Search results for: language intervention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6127

Search results for: language intervention

1657 Heart-Rate Variability Moderates the Relation between Life Threatening Events and Cancer-Development: Making Cancer Less “Vague”

Authors: Yori Gidron, Laura Caton, Irit Ben-Aharon

Abstract:

Background: Many patients and even certain clinicians attribute cancer development to psychosocial factors. Yet, empirical data supports more the prognostic role, rather than the etiological role, of psychosocial factors in cancer. Part of the inconsistency may result from not considering possible moderating factors in the etiological role of psychosocial factors. One important candidate moderating factor is the vagal nerve, whose activity is indexed by heart-rate variability (HRV). The vagal nerve may prevent cancer since it reduces inflammation on the one hand, and since it increases anti-tumor immunity on the other hand. This study examined the moderating role of the vagus in the relation between life threatening events (LTE) and cancer development. Method: We re-analyzed data from the Lifelines Dutch longitudinal cohort study of over 150,000 people. The present study included 82,751 adults, who initially were cancer-free. We extracted information on background factors (e.g., age, gender, fat consumption), whether they ever experienced LTE, HRV and cancer diagnosis as reported by patients in annual clinic visits. HRV was derived from brief ECGs. Results: Of the full sample, 1011 people developed cancer during a follow-up. In the full sample, LTE significantly predicted cancer development (R.R = 1.063 p < .01) and HRV significantly predicted a reduced risk of cancer development (R.R = .506 p <.001). Importantly, LTE significantly predicted cancer only when HRV was low (R.R = 1.056, 95% CI: 1.007 - 1.108, p < .05) but not when HRV was high (R.R = 1.014; 95% CI: 0.916 - 1.122, p > 0.05), independent of confounders. Conclusions: To the best of our knowledge, this is the first study showing in a large sample that LTE predict cancer development, and that this occurs only when vagal nerve activity (HRV) is relatively low. These results could result from lack of vagal modulation of inflammation and also from lack of vagal modulation of stress responses. Results are in line with the cancer-protective role of the vagus. HRV needs to be routinely monitored in the population and future intervention trials need to examine whether vagal nerve activation can prevent cancer in people with LTE and with other cancer risk factors.

Keywords: cancer development, life-events, moderation, vagal nerve

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1656 Organisational Change: The Impact on Employees and Organisational Development

Authors: Maureen Royce, Joshi Jariwala, Sally Kah

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Change is inevitable, but the change process is progressive. Organisational change is the process in which an organisation changes strategies, operational methods, systems, culture, and structure to affect something different in the organisation. This process can be continuous or developed over a period and driven by internal and external factors. Organisational change is essential if organisations are to survive in dynamic and uncertain environments. However, evidence from research shows that many change initiatives fail, leading to severe consequences for organisations and their resources. The complex models of third sector organisations, i.e., social enterprise, compounds the levels of change in these organisations. Interestingly, innovation is associated with a change in social enterprises due to the hybridity of product and service development. Furthermore, the creation of social intervention has offered a new process and outcomes to the lifecycle of change. Therefore, different forms of organisational innovation are developed, i.e., total, evolutionary, expansionary, and developmental, which affect the interventions of social enterprises. This raises both theoretical and business concerns on how the competing hybrid nature of social enterprises change, how change is managed, and the impact on these organisations. These perspectives present critical questions for further investigation. In this study, we investigate the impact of organisational change on employees and organisational development at DaDaFest –a disability arts organisation with a social focus based in Liverpool. The three main objectives are to explore the drivers of change and the implementation process; to examine the impact of organisational change on employees and; to identify barriers to organisation change and development. To address the preceding research objectives, qualitative research design is adopted using semi-structured interviews. Data is analysed using a six-step thematic analysis framework, which enables the study to develop themes depicting the impact of change on employees and organisational development. This study presents theoretical and practical contributions for academics and practitioners. The knowledge contributions encapsulate the evolution of change and the change cycle in a social enterprise. However, practical implications provide critical insights into the change management process and the impact of change on employees and organisational development.

Keywords: organisational change, change management, organisational change system, social enterprise

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1655 Collaborative Approaches in Achieving Sustainable Private-Public Transportation Services in Inner-City Areas: A Case of Durban Minibus Taxis

Authors: Lonna Mabandla, Godfrey Musvoto

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Transportation is a catalytic feature in cities. Transport and land use activity are interdependent and have a feedback loop between how land is developed and how transportation systems are designed and used. This recursive relationship between land use and transportation is reflected in how public transportation routes internal to the inner-city enhance accessibility, therefore creating spaces that are conducive to business activity, while the business activity also informs public transportation routes. It is for this reason that the focus of this research is on public transportation within inner-city areas where the dynamic is evident. Durban is the chosen case study where the dominating form of public transportation within the central business district (CBD) is minibus taxis. The paradox here is that minibus taxis still form part of the informal economy even though they are the leading form of public transportation in South Africa. There have been many attempts to formalise this industry to follow more regulatory practices, but minibus taxis are privately owned, therefore complicating any proposed intervention. The argument of this study is that the application of collaborative planning through a sustainable partnership between the public and private sectors will improve the social and environmental sustainability of public transportation. One of the major challenges that exist within such collaborative endeavors is power dynamics. As a result, a key focus of the study is on power relations. Practically, power relations should be observed over an extended period, specifically when the different stakeholders engage with each other, to reflect valid data. However, a lengthy data collection process was not possible to observe during the data collection phase of this research. Instead, interviews were conducted focusing on existing procedural planning practices between the inner-city minibus taxi association (South and North Beach Taxi Association), the eThekwini Transport Authority (ETA), and the eThekwini Town Planning Department. Conclusions and recommendations were then generated based on these data.

Keywords: collaborative planning, sustainability, public transport, minibus taxis

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1654 Clinical and Microbiologic Efficacy and Safety of Imipenem Cilastatin Relebactam in Complicated Infections: A Meta-analysis

Authors: Syeda Sahra, Abdullah Jahangir, Rachelle Hamadi, Ahmad Jahangir, Allison Glaser

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Background: Antimicrobial resistance is on the rise. The use of redundant and inappropriate antibiotics is contributing to recurrent infections and resistance. Newer antibiotics with more robust coverage for gram-negative bacteria are in great demand for complicated urinary tract infections (cUTIs), complicated intra-abdominal infections (cIAIs), hospital-acquired bacterial pneumonia (H.A.B.P.), and ventilator-associated bacterial pneumonia (V.A.B.P.). Objective: We performed this meta-analysis to evaluate the efficacy and safety profile of a new antibiotic, Imipenem/cilastatin/relebactam, compared to other broad-spectrum antibiotics for complicated infections. Search Strategy: We conducted a systemic review search on PubMed, Embase, and Central Cochrane Registry. Selection Criteria: We included randomized clinical trials (R.C.T.s) with the standard of care as comparator arm with Imipenem/cilastatin/relebactam as intervention arm. Analysis: For continuous variables, the mean difference was used. For discrete variables, we used the odds ratio. For effect sizes, we used a confidence interval of 95%. A p-value of less than 0.05 was used for statistical significance. Analysis was done using a random-effects model irrespective of heterogeneity. Heterogeneity was evaluated using the I2 statistic. Results: The authors observed similar efficacy at clinical and microbiologic response levels on early follow-up and late follow-up compared to the established standard of care. The incidence of drug-related adverse events, serious adverse events, and drug discontinuation due to adverse events were comparable across both groups. Conclusion: Imipenem/cilastatin/relebactam has a non-inferior safety and efficacy profile compared to peer antibiotics to treat severe bacterial infections (cUTIs, cIAIs, H.A.B.P., V.A.B.P.).

Keywords: bacterial pneumonia, complicated intra-abdominal infections, complicated urinary tract infection, Imipenem, cilastatin, relebactam

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1653 Climate Change Adaptation: Methodologies and Tools to Define Resilience Scenarios for Existing Buildings in Mediterranean Urban Areas

Authors: Francesca Nicolosi, Teresa Cosola

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Climate changes in Mediterranean areas, such as the increase of average seasonal temperatures, the urban heat island phenomenon, the intensification of solar radiation and the extreme weather threats, cause disruption events, so that climate adaptation has become a pressing issue. Due to the strategic role that the built heritage holds in terms of environmental impact and energy waste and its potentiality, it is necessary to assess the vulnerability and the adaptive capacity of the existing building to climate change, in order to define different mitigation scenarios. The aim of this research work is to define an optimized and integrated methodology for the assessment of resilience levels and adaptation scenarios for existing buildings in Mediterranean urban areas. Moreover, the study of resilience indicators allows us to define building environmental and energy performance in order to identify the design and technological solutions for the improvement of the building and its urban area potentialities. The methodology identifies step-by-step different phases, starting from the detailed study of characteristic elements of urban system: climatic, natural, human, typological and functional components are analyzed in their critical factors and their potential. Through the individuation of the main perturbing factors and the vulnerability degree of the system to the risks linked to climate change, it is possible to define mitigation and adaptation scenarios. They can be different, according to the typological, functional and constructive features of the analyzed system, divided into categories of intervention, and characterized by different analysis levels (from the single building to the urban area). The use of software simulations allows obtaining information on the overall behavior of the building and the urban system, to generate predictive models in the medium and long-term environmental and energy retrofit and to make a comparative study of the mitigation scenarios identified. The studied methodology is validated on a case study.

Keywords: climate impact mitigation, energy efficiency, existing building heritage, resilience

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1652 Real World Cancer Pain Incidence and Treatment in Daily Hospital

Authors: Alexandru Grigorescu, Alexandra Protesanu

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Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.

Keywords: cancer pain, opioids, medical oncology, palliative care

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1651 Systematic Review and Meta-analysis Investigating the Efficacy of Walking-based Aerobic Exercise Interventions to Treat Postpartum Depression

Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell

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Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020

Keywords: postpartum, exercise, depression, walking

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1650 Effectiveness of Educational and Supportive Interventions for Primiparous Women on Breastfeeding Outcomes: A Systematic Review and Meta-Analysis

Authors: Mei Sze Wong, Huanyu Mou, Wai-Tong Chien

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Background: Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Therefore, breastfeeding promotion is an important topic for infant health; whereas, different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal, or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches of educational and supportive interventions to improve breastfeeding. Outcome measures were exclusive breastfeeding, partial breastfeeding, and breastfeeding self-efficacy, being analyzed in terms of ≤ 2 months, 3-5 months, and ≥ 6 months postpartum. Method: Eleven electronic databases and the reference lists of eligible articles were searched. English or Chinese articles of randomized controlled trials on educational and supportive intervention with the above breastfeeding outcomes over recent 20 years were searched. Quality appraisal and risk of bias of the studies were checked by Effective Public Health Practice Project tool and Revised Cochrane risk-of-bias tool, respectively. Results: 13 articles that met the inclusion criteria were included; and they had acceptable quality and risk of bias. The optimal structure, format, and delivery of the interventions significantly increased exclusive breastfeeding rate at ≤ 2 months and ≥ 6 months and breastfeeding self-efficacy at ≤ 2 months included: (a) delivering from antenatal to postnatal period, (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups, (c) both individual and group basis, (d) being guided by self-efficacy theory, and (e) having ≥ 3 sessions. Conclusion: The findings showed multicomponent theory-based interventions with ≥ 3 sessions that delivered across antenatal and postnatal period; using both face-to-face teaching and telephone follow-ups can be useful to enhance exclusive breastfeeding rate for more than 6 months and breastfeeding self-efficacy over the first two months of postpartum.

Keywords: breastfeeding self-efficacy, education, exclusive breastfeeding, primiparous, support

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1649 Psychological Well-Being and Perception of Disease Severity in People with Multiple Sclerosis, Who Underwent a Program of Self-Regulation to Promote Physical Activity

Authors: Luísa Pedro, José Pais-Ribeiro, João Páscoa Pinheiro

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Multiple Sclerosis (MS) is a chronic disease of the central nervous system that affects more often young adults in the prime of his career and personal development, with no cure and unknown causes. The most common signs and symptoms are fatigue, muscle weakness, changes in sensation, ataxia, changes in balance, gait difficulties, memory difficulties, cognitive impairment and difficulties in problem solving. MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in MS patients. MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. The aim of this study is to examine the implications of the program of self-regulation in the perception of illness and mental health (psychological well-being domain) in MS patients. After this, a set of exercises was implemented to be used in daily life activities, according to studies developed with MS patients. We asked the subjects the question “Please classify the severity of your disease?” and used the domain of psychological well-being, the Mental Health Inventory (MHI-38) at the beginning (time A) and end (time B) of the program of self-regulation. We used the Statistical Package for the Social Sciences (SPSS) version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. The age range of the subjects was between 20 and 58 years with a mean age of 44 years. 58.3 % were women, 37.5 % were currently married, 67% were retired and the mean level of education was 12.5 years. In the correlation between the severity of the disease perception and psychological well before the self-regulation program, an obtained result (r = 0.26, p <0.05), then the self-regulation program, was (r = 0.37, p <0.01), from a low to moderate correlation. We conclude that the program of self-regulation for physical activity in patients with MS can improve the relationship between the perception of disease severity and psychological well-being.

Keywords: psychological well-being, multiple sclerosis, self-regulation, physical activity

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1648 Neurofeedback for Anorexia-RelaxNeuron-Aimed in Dissolving the Root Neuronal Cause

Authors: Kana Matsuyanagi

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Anorexia Nervosa (AN) is a psychiatric disorder characterized by a relentless pursuit of thinness and strict restriction of food. The current therapeutic approaches for AN predominantly revolve around outpatient psychotherapies, which create significant financial barriers for the majority of affected patients, hindering their access to treatment. Nonetheless, AN exhibit one of the highest mortality and relapse rates among psychological disorders, underscoring the urgent need to provide patients with an affordable self-treatment tool, enabling those unable to access conventional medical intervention to address their condition autonomously. To this end, a neurofeedback software, termed RelaxNeuron, was developed with the objective of providing an economical and portable means to aid individuals in self-managing AN. Electroencephalography (EEG) was chosen as the preferred modality for RelaxNeuron, as it aligns with the study's goal of supplying a cost-effective and convenient solution for addressing AN. The primary aim of the software is to ameliorate the negative emotional responses towards food stimuli and the accompanying aberrant eye-tracking patterns observed in AN patient, ultimately alleviating the profound fear towards food an elemental symptom and, conceivably, the fundamental etiology of AN. The core functionality of RelaxNeuron hinges on the acquisition and analysis of EEG signals, alongside an electrocardiogram (ECG) signal, to infer the user's emotional state while viewing dynamic food-related imagery on the screen. Moreover, the software quantifies the user's performance in accurately tracking the moving food image. Subsequently, these two parameters undergo further processing in the subsequent algorithm, informing the delivery of either negative or positive feedback to the user. Preliminary test results have exhibited promising outcomes, suggesting the potential advantages of employing RelaxNeuron in the treatment of AN, as evidenced by its capacity to enhance emotional regulation and attentional processing through repetitive and persistent therapeutic interventions.

Keywords: Anorexia Nervosa, fear conditioning, neurofeedback, BCI

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1647 Problems of Translating Technical Terms from English into Arabic

Authors: Nisreen Naji Al-Khawaldeh, Lara Ahmad Mansour El-Awar

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The present study investigated the strategies MA translation students used for translating technical terms, the most common obstacles they encountered in translating such terms, and the motives behind using such terms as they are in their original form despite their translatability into Arabic. To achieve these objectives, a translation test was administered to 100 MA students specialising in translation at both Hashemite University and The University of Jordan. It consisted of two parts: (a) 50 English technical terms to be translated (b) two questions to be answered concerning the challenges or problems encountered while translating the previous technical terms and the motives that drive them to use most of the English technical terms as they are despite their translatability into Arabic. The analysis of the results revealed that MA translation students faced problems in translating technical terms, namely the inability to find the equivalent form for the given technical terms, the use of literal translation, and the wider use of loan-words type. Besides, the students used different strategies to translate the technical terms, namely borrowing (i.e., loan- words), paraphrasing, synonymy, naturalization, equivalence, and literal translation. Moreover, it was also revealed that most technical terms were used as they are in the source language despite their translatability into Arabic because these technical terms are easier to use in English rather than in Arabic. Also, when these terms were introduced to the Arab world, they were introduced in English, not in Arabic. So, the brain links these objects to their English terms.

Keywords: arabic, english, technical terms, translation strategies, translation problems

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1646 Schoolwide Implementation of Schema-Based Instruction for Mathematical Problem Solving: An Action Research Investigation

Authors: Sara J. Mills, Sally Howell

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The field of special education has long struggled to bridge the research to practice gap. There is ample evidence from research of effective strategies for students with special needs, but these strategies are not routinely implemented in schools in ways that yield positive results for students. In recent years, the field of special education has turned its focus to implementation science. That is, discovering effective methods of implementing evidence-based practices in school settings. Teacher training is a critical factor in implementation. This study aimed to successfully implement Schema-Based Instruction (SBI) for math problem solving in four classrooms in a special primary school serving students with language deficits, including students with Autism Spectrum Disorders (ASD) and Intellectual Disabilities (ID). Using an action research design that allowed for adjustments and modification to be made over the year-long study, two cohorts of teachers across the school were trained and supported in six-week learning cycles to implement SBI in their classrooms. The learning cycles included a one-day training followed by six weeks of one-on-one or team coaching and three fortnightly cohort group meetings. After the first cohort of teachers completed the learning cycle, modifications and adjustments were made to lesson materials in an attempt to improve their effectiveness with the second cohort. Fourteen teachers participated in the study, including master special educators (n=3), special education instructors (n=5), and classroom assistants (n=6). Thirty-one students participated in the study (21 boys and 10 girls), ranging in age from 5 to 12 years (M = 9 years). Twenty-one students had a diagnosis of ASD, 20 had a diagnosis of mild or moderate ID, with 13 of these students having both ASD and ID. The remaining students had diagnosed language disorders. To evaluate the effectiveness of the implementation approach, both student and teacher data was collected. Student data included pre- and post-tests of math word problem solving. Teacher data included fidelity of treatment checklists and pre-post surveys of teacher attitudes and efficacy for teaching problem solving. Finally, artifacts were collected throughout the learning cycle. Results from cohort 1 and cohort 2 revealed similar outcomes. Students improved in the number of word problems they answered correctly and in the number of problem-solving steps completed independently. Fidelity of treatment data showed that teachers implemented SBI with acceptable levels of fidelity (M = 86%). Teachers also reported increases in the amount of time spent teaching problem solving, their confidence in teaching problem solving and their perception of students’ ability to solve math word problems. The artifacts collected during instruction indicated that teachers made modifications to allow their students to access the materials and to show what they knew. These findings are in line with research that shows student learning can improve when teacher professional development is provided over an extended period of time, actively involves teachers, and utilizes a variety of learning methods in classroom contexts. Further research is needed to evaluate whether these gains in teacher instruction and student achievement can be maintained over time once the professional development is completed.

Keywords: implementation science, mathematics problem solving, research-to-practice gap, schema based instruction

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1645 Etymological Studies and their Role in Consolidating the Identity of the Cultural Heritage; Terminology Related to the Traditional Dagger Making in the Sultanate of Oman as a Model

Authors: Muhammed Muvaffak Alhasan, Ali Alriyami, Ali Almanei

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Despite the extreme importance of etymological studies in documenting the linguistic heritage, and showing its roots and connections in the classical language; However, etymological dictionaries are still rare in the Arab library in general. Etymology is the science of etymology that investigates how vocabulary is reproduced and reproduced, by exploring the origin of words and the phonetic and semantic changes that occurred in them over time, trying to reconfigure an identity card for the word showing its origin and the path it took through time until it reached its current state. This research seeks to make an etymological study on the terminology used in the traditional dagger making in the Sultanate of Oman through the following steps: 1. Collecting the terms relating to traditional dagger making and recording them in order to document and preserve them. 2. Arranging them alphabetically in order to facilitate searching and dealing with them. 3. Setting up a historical identification card for each word by applying an etymological study that shows its source from which they descended its links with standard and the phonological and semantic changes it underwent until it reached its current form.

Keywords: cultural heritage, etymology, Omani dagger, Oman

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1644 Masked Candlestick Model: A Pre-Trained Model for Trading Prediction

Authors: Ling Qi, Matloob Khushi, Josiah Poon

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This paper introduces a pre-trained Masked Candlestick Model (MCM) for trading time-series data. The pre-trained model is based on three core designs. First, we convert trading price data at each data point as a set of normalized elements and produce embeddings of each element. Second, we generate a masked sequence of such embedded elements as inputs for self-supervised learning. Third, we use the encoder mechanism from the transformer to train the inputs. The masked model learns the contextual relations among the sequence of embedded elements, which can aid downstream classification tasks. To evaluate the performance of the pre-trained model, we fine-tune MCM for three different downstream classification tasks to predict future price trends. The fine-tuned models achieved better accuracy rates for all three tasks than the baseline models. To better analyze the effectiveness of MCM, we test the same architecture for three currency pairs, namely EUR/GBP, AUD/USD, and EUR/JPY. The experimentation results demonstrate MCM’s effectiveness on all three currency pairs and indicate the MCM’s capability for signal extraction from trading data.

Keywords: masked language model, transformer, time series prediction, trading prediction, embedding, transfer learning, self-supervised learning

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1643 Activation of Google Classroom Features to Engage Introvert Students in Comprehensible Output

Authors: Raghad Dwaik

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It is well known in language acquisition literature that a mere understanding of a reading text is not enough to help students build proficiency in comprehension. Students should rather follow understanding by attempting to express what has been understood by pushing their competence to the limit. Learners' attempt to push their competence was given the term "comprehensible output" by Swain (1985). Teachers in large classes, however, find it sometimes difficult to give all students a chance to communicate their views or to share their ideas during the short class time. In most cases, students who are outgoing dominate class discussion and get more opportunities for practice which leads to ignoring the shy students totally while helping the good ones become better. This paper presents the idea of using Google Classroom features of posting and commenting to allow students who hesitate to participate in class discussions about a reading text to write their views on the wall of a Google Classroom and share them later after they have received feedback and comments from classmates. Such attempts lead to developing their proficiency through additional practice in comprehensible output and to enhancing their confidence in themselves and their views. It was found that virtual classroom interaction would help students maintain vocabulary, use more complex structures and focus on meaning besides form.

Keywords: learning groups, reading TESOL, Google Classroom, comprehensible output

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1642 Neonatal Mortality, Infant Mortality, and Under-five Mortality Rates in the Provinces of Zimbabwe: A Geostatistical and Spatial Analysis of Public Health Policy Provisions

Authors: Jevonte Abioye, Dylan Savary

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The aim of this research is to present a disaggregated geostatistical analysis of the subnational provincial trends of child mortality variation in Zimbabwe from a child health policy perspective. Soon after gaining independence in 1980, the government embarked on efforts towards promoting equitable health care, namely through the provision of primary health care. Government intervention programmes brought hope and promise, but achieving equity in primary health care coverage was hindered by previous existing disparities in maternal health care disproportionately concentrated in urban settings to the detriment of rural communities. The article highlights policies and programs adopted by the government during the millennium development goals period between 1990-2015 as a response to the inequities that characterised the country’s maternal health care. A longitudinal comparative method for a spatial variation on child mortality rates across provinces is developed based on geostatistical analysis. Cross-sectional and time-series data was extracted from the World Health Organisation (WHO) global health observatory data repository, demographic health survey reports, and previous academic and technical publications. Results suggest that although health care policy was uniform across provinces, not all provinces received the same antenatal and perinatal services. Accordingly, provincial rates of child mortality growth between 1994 and 2015 varied significantly. Evidence on the trends of child mortality rates and maternal health policies in Zimbabwe can be valuable for public child health policy planning and public service delivery design both in Zimbabwe and across developing countries pursuing the sustainable development agenda.

Keywords: antenatal care, perinatal care, infant mortality rate, neonatal mortality rate, under-five mortality rate, millennium development goals, sustainable development agenda

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1641 Diagnostic Clinical Skills in Cardiology: Improving Learning and Performance with Hybrid Simulation, Scripted Histories, Wearable Technology, and Quantitative Grading – The Assimilate Excellence Study

Authors: Daly M. J, Condron C, Mulhall C, Eppich W, O'Neill J.

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Introduction: In contemporary clinical cardiology, comprehensive and holistic bedside evaluation including accurate cardiac auscultation is in decline despite having positive effects on patients and their outcomes. Methods: Scripted histories and scoring checklists for three clinical scenarios in cardiology were co-created and refined through iterative consensus by a panel of clinical experts; these were then paired with recordings of auscultatory findings from three actual patients with known valvular heart disease. A wearable vest with embedded pressure-sensitive panel speakers was developed to transmit these recordings when examined at the standard auscultation points. RCSI medical students volunteered for a series of three formative long case examinations in cardiology (LC1 – LC3) using this hybrid simulation. Participants were randomised into two groups: Group 1 received individual teaching from an expert trainer between LC1 and LC2; Group 2 received the same intervention between LC2 and LC3. Each participant’s long case examination performance was recorded and blindly scored by two peer participants and two RCSI examiners. Results: Sixty-eight participants were included in the study (age 27.6 ± 0.1 years; 74% female) and randomised into two groups; there were no significant differences in baseline characteristics between groups. Overall, the median total faculty examiner score was 39.8% (35.8 – 44.6%) in LC1 and increased to 63.3% (56.9 – 66.4%) in LC3, with those in Group 1 showing a greater improvement in LC2 total score than that observed in Group 2 (p < .001). Using the novel checklist, intraclass correlation coefficients (ICC) were excellent between examiners in all cases: ICC .994 – .997 (p < .001); correlation between peers and examiners improved in LC2 following peer grading of LC1 performances: ICC .857 – .867 (p < .001). Conclusion: Hybrid simulation and quantitative grading improve learning, standardisation of assessment, and direct comparisons of both performance and acumen in clinical cardiology.

Keywords: cardiology, clinical skills, long case examination, hybrid simulation, checklist

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1640 Auditor with the Javanese Characters: Revealing the Relationship towards Its Client

Authors: Krisna Damayanti

Abstract:

Negative issue about the relationship between auditors and clients often heard. It arises in view of the rise of a variety of phenomena resulting from the audit practice of greed and do not appreciate the independence of the audit profession and professional code of ethics. It is a logical consequence of the practice of capitalism in accounting. The purpose of this paper would like to uncover the existing auditing practices in Indonesia, especially Java, which is associated with a strong influence of Javanese culture with reluctant/"shy", politely, "legowo", "ngemong" friendly, "not mentholo", "tepo seliro", "ngajeni", "acquiescent". The method used by interpretive approach that emphasizes the role of language, interpret and understand and see social reality as something other than a label, name or concept. Auditing practices in each country has a culture that will affect the standard set by those regulatory standards although there has been an adaptation of IAS. In Indonesia the majority of parties dominated by Javanesse racial regulators, so Java culture is embedded in every audit practices thus conditions in Java requires auditors to behave like that, sometimes interfere with standard Java code of conduct that must be executed by an auditor. Auditors who live in Java have the characters of Javanese culture that is hard to avoid in the audit practice. However, in practice, the auditor still are relevant in their profession.

Keywords: auditors, java, character, profession, code of ethics, client

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1639 Shaping Lexical Concept of 'Mage' through Image Schemas in Dragon Age 'Origins'

Authors: Dean Raiyasmi, Elvi Citraresmana, Sutiono Mahdi

Abstract:

Language shapes the human mind and its concept toward things. Using image schemas, in nowadays technology, even AI (artificial intelligence) can concept things in response to their creator negativity or positivity. This is reflected inside one of the most selling game around the world in 2012 called Dragon Age Origins. The AI in form of NPC (Non-Playable Character) inside the game reflects on the creator of the game on negativity or positivity toward the lexical concept of mage. Through image schemas, shaping the lexical concept of mage deemed possible and proved the negativity or positivity creator of the game toward mage. This research analyses the cognitive-semantic process of image schema and shaping the concept of ‘mage’ by describing kinds of image schemas exist in the Dragon Age Origin Game. This research is also aimed to analyse kinds of image schemas and describing the image schemas which shaping the concept of ‘mage’ itself. The methodology used in this research is qualitative where participative observation is employed with five stages and documentation. The results shows that there are four image schemas exist in the game and those image schemas shaping the lexical concept of ‘mage’.

Keywords: cognitive semantic, image-schema, conceptual metaphor, video game

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1638 Transnationalization Strategies of Danish Cinema: Susanne Bier, Lone Scherfig

Authors: Ebru Thwaites Diken

Abstract:

This article analyzes the works of certain directors in Danish cinema, namely Susanne Bier and Lone Sherfig, in the context of transnationalisation of Danish cinema. It looks at how the films' narratives negotiate and reconstruct the local / national / regional and the global. Scholars such as Nestingen & Elkington (2005), Hjort (2010), Higbee and Lim (2010), Bondebjerg and Redvall (2011) address transnationalism of Danish cinema in terms of production and distribution processes and how film making trascends national boundaries. This paper employs a particular understanding of transnationalism - in terms of how ideas and characters travel - to analyze how the storytelling and style has evolved to connect the national, the regional and the global on the basis of the works of these two directors. Strategies such as Hollywoodization - i.e. focus on stardom and classical narration, adhering to conventional European genre formulas, producing Danish films in English language have been identifiable strategies in Danish cinema in the period after the 2000s. Susanne Bier and Lone Scherfig are significant for employing some of these strategies simultaneously. For this reason, this article will look at how these two directors have employed these strategies and negotiated the cultural boundaries and exchanges.

Keywords: danish cinema, transnational cinema, susanne bier, lone scherfig, national cinema

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1637 Identity of Indian Migrants and Muslim Refugee Women in Sydney, Australia

Authors: Sheikh, R. Author, Bhardwaj S. Author, Jr.

Abstract:

The emphasis of this paper is to investigate the identity shifts experienced within the Indian community and among Muslim refugee women in Sydney. Using Goffman’s paradigm of everyday interactions, attention is paid to how migrants navigate and perform their multiple identities in their daily life. By focusing on narratives of the migrant- migration is understood as processual instead of a one time decision of re-location. The paper aims to highlight how individuals choose and re-adapt their cultural and social practices within the context of Australia. Migrant narratives are rooted in specific socio-cultural settings of one’s own community as well as the nature of migration to a specific country. Differences and similarities will be observed within the Indian community, and among Muslim refugee women in terms of how identity is negotiated, social networks are re-established in Australia. Some attention will also be paid to difficulties that are being faced by migrants-especially in terms of Muslim identity for Refugee women, particularly in terms of assimilation, building on Ghassan Hage’s use of appraisal theory and how a diversity of language and religion is accommodated within the Indian community. By using two diverse groups, it would be able to identify and contrast migrant experiences.

Keywords: identity, migrant, refugee, women, assimilation, narratives

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1636 Deep Learning Based-Object-classes Semantic Classification of Arabic Texts

Authors: Imen Elleuch, Wael Ouarda, Gargouri Bilel

Abstract:

We proposes in this paper a Deep Learning based approach to classify text in order to enrich an Arabic ontology based on the objects classes of Gaston Gross. Those object classes are defined by taking into account the syntactic and semantic features of the treated language. Thus, our proposed approach is a hybrid one. In fact, it is based on the one hand on the object classes that represents a knowledge based-approach on classification of text and in the other hand it uses the deep learning approach that use the word embedding-based-approach to classify text. We have applied our proposed approach on a corpus constructed from an Arabic dictionary. The obtained semantic classification of text will enrich the Arabic objects classes ontology. In fact, new classes can be added to the ontology or an expansion of the features that characterizes each object class can be updated. The obtained results are compared to a similar work that treats the same object with a classical linguistic approach for the semantic classification of text. This comparison highlight our hybrid proposed approach that can be ameliorated by broaden the dataset used in the deep learning process.

Keywords: deep-learning approach, object-classes, semantic classification, Arabic

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1635 The Role of Acoustical Design within Architectural Design in the Early Design Phase

Authors: O. Wright, N. Perkins, M. Donn, M. Halstead

Abstract:

This research responded to anecdotal evidence that suggested inefficiencies within the Architect and Acoustician relationship may lead to ineffective acoustic design decisions.  The acoustician spoken to believed that he was approached too late in the design phase. The approached architect valued acoustical qualities, yet, struggled to interpret common measurement parameters. The preliminary investigation of these opinions indicated a gap in the current New Zealand Architectural discourse and currently informs the creation of a 2016 Master of Architecture (Prof) thesis research. Little meaningful information about acoustic intervention in the early design phase could be found from past literature. In the information that was sourced, authors focus on software as an incorporation tool without investigating why the flaws in the relationship originally exist. To further explore this relationship, a survey was designed. It underwent three phases to ensure its consistency, and was delivered to a group of 51 acousticians from one international Acoustics company. The results were then separated between New Zealand and off-shore to identify trends. The survey results suggest that 75% of acousticians meet the architect less than 5 times per project. Instead of regular contact, a mediated method is adopted though a mix of telecommunication and written reports. Acousticians tend to be introduced later into New Zealand building project than the corresponding off-shore building. This delay corresponds to an increase in remedial action for each of the building types in the survey except Auditoria and Office Buildings. 31 participants have had their specifications challenged by an architect. Furthermore, 71% of the acousticians believe that architects do not have the knowledge to understand why the acoustic specifications are in place. The issues raised in this investigation align to the colloquial evidence expressed by the two consultants. It identifies a larger gap in the industry were acoustics is remedially treated rather than identified as a possible design driver. Further research through design is suggested to understand the role of acoustics within architectural design and potential tools for its inclusion during, not after, the design process.

Keywords: architectural acoustics, early-design, interdisciplinary communication, remedial response

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1634 Planning Strategy for Sustainable Transportation in Heritage Areas

Authors: Hassam Hassan Elborombaly

Abstract:

The pollution generated from transportation modes, congestion and traffic heritage has led to the deterioration of historic buildings and the urban heritage in historic cities. Accordingly, this paper attempts to diagnose the transport and traffic problems in historic cities. In general and in Heritage Cities, and to investigate methods for conserving the urban heritage from negative effects of traffic congestion and of the traditional red modes of transportation. It also attempts to explore possible areas for intervention to mitigate transportation and traffic problems in the light of the principles of the sustainable transportation framework. It aims to draw conclusion and propose recommendation that would increase the efficiency and effectiveness of transportation plans in historic Cairo and consequently achieve sustainable transportation. Problems In historic cities public paths compose an irregular network enclosing large residential plots (defined as super blocks quarters or hettas). The blocks represent the basic morphology units in historic Cities. Each super block incorporates several uses (i.e. residential, non-residential, service uses and others). Local paths reach the interior of the super blocks in an organized inter core, which deals mainly with residential functions mixed with handicraft activities and is composed of several local path units; (b) the other core, which is bound by the public paths and contains a combination of residential, commercial and social activities. Objectives: 1- To provide amenity convenience and comfort for visitors and people who live and work in the area. Pedestrianizing, accessibility and safety are to be reinforced while respecting the organic urban pattern. 2- To enhance street life, vitality and activity, in order to attract people and increase economic prosperity. Research Contents • Relation between residential areas and transportation in the inner core • Analytical studies for historic areas in heritage cities • Sustainable transportation planning in heritage cities • Dynamic and flexible methodology for achieving sustainable transportation network for the Heritage Cities • Result and Recommendation

Keywords: irregular network, public paths, sustainable transportation, urban heritage

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1633 Cross-Cultural Pragmatics: Apology Strategies by Libyans

Authors: Ahmed Elgadri

Abstract:

In the last thirty years, studies on cross-cultural pragmatics in general and apology strategies in specific have focused on western and East-Asian societies. A small volume of research has been conducted in investigating speech acts production by Arabic dialect speakers. Therefore, this study investigated the apology strategies used by Libyan Arabic speakers using an online Discourse Completion Task (DCT) questionnaire. The DCT consisted of six situations covering different social contexts. The survey was written in Libyan Arabic dialect to help generate vernacular speech as much as possible. The participants were 25 Libyan nationals, 12 females, and 13 males. Also, to get a deeper understanding of the motivation behind the use of certain strategies, the researcher interviewed four participants using the Libyan Arabic dialect as well. The results revealed a high use of IFID, offer of repair, and explanation. Although this might support the universality claim of speech acts strategies, it was clear that cultural norms and religion determined the choice of apology strategies significantly. This led to the discovery of new culture-specific strategies, as outlined later in this paper. This study gives an insight into politeness strategies in Libyan society, and it is hoped to contribute to the field of cross-cultural pragmatics.

Keywords: apologies, cross-cultural pragmatics, language and culture, Libyan Arabic, politeness, pragmatics, socio-pragmatics, speech acts

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1632 Expression of Micro-RNA268 in Zinc Deficient Rice

Authors: Sobia Shafqat, Saeed Ahmad Qaisrani

Abstract:

MicroRNAs play an essential role in the regulation and development of all processes in most eukaryotes because of their prospective part as mediators controlling cell growth and differentiation towards the exact position of RNAs response in plants under biotic and abiotic factors or stressors. In a few cases, Zn is oblivious poisonous for plants due to its heavy metal status. Some other metals are extremely toxic, like Cd, Hg, and Pb, but these elements require in rice for the programming of genes under abiotic stress resembling Zn stress when micro RNAs268 was importantly introduced in rice. The micro RNAs overexpressed in transgenic plants with an accumulation of a large amount of melanin dialdehyde, hydrogen peroxide, and an excessive quantity of Zn in the seedlings stage. Let out results for rice pliability under Zn stress micro RNAs act as negative controllers. But the role of micro RNA268 act as a modulator in different ecological condition. It has been explained clearly with a long understanding of the role of micro RNA268 under stress conditions; pliability and practically showed outcome to increase plant sufferance under Zn stress because micro RNAs is an intervention technique for gene regulation in gene expression. The proposed study was experimented with by using genetic factors of Zn stress and toxicity effect on rice plants done at District Vehari, Pakistan. The trial was performed randomly with three replications in a complete block design (RCBD). These blocks were controlled with different concentrations of genetic factors. By overexpression of micro RNA268 rice, seedling growth was not stopped under Zn deficiency due to the accumulation of a large amount of melanin dialdehyde, hydrogen peroxide, and an excessive quantity of Zn in their seedlings. Results showed that micro RNA268 act as a negative controller under Zn stress. In the end, under stress conditions, micro RNA268 showed the necessary function in the tolerance of rice plants. The directorial work sketch gave out high agronomic applications and yield outcomes in rice with a specific amount of Zn application.

Keywords: micro RNA268, zinc, rice, agronomic approach

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1631 A Decrease in the Anxiety Levels of Participants with Autoimmune Disease: Efficacy of a Community-Based Educational Program

Authors: Jennifer Hunter, Francisco Ramirez, Neil A. Nedley, Thania Solorio, Christian Freed, Erica Kinjo

Abstract:

People who have autoimmune disease are often at an increased risk for psychological disorders such as anxiety. Untreated psychological conditions can affect the development of disease and can affect one’s general quality of life. In this study, it was hypothesized that an educational community-based intervention would be useful in decreasing the anxiety levels of participants with autoimmune disease. Programs, 2-hours long each, were held weekly over a period of eight weeks. During every meeting, a 45-minute DVD presentation by a skilled physician was shown, a small group discussion was guided by trained facilitators, and weekly practical assignments were given to each participant. The focus of the program was to educate participants about healthy lifestyle behaviors such as exercise, nutrition, sleep hygiene, helpful thought patterns etc., and to provide a group environment in which each participant was supported. Participants were assessed pre-post program for anxiety using the Depression and Anxiety Assessment Test (registration TX 7-398-022), a validated mental health test based on DSM-5 criteria and demographics. Anxiety scores were classified according to the DSM-5 criteria into 4 categories: none (0-6), mild (7-10), moderate (11-19) or severe (20 or more). Out of the participants who participated in programs conducted in the manner explained above (n=431), the average age was 54.9 (SD 16.6) and 81.9% were female. At baseline, the mean group anxiety level was 9.4 (SD 5.4). Within the baseline group, anxiety levels were as follows: none (21.1%), mild (22.0%), moderate (27.1%) and severe (29.7%). After the program, mean group anxiety decreased to 4.7 (SD 4.0). Post-program anxiety levels were as follows: none (54.8%), mild (27.1%), moderate (12.5%), severe (5.6%). The decrease in overall anxiety levels was significant t(431)=19.3 p<.001, 95% CI [0.815, 1.041]. It was concluded that the eight-week intensive was beneficial in decreasing the anxiety levels of participants. A long-term follow-up study would be beneficial in determining how lasting such improvements are especially since autoimmune diseases are often chronic. Additionally, future studies that utilize a control group would aid in establishing whether the improvements seen are due to the use of this specific lifestyle-educational program.

Keywords: anxiety, auto-immune disease, community-based educational program, lifestyle

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1630 Assessment of Trace Metals Contamination in Surficial and Core Sediments from Ghannouch- Gabes Coastline, Impact of Phosphogypsum Discharge, Southeastern of Tunisia, Mediterranean Sea: Geochemical and Mineralogical Approaches

Authors: Rim Ben Amor, Myriam Abidi, Moncef Gueddari

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The purpose of the present study is to assess the level and the distribution of CaO, SO3, Cd, Cu, Pb and Zn incore sediments of Ghannouch-Gabes coast, Gulf of Gabes, Tunisian Mediterranean coast. The XRD analyses indicate that the sediments of Ghannouch-Gabes coast are mainly composed of quartz, calcite, gypsum and fluorine reflecting the impact of the phosphate fertilizer industrial waste. The vertical distribution of surface sediments shows for all the elements analyzed, that the area located between the commercial and the fishing port of Gabes, is the most polluted zone, where the two harbors acted as barriers and limited the dispersion of phosphogypsum discharge. The abundance order of metals was found to be Zn > Cd > Cu >Pb and that the highest levels of heavy metals were found in the uppermost segment of the sediment core compared to lower depth subsurface due to a continuous input of PG release and showed that the area between the two harbor suffered from several types of pollutants compared to reference core C1, collected from non-industrialized area. The level of pollution was evaluated using contamination factor (Cf), pollution load index (PLI) and the geoaccumulation index (Igeo). The obtained results of Igeo allowed us to distinguish that the area between the commercial harbor of Ghannouch and the fishing harbor of Gabes is the most polluted where sediments are strongly contaminated for Pb, Cu and Cd. The pollution load index (PLI) of all sediments collected classified them as "polluted". According to contamination factor (Cf), the sediments can be considered as ‘considerable’ to ‘very high’ contaminated for Pb, ‘very high to moderate’ for Cd, ‘ moderate’ for Zn, between ‘moderate’ and ‘considerable’ for Cu. Statistical analyses show that heavy metals, fluoride, calcium and sulphate are resulting from the same anthropogenic origin. The metallic pollution status of sediments of Ghanouch -Gabes coast is worrying and requires a serious intervention.

Keywords: trace metals, phosphogypsum, core sediments, accumulation factor, contamination factor

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1629 A Comprehensive Approach to Mitigate Return-Oriented Programming Attacks: Combining Operating System Protection Mechanisms and Hardware-Assisted Techniques

Authors: Zhang Xingnan, Huang Jingjia, Feng Yue, Burra Venkata Durga Kumar

Abstract:

This paper proposes a comprehensive approach to mitigate ROP (Return-Oriented Programming) attacks by combining internal operating system protection mechanisms and hardware-assisted techniques. Through extensive literature review, we identify the effectiveness of ASLR (Address Space Layout Randomization) and LBR (Last Branch Record) in preventing ROP attacks. We present a process involving buffer overflow detection, hardware-assisted ROP attack detection, and the use of Turing detection technology to monitor control flow behavior. We envision a specialized tool that views and analyzes the last branch record, compares control flow with a baseline, and outputs differences in natural language. This tool offers a graphical interface, facilitating the prevention and detection of ROP attacks. The proposed approach and tool provide practical solutions for enhancing software security.

Keywords: operating system, ROP attacks, returning-oriented programming attacks, ASLR, LBR, CFI, DEP, code randomization, hardware-assisted CFI

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1628 Physical Activity Self-Efficacy among Pregnant Women with High Risk for Gestational Diabetes Mellitus: A Cross-Sectional Study

Authors: Xiao Yang, Ji Zhang, Yingli Song, Hui Huang, Jing Zhang, Yan Wang, Rongrong Han, Zhixuan Xiang, Lu Chen, Lingling Gao

Abstract:

Aim and Objectives: To examine physical activity self-efficacy, identify its predictors, and further explore the mechanism of action among the predictors in mainland Chinese pregnant women with high risk for gestational diabetes mellitus (GDM). Background: Physical activity could protect pregnant women from developing GDM. Physical activity self-efficacy was the key predictor of physical activity. Design: A cross-sectional study was conducted from October 2021 to May 2022 in Zhengzhou, China. Methods: 252 eligible pregnant women completed the Pregnancy Physical Activity Self-efficacy Scale, the Social Support for Physical Activity Scale, the Knowledge on Physical Activity Questionnaire, the 7-item Generalized Anxiety Disorder scale, the Edinburgh Postnatal Depression Scale, and a socio-demographic data sheet. Multiple linear regression was applied to explore the predictors of physical activity self-efficacy. Structural equation modeling was used to explore the mechanism of action among the predictors. Results: Chinese pregnant women with a high risk for GDM reported a moderate level of physical activity self-efficacy. The best-fit regression analysis revealed four variables explained 17.5% of the variance in physical activity self-efficacy. Social support for physical activity was the strongest predictor, followed by knowledge of the physical activity, intention to do physical activity, and anxiety symptoms. The model analysis indicated that knowledge of physical activity could release anxiety and depressive symptoms and then increase physical activity self-efficacy. Conclusion: The present study revealed a moderate level of physical activity self-efficacy. Interventions targeting pregnant women with high risk for GDM need to include the predictors of physical activity self-efficacy. Relevance to clinical practice: To facilitate pregnant women with high risk for GDM to engage in physical activity, healthcare professionals may find assess physical activity self-efficacy and intervene as soon as possible on their first antenatal visit. Physical activity intervention programs focused on self-efficacy may be conducted in further research.

Keywords: physical activity, gestational diabetes, self-efficacy, predictors

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