Search results for: educational background

Authors: Mohammad Mohammadi, Mohammad Pashmchi

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Background: Malnutrition commonly develops and worsens following gastric cancer surgery, particularly after discharge, which is associated with adverse outcomes. Former studies have primarily focused on patients during their hospital stay period, and there is limited evidence regarding the recommendation of nutritional interventions for patients after discharge from the hospital following gastric cancer surgery. This review is aimed to evaluate the efficiency of post-discharge dietary counseling with oral nutritional supplements (ONS), and dietary counseling alone on post-surgical nutritional outcomes in patients undergoing gastric cancer surgery. Methods: The four databases of Embase, PubMed, web of science, and google scholar were searched up to November 2022 for relevant randomized controlled trials. The Cochrane Collaboration’s assessment tool for randomized trials was used to evaluate the quality of studies. Results: Compared to patients who only received dietary counseling, patients who received both dietary counseling and ONS had considerably higher SMI, BMI, and less weight loss and sarcopenia occurrence rate. The patients who had received dietary counseling and ONS had significantly lower risk of chemotherapy intolerance. No differences in the readmission rate between the two groups was found. In terms of the quality of life, concomitant dietary advice and ONS significantly was associated with lower appetite loss and fatigue rate, but there was no difference in the other outcomes between the two groups. Conclusions: Post-discharge dietary advice with ONS following gastric cancer surgery may improve skeletal muscle maintenance, nutritional outcomes, quality of life variables, and chemotherapy tolerance. This evidence supports the recommendation of post-discharge dietary advice with ONS for patients who underwent gastric cancer surgery.

Keywords: gastric cancer surgery, oral nutritional supplements, malnutrition, gastric cancer

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Authors: Karen V. Lee

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The background and significance of this study involves autoethnographic research about a music teacher learning how education and curriculum planning can help her overcome harmful and lasting career consequences from sexual violence. Curriculum surrounding intervention resources from education helps her cope with consequences influencing her career as music teacher. Basic methodology involves the qualitative method of research as theoretical framework where the author is drawn into a deep storied reflection about political issues surrounding teachers who need to overcome social, psychological, and health risk behaviors from violence. Sub-themes involve counseling, curriculum, adult education to ensure teachers receive social, emotional, physical, spiritual, and intervention resources that evoke visceral, emotional responses from the audience. Major findings share how stories provide helpful resources to teachers who have been victims of violence. It is hoped the research dramatizes an episodic yet incomplete story that highlights the circumstances surrounding the protagonist’s life as teacher with previous sexual violence. In conclusion, the research has a reflexive storied framework with video and music from curriculum planning that embraces harmful and lasting consequences from sexual violence. The reflexive story of the sensory experience critically seeks verisimilitude by evoking lifelike and believable feelings from others. Thus, the scholarly importance of using education and curriculum as intervention resources to accompany storied research can provide transformative aspects that can contribute to social change. Overall, the circumstance surrounding the story about sexual violence is not uncommon in society. Thus, continued education and curriculum that supports the moral mission to help teachers overcome sexual violence that socially impacts their professional lives as victims.

Keywords: education, curriculum, sexual violence, storied autoethnography

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Authors: Ndidi Ofole

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Ongoing Boko Haram crisis and instability in North-Eastern Nigeria has placed additional stress on academic resilience of female undergraduates who are already challenged by gender discrimination in educational opportunities. Students without resilience lack stress hardiness to cope with academic challenges. There is a limited study on academic resilience targeting this disadvantaged population in Nigeria. Consequently, survey research design was employed to investigate the contextual and personal factors that could predict academic resilience among female undergraduates in Boko Haram Neighbourhood in North-Eastern, Nigeria. Five hundred and thirty female students with age range of 18 to 24 years ( = 19.2; SD=6.9) were randomly drawn from 3 Universities in North-Eastern Nigeria. They responded to five instruments, namely; Academic Resilience scale (r=0.72); Social Support questionnaire (r=0. 64); Social Connectedness questionnaire (r=0.75); Self-Efficacy scale (r=0. 68) and Emotional Regulation questionnaire (r=78). Results showed that there was significant positive relationship between the four independent variables and academic resilience. The variables jointly contributed 5.9% variance in the prediction of academic resilience. In terms of magnitude, social support was most potent while self-efficacy was the least. It concluded that the factors considered in this study are academic resilience facilitators. The outcomes of the study have both theoretical and practical implications.

Keywords: academic resilience, emotional regulation, school connectedness, self-efficacy , social support

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Authors: Paras Gupta, Rohit Goyal, Yamini Chauhan, Pyare Lal Sharma

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Background: Bombax ceiba Linn., commonly called as Semal, is used in various gastro-intestinal disturbances. It contains lupeol which inhibits PTP-1B, adipogenesis, TG synthesis and accumulation of lipids in adipocytes and adipokines whereas the flavonoids isolated from B. ceiba has FAS inhibitory activity. The present study was aimed to investigate ameliorative potential of Bombax ceiba to experimental obesity in Wistar rats, and its possible mechanism of action. Methods: Male Wistar albino rats weighing 180–220 g were employed in present study. Experimental obesity was induced by feeding high fat diet for 10 weeks. Methanolic extract of B. ceiba extract 100, 200 and 400 mg/kg and Gemfibrozil 50 mg/kg as standard drug were given orally from 7th to 10th week. Results: Induction with HFD for 10 weeks caused significant (p < 0.05) increase in % body wt, BMI, LEE indices; serum glucose, triglyceride, LDL, VLDL, cholesterol, free fatty acid, ALT, AST; tissue TBARS, nitrate/nitrite levels; different fat pads and relative liver weight; and significant decrease in food intake (g and kcal), serum HDL and tissue glutathione levels in HFD control rats. Treatment with B. ceiba extract and Gemfibrozil significantly attenuated these HFD induced changes, as compared to HFD control. The effect of B. ceiba 200 and 400 mg/kg was more pronounced in comparison to Gemfibrozil. Conclusion: On the basis of results obtained, it may be concluded that the methanolic extract of stem bark of Bombax ceiba has significant ameliorative potential against HFD induced obesity in rats, possibly through modulation of FAS and PTP-1B signaling due to the presence of flavonoids and lupeol.

Keywords: obesity, Bombax ceiba, free fatty acid, protein tyrosine phosphatase-1B, fatty acid synthase

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Authors: Shuko Takeshita

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This study investigates the identity formation of mixed-race children in Japan. From the latter half of the 1980s to the mid-2000s, Japan experienced an 'intermarriage boom,' which was soon followed by a fairly significant number of children born to these unions. These children are now coming of age. Among mixed-race children, some embraced both cultural traditions, while others chose a monocultural path despite exposure to two cultural traditions as they grew up. What factors are involved in shaping the identity of mixed-race children? How does identity formation actually occur in these children? This study addresses these questions through an interview survey of 139 cross-cultural families since 1999, including 23 Pakistani-Japanese families, 20 Turkish-Japanese families, 26 families comprising other international Muslim husbands and Japanese wives, 33 Filipino-Japanese families, and 37 Brazilian-Japanese families. The results of this two-decade-long study reveal that in cases where one cannot tell at first glance that children are mixed race, there is a tendency for them to hide their mixed background due to fear of bullying at school, as well as for their parents to encourage them to do this. To pass as a Japanese is one strategy for avoiding discrimination and prejudice, and it can provide a measure of ethnic security or a way of coping with social intolerance. Certainly, among my informants, there are some children who were bullied or teased at school, and as a result, they stopped attending or transferred to other schools. But the mixed-race experience is not always a negative thing in Japan. There is clearly a double standard involved in that mixed-race children of a Caucasian parent are more readily accepted by society than those of a non-Caucasian parent. The perceived social status of mixed-race individuals is usually understood in relation to the hierarchical positionings of monoracial groups. Mixed-race children could be guaranteed the right to enjoy the benefit of maintaining and developing an identity as a Japanese, in addition to one more identity. We need to encourage a new awareness of the children as agents for a transition from a monocultural system to a multicultural system in Japanese society.

Keywords: identity formation, intermarriage, mixed race, multicultural children

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Authors: Fatma Al Abdullah, Shahad Al Ameer, Ritaj Jaragh, Fatimah Khajah, Rawan Qambar, Amr Nounou

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Kuwait currently manufactures its tankers in foreign countries. Oil tankers play a role in the supply chain of the oil industry. Therefore, with Kuwait’s sufficient financial resources, the country should secure itself strategically in order to protect its oil industry to sustain economic development. The purpose of this report is designing an oil tankers’ shipyard facility. Basing the shipyard facility in Kuwait will have great economic rewards. The shipbuilding industry directly enhances the industrial chain in terms of new job and business opportunities as well as educational fields. Heavy Engineering Industries & Shipbuilding Co. K.S.C. (HEISCO) was chosen as a host due to benefits that will result from HEISCO’s existing infrastructure and expertise to reduce cost. The Facility Design methodology chosen has been used because it covers all aspects needed for the report. The oil tanker market is witnessing a shift from crude tankers to product tankers. Therefore the Panamax tanker (product tanker) was selected to be manufactured in the facility. The different departments needed in shipyards were identified based on studying different global shipyards. Technologies needed to build ships helped in the process design. It was noticed that ships are engineer to order. The new layout development of the proposed shipyard is currently in progress. A feasibility study will be conducted to ensure the success of the facility after developing the shipyard’s layout.

Keywords: oil tankers, shipbuilding, shipyard, facility design, Kuwait

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Authors: Amira A. A. Abdallah, Amir A. Beltagi

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Background: Core stability training has recently attracted attention for improving muscle balance and optimizing performance in healthy and unhealthy individuals. Purpose: This study investigated the effect of beginner’s core stability exercises on trunk flexors’/extensors’ peak torque ratio and trunk flexors’ and extensors’ peak torques. Methods: Thirty five healthy individuals participated in the study. They were randomly assigned to two groups; experimental “group I, n=20” and control “group II, n=15”. Their mean age, weight and height were 20.7±2.4 vs. 20.3±0.61 years, 66.5±12.1 vs. 68.57±12.2 kg and 166.7±7.8 vs. 164.28 ±7.59 cm. for group I vs. group II. Data were collected using the Biodex Isokinetic system. The participants were tested twice; before and after a 6-week period during which group I performed a core stability training program. Results: The 2x2 Mixed Design ANOVA revealed that there were no significant differences (p>0.025) in the trunk flexors’/extensors’ peak torque ratio between the pre-test and post-test conditions for either group. Moreover, there were no significant differences (p>0.025) in the trunk flexion/extension ratios between both groups at either condition. However, the 2x2 Mixed Design MANOVA revealed significant increases (p<0.025) in the trunk flexors’ and extensors’ peak torques in the post-test condition compared with the pre-test in group I with no significant differences (p>0.025) in group II. Moreover, there was a significant increase (p<0.025) in the trunk flexors’ peak torque only in group I compared with group II in the post-test condition with no significant differences in the other conditions. Interpretation/Conclusion: The improvement in muscle performance indicated by the increase in the trunk flexors’ and extensors’ peak torques in the experimental group recommends including core stability training in the exercise programs that aim to improve muscle performance.

Keywords: core stability, isokinetic, trunk muscles, muscle balance

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Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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Authors: Heba Esaily, Rawhia Eledl, Daila Aboelela, Rasha Noreldin

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Objective: Assess serum level of Transforming growth factor beta 2 (TGF-β2) and Matrilin-3 (MATN3) SNP6 polymorphism in osteoarthritic patients Background: Osteoarthritis (OA) is a musculoskeletal disease characterized by pain and joint stiffness. TGF-β 2 is involved in chondrogenesis and osteogenesis, It has found that MATN3 gene and protein expression was correlated with the extent of tissue damage in OA. Findings suggest that regulation of MATN3 expression is essential for maintenance of the cartilage extracellular matrix microenvironment Subjects and Methods: 72 cases of primary OA (56 with knee OA and 16 with generalized OA were compared with that of 18 healthy controls. Radiographs were scored with the Kellgren-Lawrence scale. Serum TGF-β2 was measured by using (ELISA), levels of marker were correlated to radiographic grading of disease and MATN3 SNP6 polymorphism was determined by (PCR-RFLP). Results: MATN3 SNP6 polymorphism and serum level of TGF-β2 were higher in OA compared with controls. Genotype, NN and N allele frequency were higher in patients with OA compared with controls. NN genotype and N allele frequency were higher in knee osteoarthritis than generalized OA. Significant positive correlation between level of TGFβ2 and radiographic grading in group with knee OA, but no correlation between serum level of TGFβ2 and radiographic grading in generalized OA. Conclusion: MATN3 SNP6 polymorphism and TGF-β2 implicated in the pathogenesis of osteoarthritis. Association of N/N genotype with primary osteoarthritis emphasizes on the need for prospective study include larger sample size to confirm the results of the present study.

Keywords: Matrilin-3, transforming growth factor beta 2, primary osteoarthritis, knee osteoarthritis

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Authors: Sharapat Sharapat

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English language is perceived as cultural capital in many non-native English-speaking countries, and minority groups in these social contexts seem to invest in the language to be empowered and reposition themselves from the imbalanced power relation with the dominant group. This study is devoted to explore how English learning influence minority Kazakh students’ identity (re)construction at Chinese universities from the scope of ‘imagined community, investment, and identity’ theory of Norton (2013). To this end the three research questions were designed as follows: 1) Kazakh minority students’ English learning experiences at Chinese universities; 2) Kazakh minority students’ views about benefits and opportunities of English learning; 3) the influence of English learning on Kazakh minority students’ identity (re)construction. The study employs an interview-based qualitative research method by interviewing nine Kazakh minority students in universities in Xinjiang and other inland cities in China. The findings suggest that through English learning, some students have reconstructed multiple identities as multicultural and global identities, which created ‘a third space’ to break limits of their ethnic and national identities and confused identity as someone in-between. Meanwhile, most minority students were empowered by the English language to resist inferior or marginalized positions and reconstruct imagined elite identity. However, English learning disempowered students who have little previous English education in school and placed them on unequal footing with other students, which further escalated the educational inequities.

Keywords: minority in China, identity construction, multilingual education, language empowerment

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Authors: Aidan Jacobsen, Morgan Motia, David Sam, Jonathan Mudge

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Background: The Centers for Disease Control (CDC) lists vaccine requirements for children under two years old to correlate with development markers. CDC lists the coverage by age 24 months to be at least 90% nationally and 84% for Rhode Island Blackstone Valley Community Health Center (BVCHC) in Central Falls, Rhode Island, currently has a completed vaccination rate of 51% for children by the age of 24 months. Current barriers to care for up to date well child vaccinations include lack of transportation, parental work, childcare, and other social stressors. Objective: Increase the vaccination rate of children under the age of 24 months at BVCHC. Conduct a literature review to identify the common barriers preventing children under 24 months from receiving vaccinations. Reduce the barriers to expand access to vaccination care for infants Methods: Setting: Blackstone Valley Community Health Center, Pawtucket, RI Participants: (n=41), Patients between the age of 20-24 months, not up to date with the CDC vaccination recommendations and without a future appointment. QI Intervention: Patients were contacted via phone and offered an appointment during extra Saturday clinic hours in order to receive up to date vaccine care. A Saturday vaccine clinic was established specifically for patients in need of vaccines and having identified barriers to care. Conclusions: Expanding clinic hours and targeting non vaccine up –to-date patients can increase the current standard of childhood immunizations at BVCHC. Overcoming barriers preventing childhood immunization can improve access to providing up to date vaccinations. Other barriers still deter from reaching the national standard of immunizations rates.

Keywords: vaccinations, well child care, barriers to care, social determinants of health

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Authors: Runlin Liu, Shilong Li

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China is a mountainous country, with two-thirds of its territory covered by plateaus, hills, and mountains, and nearly half of the cities and towns are distributed in mountainous areas. Compared with the environmental constraints in the development path of cities and towns in the plains, there are heterogeneities in aspects such as spatial characteristics, growth mode, and ecological protection and so on for mountain village and townlets, and the development path of mountain village and townlets has a bidirectional relationship between mountain space and economic growth. Based on classical growth theory, this article explores the two-dimensional coupling relation between space and economy in mountain village and townlets under background of rural rejuvenation. GIS technology is adopted in the study to analyze spatial trends and patterns, economical spatial differentiation characteristics of village and townlets. This powerful tool can also help differentiate and analyze limiting factors and assessment systems in the economic growth of village and townlets under spatial dimension of mountainous space. To make the research more specific, this article selects mountain village and townlets in Southwest China as the object of study; this provides good cases for analyzing parallel coupling mechanism of the duality structure system between economic growth and spatial expansion and discussing the path selection of spatial economic growth of mountain village and towns with multiple constraints. The research results can provide quantitative references for the spatial and economic development paths of mountain villages and towns, which is helpful in realizing efficient and high-quality development mode with equal emphasis on spatial and economic benefits for these type of towns.

Keywords: coupling mechanism, geographic information technology, mountainous town, synergetic development, spatial economy

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Authors: Oren Shtayermman

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The current investigation expended on research among parents caring for a child who is diagnosed with an autism spectrum disorder (ASD). An online web survey was used to collect data from 253 parents caring for a child with a diagnosis of ASD. Both parents reported on elevated levels of parental stress associated with caring for the child on the spectrum. In addition, lower levels of marital satisfaction were found in both parents. About 13% of the parents in the sample met the diagnostic criteria for Major Depressive Disorder and About 15% of the parents met the diagnostic criteria for Generalized Anxiety Disorder. Although the majority of the sample was females (94%) significant differences were found between males and females in relation to meeting the diagnostic criteria for Major Depressive Disorder and for Generalized Anxiety Disorder. Higher levels of stress were associated with higher number of Generalized Anxiety Disorder symptoms and higher number of Major Depressive Disorder symptoms. Findings from this study indicate how vulnerable parents and especially females are in relation to caring to a child diagnosed with ASD. Educational Objectives: At the conclusion of the paper, the readers should be able to: -Identify levels of stress and marital satisfaction among parents caring for a child diagnosed with autism spectrum disorder, -Recognize the impact of stress on the development of mental health issues, -Name the two most common mood and anxiety related disorders associated with caring for a child diagnosed with an autism spectrum disorder.

Keywords: autism, stress, parents, children

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Authors: Christelle Navarro, Sébastien Viaud, Carole Gard, Bruno Jahier

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Background: Idiopathic or familial nasal hyperkeratosis (NHK) may be considered a cosmetic issue in its uncomplicated form. Nevertheless, prevention of secondary lesions such as fissures or infections could be advised by proper management. The objective of this open-field study is to evaluate the benefits of a moisturizing balm in privately owned dogs with NHK, using an original validation grid for both investigator and owner assessments. Methods: Dogs with idiopathic or familial NHK received a vegetable-based ointment (Sensiderm® Balm, MP Labo, France) BID for 60 days. A global dermatological score (GDS) was defined using the sum of 4 criteria (“dryness,” “lichenification”, “crusts,” and “affected area”) on a 0 (no) to 3 (severe or > 2/3 extension) scale. Evaluation of this GDS (0-12) on D0, D30, and D60, by owners and investigators was the main outcome. The score’s percentage decrease versus D0, the evolution of each individual score, the correlation between observers, and the evaluation of clinical improvement and animal discomfort on VAS (0-10) during follow-up were analysed. Results: The global dermatological score significantly decreased over time (p<0.0001) for all observers. The decrease reached 44.9% and 54.3% at D30 and 54.5% and 62.3% at D60, for investigators and owners, respectively. “Dryness”, “Lichenification,” and “Affected area scores” decreased significantly and steadily over time compared to Day 0 for both investigators and owners (p < 0.001 and p = 0.001 for investigator assessment of dryness). All but one score (lichenification) were correlated at all times between observers (only at D60 for crusts). Whoever the observer, clinical improvement was always above 7. At D30 and until D60, “animal discomfort” was more than halved. Owner satisfaction was high as soon as D30 (8.1/10). No adverse effects were reported. Conclusion and clinical importance: The positive results confirm the benefits and safety of a moisturizing balm when used in dogs with uncomplicated NHK.

Keywords: hyperkeratosis, nose, dog, moisturizer

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Authors: Samaneh Yavari, Christiane Pferrer, Elisabeth Engelke, Alexander Starke, Juergen Rehage

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Background: Three nociceptive thresholds of thermal, electrical, and mechanical thresholds commonly use to evaluate the local anesthesia in many species, for instance, cow, horse, cat, dog, rabbit, and so on. Due to the lack of investigations to evaluate and/or validate such those nociceptive thresholds, our plan was the comparison of two-foot local anesthesia methods of Intravenous Regional Anesthesia (IVRA) and our modified four-point Nerve Block Anesthesia (NBA). Materials and Methods: Eight healthy nonpregnant nondairy Holstein Frisian cows in a cross-over study design were selected for this study. All cows divided into two different groups to receive two local anesthesia techniques of IVRA and our modified four-point NBA. Three thermal, electrical, and mechanical force and pinpricks were applied to evaluate the quality of local anesthesia methods before and after local anesthesia application. Results: The statistical evaluation demonstrated that our four-point NBA has a qualification to select as a standard foot local anesthesia. However, the recorded results of our study revealed no significant difference between two groups of local anesthesia techniques of IVRA and modified four-point NBA related to quality and duration of anesthesia stimulated by electrical, mechanical and thermal nociceptive stimuli. Conclusion and discussion: All three nociceptive threshold stimuli of electrical, mechanical and heat nociceptive thresholds can be applied to measure and evaluate the efficacy of foot local anesthesia of dairy cows. However, our study revealed no superiority of those three nociceptive methods to evaluate the duration and quality of bovine foot local anesthesia methods. Veterinarians to investigate the duration and quality of their selected anesthesia method can use any of those heat, mechanical, and electrical methods.

Keywords: mechanical, thermal, electrical threshold, IVRA, NBA, hind limb, dairy cow

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Authors: Li Yin, Xiaoqin Wang

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Background and purpose: Cancer diagnosis is part of a complex stochastic process, in which patients' personal and social characteristics influence the choice of diagnosing methods, diagnosing methods, in turn, influence the initial assessment of cancer stage, the initial assessment, in turn, influences the choice of treating methods, and treating methods in turn influence cancer outcomes such as cancer survival. To evaluate diagnosing methods, one needs to estimate and test the causal effect of a regime of cancer diagnosis and treatments. Recently, Wang and Yin (Annals of statistics, 2020) derived a new general formula, which expresses these causal effects in terms of the point effects of treatments in single-point causal inference. As a result, it is possible to estimate and test these causal effects via point effects. The purpose of the work is to estimate and test causal effects under various regimes of cancer diagnosis and treatments via point effects. Challenges and solutions: The cancer stage has influences from earlier diagnosis as well as on subsequent treatments. As a consequence, it is highly difficult to estimate and test the causal effects via standard parameters, that is, the conditional survival given all stationary covariates, diagnosing methods, cancer stage and prognosis factors, treating methods. Instead of standard parameters, we use the point effects of cancer diagnosis and treatments to estimate and test causal effects under various regimes of cancer diagnosis and treatments. We are able to use familiar methods in the framework of single-point causal inference to accomplish the task. Achievements: we have applied this method to stomach cancer survival from a clinical study in Sweden. We have studied causal effects under various regimes, including the optimal regime of diagnosis and treatments and the effect moderation of the causal effect by age and gender.

Keywords: cancer diagnosis, causal effect, point effect, G-formula, sequential causal effect

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Authors: Samar Alharbi, Yota Dimitriadi

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The literature on educational technology in Saudi Arabia reveals female learners’ unwillingness to study fully online courses in higher education despite the fact that Saudi universities have offered a variety of online degree programmes to undergraduate students in many regions of the country. The root causes keeping female students from successfully learning in online environments are limited social interaction, lack of motivation and difficulty with the use of e-learning platforms. E-immediacy remains an important method of online teaching to enhance students’ interaction and support their online learning. This study explored Saudi female students’ perceptions, as well as the experiences of lecturers’ immediacy behaviours in online environments, who participate in fully online courses using Blackboard at a Saudi university. Data were collected through interviews with focus groups. The three focus groups included five to seven students each. The female participants were asked about lecturers’ e-immediacy behaviours and which e-immediacy behaviours were important for an effective learning environment. A thematic analysis of the data revealed three main themes: the encouragement of student interaction, the incorporation of social media and addressing the needs of students. These findings provide lecturers with insights into instructional designs and strategies that can be adopted in using e-immediacy in effective ways, thus improving female learners’ interactions as well as their online learning experiences.

Keywords: e-learning, female students, higher education, immediacy

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Authors: Rebecca Haythorne

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Background: Agendas continuously emphasise the need to increase work based training and opportunities for individuals with learning disabilities. However research and statistics suggest that there is still significant stigma and stereotypes as to what they can contribute, or gain from being part of the working environment. Method: To tackles some of these prejudices an Occupational Therapy based intervention was developed for learning disability service users working at a social enterprise farm. The intervention aimed to increase positive public perception around individual capabilities and encourage individuals with learning disabilities to take ownership and be proud of their individual personhood and citizenship. This was achieved by using components of the Model of Human Occupation to tailor the intervention to individual values, skills and working contributions. The final project involved making creative wall art for public viewing, focusing on 'who works there and what they do'. This was accompanied by a visitor information guide, allowing individuals to tell visitors about themselves, the work they do and why it is meaningful to them. Outcomes: The intervention has helped to increased metal well-being and confidence of learning disability service users “people will know I work here now” and “I now have something to show my family about the work I do at the farm”. The intervention has also increased positive public perception and community awareness “you can really see the effort that’s gone into doing this” and “it’s a really visual experience to see people you don’t expect to see doing this type of work”. Resources left behind have further supported individuals to take ownership in creating more wall art to be sold at the farm shop. Conclusion: the intervention developed has helped to improve mental well-being of both service users and staff and improve community awareness. Due to this, the farm has decided to roll out the intervention to other areas of the social enterprise and is considering having more Occupational Therapy involvement in the future.

Keywords: citizenship, intervention, occupational therapy, personhood

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Authors: Mir Afzal Tajik

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The 'Strengthening Teacher Education in Pakistan' (STEP) is an innovative programme jointly funded by the Government of Canada and the Aga Khan Foundation Canada and implemented by the Aga Khan University - Institute for Educational Development (AKU-IED) in partnership with the local governments, education departments and communities in the provinces of Balochistan, Sindh and Gilgit-Baltistan in Pakistan. One of the key components of the programme is professional development of teachers, head teachers and teacher educators through a variety of teacher education programmes including a two-year Masters of Education (MEd) Programme offered by AKU-IED. A number of teachers, head teachers and teacher educators from these provinces have been developed through the MEd Programme. This paper discusses a qualitative research study conducted to explore the nature, relevance, rigor and richness of the experiences of the MEd graduates, and how these experiences have fostered their own professional development and their ability to bring about positive changes in their schools. The findings of the study provide useful insights into the graduates’ self-actualization, transformation of their professional beliefs and practices, the difference they have made in their schools, and the challenges they face. The study also provides evidences of how the implementation of this multi-stakeholders and multi-partners STEP programme has led to the development of ‘communities of practice’ in schools. The study then makes a number of recommendations for policy and practice related to teacher education programmes as well as for partnerships in education.

Keywords: STEP, change agents, Pakistan, Canada, teacher education, MEd

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Authors: V. N. Chebotkevich, E. E. Schetinkina, V. V. Burylev, E. I. Kaytandzhan, N. P. Stizhak

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Objective: Blood stream infections (BSI) are severe, life-threatening illness for immuno compromised patients with hematological malignancies. We report the trend in blood-stream infections in this group of patients in the period 1991-2013. Methods: A total of 4742 blood samples investigated. All blood cultures were incubated in a continuous monitoring system for 7 days before discarding negative. On signaled positive, organism was identified by conventional methods. The Real-time polymerase chain reaction (PCR) was used for the indication of human herpes virus 6 (HHV-6), Cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Results: Between 1991 and 2001 the incidence of Gram-positive bacteria (Staphylococcus epidermidis, Staphylococcus aureus) being the most common germs isolated (70,9%) were as Gram-negative rods (Escherichia coli, Klebsiella spp., Pseudomonas spp.) – 29,1%. In next decade 2002-2012 the number of Gram-negative bacteria was increased up to 40.2%. It is shown that the incidence of bacteremia was significantly more frequent at the background of detectable Cytomegalovirus and Epstein-Barr virus-specific DNA in blood. Over recent years, an increased frequency of micro mycetes was registered in blood of the patients with hematological malignancies (Candida spp. was predominant). Conclusion: Accurate and timely detection of BSI is important in determining appropriate treatment of infectious complications in patients with hematological malignancies. The isolation of Staphylococcus epidermidis from blood cultures remains a clinical dilemma for physicians and microbiologists. But in many cases this agent is of the clinical significance in immunocompromised patients with hematological malignancies. The role of CMV and EBV in development of bacteremia was demonstrated.

Keywords: infectious complications, blood stream infections, bacteremia, hemoblastosis

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Authors: T. Esteves, S. Mesquita, A. Santos, A. Campina, C. Costa-Lobo

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The theme regarding the differentiation of high-performance athletes has always aroused curiosity and fascination, becoming a target for study, especially in the social and human sciences. It was from the 60's and 70's that the concern for the study of the excellence of athletes that showed indices of high performance in sports began to arise. From the 1990s, it became possible to specify the mental competencies and psychological characteristics associated with Olympic athletes with high levels of success. Several studies considered that well-structured pre-competitive and competitive routines and plans were predictors of sports success. Likewise, the high levels of motivation, commitment and concentration; the high levels of self-confidence and optimism; the presence of effective coping strategies to deal with distractions and unexpected situations or events; adequate regulation of activation and anxiety; the establishment and formulation of objectives; and mental visualization and practice were determinants in the manifestation of excellence in these athletes. As such, the promotion of these cognitive abilities has been emphasized in the good performance of the athletes. With the objective of implementing cognitive stimulation programs to meet the specific needs of talented athletes, together with pedagogical activities to promote educational strategies and promote interpersonal relationships, this communication systematizes a proposal for a psychopedagogical service to promote cognitive abilities in competitive athletes, SPAC, to implement in a Portuguese soccer team. This service will be based on a holistic vision in order to promote talent.

Keywords: athletes, cognitive abilities, high competition, psycho-pedagogical service

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Authors: Ebobo Urowoli Christiana

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The Nigerian Prison Service statistics of 2007; 2009 revealed that though crime in the past was ascribed to men, but today there is a steady increase in the population of women involved in crime. This study focused on the investigation of female criminality in Lagos State: A case of Armed Robbery. Its major objective was to find out if there is an increase or decrease in female involvement in armed robbery and its growth rate. The major research question is 'Is there an increase in the perpetration of armed robbery by females in Lagos State?' the null hypotheses is 'There is no significant increase in the perpetration of armed robbery by females in Lagos State.' As a result, this study adopted the survey design, purposive sampling method and a sample size of 120 respondents. The rational choice theory was used to explain the reason for female involvement in armed robbery. Both primary and secondary data was generated for this study; the primary data was collected from the criminal records in Lagos State Police Command, Panti while the Quantitative data was collected using the questionnaire from 120 female detainees and inmates. The data collected was analyzed using the simple frequency tables and percentages and chi square was used to test for relationships. The study revealed a persistent rise in the prevalence of female armed robbery and recommended that youths should be equipped with educational/vocational skills in order to lead responsible lives.

Keywords: criminality, armed robbery, female, police commands, panti, nature

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Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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Authors: Mathias Ebot, Päivi Harinen

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This article focuses on challenges of parenthood for Sub-Saharan African fathers in Finland. In this analysis Finland represents a Nordic welfare society where family relationships are strongly guided by national family policies and discourses. These policies are based on both traditional ideas of a proper Finnish family, as well as on the contemporary waves of female liberation and emphasis on children’s rights. We analyze how especially Cameroonian fathers perceive their parenthood positions and how they characterize and frame their fathering experiences in relation to the mainstream sociopolitical, cultural and national representations of fatherhood in Finland. The analysis is based on interviews and narrative reports collected among Cameroonian fathers living in Finland with their African spouses. The scrutiny shows that in the context where the mainstream cultural and national family representation is created by equality between parents and also between parents and their children, and where “good fatherhood” is created by embodied presence and warm relationships with children these fathers have difficulties: They have to fulfill another fatherhood duty – bread-winning – and thus ensure their labor possibilities all the time, from very marginalized positions of the labor market. When comparing their fatherhood position with the one in Cameroon they also feel embarrassed as the Finnish educational system teaches and encourages their children to challenge their authority as up-raising adults, which in Cameroon could not be possible.

Keywords: Cameroonian fathers, perception, fathering experiences, Finland

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Authors: Tess Hartland, Moitree Banerjee, Sue Churchill, Antonina Pereira, Ian Tyndall, Ruth Lowry

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Background: Sexual health services and policies for middle-aged and older adults are underdeveloped, while global sexually transmitted infections in this age group are on the rise. The Interreg cross-Europe Sexual Health In Over 45s (SHIFT) project aims to increase participation in sexual health services and improve sexual health and wellbeing in people aged over 45, with an additional focus on disadvantaged groups. Methods: A two-pronged mixed-methodology is being used to develop a model for good service provision in sexual health for over 45s. (1) Following PRISMA-ScR guidelines, a scoping review is being conducted, using the databases PsychINFO, Web of Science, ERIC and PubMed. A key search strategy using terms around sexual health, good practice, over 45s and disadvantaged groups. The initial search for literature yielded 7914 results. (2) Surveys (n=1000) based on the Theory of Planned Behaviour are being administered across the UK, Belgium and Netherlands to explore current sexual health knowledge, awareness and attitudes. Expected results: It is expected that sexual health needs and potential gaps in service provision will be identified in order to inform good practice for sexual health services for the target population. Results of the scoping review are being analysed, while focus group and survey data is being gathered. Preliminary analysis of the survey data highlights barriers to access such as limited risk awareness and stigma. All data analysis will be completed by the time of the conference. Discussion: Findings will inform the development of a model to improve sexual health and wellbeing for among over 45s, a population which is often missed in sexual health policy improvement.

Keywords: adult health, disease prevention, health promotion, over 45s, sexual health

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Authors: Wei Zhang, Chye Kiang Heng, John Chye Fung

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Background: The world’s demographics is currently undergoing the largest wave of both rapid ageing and dramatic urbanisation in human history. As one of the most rapidly ageing countries, Singapore will see about one in four residents aged 65 years and above by 2030 in its high-rise and high-density urban environment. Research questions: To support urban seniors ageing in place and interdependence among senior residents and their informal caregivers, this study argues a community-based care model with bottom-up mutual help networks and asks how neighbourhood built-environment influences the formulation and facilitation of bottom-up mutual help networks in Singapore. Methods: Two public housing communities with different physical environment and rich age-friendly neighbourhood initiatives were chosen as the case studies. The categories, participants and places of bottom-up mutual help activities will be obtained via field observation, non-structural interviews of participants, service providers and managers of care facilities, and documents. Mapping and content analysis will be used to explore the influences of neighbourhood built-environment on the formulation and facilitation of bottom-up mutual help networks. Results and conclusions: The results showed that neighbourhood design, place programming, and place governance have a confluence on the bottom-up mutual help networks for senior residents. Significance: The outcomes of this study will provide fresh evidence for paradigm shifts of community-based care for the elderly and neighbourhood planning. In addition, the research findings will shed light on meaningful implications of urban planners and policy makers as they tackle with the issues arising from the ageing society.

Keywords: Built environment, Mutual help, Neighbourhood, Senior residents, Singapore

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Authors: David Tanujaya Kurniawan

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Background: Liver injury caused by paracetamol is marked by increased serum transaminase levels. Turmeric is a local herb that is available in large quantities and inexpensive in contradiction to its substantial benefits, including its potency to increase glutathione production and regenerate hepatocyte into normal condition. Aim: The aim of this study was to analyze the potencial treatment effect of turmeric rhizome extract to reduce serum transaminase level on paracetamol induced liver toxicity in rats. Methods: This study was a laboratory experimental research with post-test only controlled group design. A group of 24 Wistar white male rats was induced with paracetamol 360 mg/kg body weight for 10 days. The group was then separated into four groups: the first and the second was treated with 100 mg/kg body weight and 150 mg/kg body weight of turmeric rhizome extract, subsequently, the third as positive control was given 27 mg/kg body weight of lesichol, while the fourth as negative control was given CMC-Na 1%. Each of this treatment was given for seven days. At the end of the study, the blood samples were taken to measure SGOT and SGPT levels. The one-way Anova test revealed significant difference in mean of SGPT level (p=0,001). The LSD test showed significant differences of SGPT levels in both treatment groups and negative control group. However, there was no sgnificant difference between positive control and both treatment groups. Conclusion: Curcuma domestica Val. rhizome extract could not reduce SGOT level, but it reduced SGPT level significantly.

Keywords: Curcuma domestica val., SGOT, SGPT, paracetamol, liver toxicity

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Authors: Tibor Koltay

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Among varied new literacies, information literacy is not only the best-known one but displays numerous models and frameworks. Nonetheless, there is still a lack of its complex theoretical model that could be applied to information literacy education in public (K12) education, which often makes use of constructivist approaches. This paper aims to present the main features of such a model. To develop a complex model, the literature and practice of phenomenographic and sociocultural theories, as well as discourse analytical approaches to information literacy, have been reviewed. Besides these constructivist and expressive based educational approaches, the new model is intended to include the innovation of coupling them with a cognitive model that takes developing informational and operational knowledge into account. The convergences between different literacies (information literacy, media literacy, media and information literacy, and data literacy) were taken into account, as well. The model will also make use of a three-country survey that examined secondary school teachers’ attitudes to information literacy. The results of this survey show that only a part of the respondents feel properly prepared to teach information literacy courses, and think that they can teach information literacy skills by themselves, while they see a librarian as an expert in educating information literacy. The use of the resulting model is not restricted to enhancing theory. It is meant to raise the level of awareness about information literacy and related literacies, and the next phase of the model’s development will be a pilot study that verifies the usefulness of the methodology for practical information literacy education in selected Hungarian secondary schools.

Keywords: communication, data literacy, discourse analysis, information literacy education, media and information literacy media literacy, phenomenography, public education, sociocultural theory

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Authors: Farida Habib, Haya Alfozan, Eman Miligi, Najla Alotaibi

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Background: Women’s satisfaction with maternity services, especially care during labor and birth, has become highly significant to healthcare providers, administrators, and policymakers. Purpose: The aims of this study were to assess maternal satisfaction regarding the quality of care during labor and to compare the level of maternal satisfaction between women who delivered by physicians and those delivered by midwives. Methodology: A descriptive, cross-sectional, correlational design was used. A convenient sample of 180 low-risk cases of immediate postpartum women who delivered at King Abdul-Aziz medical city was recruited. Women whose babies were diagnosed with serious health problems were excluded from the study. Data were collected using a self-administered questionnaire. The validity and reliability of the questionnaire were ensured. The questionnaire included three parts, namely: demographics data, medical history, and obstetrical history, and the last part is the satisfaction assessment tool. Ethical confederations were ensured. Maternal satisfaction during labor was classified in terms of health care, health workers' communication, and the environment. Results: Regarding health care, women were highly satisfied with care received from nurse (M = 4.21 + 0.88), medical care received (M = 4.17 + 0.79), and comfort techniques (M = 4.04 + 0.91). Regarding health workers' communication, women were highly satisfied with the provider to treat with dignity and respect (M = 4.03 + 0.91) and orientation to the toilet, bathroom, washing area (M = 4.00 + 0.93). Regarding the environment, women were highly satisfied with the experience of their baby's birth (M = 4.18 + 0.98) and supplies with drugs and supplies (M = 4.09 + 0.97). There was no statistically significant difference in maternal satisfaction between women who delivered by physicians and those delivered by midwives. Conclusion: Women were generally satisfied with their labor and delivery experience. There was no difference in maternal satisfaction on the labor process between women who delivered by physicians and those delivered by midwives.

Keywords: maternity, satisfaction, labor, delivery

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Authors: Thanduxolo Nomngcoyiya, Simon M. Kang’ethe

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The aim of this article is to explore whether a relationship exists between traditional male circumcision mishaps and level of education in the Eastern Cape, South Africa, exemplified by an empirical case study. The study used qualitative paradigm; was exploratory in nature and used case study design that was descriptive and exploratory; and entailed interviewing twenty-eight (28) research participants comprising of eleven (11) newly initiated men and their families on one-on-one in-depth interviews, twelve (12) traditional nurses and community members in focus group discussions; and five (5) society key informants on key informant method. An interview guide served as a data collection instrument for focus group discussions, key informant method and in-depth interviews with unstructured open-ended questions. Findings indicated an array of traditional male circumcision (TMC) gaps, some of which were indicative of a relationship between the mishaps and level of education: the phenomenon of schooling became secondary in newly initiated men’s lives; TMC mishaps became a drawback towards the newly initiated men’s education progression; the newly initiated men are sacrificed at the altar of culture, and TMC mishaps ushered in socioeconomic setback to the newly initiated men. The study suggested that: TMC be developmental; TMC as a cultural endeavor be educational and human rights friendly; and the need to identify and integrate all other players with diverse specialties.

Keywords: culture, education for all, EFA, millennium development goals, traditional male circumcision

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