Search results for: medical school

Authors: Muhammad Shahid Shah, Akram Maqbool, Samina Ashraf

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Since start of this century, world has adopted inclusion as a trend in special education. To meet the challenges of inclusion response, the Punjab government has developed a progressive policy to implement inclusive education. The objectives of this research were to analyze the administration and implementation process by consideration on the management, student’s admission process, screening and assessment, adaptations in curriculum and instruction along with an evaluation, government and nonprofit organizations support. The sample consisted of 50 schools both public and private with a total of 3000 students, 9 percent of which (270) were students with disabilities. Among all the students with disabilities, 63 percent (170) were male and 37 percent (100) were female. The concluded remarks regarding management revealed that a large number of inclusive schools was lacking in terms of developing a certain model for inclusion, including the managerial breakup of staff, the involvement of stakeholders, and conducted frequent meetings. Many of schools are not able to restructure their school organizations due to lack of financial resources, consultations, and backup. As for as student’s admission/identification/assessment was concerned, only 12 percent schools applied a selection process regarding student admission, half of which used different procedures for disable candidates. Approximately 5 percent of inclusive schools had modified their curriculum, including a variety of standards. In terms of instruction, 25 percent of inclusive schools reported that they modified their instructional process. Only a few schools, however, provided special equipment for students with visual impairment, physical impairment, speech and hearing problems, students with mild intellectual disabilities, and autism. In a student evaluation, more than 45 percent reported that test items, administration, time allocations, and students’ reports were modified. For the primary board examination conducted by the Education Department of Government of Punjab, this number decreased dramatically. Finally, government and nonprofit organizations support in the forms of funding, coaching, and facilities were mostly provided by provincial governments and by Ghazali Education Trust.

Keywords: inclusion, identification, assessment, funding, facilities, evaluation

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Authors: Stanimira Ntermentzieva

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Gender studies in post-communist Eastern Europe emerged in the early 1990s after the collapse of the communist regime. It can be explained by a series of cultural and political factors. However, Bulgarian female composers’ contribution to Western art music has not been studied. This field shows us some aspects of the impact of globalization on gender issues. This paper outlines the female composers in the establishment of the modern Bulgarian state and society. It is dedicated to the Bulgarian award-winning female composers who studied in Western European and American universities in the 1990s. Many of them migrated to these regions as part of a great migration in which Bulgaria lost 2.3 to three million of its population and strived to modernize Bulgarian music. Nowadays, the Union of Bulgarian Composers has 262 members, but only 19 of them are women. The Grammy-awarded Penka Kouneva (b. 1967) is one of the few female composers in Hollywood. She composed and orchestrated film scores, music for video games and television. Anna-Maria Ravnopolska-Dean (b. 1960) is a Bulgarian/American harpist, arranger, composer, pedagogue and TV host. She wrote pieces for harp and chamber ensembles. Maria Panayotova (b. 1976) studied composition in the USA. Alexandra Fol (b. 1981) and Vania Angelova (b. 1954) work in Canada and are recipients of grants from the Canada Council for the Arts and the Bulgarian Ministry of Culture, among others. Afroditi Katmeridou, born in Bulgaria in 1956 by Greek parents, was the first woman who wrote electroacoustic music. One of the well-known contemporary composers is the British/Bulgarian Dobrinka Tabakova (b. 1980). She moved with her family to the United Kingdom when she was 11 and studied Composition at Guildhall School of Music and Drama in London. Her album String Paths was nominated for a Grammy award. Many female composers made a successful career in EU countries: Albena Petrovic-Vratchanska (Luxemburg), Yuliana Tochkova-Patrouilleau (France), Dariana Kumanova (Italy), Tveta Dimitrova (Austria), Ivajla Kirova (Germany), Alexandra Karastoyanova-Hermentin (Austria) and more.

Keywords: balgarian music, female composers, gender studies, western art music, migration

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Authors: Yaeji Lim, Hee-Seok Oh

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The coherence analysis measures the linear time-invariant relationship between two data sets and has been studied various fields such as signal processing, engineering, and medical science. However classical coherence analysis tends to be sensitive to outliers and focuses only on mean relationship. In this paper, we generalized cross periodogram to quantile cross periodogram and provide richer inter-relationship between two data sets. This is a general version of Laplace cross periodogram. We prove its asymptotic distribution under the long range process and compare them with ordinary coherence through numerical examples. We also present real data example to confirm the usefulness of quantile coherence analysis.

Keywords: coherence, cross periodogram, spectrum, quantile

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Authors: Rafael Ricieri, Rogerio Barros, Francisco Clovis

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Objective– The Objective of this is study is to report a rare case of dermoid cyst, with a sublingual location and cutaneous fistula in a 4 year-old child.Methods: This study is a case report. The main study instrument was the medical record and the radiological and intraoperative image bank. Results: Infants with congenital cervical lesions eventually need tomography for diagnostic elucidation, and health services should be structured to perform sedation and thin tomographic sections in order to reduce morbidity.

Keywords: congenital, sublingual dermoid cyst, fistula, pediatric surgery, head and kneck surgery

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Authors: Florence Matsveru

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The 21st-century church in Africa is faced with a myriad of challenges, which need attention. One of those challenges is pastoral ministry to congregants in high positions. This paper is based on a Ph.D. study entitled, ‘Wellbeing and work performance of Christians in managerial positions: A Namibian case study’ conducted between 2015 and 2018. The study was conducted with 32 purposively selected Christians working in managerial positions in Ohangwena Region, Namibia. The study employed a mixed-methods approach, i.e., both qualitative (to get participants’ feelings and perceptions) and quantitative (to get proportions of the experiences and perceptions). The research process involved a questionnaire survey and interviews. The study revealed that Christians in managerial positions have both common and unique experiences in three spheres: the workplace, the family and the church. The experiences lead to physical, emotional, psychological, social and spiritual needs. The findings also showed that some of the expectations placed upon Christians in managerial positions in the church may be unrealistic, while at the same time this group of congregants want to use their work experiences for the benefit of the church. A worrying finding was that pastors are generally not well-trained for ministry to congregants in high positions. Since these were perceptions of the participants (some of whom were also pastors), the researcher went further to do a short internet survey of the curricula of a number of theological colleges in Southern Africa. This survey did not show any ‘manager-sensitive’ modules in the surveyed colleges. Theological education for pastors, especially in African theological institutions, seems to ignore the unique needs of congregants in high positions. This paper argues that the needs of Christians in high positions should be considered in pastoral care and that theological education is key in equipping pastors with the necessary knowledge and skills. This paper is, therefore, a call to theological institutions to include ministry to people in high positions in their curricula. Pastors who are already beyond theological school may find it helpful to attend or hold workshops that focus on congregants in high positions so that this kind of 'sheep' will find good pasture in the church. A paper of this nature helps to strengthen pastoral ministry and to enhance the relevance of theological education.

Keywords: Christian managers, theological curricula, pastoral care, African

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Authors: Amirreza Razzaghipour Sorkhab

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One of the most common disorders among humans is hearing impairment. This paper provides an evidence base that recovers understanding of Meniere’s disease and highlights the physical and mental health correlates of the disorder. Meniere's disease is more common in the elderly. The term idiopathic endolymphatic hydrops has been attributed to this disease by some in the previous. Meniere’s disease demonstrations a genetic tendency, and a family history is found in 10% of cases, with an autosomal dominant inheritance pattern. The COCH gene may be one of the hereditary factors contributing to Meniere’s disease, and the possibility of a COCH mutation should be considered in patients with Meniere’s disease symptoms. Should be considered Missense mutations in the COCH gene cause the autosomal dominant sensorineural hearing loss and vestibular disorder. Meniere’s disease is a complex, heterogeneous disorder of the inner ear and that is characterized by episodes of vertigo lasting from minutes to hours, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. The existing evidence supports the suggestion that age and sleep disorder are risk factors for Meniere's disease. Many factors have been reported to precipitate the progress of Menier, including endolymphatic hydrops, immunology, viral infection, inheritance, vestibular migraine, and altered intra-labyrinthine fluid dynamics. Although there is currently no treatment that has a proven helpful effect on hearing levels or on the long-term evolution of the disease, however, in the primary stages, the hearing may improve among attacks, but a permanent hearing loss occurs in the majority of cases. Current publications have proposed a role for the intratympanic use of medicine, mostly aminoglycosides, for the control of vertigo. more than 85% of patients with Meniere's disease are helped by either changes in lifestyle and medical treatment or minimally aggressive surgical procedures such as intratympanic steroid therapy, intratympanic gentamicin therapy, and endolymphatic sac surgery. However, unilateral vestibular extirpation methods (intratympanic gentamicin, vestibular nerve section, or labyrinthectomy) are more predictable but invasive approaches to control the vertigo attacks. Medical therapy aimed at reducing endolymph volume, such as low-sodium diet, diuretic use, is the typical initial treatment.

Keywords: meniere's disease, endolymphatic hydrops, hearing loss, vertigo, tinnitus, COCH gene

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Authors: Željka Rogač, Dejan Stevanović, Sara Bečanović, Ljubica Božić, Aleksandar Dimitrijević, Dragana Bogićević, Dimitrije Nikolić

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Children with epilepsy face changes in cognitive functioning, the appearance of symptoms of psychopathology and a decline in their quality of life. Factors related to epileptic seizures and the side effects of AEDs are considered to be potential causes of these changes.These changes can be prevented by prompt action, replacement of AEDs, psychological and psychiatric treatment, and social support. However, a review of literature has not yielded a conclusion as to when it is best to react, i.e., when changes in the functioning of children with newly-diagnosed epilepsy appears. The primary goal of this study was to investigate the impact of the most commonly used AEDs on cognitive status, behavior, anxiety and depression, as well as quality of life of children with newly-diagnosed epilepsy, during the first six months of treatment. This is a non-interventional, prospective study involving six-month monitoring of cognitive status, internalizing and externalizing symptoms, as well as quality of life of children with newly-diagnosed epilepsy, and the impact of antiepileptic drugs on these domains. Children with new-onset epilepsy and their parents, immediately after the introduction of antiepileptic drugs as well as six months later, filled out appropriate questionnaires (RCADS, NCBRF, CHEQOL-25, KIDSCREEN-10, AEP). At the same time, a psychologist performed the psychological testing of the child (REVISK). At the very beginning of REVISK treatment, a reduced VIQ was established, while after six months there was a significant decrease in IQ, VIQ and especially PIQ, under the influence of primary cognitive potentials and the development of depressive symptoms. All scores of the RCADS and NCBFR questionnaires were significantly elevated after six months while internalizing and externalizing symptoms affected each other. The development of depressive symptoms was significantly influenced by AED. The scores of the CHEQOL25 and KIDSCREEN10 questionnaires were significantly reduced, influenced by the adverse effects of AED and quality of life at the start of treatment. Side effects of AEDs, were significantly associated with depressive symptoms and reduced quality of life and did not significantly affect cognitive decline, anxiety, ADHD, and behavioral disorders during the first six months.

Keywords: epilepsy, children, AEDs, cognition, behavior, ADHD, anxiety, depression, QOL

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Authors: Sarah Holdren, Laura Crook, Anne Drapkin Lyerly

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Objective: The COVID-19 Pandemic has drawn new attention to long-existing bioethical questions around pregnancy, childbirth, and parenthood. Due to the increased risk of severe COVID-19, pregnant individuals may experience anxiety regarding medical decision-making. Especially in the case of hospital births, questions around the ethics of bringing healthy pregnant individuals into a high-risk environment for viral transmission illuminate gaps in the American maternal and child healthcare system. Limited research has sought to understand the experiences of those who gave birth outside hospitals during this time. This study aims to understand pregnant individuals’ conceptualization of risk during the COVID-19 pandemic. Methods: Individuals who gave birth after March 2020 were recruited through advertisements on social media. Participants completed a 1-hour semi-structured interview and a demographic questionnaire. Interviews were transcribed and coded by members of the research team using thematic narrative analysis. Results: A total of 18 participants were interviewed and completed the demographic questionnaire. The language of risk was utilized in birth narratives in three different ways, which highlighted the multileveled and nuanced ways in which risk is understood and mitigated by pregnant and birthing individuals. These included: 1. The risk of contracting COVID-19 before, during, and after birth, 2. The risk of birth complications requiring medical interventions dependent on selected birthing space (home, birthing center, hospital), and 3. The overall risk of creating life in the middle of a pandemic. The risk of contracting COVID-19 and risk of birth complications were often weighed in paradoxical ways throughout each individual’s pregnancy, while phrases such as “pandemic baby” and “apocalypse” appeared throughout narratives and highlighted the broader implications of pregnancy and childbirth during this momentous time. Conclusions: Healthcare professionals should consider the variety of ways that pregnant and birthing individuals understand the risk when counseling patients on healthcare decisions, especially during times of healthcare crisis such as COVID-19. Future work should look to understand how the language of risk fits into a broader understanding of the human experience of growing life in times of crisis.

Keywords: maternal and child health, thematic narrative analysis, COVID-19, risk mitigation

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Authors: Dina Siniora, Jasia Baig

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During the past few decades, the healthcare system has undergone profound changes in their healthcare decision-making competencies and moral aptitudes due to the vast advancement in technology, clinical skills, and scientific knowledge. Healthcare decision-making deals with morally contentious dilemmas ranging from illness, life and death judgments that require sensitivity and awareness towards the patient’s preferences while taking into consideration medicine’s abilities and boundaries. As the ever-evolving field of medicine continues to become more scientifically and morally multifarious; physicians and the hospital administrators increasingly rely on ethics committees to resolve problems that arise in everyday patient care. The role and latitude of responsibilities of ethics committees which includes being dispute intermediaries, moral analysts, policy educators, counselors, advocates, and reviewers; suggest the importance and effectiveness of a fully integrated committee. Despite achievements on Integrated Ethics and progress in standards and competencies, there is an imminent necessity for further improvement in quality within ethics consultation services in areas of credentialing, professionalism and standards of quality, as well as the quality of healthcare throughout the system. These concerns can be resolved first by collecting data about particular quality gaps and comprehend the level to which ethics committees are consistent with newly published ASBH quality standards. Policymakers should pursue improvement strategies that target both academic bioethics community and major stakeholders at hospitals, who directly influence ethics committees. This broader approach oriented towards education and intervention outcome in conjunction with preventive ethics to address disparities in quality on a systematic level. Adopting tools for improving competencies and processes within ethics consultation by implementing a credentialing process, upholding normative significance for the ASBH core competencies, advocating for professional Code of Ethics, and further clarifying the internal structures will improve productivity, patient satisfaction, and institutional integrity. This cannot be systemically achieved without a written certification exam for HCEC practitioners, credentialing and privileging HCEC practitioners at the hospital level, and accrediting HCEC services at the institutional level.

Keywords: ethics consultation, hospital, medical ethics, quality

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Authors: Twinkle Sara Joseph

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Virtual reality technology has emerged as a revolutionary power that can transform the education sector in many ways. VR environments can break the boundaries of the traditional classroom setting by immersing the students in realistic 3D environments where they can interact with virtual characters without fearing being judged. Communication skills are essential for every profession, and studies suggest the importance of implementing basic-level communication courses at both the school and graduate levels. Interpersonal communication is a skill that gains prominence as it is required in every profession. Traditional means of training have limitations for trainees as well as participants. The fear of being judged, the audience interaction, and other factors can affect the performance of a participant in a traditional classroom setting. Virtual reality offers a unique opportunity for its users to participate in training that does not set any boundaries that prevent the participants from performing in front of an audience. Specialised applications designed in VR headsets offer a range of training and exercises for participants without any time, space, or audience limitations. The present study aims at measuring the effectiveness of VR training in improving interpersonal communication skills among students. The study uses a mixed-method approach, in which a pre-and post-test will be designed to measure effectiveness. A preliminary selection process involving a questionnaire and a screening test will identify suitable candidates based on their current communication proficiency levels. Participants will undergo specialised training through the VR application Virtual Speech tailored for interpersonal communication and public speaking, designed to operate without the traditional constraints of time, space, or audience. The training's impact will subsequently be measured through situational exercises to engage the participants in interpersonal communication tasks, thereby assessing the improvement in their skills. The significance of this study lies in its potential to provide empirical evidence supporting VR technology's role in enhancing communication skills, thereby offering valuable insights for integrating VR-based methodologies into educational frameworks to prepare students more effectively for their professional futures.

Keywords: virtual reality, VR training, interpersonal communication, communication skills, 3D environments

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Authors: N. Kashif, M. K. Naseer

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This is an undeniable fact that parents are the very first role model for their children and children are the silent observers and followers of their parents. The environment they would be provided will leave either positive or negative lasting impact on their physical and mental behavior and abilities to grow, progress and conquer. This paper focuses on the observation particularly in South Asian countries where females have been facing problems in accessing education and getting financially independent or stable. This paper emphasizes on a survey conducted in rural areas of Punjab State in Pakistan. It explains how the parents’ educational background, financial status, conservative and interdependent accommodation style influence a prominent inequality of giving their female child right to study and get empowered. The forces behind this gender discrimination are not limited to parents’ life style impact but also include some major social problems like distant schools, gender-based harassment, and threat, insecurities, employment opportunities, so on. As a grass root level solution, it is proposed to develop an institution which collects data regarding child birth in their region and can contact the parent when their child is ready to start school. Building up trust based relationship with parents is the most crucial and significant factor. Secondly, celebrities and public figures can play an extraordinary role in running a campaign to advocate and encourage people living in rural areas, villages and small towns. All possible solutions can never be implemented without the support of the state government. Therefore, this paper invites more thoughtful actions, properly planned strategies, initiators to take the lead and make a platform for those who are underprivileged and deprived of their basic rights. Any country, where female constitute 49% of its entire population can never progress without promoting female empowerment and their right to compulsory education, and it is never late or impossible to admit the facts and practically start a flexible solution- oriented approach.

Keywords: employment opportunities, female empowerment, gender based harassment, gender discrimination, inequality, parents' life style impact

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Authors: C. Lalitha, R. Sayee, D. Apoorva

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Reproductive failure or infertility may be due to several factors that are not limited to one sex. It remains a common problem causing significant psychological distress to those affected individuals and who are increasingly seeking medical advice. Male infertility means inability to induce conception in normal woman within a year. The etiological factors associated with male infertility are anatomical, developmental, seminal, hormonal, immunological and environmental factors. The paper was aimed to highlight the environmental factors and its association to male infertility and seasonality of birth and its influence. The data was collected from the 75 male patients referred with infertility for karyotyping and counseling. Their age ranged from 21 to 45 years. It is opined that certain occupations are preferentially associated with male infertility.

Keywords: environmental, occupational, seasonal, male infertility

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Authors: Ionel Botef

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Studies show that, for viable product realisation and maintenance, a spectrum of novel processing technologies and materials to improve performance and reduce costs and environmental impact must constantly be addressed. One of these technologies, namely the cold spray process, has enabled a broad range of coatings and applications, including many that have not been previously possible or commercially practical, hence its potential for new aerospace, electronics, or medical applications. Therefore, the purpose of this paper is to summarise the state of the art of this technology alongside its theoretical and experimental studies, and explore the role and impact of cold spraying on surface engineering.

Keywords: surface engineering, cold spray, ageing aircrafts, corrosion, microchannels, maintenance

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Authors: Peter Akayuure

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Geometry is considered an important strand in mathematics due to its wide-ranging utilitarian value and because it serves as a building block for understanding other aspects of undergraduate mathematics, including algebra and calculus. Matters regarding students’ geometric thinking have therefore long been pursued by mathematics researchers and educators globally via different theoretical lenses, curriculum reform efforts, and innovative instructional practices. However, so far, studies remain inconclusive about the instructional platforms that effectively promote geometric thinking. At the University of Education, Winneba, an undergraduate geometry course was designed and delivered on UEW Learning Management System (LMS) using Moodle platform. This study utilizes van Hiele’s theoretical lens to examine the entry and exit’s geometric thinking behaviours of prospective teachers who took the undergraduate geometry course in the LMS platform. The study was a descriptive survey that involved an intact class of 280 first-year students enrolled to pursue a bachelor's in mathematics education at the university. The van Hiele’s Geometric thinking test was used to assess participants’ entry and exit behaviours, while semi-structured interviews were used to obtain data for triangulation. Data were analysed descriptively and displayed in tables and charts. An Independent t-test was used to test for significant differences in geometric thinking behaviours between those who entered the university with a diploma certificate and with senior high certificate. The results show that on entry, more than 70% of the prospective teachers operated within the visualization level of van Hiele’s geometric thinking. Less than 20% reached analysis and abstraction levels, and no participant reached deduction and rigor levels. On exit, participants’ geometric thinking levels increased markedly across levels, but the difference from entry was not significant and might have occurred by chance. The geometric thinking behaviours of those enrolled with diploma certificates did not differ significant from those enrolled directly from senior high school. The study recommends that the design principles and delivery of undergraduate geometry course via LMS should be structured and tackled using van Hiele’s geometric thinking levels to serve as means of bridging the existing learning gaps of undergraduate students.

Keywords: geometric thinking, van Hiele’s, UEW learning management system, undergraduate geometry

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Authors: Rhea Khosla, Victoria Tzortziou-Brown

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Introduction: Adolescent SRH has been neglected since the start of the millennium. Adolescents comprise 16% of the global population, with the largest proportion living in Asia (650 million). By late adolescence, individuals in these regions are likely to become sexually active, and thus they must understand their SRH rights. Many lack knowledge of SRH, using unreliable sources for such information. Sex education is necessary to standardize and inform sexual knowledge, which empowers adolescents to make informed SRH decisions. School is an appropriate environment for this, however, SRH education requires effective policy to enforce. Nonetheless, this issue remains of low political priority in Asia and Africa. Current literature on sex education policy in schools in these regions is scarce and tends to have broad aims. Thus, a scoping review was necessary. Methods: Literature searches were conducted in February 2023 using six databases, including grey literature databases (PubMed, Scopus, Embase, Web of Science, Google Scholar, Global Index Medicus), returning a total of 1537 unique articles. After screening titles, abstracts and full text, 17 articles remained. References of included articles were additionally searched, producing a further 7 articles, which then underwent thematic analysis Results: Most countries in Africa and Asia did not have studies on this topic. Studies derived data from interviews with key stakeholders and quantitative methods quantified questionnaire responses. Barriers were: policy/curriculum issues, societal opinions, teaching discomfort, and lack of educator training. Limitations were insufficient timing, inconsistent implementation, insufficient hours dedicated to teaching, education received late into schooling, and discrepancies between teachers, schools, and students about whether policies were being implemented. Discussion: Based on the existing limited evidence, a cultural shift to reduce stigma seems necessary, alongside teacher and student involvement in policy formulation with effective implementation monitoring and educator training.

Keywords: adolescent, Africa, Asia, education, sexual and reproductive health, policy

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Authors: Monica Karlsson

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The positive effect of a supportive written context on comprehension and retention when faced with a previously unknown idiomatic expression is today an indisputable fact, especially if relevant clues are given in close proximity of the item in question. Also, giving learners a chance of visualizing the meaning of an idiom by offering them its source domain and/or by elaborating etymologically, i.e. providing a mental picture in addition to the spoken/written form (referred to as dual coding), seems to enhance comprehension and retention even further, especially if the idiom is of a more transparent kind. For example, by explaining that walk the plank has a maritime origin and a canary in a coal mine comes from the time when canaries were kept in cages to warn miners if gas was leaking out at which point the canaries succumbed immediately, learners’ comprehension and retention have been shown to increase. The present study aims to investigate whether contextualization of an audiovisual kind could help increase comprehension and retention of L2 idioms. 40 Swedish first-term university students studying English as part of their education to become middle-school teachers participated in the investigation, which tested 24 idioms, all of which were ascertained to be previously unknown to the informants. While half of the learners were subjected to a test in which they were asked to watch scenes from various TV programmes, each scene including one idiomatic expression in a supportive context, the remaining 20 students, as a point of reference, were only offered written contexts, though equally supportive. Immediately after these sessions, both groups were given the same idioms in a decontextualized form and asked to give their meaning. After five weeks, finally, the students were subjected to yet another decontextualized comprehension test. Furthermore, since mastery of idioms in one’s L1 appears to correlate to a great extent with a person’s ability to comprehend idioms in an L2, all the informants were also asked to take a test focusing on idioms in their L1. The result on this test is thus seen to indicate each student’s potential for understanding and memorizing various idiomatic expressions from a more general perspective. Preliminary results clearly show that audiovisual contextualization indeed has a positive effect on learners’ retention. In addition, preliminary results also show that those learners’ who were able to recall most meanings were those who had a propensity for idiom comprehension in their L1.

Keywords: English, L2, idioms, audiovisual context

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Authors: Betül Ersoy, Deniz Özalp Kizilay, Gül Gümüşer, Fatma Taneli

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Introduction: Peak bone mass is reached in late adolescence in females. Age at menarche influences estrogen exposure, which plays a vital role in bone metabolism. The relationship between age at menarche and bone mineral density (BMD) is still controversial. In this study, we investigated the relationship between age at menarche, BMD, socioeconomic status (SES) and body composition in female university student. Participant and methods: A total of 138 healthy girls at late adolescence period (mean age 20.13±0.93 years, range 18-22) were included in this university school-based cross-sectional study in the urban area western region of Turkey. Participants have been randomly selected to reflect the university students studying in all faculties. We asked relevant questions about socioeconomic status and age at menarche to female university students. Students were grouped into three SES as lower, middle and higher according to the educational and occupational levels of their parents using Hollingshead index. Height and weight were measured. Body Mass Index (BMI) (kg/m2 ) was calculated. Dual energy X-ray absorptiometry (DXA) was performed using the Lunar DPX series, and BMD and body composition were evaluated. Results: The mean age of menarche of female university student included in the study was 13.09.±1.3 years. There was no significant difference between the three socioeconomic groups in terms of height, body weight, age at menarche, BMD [BMD (gr/cm2 ) (L2-L4) and BMD (gr/cm2 ) (total body)], and body composition (lean tissue, fat tissue, total fat, and body fat) (p>0.05). While no correlation was found between the age at menarche and any parameter (p>0.05), a positive significant correlation was found between lean tissue and BMD L2-L4 (r=0.286, p=0.01). When the relationships were evaluated separately according to socioeconomic status, there was a significant correlation between BMDL2-L4 (r: 0.431, p=0.005) and lean tissue in females with low SES, while this relationship disappeared in females with middle and high SES. Conclusion: Age at menarche did not change according to socioeconomic status, nor did BMD and body composition in female at late adolescents. No relationship was found between age at menarche and BMD and body composition determined by DEXA in female university student who were close to reaching peak bone mass. The results suggested that especially BMDL2-L4 might increase as lean tissue increases.

Keywords: bone, osteoposis, menarche, dexa

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Authors: Sreelekha Prakash, Yulong Gu

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Background: About 61% of adults surveyed across 25 states reported they had experienced at least one type of Adverse Childhood Experience (ACE) before 18 years of age. Relationships between ACEs and a variety of substance-related behaviors and behavioral health have been reported in previous studies. ACEs can have lasting, negative effects on health, well-being, as well as life opportunities such as education and job potential. Objectives: For the current research, the aim was to assess the factors affecting substance use behavior in young adults. The further onset of drug use and its association was analyzed with ACEs and mental health. Method: The young adults from a county in the north-eastern United States were invited to participate in an online questionnaire survey with prior consent through an IRB approved study. The Survey included questions related to social determinants of health, 10 item ACE questionnaire, and substance use related to Alcohol, Marijuana, Opioids, Stimulants, and other drugs. PHQ-9 questionnaire was used to assess cognitive health. Results: Data was analyzed for the 244 completed surveys {68% (165) were females, and 78% (190) were Whites}. The average age of the participants was 26.7 years, and approximately 80% were lifelong residents of the county or year-round residents. Of the respondents, 50% (122) were high school graduates with some college education, and 56% (136) had a full-time jobs. Past 30-day usage for alcohol was 76% (72), and marijuana was 28.4% (27). The data showed that the higher the ACE scores, the younger they start using any substance (p < 0.0001). The data for PHQ-9 and ACE scores showed that the higher the ACE score, the higher the PHQ-9 score, with a significant p-value (p 0.0001). The current data also showed a significant association with other drugs; marijuana use showed significance for 30 days of use (p 0.0001), stimulant use (0.0008), prescription drug misuse (0.01), and opioids (0.01). Conclusion: These findings further support the association between ACEs and initiation of drug use and its correlation with mental health symptoms. Promoting a safe and supportive environment for children and youth in their earlier ages can prevent the youth and young adults from the effects of drug use and create healthy living habits for young adults.

Keywords: subtance use, young adults, adverse childhood experience, PHQ-9

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Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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Authors: Sonia Arradaza-Pajaron

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This study examined the relationship between transformational leadership (TL) and self-efficacy (SE) of academic heads in the implementation of a customized English language curriculum (CELC) among technological state universities and colleges in Leyte provinces and Biliran, Philippines. Results manifested that academic leaders practiced transformational leadership and are self-efficacious enough but with only moderate level in the effectiveness of CELC implementation. It was found out; further, that of the four identified transformational leadership components, except idealized influence, three of which demonstrated a significant relationship with CELC component variables, although in varying degree. Moreover, self-efficacy sources, especially vicarious experiences and verbal persuasion manifested moderate to high significant relationships with effective CELC curriculum implementation. Further, verbal persuasion and physiological/emotional condition manifested significant relationship with CELC-resource and CELC-contextual/community influence, respectively. Regression analysis showed that TL-individualized consideration component explained wider extent when correlated with CELC contextual/community components, while self-efficacy source-verbal persuasion demonstrated a wider extent with the three CELC components, namely; resource, process and physiological/emotional condition. Results further revealed that TL-individualized consideration manifested lesser influence with CELC implementation, while SE-verbal persuasion demonstrated stronger influence or effect on CELC-process, CELC-physiological/emotional, while lesser influence with CELC-resource. This implies that academic leaders, in order to carry out effective curriculum implementation, should provide more emphasis on school culture, its beliefs, practices and academic atmosphere but most of all empower human resources who are considered the backbone of the work place and can be directly affected by any curriculum shifts and challenges. To realize this, more values-skilled training programs must be designed for academic heads are needed to equip them with the necessary leadership skills, beliefs in their capacity to lead and their own enhance emotional well-being in leading subordinates and facilitating curriculum implementation.

Keywords: Customized English Language curriculum, CELC, self-efficacy, transformational leadership, values-skilled training

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Authors: Robbi Beyer, Tiffanye Vargas, Margaret Flores

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Within the United States, youths with hidden disabilities (specific learning disabilities, attention deficit hyperactivity disorder, emotional behavioral disorders, mild intellectual disabilities and speech/language disorders) can often be part of the kindergarten through twelfth grade school population. Because individuals with hidden disabilities have no apparent physical disability, learning difficulties may be overlooked and these youths may be mistakenly labeled as unmotivated, or defiant because they don't understand and follow directions, or maintain enough attention to remember and perform. These behaviors are considered especially challenging for youth sport coaches to manage and they often find it difficult to successfully select and deliver effective accommodations for the athletes. These deficits can be remediated and compensated through the use of research-validated strategies and instructional methods. However, while these techniques are commonly included in teacher preparation, they rarely, if ever, are included in coaching preparation. Therefore, the purpose of this presentation is to summarize consecutive research studies that examined coaching education within the United States for youth athletes with hidden disabilities. Each study utilized a questionnaire format to collect data from coaches on attitudes, efficacy and solutions for addressing challenging behaviors. Results indicated that although the majority of coaches’ attitudes were positive and they perceived themselves confident in working with athletes who have hidden disabilities, there were significant differences in the understanding of appropriate teaching strategies and techniques for this population. For example, when asked to describe a videotaped situation of why an athlete is not performing correctly, coaches often found the athlete to be at fault, as opposed to considering the possibility of faulty directions, or the need for accommodations in teaching/coaching style. When considering coaches’ preparation, 83% of participants declared they were inadequately prepared to coach athletes with hidden disabilities and 92% strongly supported improved preparation for coaches. The comprehensive examination of coaches’ perceptions and efficacy in working with youth athletes with hidden disabilities has provided valuable insight and highlights the need for continued research in this area.

Keywords: health, hidden disabilties, physical activity, youth recreational sports

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Authors: Zeineb Yousse, Fakher Kharrat

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Mosaic is a part of a broad universal cultural heritage; sometimes it represents a rather essential source for the researches on the everyday life of some of the previous civilizations. Tunisia has one of the finest and largest collections of mosaics in the world, which is essentially exhibited in the Museums of Bardo and Sousse. Restored and reconstituted, they bear witnesses to hard work. Our paper deals with the discipline of conservation of Roman mosaics based on the proceedings of the workshop of the Museum of Sousse. Thus, we highlight two main objectives. In the first place, it is a question of revealing the techniques adopted by professionals to handle mosaics and to which school of conservation these techniques belong. In the second place, we are going to interpret the works initiated to preserve the archaeological heritage in order to protect it in present time and transmit it to future generations. To this end, we paid attention to four Roman mosaics currently exhibited in the Museum of Sousse. These Mosaics show different voids or gaps at the level of their surfaces and the method used to fill these gaps seems to be interesting to analyze. These mosaics are known under the names of: Orpheus Charming the Animals, Gladiator and Bears, Stud farm of Sorothus and finally Head of Medusa. The study on the conservation passes through two chained phases. We start with a small historical overview in order to gather information related to the original location, the date of its composition as well as the description of its image. Afterward, the intervention process is analyzed by handling three complementary elements which are: diagnosis of the existing state, the study of the medium processing and the study of the processing of the tesselatum surface which includes the pictorial composition of the mosaic. Furthermore, we have implemented an evaluation matrix with six operating principles allowing the assessment of the appropriateness of the intervention. These principles are the following: minimal intervention, reversibility, compatibility, visibility, durability, authenticity and enhancement. Various accumulated outcomes are pointing out the techniques used to fill the gaps as well as the level of compliance with the principles of conservation. Accordingly, the conservation of mosaics in Tunisia is a practice that combines various techniques without really arguing about the choice of a particular theory.

Keywords: conservation, matrix, museum of Sousse, operating particular theory, principles, Roman mosaics

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Authors: Heng W. Chang, Mao F. Sun

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Chronic Idiopathic Urticaria (CIU) and hypertension are rarely discussed together in modern and traditional Chinese medicine, and often belong to different medical departments. However, in traditional Chinese medicinal theory, the two diseases have some similar characters. For example, they are both relevant to 'wind'. This study conducted a literature review using the China National Knowledge Infrastructure to identify herbs yielding the same effect for the two diseases. The finding showed that the common herbs used most frequently is Rehmanniae. The conclusion is that the same TCM (Traditional Chinese Medicine) mechanism of the two diseases may be 'blood heat'. It requires further study to prove it in the future.

Keywords: urticaria, herbs, hypertension, Rehmanniae

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Authors: Prakash K. Aithal, U. Dinesh Acharya, Rajesh Gopakumar

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Edge is variation of brightness in an image. Edge detection is useful in many application areas such as finding forests, rivers from a satellite image, detecting broken bone in a medical image etc. The paper discusses about finding edge of multiple aerial images in parallel .The proposed work tested on 38 images 37 colored and one monochrome image. The time taken to process N images in parallel is equivalent to time taken to process 1 image in sequential. The proposed method achieves pixel level parallelism as well as image level parallelism.

Keywords: edge detection, multicore, gpu, opencl, mpi

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Authors: Tawatchai Apidechkul

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This operational research was conducted and divided into two phases: the first phase aimed to determine the risk behaviors used a cross-sectional study design, following by the community participatory research design to develop the HIV/AIDS preventive model among the Akha youths. The instruments were composed of completed questionnaires and assessment forms that were tested for validity and reliability before use. Study setting was Jor Pa Ka and Saen Suk Akha villages, Mae Chan District, Chiang Rai, Thailand. Study sample were the Akha youths lived in the villages. Means and chi-square test were used for the statistical testing. Results: Akha youths in the population mobilization villages live in agricultural families with low income and circumstance of narcotic drugs. The average age was 16 (50.00%), 51.52% Christian, 48.80% completed secondary school, 43.94% had annual family income of 30,000-40,000 baht. Among males, 54.54% drank, 39.39% smoked, 7.57% used amphetamine, first sexual intercourse reported at 14 years old, 50.00% had 2-5 partners, 62.50% had unprotected sex (no-condom). Reasons of unprotected sex included not being able to find condom, unawareness of need to use condoms, and dislike. 28.79% never been received STI related information, 6.06% had STI. Among females, 15.15% drank, 28.79% had sexual intercourse and had first sexual intercourse less than 15 year old. 40.00% unprotected sex (no-condom), 10.61% never been received STI related information, and 4.54% had STI. The HIV/AIDS preventive model contained two components. Peer groups among the youths were built around interests in sports. Improving knowledge would empower their capability and lead to choices that would result in HIV/AIDS prevention. The empowering model consisted of 4 courses: a. human reproductive system and its hygiene, b. risk-avoid skills, family planning, and counseling techniques, c. HIV/AIDS and other STIs, d. drugs and related laws and regulations. The results of the activities found that youths had a greater of knowledge and attitude levels for HIV/AIDS prevention with statistical significance (χ2-τεστ= 12.87, p-value= 0.032 and χ2-τεστ= 9.31, p-value<0.001 respectively). A continuous and initiative youths capability development program is the appropriate process to reduce the spread of HIV/AIDS in youths, particularly in the population who have the specific of language and culture.

Keywords: AIV/AIDS, preventive program, effective, hill tribe

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Authors: Ketan Tamirisa, Kathleen P. Tebb

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In the U.S., annually, there are over 1 million pregnancies in teenagers and most (85%) are unintended. The need for proactive prevention measures is imperative to support adolescents with their pregnancy prevention and family planning goals. To date, there is limited research examining the extent to which support from a sexual partner(s) influences contraceptive use. To address this gap, this study assessed the relationship between sexually active adolescents, sex-assigned birth as female, and their perceived support from their sexual partner(s) about their contraceptive use in the last three months. Baseline data from sexually active adolescent females, between 13-19 years who were not currently using a long-acting contraceptive device, were recruited from 32 school-based health centers (SBHCs) in seven states in the U.S. as part of a larger study to evaluate Health-E You/ Salud iTuTM, a web-based contraceptive decision support tool. Fisher’s exact test assessed the cross-sectional association between perceived sexual partner support of contraceptive use in the past three months (felt no support, felt little support, and felt a lot of support), and current use of non-barrier contraception. A total of 91 sexually active adolescent females were eligible and completed the baseline survey. The mean age was 16.7 and nearly half (49.3%) were Hispanic/Latina. Most (85.9%) indicated it was very important to avoid becoming pregnant. A total of 60 participants (65.9%) reported use of non-barrier contraception. Of these, most used birth control pills (n=26), followed by Depo-Provera injection (n=12), patch (n=1), and ring (n=1). Most of the participants (80.2%) indicated that they perceived a lot of support from their partners and 19.8% reported no or little support. Among those reporting a lot of support, 69.9% (51/73) reported current use of non-barrier contraception compared to 50% (9/18) who felt no/little support and reported contraceptive use. This difference approached but did not reach statistical significance (p=0.096). Results from this preliminary data indicate that many adolescents who are coming in for care at SBHCs are at risk of unintended pregnancy. Many participants also reported a lot of support from their sexual partner(s) to use contraception. While the associations only approached significance, this is likely due to the small sample size. This and future research can better understand this association to inform interventions aimed at sexual partners to strengthen education and social support, increase healthcare accessibility, and ultimately reduce rates of unintended pregnancy.

Keywords: adolescents, contraception, pregnancy, SBHCs, sexual partners

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Authors: Miguel Angel Calvo Salve

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Building enclosures and façades not only have an aesthetic component they must also ensure thermal comfort and improve the acoustics and air quality in buildings. The role of facades design, its assemblies, and construction are key in developing a greener future in architecture. This research and study focus on the design of a multi-leaves building envelope, with a self-supporting wall of granite slabs. The study will demonstrate the advantages of its use in compare with the hanging stone veneer in a vented cladding system. Using the Design of the School of Music and Theatre of the Atlantic Area in Spain as a case study where the multi-leaves enclosure system consists in a self-supported outer leaf of large granite slabs of 15cm. of thickness, a vent cavity with thermal isolation, a brick wall, and a series of internal layers. The methodology used were simulations and data collected in building. The advantages of the self-supporting wall of granite slabs in the outer leaf (15cm). compared with a hanging stone veneer in a vented cladding system can summarize the goals as follows: Using the stone in more natural way, by compression. The weight of the stone slabs goes directly to a strip-footing and don't overload the reinforced concrete structure of the building. The weight of the stone slabs provides an external aerial soundproofing, preventing the sound transmission to the structure. The thickness of the stone slabs is enough to provide the external waterproofing of the building envelope. The self-supporting system with minimum anchorages allows having a continuous and external thermal isolation without thermal bridges. The thickness of ashlars masonry provides a thermal inertia that balances the temperatures between day and night in the external thermal insulation layer. The absence of open joints gives the quality of a continuous envelope transmitting the sensations of the stone, the heaviness in the facade, the rhythm of the music and the sequence of the theatre. The main cost of stone due his bigger thickness is more than compensated with the reduction in assembly costs. Don´t need any substructure systems for hanging stone veneers.

Keywords: self-supporting wall, stone cladding systems, hanging veneer cladding systems, sustainability of facade systems

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Authors: Sera Ratu, Jane Chivers, Jessica Botfield

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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.

Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools

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Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

Procedia PDF Downloads 137

Authors: Muna Al-Siyabi

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When students bring mobile devices into the classrooms, they are frequently viewed as distractions from their daily educational practices rather than developing the twenty-first century skills. Such skills may involve sorting and extracting information, solving problems and evaluating results. Mobile devices, such as smartphones and tablets, have great potential for learning. Currently, schools and universities are embracing these devices with the aim of enhancing education. In Oman, mobile technologies have been introduced in the last ten years in two private schools to keep pace with the technological advancement. The researcher set out to examine the benefits and challenges of employing mobile learning in these two schools with the aim to inform the implementation of mobile technologies in more schools in Oman. The total of 16 teachers and 237 students responded to questionnaires, and 7 teachers and three student focus groups (of 13 students) were involved in interviews to explore how mobile technologies are used in these two schools. The questionnaires indicated that 87.5% of the sample teachers considered mobile learning helpful for learning and teaching. The teachers believed that mobile learning could promote learning, help teaching, offer vast resources, motivate students and save lesson time. Moreover, interviews with the teachers showed that mobile learning could offer several benefits like immediacy, saving lesson time, supporting differentiation, opportunities to learn anywhere, showing understanding, and offering vast resources. Most of the sample were also facing technical and classroom management challenges when employing mobile technologies in their lessons. In the interviews, most teachers complained of the difficulty to control their classes when they had mobile devices, which distracted their attention and understanding. They reported that their students were distracted by games and they needed to be trained to use mobile technologies for educational purposes. Most teachers recommended that certain parameters or restrictions should be established in any mobile learning project that restrict the usage of mobile technologies to educational purposes. In addition, teachers also emphasised that students needed to be trained on the advantages and limitations of mobile technologies. Teachers were also recommending that pedagogical training for using mobile technologies should be considered when implementing mobile learning in schools. These findings reveal that although of the challenges of managing their classes, teachers believe that mobile learning has great potential for learning. These results imply that mobile learning can be effectively implemented in school in Oman if certain factors and restrictions are considered.

Keywords: effective implementation, challenges, mobile learning, opportunities

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