013. Currently, there are 23 on-going and 13 completed projects. The mentees are encouraged to present their projects at conferences and to publish in peer-reviewed journals. Six mentees have presented their completed projects at local or international conferences and one mentee has her work published. To further support student research, Surgery ACP organized a Research Day in 2015 to recognize their research efforts and to showcase their wide-range of research. Surgery ACP recognizes that early exposure of medical students to research is important in developing them into clinician scientists. As interest in research take time to develop and are usually realized during various research attachments, it is crucial that programmes such as the student research mentorship programme exist. Surgery ACP will continue to build on this programme.

Keywords: academic clinical programme, clinician scientist, medical student, mentoring

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Authors: Ewa Toloczko

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Studies show that developing writing skills throughout years of formal foreign language instruction does not necessarily result in rewarding accomplishments among learners, nor an affirmative attitude they build towards written assignments. What causes this apparently wide-spread bias to writing might be a diminished relevance students attach to it, as opposed to the other productive skill — speaking, insufficient resources available for them to succeed, or the ways writing is approached by instructors, that is inapt teaching techniques that discourage rather that inflame learners’ engagement. The assumption underlying this presentation is that psychological and psycholinguistic factors constitute a key dimension of every writing process, and hence should be seriously considered in both material design and lesson planning. The author intends to demonstrate research in which writing tasks were conceived of as attitudinal rather than technical operations, and consequently turned into meaningful and socially-oriented incidents that students could relate to and have an active hand in. The instrument employed to achieve this purpose and to make writing even more interactive was the format of a project, a carefully devised series of tasks, which involved students as human beings, not only language learners. The projects rested upon the premise that the presence of peers and the teacher in class could be taken advantage of in a supportive rather than evaluative mode. In fact, the research showed that collaborative work and constant meaning negotiation reinforced not only bonds between learners, but also the language form and structure of the output. Accordingly, the role of the teacher shifted from the assessor to problem barometer, always ready to accept the slightest improvements in students’ language performance. This way, written verbal communication, which usually aims to merely manifest accuracy and coherent content for assessment, became part of the enterprise meant to emphasise its social aspect — the writer in real-life setting. The samples of projects show the spectrum of possibilities teachers have when exploring the domain of writing within school curriculum. The ideas are easy to modify and adjust to all proficiency levels and ages. Initially, however, they were meant to suit teenage and young adult learners of English as a foreign language in both European and Asian contexts.

Keywords: projects, psycholinguistic/ psychological dimension of writing, writing as a social enterprise, writing skills, written assignments

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Authors: Amy L. Smith

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This study investigates the impact of student authenticity while engaging in academic exploration of students' sense of belonging, autonomy, and persistence. Research questions include: How does incorporating authenticity in first-year academic exploration courses impact; 1) first-year students’ sense of belonging, autonomy, and persistence? 2) first-year students’ sense of belonging, autonomy, and persistence during the first and last halves of the fall semester? 3) first-year students’ sense of belonging, autonomy, and persistence among various student demographics? First-year students completed a Likert-like survey at the conclusion of eight weeks (first and last eight weeks/fall semester) academic exploration courses. Course redesign included grounding the curriculum and instruction with student authenticity and creating opportunities for students to explore, define, and reflect upon their authenticity during academic exploration. Surveys were administered at the conclusion of these eight week courses (first and last eight weeks/fall semester). Data analysis included an entropy balancing matching method and t-tests. Research findings indicate integrating authenticity into academic exploration courses for first-year students has a positive impact on students' autonomy and persistence. There is a significant difference between authenticity and first-year students' autonomy (p = 0.00) and persistence (p = 0.01). Academic exploration courses with the underpinnings of authenticity are more effective in the second half of the fall semester. There is a significant difference between an academic exploration course grounding the curriculum and instruction in authenticity offered M8A (first half, fall semester) and M8B (second half, fall semester) (p = 0); M8B courses illustrate an increase of students' sense of belonging, autonomy, and persistence. Integrating authenticity into academic exploration courses for first-year students has a positive impact on varying student demographics (p = 0.00). There is a significant difference between authenticity and low-income (p = 0.04), first-generation (p = 0.00), Caucasian (p = 0.02), and American Indian/Alaskan Native (p = 0.05) first-year students' sense of belonging, autonomy, and persistence. Academic exploration courses embedded in authenticity helps develop first-year students’ sense of belonging, autonomy, and persistence, which are effective traits of college students. As first-year students engage in content courses, professors can empower students to have greater engagement in their learning process by relating content to students' authenticity and helping students think critically about how content is authentic to them — how students' authenticity relates to the content, how students can take their content expertise into the future in ways that, to the student, authentically contribute to the greater good. A broader conversation within higher education needs to include 1) designing courses that allow students to develop and reflect upon their authenticity/to formulate answers to the questions: who am I, who am I becoming, and how will I move my authentic self forward; and 2) a discussion of how to shift from the university shaping students to the university facilitating the process of students shaping themselves.

Keywords: authenticity, first-year experience, sense of belonging, autonomy, persistence

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Authors: Esra Danaci, Tugba Kavalali Erdogan, Sevil Masat, Selin Keskin Kiziltepe, Tugba Cinarli, Zeliha Koc

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This study was conducted in a descriptive and cross-sectional manner to determine that factors that influence the self-efficacy and self-sufficiency levels among oncology patients. The research was conducted between January 24, 2017 and September 24, 2017 in the oncology and hematology departments of a university hospital in Turkey with 179 voluntary inpatients. The data were collected through the Self-Sufficiency/Self-Efficacy Scale and a 29-question survey, which was prepared in order to determine the sociodemographic and clinical properties of the patients. The Self-Sufficiency/Self-Efficacy Scale is a Likert-type scale with 23 articles. The scale scores range between 23 and 115. A high final score indicates a good self-sufficiency/self-efficacy perception for the individual. The data were analyzed using percentage analysis, one-way ANOVA, Mann Whitney U-test, Kruskal Wallis test and Tukey test. The demographic data of the subjects were as follows: 57.5% were male and 42.5% were female, 82.7% were married, 46.4% were primary school graduate, 36.3% were housewives, 19% were employed, 93.3% had social security, 52.5% had matching expenses and incomes, 49.2% lived in the center of the city. The mean age was 57.1±14.6. It was determined that 22.3% of the patients had lung cancer, 19.6% had leukemia, and 43.6% had a good overall condition. The mean self-sufficiency/self-efficacy score was 83,00 (41-115). It was determined that the patients' self-sufficiency/self-efficacy scores were influenced by some of their socio-demographic and clinical properties. This study has found that the patients had high self-sufficiency/self-efficacy scores. It is recommended that the nursing care plans should be developed to improve their self-sufficiency/self-efficacy levels in the light of the patients' sociodemographic and clinical properties.

Keywords: oncology, patient, self-efficacy, self-sufficiency

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Authors: Kieren Luellman, Makenzi Rockwell, Eduardo Callegari, Nichole Haag, Chun Wu

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Multiple sclerosis (MS) is an autoimmune disorder that damages the myelin sheath of neurons in the central nervous system. The presence of Acinetobacter bacteria and anti-Acinetobacter antibodies in MS patients has led to the hypothesis that the bacteria may contribute to MS pathogenesis. In this study, the protein sequences of Acinetobacter baumannii were compared to five peptides from three mammalian myelin proteins, i.e., Proteolipid Protein (PLP): PLP 139-151, PLP 178-191, Myelin Basic Protein (MBP): MBP 84-104 and Myelin Oligodendrocyte Glycoprotein (MOG): MOG 35-55 and MOG 92-106 respectively, known to induce experimental autoimmune encephalomyelitis (EAE), a condition similar to MS. We found 11 hits (i.e., with five or more amino acid sequence similarity) in Acinetobacter baumannii, which are identical or similar to PLP139-151, 32 hits to PLP178-191, 35 to MBP 84-104, 41 hits to MOG 35-55 and 26 hits to MOG92-106. In addition, Western blotting was used to assess possible interaction between the bacterial proteins and human anti-MBP, anti-MOG, and anti-PLP antibodies produced in rabbits, corresponding to MBP 84-104, MOG 35-55, and PLP 139-151, respectively. We found that both human Polyclonal anti-MOG antibody and anti-PLP antibody recognized a protein or more proteins of the same molecular mass of around 25 kDa. in Acinetobacter baumannii. The results suggested that this/these protein(s) might potentially serve as antigen(s) to induce anti-MOG antibody and anti-PLP antibody production in mammalian B cells. The proteomic study identified 433 hits, among which the sequence of Acinetobacter baumannii protein 491 subunit A matches a previously published enzyme Acinetobacter 3-Oxoadipate CoA-Transferase, in which a fragment of its peptide was observed to recognize MS patient serum via ELISA method. Our findings might pave the road to understanding one of the pathogenesis mechanisms of MS.

Keywords: multiple sclerosis, pathogenesis, Acinetobacter baumannii, antibody recognition

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Authors: Fenni Sim

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Objectives: The purpose of the study is to examine the relationship between family functioning and level of self-efficacy: how family functioning can potentially affect self-efficacy which will eventually lead to better clinical outcomes. The hypothesis was ‘Patients on haemodialysis with perceived higher family functioning are more likely to have higher perceived level of self-efficacy’. Methods: The study was conducted with a mixed methodology of quantitative and qualitative data collection of survey and semi-structured interview respectively. The General Self-Efficacy scale and SCORE-15 were self-administered by participants. The data will be analysed with correlation analysis method using Microsoft Excel. 79 patients were recruited for the study through random sampling. 6 participants whose results did not reflect the hypothesis were then recruited for the qualitative study. Interpretive phemenological analysis was then used to analyse the qualitative data. Findings: The hypothesis was accepted that higher family functioning leads to higher perceived self-efficacy. The correlation coefficient of -0.21 suggested a mild correlation between the two variables. However, only 4.6% of the variation in perceived self-efficacy is accounted by the variation in family functioning. The qualitative study extrapolated three themes that might explain the variations in the outliers: (1) level of physical functioning affects perceived self-efficacy, (2) instrumental support from family influenced perceived level of family functioning, and self-efficacy, (3) acceptance of illness reflects higher level of self-efficacy. Conclusion: While family functioning does have an impact on perceived self-efficacy, there are many intrapersonal and physical factors that may affect self-efficacy. The concepts of family functioning and self-efficacy are more appropriately seen as complementing each other to help a patient in managing his illness. Healthcare social workers can look at how family functioning is supporting the individual needs of patients with different trajectory of ESRD and the support we can provide to improve one’s self-efficacy.

Keywords: chronic kidney disease, coping of illness, family functioning, self efficacy

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Authors: Paweł Konieczka, Lech Raczyński, Wojciech Wiślicki, Oleksandr Fedoruk, Konrad Klimaszewski, Przemysław Kopka, Wojciech Krzemień, Roman Shopa, Jakub Baran, Aurélien Coussat, Neha Chug, Catalina Curceanu, Eryk Czerwiński, Meysam Dadgar, Kamil Dulski, Aleksander Gajos, Beatrix C. Hiesmayr, Krzysztof Kacprzak, łukasz Kapłon, Grzegorz Korcyl, Tomasz Kozik, Deepak Kumar, Szymon Niedźwiecki, Dominik Panek, Szymon Parzych, Elena Pérez Del Río, Sushil Sharma, Shivani Shivani, Magdalena Skurzok, Ewa łucja Stępień, Faranak Tayefi, Paweł Moskal

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This paper develops the transformation of non-image data into 2-dimensional matrices, as a preparation stage for classification based on convolutional neural networks (CNNs). In positron emission tomography (PET) studies, CNN may be applied directly to the reconstructed distribution of radioactive tracers injected into the patient's body, as a pattern recognition tool. Nonetheless, much PET data still exists in non-image format and this fact opens a question on whether they can be used for training CNN. In this contribution, the main focus of this paper is the problem of processing vectors with a small number of features in comparison to the number of pixels in the output images. The proposed methodology was applied to the classification of PET coincidence events.

Keywords: convolutional neural network, kernel principal component analysis, medical imaging, positron emission tomography

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Authors: Cely D. Magpantay, Geolynne Marie Adel, Cire-rine Mae Concepcion, Dessa Jean Orcajada, Jorgette Andrea Santos, Orian Laurace Canaman

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Mental illness initiative is very relevant in promoting the Mental Health Bill act of 2017. In the Philippines alone, the public is more open and receptive to people at risks with a mental condition. Although it is uncommon that parents can become more psychologically unfit compared to their children, research shows that parents who are suffering from mental illness have a more significant negative effect than another family member. The impact of parent’s mental health can put their children more susceptible to acquire the same disorder. The aim of the study is to explore the lived experiences of children whose parents suffered from mental illness. It discusses how their parent's mental condition in, anyway, affects their psychological development. Using Phenomenological Qualitative Research, an in-depth, interview was conducted to five (5) consenting adults who lived with their parents diagnosed with a mental disorder. Results are clustered into four themes. The first theme is the negative emotion towards parents, the second theme is the psychosocial dynamics in caring for the patient, third is accepting the disease, and fourth is a general perspective on the family. Each themes is validated by experts and the participants. This theme generates subcomponent like isolation, shallow relationship and debt of gratitude. Along with these themes comes the fear of having a family emerged. There is a growing need to strengthen the family ties even more because of parent’s mental illness. Therefore, parental mental illness has an effect on the children’s psychological and social development.

Keywords: lived experience in Philippines, mental health, parental mental illness, psychosocial dynamics

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Authors: Amir Moslemi, Amir movafeghi, Shahab Moradi

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One of the most important challenging factors in medical images is nominated as noise.Image denoising refers to the improvement of a digital medical image that has been infected by Additive White Gaussian Noise (AWGN). The digital medical image or video can be affected by different types of noises. They are impulse noise, Poisson noise and AWGN. Computed tomography (CT) images are subjected to low quality due to the noise. The quality of CT images is dependent on the absorbed dose to patients directly in such a way that increase in absorbed radiation, consequently absorbed dose to patients (ADP), enhances the CT images quality. In this manner, noise reduction techniques on the purpose of images quality enhancement exposing no excess radiation to patients is one the challenging problems for CT images processing. In this work, noise reduction in CT images was performed using two different directional 2 dimensional (2D) transformations; i.e., Curvelet and Contourlet and Discrete wavelet transform(DWT) thresholding methods of BayesShrink and AdaptShrink, compared to each other and we proposed a new threshold in wavelet domain for not only noise reduction but also edge retaining, consequently the proposed method retains the modified coefficients significantly that result in good visual quality. Data evaluations were accomplished by using two criterions; namely, peak signal to noise ratio (PSNR) and Structure similarity (Ssim).

Keywords: computed tomography (CT), noise reduction, curve-let, contour-let, signal to noise peak-peak ratio (PSNR), structure similarity (Ssim), absorbed dose to patient (ADP)

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Authors: Husham Bayazed

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Immune responses following surgical trauma play a pivotal role in predicting postoperative outcomes from healing and recovery to postoperative complications. Postoperative complications, including infections and protracted recovery, occur in a significant number of about 300 million surgeries performed annually worldwide. Complications cause personal suffering along with a significant economic burden on the healthcare system in any community. The accurate prediction of postoperative complications and patient-targeted interventions for their prevention remain major clinical provocations. Recent Findings: Recent studies are focusing on immune dysregulation mechanisms that occur in response to surgical trauma as a key determinant of postoperative complications. Antecedent studies mainly were plunging into the detection of inflammatory plasma markers, which facilitate in providing important clues regarding their pathogenesis. However, recent Single-cell technologies, such as mass cytometry or single-cell RNA sequencing, have markedly enhanced our ability to understand the immunological basis of postoperative immunological trauma complications and to identify their prognostic biological signatures. Summary: The advent of proteomic technologies has significantly advanced our ability to predict the risk of postoperative complications. Multiomic modeling of patients' immune states holds promise for the discovery of preoperative predictive biomarkers and providing patients and surgeons with information to improve surgical outcomes. However, more studies are required to accurately predict the risk of postoperative complications in individual patients.

Keywords: immune dysregulation, postoperative complications, surgical trauma, flow cytometry

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Authors: Zehra Betül Karakoç

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Aim: The aim of our study is to determine the changement pf plantar pressure after extracorporeal shock wave therapy (ESWT) in a patient with calcaneal spur (CS). Method: Thirty patients with CS who received ESWT treatment at Kartal Yavuz Selim State Hospital between May 2020 and November 2022 participated in this study. Demographic information of the cases was obtained. Pain levels and plantar pressure were measured with Visuel Analog Scale (VAS) and pedobarography, respectively. Pedobarography measured the maximal strength, peak pressure level, and contact area values of the hind, middle, forefoot, and toes. The cases were re-evaluated 4 weeks after the application of 15 Hz, 2-3 bar, 2,000 beats ESWT for 3 sessions. 22 cases participated in the second evaluation. The data of all patients were evaluated bilaterally. Results: Pain intensity levels after treatment were statistically significantly decreased compared to before treatment (p=0.012). Maximum force and contact area values of total foot and forefoot increased significantly (p < 0.05). Conclusion: We consider that the increased max force value of total foot and forefoot area after ESWT is due to the normal walking rate gained related to decreased pain. ESWT treatment may have positive effects on foot pressure distribution and body biomechanics. In order to interpret the results of our study more clearly, randomized controlled studies with a larger number of cases were planned in the future.

Keywords: calcaneal spur, ESWT, plantar pressure, pain

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Authors: Wissem Abdaoui, Nizar M. Mhaidat, Ilhem Mokhtari, Adel Gouri

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Colorectal cancer (CRC) is one of the most common tumors all over the world. Obesity, considered a risk factor of CRC, is characterized by a high level of secreted cytokines from adipose tissue. Among these inflammatory molecules, leptin is considered the key mediator for CRC cancer development and progression by activation of mitogenic and anti apoptotic signaling pathways. Gene expression can be significantly modulated by alterations in DNA methylation patterns. The aim of this study is to investigate the impact of leptin gene methylation on CRC prognosis and sensitivity to chemotherapy. The study involved 70 CRC tissue samples collected from King Abdullah University Hospital (KAUH) from which only 53 was analyzed because of bisulfate fragmentation and low yield of DNA extracted from FFPE tissues. A total of 22 blood samples were collected from healthy volunteers and enrolled as a control group. Leptin promoter methylation was analyzed by methylation specific PCR after bisulfate conversion. Results revealed that the incidence of leptin gene methylation was significantly higher in CRC patients in comparison to that of controls (P < 0.05). The correlation between patient’s demographics and leptin gene methylation was not significant (P < 0.05). However, a significant correlation between leptin gene methylation status and early cancer stages (I, II and III) was found in male but not in female (p < 0.05). Moreover, a significant correlation was found between leptin promoter methylation and early tumor localization T1-2 (p < 0.05). The correlation between epigenetic regulation of leptin and chemosensitivity was not significant. Taken together, these results suggest the possibility to use leptin gene methylation as a biomarker for the evaluation of CRC prognosis and metastasis.

Keywords: colorectal cancer, obesity, leptin, DNA methylation, disease prognosis, bisulfate conversion, chemoresistance

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Authors: Mohsin Ali Baloch, Saira Baloch

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Objective: To analyze hematological changes in patients of oral cancer with history of smokable and chewable tobacco use, and to compare them with healthy controls. Study Design: Descriptive type of study survey. Setting: This study was conducted at the Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro. Study Period: One year July, 2013 to July, 2014. Subject and Methods: Histopathologically confirmed hundred cases of oral cancer with the history of smokable and non-smokable tobacco were selected to analyze the hematological variation. Inclusion Criteria: Histopathologically diagnosed patients of oral squamous cell carcinoma, with history of smokable and non-smokable tobacco. Exclusion Criteria: Patient with any systemic medically compromising problem, terminally ill patients, radio or chemotherapeutically treated patients, patients with metastasis to lungs or any distant metastasis, patients with the history of more than one well-defined etiological factor involved. Results: There were 73% patients of oral cancer reported with anemic. Significantly lower values of Hb, platelet, and higher mean values of ESR, TLC, and were observed in both groups of oral cancer patients; tobacco smokers and tobacco chewers as compared to non-smokers healthy controls. There was more decline in the level of haemoglobin and incline in the level of ESR observed in tobacco chewer oral cancer patients as compared to tobacco smokers patients, while TLC was more observed in smokers. Conclusion: Oral cancer patients with a history of chewable/smokable tobacco have likely worse hematological profile, which increases the anesthetic and surgical challenges for maxillofacial surgeons, which have a significant impact on treatment planning as well.

Keywords: oral cancer, hematological variations, tobacco, smokers

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Authors: Hossein Miri, Zhou YongQi, Chan Bormei-Suy

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The development of advanced technologies and innovative solutions has opened up exciting new possibilities for revolutionizing healthcare systems. One such emerging concept is the use of virtual and holographic health information platforms that aim to provide interactive and personalized medical information to users. This paper provides a review of notable virtual and holographic health information platforms. It begins by highlighting the need for information visualization and 3D representation in healthcare. It then proceeds to provide background knowledge on information visualization and historical developments in 3D visualization technology. Additional domain knowledge concerning holography, holographic computing, and mixed reality is then introduced, followed by highlighting some of their common applications and use cases. After setting the scene and defining the context, the need and importance of virtual and holographic visualization in medicine are discussed. Subsequently, some of the current research areas and applications of digital holography and holographic technology are explored, alongside the importance and role of virtual and holographic visualization in genetics and genomics. An analysis of the key principles and concepts underlying virtual and holographic health information systems is presented, as well as their potential implications for healthcare are pointed out. The paper concludes by examining the most notable existing mixed-reality applications and systems that help doctors visualize diagnostic and genetic data and assist in patient education and communication. This paper is intended to be a valuable resource for researchers, developers, and healthcare professionals who are interested in the use of virtual and holographic technologies to improve healthcare.

Keywords: virtual, holographic, health information platform, personalized interactive medical information

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Introduction: Digital innovations have been useful in supporting a client’s contraceptive user journey from awareness to method initiation. The concept of contraceptive self-care is being promoted globally as a means for achieving universal access to quality contraceptive care; however, information about this approach is limited. An important determinant of the scale of awareness is the message construct, choice of information channel, and an understanding of the socio-epidemiological dynamics within the target audience. Significant gains have been made recently in expanding the awareness base of DMPA-SC -a relatively new entrant into the family planning method mix. The cornerstone of this success is a multichannel promotion campaign themed Discover your Power (DYP). The DYP campaign combines content marketing across select social media platforms, chatbots, Cyber-IPC, Interactive Voice Response (IVR), and radio campaigns. Methodology: During implementation, the project monitored predefined metrics of awareness and intent, such as the number of persons reached with the messages, the number of impressions, and meaningful engagement (link-clicks). Metrics/indicators are extracted through native insight/analytics tools across the various platforms. The project also enlists community mobilizers (CMs) who go door-to-door and engage WRA to advertise DISC’s online presence and support them to engage with IVR, digital companion (chatbot), Facebook page, and DiscoverYourPower website. Results: The result showed that the digital platforms recorded 242 million impressions and reached 82 million users with key DMPA-SC self-injection messaging in the three countries. As many as 3.4 million persons engaged (liked, clicked, shared, or reposted) digital posts -an indication of intention. Conclusion: Digital solutions and innovations are gradually becoming the archetype for the advancement of the self-care agenda. Digital innovations can also be used to increase awareness and normalize contraceptive self-care behavior amongst women of reproductive age if they are made an integral part of reproductive health programming.

Keywords: digital transformation, health systems, DMPA-SC, family planning, self-care

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Authors: Qingqing Feng, S. Thomas Ng, Frank J. Xu, Jiduo Xing

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Faced with unprecedented challenges including aging assets, lack of maintenance budget, overtaxed and inefficient usage, and outcry for better service quality from the society, today’s infrastructure systems has become the main focus of many metropolises to pursue sustainable urban development and improve resilience. Digital twin, being one of the most innovative enabling technologies nowadays, may open up new ways for tackling various infrastructure asset management (IAM) problems. Digital twin application for IAM, as its name indicated, represents an evolving digital model of intended infrastructure that possesses functions including real-time monitoring; what-if events simulation; and scheduling, maintenance, and management optimization based on technologies like IoT, big data and AI. Up to now, there are already vast quantities of global initiatives of digital twin applications like 'Virtual Singapore' and 'Digital Built Britain'. With digital twin technology permeating the IAM field progressively, it is necessary to consider the maturity of the application and how those institutional or industrial digital twin application processes will evolve in future. In order to deal with the gap of lacking such kind of benchmark, a draft maturity model is developed for digital twin application in the IAM field. Firstly, an overview of current smart cities maturity models is given, based on which the draft Maturity Model of Digital Twin Application for Infrastructure Asset Management (MM-DTIAM) is developed for multi-stakeholders to evaluate and derive informed decision. The process of development follows a systematic approach with four major procedures, namely scoping, designing, populating and testing. Through in-depth literature review, interview and focus group meeting, the key domain areas are populated, defined and iteratively tuned. Finally, the case study of several digital twin projects is conducted for self-verification. The findings of the research reveal that: (i) the developed maturity model outlines five maturing levels leading to an optimised digital twin application from the aspects of strategic intent, data, technology, governance, and stakeholders’ engagement; (ii) based on the case study, levels 1 to 3 are already partially implemented in some initiatives while level 4 is on the way; and (iii) more practices are still needed to refine the draft to be mutually exclusive and collectively exhaustive in key domain areas.

Keywords: digital twin, infrastructure asset management, maturity model, smart city

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Authors: Antonio Piga

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The study of language strategies in financial and corporate discourse has always been vital for understanding how companies manage to communicate effectively with a wider customer base and offers new perspectives on how companies interact with key stakeholders, not only to convey transparency and an image of trustworthiness, but also to create affiliation and attract investment. In the light of Systemic Functional Linguistics, the purpose of this study is to examine and analyse the annual reports of Asian and Western joint-stock companies involved in oil refining and power generation from the point of view of the functions and frequency of grammatical metaphors. More specifically, grammatical metaphor - through the lens of Critical Discourse Analysis (CDA) - is used as a theoretical tool for analysing a synchronic cross-cultural study of the communicative strategies adopted by Asian and Western companies to communicate social and environmental sustainability and showcase their ethical values, performance and competitiveness to local and global communities and key stakeholders. According to Systemic Functional Linguistics, grammatical metaphor can be divided into two broad areas: ideational and interpersonal. This study focuses on the first type, ideational grammatical metaphor (IGM), which includes de-adjectival and de-verbal nominalisation. The dominant and more effective grammatical tropes used by Asian and Western corporations in their annual reports were examined from both a qualitative and quantitative perspective. The aim was to categorise and explain how ideational grammatical metaphor is constructed cross-culturally and presented through structural language patterns involving re-mapping between semantics and lexico-grammatical features. The results show that although there seem to be more differences than similarities in terms of the categorisation of the ideational grammatical metaphors conceptualised in the two case studies analysed, there are more similarities than differences in terms of the occurrence, the congruence of process types and the role and function of IGM. Through the immediacy and essentialism of compacting and condensing information, IGM seems to be an important linguistic strategy adopted in the rhetoric of corporate annual reports, contributing to the ideologies and actions of companies to report and promote efficiency, profit and social and environmental sustainability, thus advocating the engagement and investment of key stakeholders.

Keywords: corporate annual reports, cross-cultural perspective, ideational grammatical metaphor, rhetoric, systemic functional linguistics

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Authors: Cheng-Yu Tsai, Wen-Te Liu, Shin-Mei Hsu, Yin-Tzu Lin, Chi Wu

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Background: Obstructive Sleep apnea syndrome (OSAS) is a common respiratory disorder during sleep. In addition, Body parameters were identified high predictive importance for OSAS severity. However, the effects of body parameters on OSAS severity remain unclear. Objective: In this study, the objective is to establish a prediction model for OSAS by using body parameters and investigate the effects of body parameters in OSAS. Methodologies: Severity was quantified as the polysomnography and the mean hourly number of greater than 3% dips in oxygen saturation during examination in a hospital in New Taipei City (Taiwan). Four levels of OSAS severity were classified by the apnea and hypopnea index (AHI) with American Academy of Sleep Medicine (AASM) guideline. Body parameters, including neck circumference, waist size, and body mass index (BMI) were obtained from questionnaire. Next, dividing the collecting subjects into two groups: training and testing groups. The training group was used to establish the random forest (RF) to predicting, and test group was used to evaluated the accuracy of classification. Results: There were 3330 subjects recruited in this study, whom had been done polysomnography for evaluating severity for OSAS. A RF of 1000 trees achieved correctly classified 79.94 % of test cases. When further evaluated on the test cohort, RF showed the waist and BMI as the high import factors in OSAS. Conclusion It is possible to provide patient with prescreening by body parameters which can pre-evaluate the health risks.

Keywords: apnea and hypopnea index, Body parameters, obstructive sleep apnea syndrome, Random Forest

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Authors: Chia-Ling Hsieh, Kankanit Potikit

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Metadiscourse refers to linguistic resources employed by writers to organize text and interact with readers. While metadiscourse has received considerable attention within the field of discourse analysis, few studies have explored the use of metadiscourse in email, one of the most popular forms of computer-mediated communication. Furthermore, the diversity of cross-linguistic research required to uncover the influence of cultural factors on metadiscourse use is lacking. The present study compares metadiscourse markers employed in Chinese and Thai-language request emails with the purpose of discovering cross-cultural similarities and differences that are meaningful and applicable to foreign language teaching. The analysis is based on a corpus of 200 request emails: 100 composed in Chinese and 100 in Thai, with half of the emails from each language data set addressed to professors and the other half addressed to classmates. Adopting Hyland’s model as an analytical framework, two primary categories of metadiscourse are identified. Textual metadiscourse helps to create text coherence, while interpersonal metadiscourse functions to convey authorial stance. Results of the study make clear that both Chinese and Thai-language emails use significantly more interpersonal markers than textual markers, indicating that email, as a unique communicative medium, is characterized by high degrees of concision and interactivity. Users of both languages further deploy similar patterns in writing emails to recipients of different social statuses. Compared with emails addressed to classmates, emails addressed to professors are notably longer and include more transition and engagement markers. Nevertheless, cultural factors do play a role. Emails composed in Thai, for example, include more textual markers than those in Chinese, as Thai favors formal expressions and detailed explanations, while in contrast, emails composed in Chinese employ more interpersonal markers than those in Thai, since Chinese tends to emphasize recipient involvement and attitudinal warmth. These findings thereby demonstrate the combined effects of email as a communicative medium, social status, and cultural values on metadiscourse usage. The study concludes by applying these findings to pedagogical suggestions for teaching email writing to Chinese and Thai language learners based on similarities and differences in metadiscourse strategy between the two languages.

Keywords: discourse analysis, email, metadiscourse, writing instruction

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Authors: Bing Xu, Kerry Lee, Jason M. Stephen

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Collaborative learning (CL) has been regarded as a way to facilitate students to gain knowledge and improve social skills. In China, lecturers in higher education institutions have commonly adopted CL in their daily practice. However, such a strategy could not be effective when it is designed and applied in an inappropriate way. Previous research hardly focused on how CL was applied in Chinese universities. This present study aims to gain a deep understanding of how Chinese lecturers design and implement CL tasks. The researchers interviewed ten lecturers from different faculties in various universities in China and usedGroup Learning Activity Instructional Design (GLAID) framework to analyse the data. We found that not all lecturers pay enough attention to eight essential components (proposed by GLAID) when they designed CL tasks, especially the components of Structure and Guidance. Meanwhile, only a small part of lecturers made formative assessment to help students improve learning. We also discuss the strengths and limitations and CL design and further provide suggestions to the lecturers who intend to use CL in class. Research Objectives: The aims of the present research are threefold. We intend to 1) gain a deep understanding of how Chinese lecturers design and implement collaborative learning (CL) tasks, 2) find strengths and limitations of CL design in higher education, and 3) give suggestions about how to improve the design and implement. Research Methods: This research adopted qualitative methods. We applied the semi-structured interview method to interview ten Chinese lecturers about how they designed and implemented CL tasks in their courses. There were 9 questions in the interview protocol focusing on eight components of GLAID. Then, underpinning the GLAID framework, we utilized the coding reliability thematic analysis method to analyse the research data. The coding work was done by two PhD students whose research fields are CL, and the Cohen’s Kappa was 0.772 showing the inter-coder reliability was good. Contribution: Though CL has been commonly adopted in China, few studies have paid attention to the details about how lecturers designed and implemented CL tasks in practice. This research addressed such a gap and found not lecturers were aware of how to design CL and felt it difficult to structure the task and guide the students on collaboration, and further ensure student engagement in CL. In summary, this research advocates for teacher training; otherwise, students may not gain the expected learning outcomes.

Keywords: collaborative learning, higher education, task design, GLAID framework

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Authors: Ilma Robo, Saimir Heta, Greta Plaka, Vera Ostreni

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Purpose: Drug gingival hyperplasia is an uncommon pathology encountered during routine work in dental units. The purpose of this paper is to present the clinical appearance of gingival hyperplasia caused by medications. There are already three classes of medications that cause hyperplasia and based on data from the literature, the clinical cases encountered and included in this study have been compared. Materials and Methods: The study was conducted in a total of 311 patients, out of which 182 patients were included in our study, meeting the inclusion criteria. After each patient's history was recorded and it was found that patients were in their knowledge of chronic illness, undergoing treatment of gingivitis hypertrophic drugs was performed with a clinical examination of oral cavity and assessment by vertical and horizontal evaluation according to the periodontal indexes. Results: Of the data collected during the study, it was observed that 97% of patients with gingival hyperplasia are treated with nifedipine. 84% of patients treated with selected medicines and gingival hyperplasia in the oral cavity has been exposed at time period for more than 1 year and 1 month. According to the GOI, in the first rank of this index are about 21% of patients, in the second rank are 52%, in the third rank are 24% and in the fourth grade are 3%. According to the horizontal growth index of gingival hyperplasia, grade 1 included about 61% of patients and grade 2 included about 39% of patients with gingival hyperplasia. Bacterial index divides patients by degrees: grading 0 - 8.2%, grading 1 - 32.4%, grading 2 - 14% and grading 3 - 45.1%. Conclusions: The highest percentage of gingival hyperplasia caused by drugs is due to dosing of nifedipine for a duration of dosing and application for systemic healing for more than 1 year.

Keywords: drug gingival hyperplasia, horizontal growth index, vertical growth index

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Authors: Medha Talpade, Salil Talpade

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The intent of this quantitative project was to compare the values and perceptions of students from a predominantly white college (PWI) to those from a historically black college (HBCU) about culturally relevant teaching and learning practices in the academic realm. The reason for interrelating student culture with teaching practices is to enable a pedagogical response to the low retention rates of African American students and first generation Caucasian students in high schools, colleges, and their low rates of social mobility and educational achievement. Culturally relevant pedagogy, according to related research, is deemed rewarding to students, teachers, the local and national community. Critical race theory (CRT) is the main framework used in this project to explain the ubiquity of a culturally relevant pedagogy. The purpose of this quantitative study was to test the critical race theory that relates the presence of the factors associated with culturally relevant teaching strategies with perceived relevance. The culturally relevant teaching strategies were identified based on the recommendations and findings of past research. Participants in this study included approximately 145 students from a HBCU and 55 students from the PWI. A survey consisting of 37 items related to culturally relevant pedagogy was administered. The themes used to construct the items were: Use of culturally-specific examples in class whenever possible; use of culturally-specific presentational models, use of relational reinforcers, and active engagement. All the items had a likert-type response scale. Participants reported their degree of agreement (5-point scale ranging from strongly disagree to strongly agree) and importance (3-point scale ranging from not at all important to very important) with each survey item. A new variable, Relevance was formed based on the multiplicative function of importance and presence of a teaching and learning strategy. A set of six demographic questions were included in the survey. A consent form based on NIH and APA ethical standards was distributed prior to survey administration to the volunteers. Results of a Factor Analyses on the data from the PWI and the HBCU, and a ANOVA indicated significant differences on ‘Relevance’ related to specific themes. Results of this study are expected to inform educational practices and improve teaching and learning outcomes.

Keywords: culturally relevant pedagogy, college students, cross-cultural, applied psychology

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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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