Search results for: tertiary education
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7779

Search results for: tertiary education

3669 Operational Measures for Greenhouse Gas Reduction from Ships

Authors: Gorana Jelic Mrcelic

Abstract:

In order to reduce greenhouse gas emissions from ships, technical and operational measures can be used. Operational measures are easier and cheaper compared to technical measures, so are well recommended. One of the most cost-effective operational measure is fuel consumption. Fuel consumption can be reduced by various options but it sometimes needs investments in new equipment, new procedures and crew education. In order to implement operational measures in everyday procedures and routines on board, good understanding of the mechanisms by which these measures work is essential for the seamen.

Keywords: green shipping, gas emission reduction, operational measures, seamen

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3668 UVA or UVC Activation of H₂O₂ and S₂O₈²⁻ for Estrogen Degradation towards an Application in Rural Wastewater Treatment Plant

Authors: Anaelle Gabet, Helene Metivier, Christine De Brauer, Gilles Mailhot, Marcello Brigante

Abstract:

The presence of micropollutants in surface waters has been widely reported around the world, particularly downstream from wastewater treatment plants (WWTPs). Rural WWTPs constitute more than 90 % of the total WWTPs in France. Like conventional ones, they are not able to fully remove micropollutants. Estrogens are excreted by human beings every day and several studies have highlighted their endocrine disruption properties on river wildlife. They are mainly estrone (E1), 17β-estradiol (E2) and 17α-ethinylestradiol (EE2). Rural WWTPs require cheap and robust tertiary processes. UVC activation of H₂O₂ for HO· generation, a very reactive molecule, has demonstrated its effectiveness. However, UVC rays are dangerous to manipulate and energy-consuming. This is why the ability of UVA rays was investigated in this study. Moreover, the use of S₂O₈²⁻ for SO₄·- generation as an alternative to HO· has emerged in the last few years. Such processes have been widely studied on a lab scale. However, pilot-scale works constitute fewer studies. This study was carried out on a 20-L pilot composed of a 1.12-L UV reactor equipped with a polychromatic UVA lamp or a monochromatic (254 nm) UVC lamp fed in recirculation. Degradation rates of a mixture of spiked E1, E2 and EE2 (5 µM each) were followed by HPLC-UV. Results are expressed in UV dose (mJ.cm-2) received by the compounds of interest to compare UVC and UVA. In every system, estrogen degradation rates followed pseudo-first-order rates. First, experiments were carried out in tap water. All estrogens underwent photolysis under UVC rays, although E1 photolysis is higher. However, only very weak photolysis was observed under UVA rays. Preliminary studies on both oxidants have shown that S₂O₈²⁻ photolysis constants are higher than H₂O₂ under both UVA and UVC rays. Therefore, estrogen degradation rates are about ten times higher in the presence of 1 mM of S₂O₈²⁻ than with one mM of H₂O₂ under both radiations. In the same conditions, the mixture of interest required about 40 times higher UV dose when using UVA rays compared to UVC. However, the UVA/S₂O₈²⁻ system only requires four times more UV dose than the conventional UVC/H₂O₂ system. Further studies were carried out in WWTP effluent with the UVC lamp. When comparing these results to the tap water ones, estrogen degradation rates were more inhibited in the S₂O₈²⁻ system than with H₂O₂. It seems that SO₄·- undergo higher quenching by a real effluent than HO·. Preliminary experiments have shown that natural organic matter is mainly responsible for the radical quenching and that HO and SO₄ both had similar second-order reaction rate constants with dissolved organic matter. However, E1, E2 and EE2 second-order reaction rate constants are about ten times lower with SO₄ than with HO. In conclusion, the UVA/S₂O₈²⁻ system showed encouraging results for the use of UVA rays but further studies in WWTP effluent have to be carried out to confirm this interest. The efficiency of other pollutants in the real matrix also needs to be investigated.

Keywords: AOPs, decontamination, estrogens, radicals, wastewater

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3667 Reading Strategy Instruction in Secondary Schools in China

Authors: Leijun Zhang

Abstract:

Reading literacy has become a powerful tool for academic success and an essential goal of education. The ability to read is not only fundamental for pupils’ academic success but also a prerequisite for successful participation in today’s vastly expanding multi-literate textual environment. It is also important to recognize that, in many educational settings, students are expected to learn a foreign/second language for successful participation in the increasingly globalized world. Therefore, it is crucial to help learners become skilled foreign-language readers. Research indicates that students’ reading comprehension can be significantly improved through explicit instruction of multiple reading strategies. Despite the wealth of research on how to enhance learners’ reading comprehension achievement by identifying an enormous range of reading strategies and techniques for assisting students in comprehending specific texts, relatively scattered studies have centered on whether these reading comprehension strategies and techniques are used in classrooms, especially in Chinese academic settings. Given the central role of ‘the teacher’ in reading instruction, the study investigates the degree of importance that EFL teachers attach to reading comprehension strategies and their classroom employment of those strategies in secondary schools in China. It also explores the efficiency of reading strategy instruction on pupils’ reading comprehension performance. As a mix-method study, the analysis drew on data from a quantitative survey and interviews with seven teachers. The study revealed that the EFL teachers had positive attitudes toward the use of cognitive strategies despite their insufficient knowledge about and limited attention to the metacognitive strategies and supporting strategies. Regarding the selection of reading strategies for instruction, the mandated curriculum and high-stakes examinations, text features and demands, teaching preparation programs and their own EFL reading experiences were the major criteria in their responses, while few teachers took into account the learner needs in their choice of reading strategies. Although many teachers agreed upon the efficiency of reading strategy instruction in developing students’ reading comprehension competence, three challenges were identified in their implementation of the strategy instruction. The study provides some insights into reading strategy instruction in EFL contexts and proposes implications for curriculum innovation, teacher professional development, and reading instruction research.

Keywords: reading comprehension strategies, EFL reading instruction, language teacher cognition, teacher education

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3666 Closing the Assessment Loop: Case Study in Improving Outcomes for Online College Students during Pandemic

Authors: Arlene Caney, Linda Fellag

Abstract:

To counter the adverse effect of Covid-19 on college student success, two faculty members at a US community college have used web-based assessment data to improve curricula and, thus, student outcomes. This case study exemplifies how “closing the loop” by analyzing outcome assessments in real time can improve student learning for academically underprepared students struggling during the pandemic. The purpose of the study was to develop ways to mitigate the negative impact of Covid-19 on student success of underprepared college students. Using the Assessment, Evaluation, Feedback and Intervention System (AEFIS) and other assessment tools provided by the college’s Office of Institutional Research, an English professor and a Music professor collected data in skill areas related to their curricula over four semesters, gaining insight into specific course sections and learners’ performance across different Covid-driven course formats—face-to-face, hybrid, synchronous, and asynchronous. Real-time data collection allowed faculty to shorten and close the assessment loop, and prompted faculty to enhance their curricula with engaging material, student-centered activities, and a variety of tech tools. Frequent communication, individualized study, constructive criticism, and encouragement were among other measures taken to enhance teaching and learning. As a result, even while student success rates were declining college-wide, student outcomes in these faculty members’ asynchronous and synchronous online classes improved or remained comparable to student outcomes in hybrid and face-to-face sections. These practices have demonstrated that even high-risk students who enter college with remedial level language and mathematics skills, interrupted education, work and family responsibilities, and language and cultural diversity can maintain positive outcomes in college across semesters, even during the pandemic.

Keywords: AEFIS, assessment, distance education, institutional research center

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3665 Financial Burden of Family for the Children with Autism Spectrum Disorder

Authors: M. R. Bhuiyan, S. M. M. Hossain, M. Z. Islam

Abstract:

Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p<0.001). Again, families with higher monthly family income incurred higher treatment cost (r=0.526, p<0.05). Difference between mean direct and indirect cost was found significant (t=4.190, df=61, p<0.001). According to the analysis of variance, mean difference of father’s educational status among direct cost (F=10.337, p<0.001) and total treatment cost (F=7.841, p<0.001), which were statistically significant. The study revealed that maximum children with ASD were under five years, three-fourth were male. According to monthly family income, maximum family were in middle class. The study recommends cost effective interventions and financial safety-net measures to reduce the financial burden of families for the children with ASD.

Keywords: autism spectrum disorder, financial burden, direct cost, indirect cost, special education

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3664 Features of Fossil Fuels Generation from Bazhenov Formation Source Rocks by Hydropyrolysis

Authors: Anton G. Kalmykov, Andrew Yu. Bychkov, Georgy A. Kalmykov

Abstract:

Nowadays, most oil reserves in Russia and all over the world are hard to recover. That is the reason oil companies are searching for new sources for hydrocarbon production. One of the sources might be high-carbon formations with unconventional reservoirs. Bazhenov formation is a huge source rock formation located in West Siberia, which contains unconventional reservoirs on some of the areas. These reservoirs are formed by secondary processes with low predicting ratio. Only one of five wells is drilled through unconventional reservoirs, in others kerogen has low thermal maturity, and they are of low petroliferous. Therefore, there was a request for tertiary methods for in-situ cracking of kerogen and production of oil. Laboratory experiments of Bazhenov formation rock hydrous pyrolysis were used to investigate features of the oil generation process. Experiments on Bazhenov rocks with a different mineral composition (silica concentration from 15 to 90 wt.%, clays – 5-50 wt.%, carbonates – 0-30 wt.%, kerogen – 1-25 wt.%) and thermal maturity (from immature to late oil window kerogen) were performed in a retort under reservoir conditions. Rock samples of 50 g weight were placed in retort, covered with water and heated to the different temperature varied from 250 to 400°C with the durability of the experiments from several hours to one week. After the experiments, the retort was cooled to room temperature; generated hydrocarbons were extracted with hexane, then separated from the solvent and weighted. The molecular composition of this synthesized oil was then investigated via GC-MS chromatography Characteristics of rock samples after the heating was measured via the Rock-Eval method. It was found, that the amount of synthesized oil and its composition depending on the experimental conditions and composition of rocks. The highest amount of oil was produced at a temperature of 350°C after 12 hours of heating and was up to 12 wt.% of initial organic matter content in the rocks. At the higher temperatures and within longer heating time secondary cracking of generated hydrocarbons occurs, the mass of produced oil is lowering, and the composition contains more hydrocarbons that need to be recovered by catalytical processes. If the temperature is lower than 300°C, the amount of produced oil is too low for the process to be economically effective. It was also found that silica and clay minerals work as catalysts. Selection of heating conditions allows producing synthesized oil with specified composition. Kerogen investigations after heating have shown that thermal maturity increases, but the yield is only up to 35% of the maximum amount of synthetic oil. This yield is the result of gaseous hydrocarbons formation due to secondary cracking and aromatization and coaling of kerogen. Future investigations will allow the increase in the yield of synthetic oil. The results are in a good agreement with theoretical data on kerogen maturation during oil production. Evaluated trends could be tooled up for in-situ oil generation by shale rocks thermal action.

Keywords: Bazhenov formation, fossil fuels, hydropyrolysis, synthetic oil

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3663 Checklist for Autism Spectrum Disorder as an In-Class Observation Tool for Teachers

Authors: Werona Król-Gierat

Abstract:

The majority of Special Educational Needs checklists are intended for preliminary screening in the special education disability process. The aim of the present paper is to present their potential usefulness as in-class observation tools for teachers working with students who have already been diagnosed with a disorder. A checklist may complement and organize information about a given child, which is indispensable to improve his or her condition. The case of a Polish boy with autism will serve as an example. Last but not the least, alternative uses of checklists are suggested in the article.

Keywords: autism spectrum disorders, case study, checklist, observation tool

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3662 Mentor and Peer Feed-Back on Micro-Teaching: As a Tool for Enhancing of Pre-Service Teachers' Teaching Practices

Authors: Ayhan Cinici, Mustafa Ozden, Umit Duruk, Gulden Akdag

Abstract:

The purpose of this study was to investigate how feedbacks left from two different sources (mentors and peers) during microteaching sessions effecting preservice teachers’ teaching skills and views on science teaching. Sampling process is twofold in the study. As part of qualitative research, among other counterparts, case study method was chosen and respectively, constructed six working groups in which there were six preservice teachers, totally from thirty six preservice teachers enrolled in the third grade of Elementary Education Department by random assignment. Subsequently, one preservice teacher from all groups was appointed as the moderator of those groups (totally six moderators). Rest of them taking part remained as audience in all groups. At the beginning of the instructional process, all participants were asked to watch some videos by which someone already recorded. After watching these videos, they were also given a chance to discuss their ideas and impressions regarding microteaching in the classroom atmosphere. Both academic staff as mentors and participants as preservice teachers took role in the process of determining which teaching skills would be taken into consideration as part of microteaching sessions. Each group were gathered at regular intervals throughout twelve weeks together with their mentor who guided them and performed their microteaching. Data was collected using reflective diaries by which researchers constructed for both preservice teachers playing role as teacher of the group and preservice teachers playing role as audience during these microteaching sessions. Semi structured interviews were also carried out with only preservice teachers playing role as teachers of the groups. Findings from these reflective diaries and semi structured interviews were analysed by descriptive statistics and content analysis method. With regard to these findings, explanatory themes and subthemes were categorized and supported by direct citations. The results reveal that preservice teachers playing role as the teachers of the each group consider “content knowledge” as the most important aspect among other teaching skills. Furthermore, preservice teachers also point out that the more they get feedback on any teaching skill, the more they get motivated to develop it.

Keywords: teacher education, microteaching, mentor, peer feedback

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3661 Video Club as a Pedagogical Tool to Shift Teachers’ Image of the Child

Authors: Allison Tucker, Carolyn Clarke, Erin Keith

Abstract:

Introduction: In education, the determination to uncover privileged practices requires critical reflection to be placed at the center of both pre-service and in-service teacher education. Confronting deficit thinking about children’s abilities and shifting to holding an image of the child as capable and competent is necessary for teachers to engage in responsive pedagogy that meets children where they are in their learning and builds on strengths. This paper explores the ways in which early elementary teachers' perceptions of the assets of children might shift through the pedagogical use of video clubs. Video club is a pedagogical practice whereby teachers record and view short videos with the intended purpose of deepening their practices. The use of video club as a learning tool has been an extensively documented practice. In this study, a video club is used to watch short recordings of playing children to identify the assets of their students. Methodology: The study on which this paper is based asks the question: What are the ways in which teachers’ image of the child and teaching practices evolve through the use of video club focused on the strengths of children demonstrated during play? Using critical reflection, it aims to identify and describe participants’ experiences of examining their personally held image of the child through the pedagogical tool video club, and how that image influences their practices, specifically in implementing play pedagogy. Teachers enrolled in a graduate-level play pedagogy course record and watch videos of their own students as a means to notice and reflect on the learning that happens during play. Using a co-constructed viewing protocol, teachers identify student strengths and consider their pedagogical responses. Video club provides a framework for teachers to critically reflect in action, return to the video to rewatch the children or themselves and discuss their noticings with colleagues. Critical reflection occurs when there is focused attention on identifying the ways in which actions perpetuate or challenge issues of inherent power in education. When the image of the child held by the teacher is from a deficit position and is influenced by hegemonic dimensions of practice, critical reflection is essential in naming and addressing power imbalances, biases, and practices that are harmful to children and become barriers to their thriving. The data is comprised of teacher reflections, analyzed using phenomenology. Phenomenology seeks to understand and appreciate how individuals make sense of their experiences. Teacher reflections are individually read, and researchers determine pools of meaning. Categories are identified by each researcher, after which commonalities are named through a recursive process of returning to the data until no more themes emerge or saturation is reached. Findings: The final analysis and interpretation of the data are forthcoming. However, emergent analysis of the data collected using teacher reflections reveals the ways in which the use of video club grew teachers’ awareness of their image of the child. It shows video club as a promising pedagogical tool when used with in-service teachers to prompt opportunities for play and to challenge deficit thinking about children and their abilities to thrive in learning.

Keywords: asset-based teaching, critical reflection, image of the child, video club

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3660 Exploring the In-Between: An Examination of the Contextual Factors That Impact How Young Children Come to Value and Use the Visual Arts in Their Learning and Lives

Authors: S. Probine

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The visual arts have been proven to be a central means through which young children can communicate their ideas, reflect on experience, and construct new knowledge. Despite this, perceptions of, and the degree to which the visual arts are valued within education, vary widely within political, educational, community and family contexts. These differing perceptions informed my doctoral research project, which explored the contextual factors that affect how young children come to value and use the visual arts in their lives and learning. The qualitative methodology of narrative inquiry with inclusion of arts-based methods was most appropriate for this inquiry. Using a sociocultural framework, the stories collected were analysed through the sociocultural theories of Lev Vygotsky as well as the work of Urie Bronfenbrenner, together with postmodern theories about identity formation. The use of arts-based methods such as teacher’s reflective art journals and the collection of images by child participants and their parent/caregivers allowed the research participants to have a significant role in the research. Three early childhood settings at which the visual arts were deeply valued as a meaning-making device in children’s learning, were purposively selected to be involved in the research. At each setting, the study found a unique and complex web of influences and interconnections, which shaped how children utilised the visual arts to mediate their thinking. Although the teachers' practices at all three centres were influenced by sociocultural theories, each settings' interpretations of these theories were unique and resulted in innovative interpretations of the role of the teacher in supporting visual arts learning. These practices had a significant impact on children’s experiences of the visual arts. For many of the children involved in this study, visual art was the primary means through which they learned. The children in this study used visual art to represent their experiences, relationships, to explore working theories, their interests (including those related to popular culture), to make sense of their own and other cultures, and to enrich their imaginative play. This research demonstrates that teachers have fundamental roles in fostering and disseminating the importance of the visual arts within their educational communities.

Keywords: arts-based methods, early childhood education, teacher's visual arts pedagogies, visual arts

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3659 Effect of Maternal Factors and C-Peptide and Insulin Levels in Cord Blood on the Birth Weight of Newborns: A Preliminary Study from Southern Sri Lanka

Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

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3658 Punishment In Athenian Forensic Oratory

Authors: Eleni Volonaki

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In Athenian forensic speeches, the argumentation on punishment of the wrongdoers constitutes a fundamental ideal of exacting justice in court. The present paper explores the variation of approaches to punishment as a means of reformation, revenge, correction, education, example, chance to restoration of justice. As it will be shown, all these approaches reflect the social and political ideology of Athenian justice in the classical period and enhances the role of the courts and the importance of rhetoric in the process of decision-making. Punishment entails a wide range of penalties but also of ideological principles related to the Athenian constitution of democracy.

Keywords: punishment, athenian forensic speeches, justice, athenian democracy

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3657 Assessing the Impact of Frailty in Elderly Patients Undergoing Emergency Laparotomies in Singapore

Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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3656 Post-harvest Handling Practices and Technologies Harnessed by Smallholder Fruit Crop Farmers in Vhembe District, Limpopo Province, South Africa

Authors: Vhahangwele Belemu, Isaac Busayo Oluwatayo

Abstract:

Post-harvest losses pose a serious challenge to smallholder fruit crop farmers, especially in the rural communities of South Africa, affecting their economic livelihoods and food security. This study investigated the post-harvest handling practices and technologies harnessed by smallholder fruit crop farmers in the Vhembe district of Limpopo province, South Africa. Data were collected on a random sample of 224 smallholder fruit crop farmers selected from the four municipalities of the district using a multistage sampling technique. Analytical tools employed include descriptive statistics and the tobit regression model. A descriptive analysis of farmers’ socioeconomic characteristics showed that a sizeable number of these farmers are still in their active working age (mean = 52 years) with more males (63.8%) than their female (36.2%) counterparts. Respondents’ distribution by educational status revealed that only a few of these had no formal education (2.2%), with the majority having secondary education (48.7%). Results of data analysis further revealed that the prominent post-harvest technologies and handling practices harnessed by these farmers include using appropriate harvesting techniques (20.5%), selling at a reduced price (19.6%), transportation consideration (18.3%), cleaning and disinfecting (17.9%), sorting and grading (16.5%), manual cleaning (15.6%) and packaging technique (11.6%) among others. The result of the Tobit regression analysis conducted to examine the determinants of post-harvest technologies and handling practices harnessed showed that age, educational status of respondents, awareness of technology/handling practices, farm size, access to credit, extension contact, and membership of association were the significant factors. The study suggests enhanced awareness creation, access to credit facility and improved access to market as important factors to consider by relevant stakeholders to assist smallholder fruit crop farmers in the study area.

Keywords: fruit crop farmers, handling practices, post harvest losses, smallholder, Vhembe District, South Africa

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3655 Cultivating Concentration and Flow: Evaluation of a Strategy for Mitigating Digital Distractions in University Education

Authors: Vera G. Dianova, Lori P. Montross, Charles M. Burke

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In the digital age, the widespread and frequently excessive use of mobile phones amongst university students is recognized as a significant distractor which interferes with their ability to enter a deep state of concentration during studies and diminishes their prospects of experiencing the enjoyable and instrumental state of flow, as defined and described by psychologist M. Csikszentmihalyi. This study has targeted 50 university students with the aim of teaching them to cultivate their ability to engage in deep work and to attain the state of flow, fostering more effective and enjoyable learning experiences. Prior to the start of the intervention, all participating students completed a comprehensive survey based on a variety of validated scales assessing their inclination toward lifelong learning, frequency of flow experiences during study, frustration tolerance, sense of agency, as well as their love of learning and daily time devoted to non-academic mobile phone activities. Several days after this initial assessment, students received a 90-minute lecture on the principles of flow and deep work, accompanied by a critical discourse on the detrimental effects of excessive mobile phone usage. They were encouraged to practice deep work and strive for frequent flow states throughout the semester. Subsequently, students submitted weekly surveys, including the 10-item CORE Dispositional Flow Scale, a 3-item agency scale and furthermore disclosed their average daily hours spent on non-academic mobile phone usage. As a final step, at the end of the semester students engaged in reflective report writing, sharing their experiences and evaluating the intervention's effectiveness. They considered alterations in their love of learning, reflected on the implications of their mobile phone usage, contemplated improvements in their tolerance for boredom and perseverance in complex tasks, and pondered the concept of lifelong learning. Additionally, students assessed whether they actively took steps towards managing their recreational phone usage and towards improving their commitment to becoming lifelong learners. Employing a mixed-methods approach our study offers insights into the dynamics of concentration, flow, mobile phone usage and attitudes towards learning among undergraduate and graduate university students. The findings of this study aim to promote profound contemplation, on the part of both students and instructors, on the rapidly evolving digital-age higher education environment. In an era defined by digital and AI advancements, the ability to concentrate, to experience the state of flow, and to love learning has never been more crucial. This study underscores the significance of addressing mobile phone distractions and providing strategies for cultivating deep concentration. The insights gained can guide educators in shaping effective learning strategies for the digital age. By nurturing a love for learning and encouraging lifelong learning, educational institutions can better prepare students for a rapidly changing labor market, where adaptability and continuous learning are paramount for success in a dynamic career landscape.

Keywords: deep work, flow, higher education, lifelong learning, love of learning

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3654 Multimodal Ophthalmologic Evaluation Can Detect Retinal Injuries in Asymptomatic Patients With Primary Antiphospholipid Syndrome

Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

Abstract:

Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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3653 The Effectiveness and the Factors Affect Farmer’s Adoption of Technological Innovation Citrus Gerga Lebong in Bengkulu Indonesia

Authors: Umi Pudji Astuti, Dedi Sugandi

Abstract:

The effectiveness of agricultural extension is determined by the component in the agricultural extension system among others are agricultural extension methods. Effective methods should be selected and defined based on the characteristics of the target, the resources, the materials, and the objectives to be achieved. Citrus agribusiness development in Lebong is certainly supported by the role of stakeholders and citrus farmers, as well as the proper dissemination methods. Adoption in the extension process substantially can be interpreted as the changes of behavior process such as knowledge (cognitive), attitudes (affective), and skill (psycho-motoric) in a person after receiving "innovation" from extension submitted by target communities. Knowledge and perception are needed as a first step in adopting a innovation, especially of citrus agribusiness development in Lebong. The process of Specific technology adoption is influenced by internal factors and farmer perceptions of technological innovation. Internal factors such as formal education, experience trying to farm, owned land, production farm goods. The output of this study: 1) to analyze the effectiveness of field trial methods in improving cognitive and affective farmers; 2) Knowing the relationship of adoption level and knowledge of farmers; 3) to analyze the factors that influence farmers' adoption of citrus technology innovation. The method of this study is through the survey to 40 respondents in Rimbo Pengadang Sub District, Lebong District in 2014. Analyzing data is done by descriptive and statistical parametric (multiple linear functions). The results showed that: 1) Field trip method is effective to improve the farmer knowledge (23,17% ) and positively affect the farmer attitude; 2) the knowledge level of PTKJS innovation farmers "positively and very closely related".; 3) the factors that influence the level of farmers' adoption are internal factors (education, knowledge, and the intensity of training), and external factors respondents (distance from the house to the garden and from the house to production facilities shop).

Keywords: affect, adoption technology, citrus gerga, effectiveness dissemination

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3652 Effectiveness of Peer Reproductive Health Education Program in Improving Knowledge, Attitude, and Use Health Service of High School Adolescent Girls in Eritrea in 2014

Authors: Ghidey Ghebreyohanes, Eltahir Awad Gasim Khalil, Zemenfes Tsighe, Faiza Ali

Abstract:

Background: reproductive health (RH) is a state of physical, mental and social well-being in all matters relating to the reproductive system at all stages of life. In East Africa including Eritrea, adolescents comprise more than a quarter of the population. The region holds the highest rates of sexually transmitted diseases, HIV, unwanted pregnancy and unsafe abortion with its complications. Young girls carry the highest burden of reproductive health problems due to their risk taking behavior, lack of knowledge, peer pressure, physiologic immaturity and low socioeconomic status. Design: this was a Community-based, randomized, case-controlled and pre-test-post-test intervention study. Setting: Zoba Debub was randomly selected out of the six zobas in Eritrea. The four high schools out of the 26 in Zoba Debub were randomly selected as study target schools. Over three quarter of the people live on farming. The target population was female students attending grade nine with majority of these girls live in the distant villages and walk to school. The study participants were randomly selected (n=165) from each school. Furthermore, the 1 intervention and 3 controls for the study arms were assigned randomly. Objectives: this study aimed to assess the effectiveness of peer reproductive health education in improving knowledge, attitude, and health service use of high school adolescent girls in Eritrea Methods: the protocol was reviewed and approved by the Scientific and Ethics Committees of Faculty of Nursing Sciences, University of Khartoum. Data was collected using pre-designed and pretested questionnaire emphasizing on reproductive health knowledge, attitude and practice. Sample size was calculated using proportion formula (α 0.01; power of 95%). Measures used were scores and proportions. Descriptive and inferential statistics, t-test and chi square at (α .01), 99% confidence interval were used to compare changes of pre and post-intervention scores using SPSS soft ware. Seventeen students were selected for peer educators by the school principals and other teachers based on inclusion criteria that include: good academic performance and acceptable behavior. One peer educator educated one group composed of 8-10 students for two months. One faculty member was selected to supervise peer educators. The principal investigator conducted the training of trainers and provided supervision and discussion to peer educators every two weeks until the end of intervention. Results: following informed consent, 627 students [164 in intervention and 463 in the control group] with a ratio of 1 to 3, were enrolled in the study. The mean age for the total study population was 15.4±1.0 years. The intervention group mean age was 15.3±1.0 year; while the control group had a mean age of 15.4±1.0. The mean ages for the study arms were similar (p= 0.4). The majority (96 %) of the study participants are from Tigrigna ethnic group. Reproductive knowledge scores which was calculated out of a total 61 grade points: intervention group (pretest 6.7 %, post-test 33.6 %; p= 0.0001); control group (pretest 7.3 %, posttest 7.3 %, p= 0.92). Proportion difference in attitude calculated out of 100%: intervention group (pretest 42.3 % post test 54.7% p= 0.001); controls group (pretest 45%, post test 44.8 p= 0.7). Proportion difference in Practice calculated out of 100 %: intervention group (pretest 15.4%, post test 80.4 % p= 0.0001); control group (pretest 16.8%, posttest 16.9 % p= 0.8). Mothers were quoted as major (> 90 %) source of reproductive health information. All focus group discussants and most of survey participants agreed on the urgent need of reproductive health information and services for adolescent girls. Conclusion: reproductive health knowledge and use of facilities is poor among adolescent girls in sub-urban Eretria. School-based peer reproductive health education is effective and is the best strategy to improve reproductive health knowledge and attitudes.

Keywords: reproductive health, adolescent girls, eretria, health education

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3651 Method for Improving Antidepressants Adherence in Patients with Depressive Disorder: Systemic Review and Meta-Analysis

Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

Abstract:

Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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3650 Satisfaction Among Preclinical Medical Students with Low-Fidelity Simulation-Based Learning

Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

Abstract:

Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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3649 Art History as Inspiration for Chefs. An Autoethnographic Research About Art History Education in a Restaurant

Authors: Marta Merkl

Abstract:

The ongoing project what the paper will present is about how the author introduces chefs to the history of art through a selected piece of art. The author is originally an art historian, but since 2019 she has been working on her PhD research topic related to designing dining experiences in the restaurant context, including the role of sensory experiences and storytelling. Due to a scholarship, she can participate in the re-design of a fine dining restaurant called Onyx in Budapest, which was awarded two Michelin stars before the pandemic caused by COVID-19. The management of the restaurant wants to broaden the chefs' horizons and develop their creativity by introducing them to each chapter of the visual arts. There is a kind of polyphony in the mass of information about what should a chef, a food designer, or anybody who make food in everyday basis use as a source of inspiration for inventing and preparing new dishes: nostalgia, raw material, cookbooks, etc. In today's world of fine dining, nature is the main inspiration for outstanding achievements, as exemplified by the Slovenian restaurant Hiša Franko** and its chef Ana Roš. The starting point for the project and the research was the idea of using art history as an inspiration for gastronomy. The research relies on data collection via interviews, ethnography, and autoethnography. In this case, the reflective introspection of the researcher is also relevant because the researcher is an important part of the process (GOULD, 1995). The paper overviews the findings of the autoethnography literature relevant to our topic. In the literature review, it will be also pointed out that sustainability, eating as an experience, and the world of art can be linked. As ERDMANN and co-authors (1999) argues that the health dimension of sustainability has a component called 'joy of eating,' which implies strong ties to the experiential nature of eating. Therefore, it is worth to compare with PINE and GILMORE's (1998) theory of experience economy and with CSÍKSZENTMIHÁLYI's (1999) concept of flow, which give examples of gastronomy and art. The aim of the research is to map experiences of the pilot project, the discourse between the art world and the gastronomy actors. Another noteworthy aspect is whether the chefs are willing to use art history as an inspiration.

Keywords: art history, autoethnography, chef, education, experience, food preparation, inspiration, sustainability

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3648 Finding Elves in Play Based Learning

Authors: Chloe L. Southern

Abstract:

If play is deemed to fulfill children’s social, emotional, and physical domains, as well as satisfy their natural curiosity and promote self-reflexivity, it is difficult to understand why play is not prioritized to the same extent for older children. This paper explores and discusses the importance of play-based learning as well as the preliminary implications beyond the realm of kindergarten. To further extend the inquiry, discussions pertaining to play-based learning are looked at through the lens of relevant methodologies and theories. Different education systems are looked at in certain areas of the world that lead to curiosities not only towards their play-based practices and curriculum but what ideologies they have that set them apart.

Keywords: 21ˢᵗ century learning, play-based learning, student-centered learning, transformative learning

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3647 Method of Nursing Education: History Review

Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán

Abstract:

Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.

Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education

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3646 Payment of Carbon Offsetting: A Case Study in Dharan, Nepal

Authors: Mana Shrestha, Dhruba Khatri, Pralhad Kunwor

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The objective of the study was to explore the vehicle owners’ willingness to pay (WTP) for offsetting carbon that could eventually facilitate local governmental institutions to take further step in environmental conservation. Contingent valuation method was used to find out how much amount people were willing to pay for the carbon service they are getting from providers. Open ended questionnaire was carried out with 181 respondents randomly. The result shows different mean willingness to pay amount depending upon demographic variations like education, occupation, sex and residence but the occupation and the educational status significantly affected the WTP of respondent. Total WTP amount was calculated as 650 NRS.

Keywords: community forest, carbon offset, Kyoto, REDD WTP

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3645 Use of Low-Cost Hydrated Hydrogen Sulphate-Based Protic Ionic Liquids for Extraction of Cellulose-Rich Materials from Common Wheat (Triticum Aestivum) Straw

Authors: Chris Miskelly, Eoin Cunningham, Beatrice Smyth, John. D. Holbrey, Gosia Swadzba-Kwasny, Emily L. Byrne, Yoan Delavoux, Mantian Li.

Abstract:

Recently, the use of ionic liquids (ILs) for the preparation of lignocellulose derived cellulosic materials as alternatives to petrochemical feedstocks has been the focus of considerable research interest. While the technical viability of IL-based lignocellulose treatment methodologies has been well established, the high cost of reagents inhibits commercial feasibility. This work aimed to assess the technoeconomic viability of the preparation of cellulose rich materials (CRMs) using protic ionic liquids (PILs) synthesized from low cost alkylamines and sulphuric acid. For this purpose, the tertiary alkylamines, triethylamine, and dimethylbutylamine were selected. Bulk scale production cost of the synthesized PILs, triethylammonium hydrogen sulphate and dimetheylbutylammonium hydrogen sulphate, was reported as $0.78 kg-1 to $1.24 kg-1. CRMs were prepared through the treatment of common wheat (Triticum aestivum) straw with these PILs. By controlling treatment parameters, CRMs with a cellulose content of ≥ 80 wt% were prepared. This was achieved using a T. aestivum straw to PIL loading ratio of 1:15 w/w, a treatment duration of 180 minutes, and ethanol as a cellulose antisolvent. Infrared spectra data and decreased onset degradation temperature of CRMs (ΔTONSET ~ 70 °C) suggested the formation of cellulose sulphate esters during treatment. Chemical derivatisation can aid the dispersion of prepared CRMs in non-polar polymer/ composite matrices, but act as a barrier to thermal processing at temperatures above 150 °C. It was also shown that treatment increased the crystallinity of CRMs (ΔCrI ~ 40 %) without altering the native crystalline structure or crystallite size (~ 2.6 nm) of cellulose; peaks associated with the cellulose I crystalline planes (110), (200), and (004) were observed at Bragg angles 16.0 °, 22.5 ° and 35.0 ° respectively. This highlighted the inability of assessed PILs to dissolve crystalline cellulose and was attributed to the high acidity (pKa ~ - 1.92 to - 6.42) of sulphuric acid derived anions. Electron micrographs revealed that the stratified multilayer tissue structure of untreated T. aestivum straw was significantly modified during treatment. T. aestivum straw particles were disassembled during treatment, with prepared CRMs adopting a golden-brown film-like appearance. This work demonstrated the degradation of non-cellulosic fractions of lignocellulose without dissolution of cellulose. It is the first to report on the derivatisation of cellulose during treatment with protic hydrogen sulphate ionic liquids, and the potential implications of this with reference to biopolymer feedstock preparation.

Keywords: cellulose, extraction, protic ionic liquids, esterification, thermal stability, waste valorisation, biopolymer feedstock

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3644 Innovative Food Related Modification of the Day-Night Task Demonstrates Impaired Inhibitory Control among Patients with Binge-Purge Eating Disorder

Authors: Sigal Gat-Lazer, Ronny Geva, Dan Ramon, Eitan Gur, Daniel Stein

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Introduction: Eating disorders (ED) are common psychopathologies which involve distorted body image and eating disturbances. Binge-purge eating disorders (B/P ED) are characterized by repetitive events of binge eating followed by purges. Patients with B/P ED behavior may be seen as impulsive especially when relate to food stimulation and affective conditions. The current study included innovative modification of the day-night task targeted to assess inhibitory control among patients with B/P ED. Methods: This prospective study included 50 patients with B/P ED during acute phase of illness (T1) upon their admission to specialized ED department in tertiary center. 34 patients repeated the study towards discharge to ambulatory care (T2). Treatment effect was evaluated by BMI and emotional questionnaires regarding depression and anxiety by the Beck Depression Inventory and State Trait Anxiety Inventory questionnaires. Control group included 36 healthy controls with matched demographic parameters who performed both T1 and T2 assessments. The current modification is based on the emotional day-night task (EDNT) which involves five emotional stimulation added to the sun and moon pictures presented to participants. In the current study, we designed the food-emotional modification day night task (F-EDNT) food stimulations of egg and banana which resemble the sun and moon, respectively, in five emotional states (angry, sad, happy, scrambled and neutral). During this computerized task, participants were instructed to push on “day” bottom in response to moon and banana stimulations and on “night” bottom when sun and egg were presented. Accuracy (A) and reaction time (RT) were evaluated and compared between EDNT and F-EDNT as a reflection of participants’ inhibitory control. Results: Patients with B/P ED had significantly improved BMI, depression and anxiety scores on T2 compared to T1 (all p<0.001). Task performance was similar among patients and controls in the EDNT without significant A or RT differences in both T1 and T2. On F-EDNT during T1, B/P ED patients had significantly reduced accuracy in 4/5 emotional stimulation compared to controls: angry (73±25% vs. 84±15%, respectively), sad (69±25% vs. 80±18%, respectively), happy (73±24% vs. 82±18%, respectively) and scrambled (74±24% vs. 84±13%, respectively, all p<0.05). Additionally, patients’ RT to food stimuli was significantly faster compared to neutral ones, in both cry and neutral emotional stimulations (356±146 vs. 400±141 and 378±124 vs. 412±116 msec, respectively, p<0.05). These significant differences between groups as a function of stimulus type were diminished on T2. Conclusion: Having to process food related content, in particular in emotional context seems to be impaired in patients with B/P ED during the acute phase of their illness and elicits greater impulsivity. Innovative modification using such procedures seem to be sensitive to patients’ illness phase and thus may be implemented during screening and follow up through the clinical management of these patients.

Keywords: binge purge eating disorders, day night task modification, eating disorders, food related stimulations

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3643 Examining the Overuse of Cystoscopy in the Evaluation of Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia: A Prospective Study

Authors: Ilija Kelepurovski, Stefan Lazorovski, Pece Petkovski, Marian Anakievski, Svetlana Petkovska

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Introduction: Benign prostatic hyperplasia (BPH) is a common condition that affects men over the age of 50 and is characterized by an enlarged prostate gland that can cause lower urinary tract symptoms (LUTS). Uroflowmetry and cystoscopy are two commonly used diagnostic tests to evaluate LUTS and diagnose BPH. While both tests can be useful, there is a risk of overusing cystoscopy and underusing uroflowmetry in the evaluation of LUTS. The aim of this study was to compare the use of uroflowmetry and cystoscopy in a prospective cohort of 100 patients with suspected BPH or other urinary tract conditions and to assess the diagnostic yield of each test. Materials and Methods: This was a prospective study of 100 male patients over the age of 50 with suspected BPH or other urinary tract conditions who underwent uroflowmetry and cystoscopy for the evaluation of LUTS at a single tertiary care center. Inclusion criteria included male patients over the age of 50 with suspected BPH or other urinary tract conditions, while exclusion criteria included previous urethral or bladder surgery, active urinary tract infection, and significant comorbidities. The primary outcome of the study was the frequency of cystoscopy in the evaluation of LUTS, and the secondary outcome was the diagnostic yield of each test. Results: Of the 100 patients included in the study, 86 (86%) were diagnosed with BPH and 14 (14%) had other urinary tract conditions. The mean age of the study population was 67 years. Uroflowmetry was performed on all 100 patients, while cystoscopy was performed on 70 (70%) of the patients. The diagnostic yield of uroflowmetry was high, with a clear diagnosis made in 92 (92%) of the patients. The diagnostic yield of cystoscopy was also high, with a clear diagnosis made in 63 (90%) of the patients who underwent the procedure. There was no statistically significant difference in the diagnostic yield of uroflowmetry and cystoscopy (p = 0.20). Discussion: Our study found that uroflowmetry is an effective and well-tolerated diagnostic tool for evaluating LUTS and diagnosing BPH, with a high diagnostic yield and low risk of complications. Cystoscopy is also a useful diagnostic tool, but it is more invasive and carries a small risk of complications such as bleeding or urinary tract infection. Both tests had a high diagnostic yield, suggesting that either test can provide useful information in the evaluation of LUTS. However, the fact that 70% of the study population underwent cystoscopy raises concerns about the potential overuse of this test in the evaluation of LUTS. This is especially relevant given the focus on patient-centered care and the need to minimize unnecessary or invasive procedures. Our findings underscore the importance of considering the clinical context and using evidence-based guidelines. Conclusion: In this prospective study of 100 patients with suspected BPH or other urinary tract conditions, we found that uroflowmetry and cystoscopy were both valuable diagnostic tools for the evaluation of LUTS. However, the potential overuse of cystoscopy in this population warrants further investigation and highlights the need for careful consideration of the optimal use of diagnostic tests in the evaluation of LUTS and the diagnosis of BPH. Further research is needed to better understand the relative roles of uroflowmetry and cystoscopy in the diagnostic workup of patients with LUTS, and to develop evidence-based guidelines for their appropriate use.

Keywords: uroflowmetry, cystoscopy, LUTS, BPH

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3642 Consumer Choice Determinants in Context of Functional Food

Authors: E. Grochowska-Niedworok, K. Brukało, M. Kardas

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The aim of this study was to analyze and evaluate the consumption of functional food by consumers by: age, sex, formal education level, place of residence and diagnosed diseases. The study employed an ad hoc questionnaire in a group of 300 inhabitants of Upper Silesia voivodship. Knowledge of functional food among the group covered in the study was far from satisfactory. The choice of functional food was of intuitive character. In addition, the group covered was more likely to choose pharmacotherapy instead of diet-related prevention then, which can be associated with presumption of too distant effects and a long period of treatment.

Keywords: consumer choice, functional food, healthy lifestyle, consumer knowledge

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3641 Breast Cancer Awareness among Female Nurses: Time to Scrub off Assumptions

Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

Abstract:

Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

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3640 The Influence of Contextual Factors on Long-Term Contraceptive Use in East Java

Authors: Ni'mal Baroya, Andrei Ramani, Irma Prasetyowati

Abstract:

The access to reproduction health services, including with safe and effective contraception were human rights regardless of social stratum and residence. In addition to individual factors, family and contextual factors were also believed to be the cause in the use of contraceptive methods. This study aimed to assess the determinants of long-term contraceptive methods (LTCM) by considering all the factors at either the individual level or contextual level. Thereby, this study could provide basic information for program development of prevalence enhancement of MKJP in East Java. The research, which used cross-sectional design, utilized Riskesdas 2013 data, particularly in East Java Province for further analysis about multilevel modeling of MKJP application. The sample of this study consisted of 20.601 married women who were not in pregnant that were drawn by using probability sampling following the sampling technique of Riskesdas 2013. Variables in this study were including the independent variables at the individual level that consisted of education, age, occupation, access to family planning services (KB), economic status and residence. As independent variables in district level were the Human Development Index (HDI, henceforth as IPM) in each districts of East Java Province, the ratio of field officers, the ratio of midwives, the ratio of community health centers and the ratio of doctors. As for the dependent variable was the use of Long-Term Contraceptive Method (LTCM or MKJP). The data were analyzed by using chi-square test and Pearson product moment correlation. The multivariable analysis was using multilevel logistic regression with 95% of Confidence Interval (CI) at the significance level of p < 0.05 and 80% of strength test. The results showed a low CPR LTCM was concentrated in districts in Madura Island and the north coast. The women which were 25 to 35 or more than 35 years old, at least high school education, working, and middle-class social status were more likely to use LTCM or MKJP. The IPM and low PLKB ratio had implications for poor CPR LTCM / MKJP.

Keywords: multilevel, long-term contraceptive methods, east java, contextual factor

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