Search results for: Student Outcomes

Authors: Mahdi Eskandarlou, Mehrdad Taghipour

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Background: Partial-thickness skin graft is the cornerstone for scalp defect repair. Routine donor sites include abdomen, thighs, and buttocks. Given the potential side effects following harvesting from these sites and the potential advantages of harvesting from scalp (broad surface, rapid healing, and better cosmetics results), this study is trying to compare the outcomes of graft harvesting from scalp and lower limb. Methods: This clinical trial is conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to plastic surgery clinic at Besat Hospital during the time period between 2018 and 2019. Sampling was done by simple randomization using random digit table. Data gathering was performed using a designated checklist. The donor site in case group and control group was scalp and lower limb, respectively. The resultant data were analyzed using chi-squared and t-test and SPPS version 21 (SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp). Results: Of the total 40 patients participating in this study, 28 patients (70%) were male, and 12 (30%) were female with and mean age of 63.62 ± 09.73 years. Hypertension and diabetes mellitus were the most common comorbidities among patients with basal cell carcinoma (BCC) and trauma being the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The most common anatomic location of defect for case and control groups was temporal and parietal, respectively. Most of the defects were deep to galea zone. The mean diameter of defect was 24.28 ± 45.37 mm for all of the patients. The difference between diameter of defect in both groups was statistically meaningful, while no such difference between graft diameter was seen. The graft 'Take' was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale, and the satisfaction was higher in them per Likert scale. Conclusion: Scalp can safely be used as donor site for skin graft to be used for scalp defects, which is associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, leg, partial-thickness graft, scalp

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Authors: Eakarat Boonreang, Anothai Harasarn

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The objectives of this study are to investigate the flood disaster management capacity of communities in Ubon Ratchathani province, Thailand, and to recommend the sustainable flood management approaches of communities in Ubon Ratchathani province, Thailand. The selected population consisted of the community leaders and committees, the executives of local administrative organizations, and the head of Ubon Ratchathani provincial office of disaster prevention and mitigation. The data was collected by in-depth interview, focus group, and observation. The data was analyzed and classified in order to determine the communities’ capacity in flood disaster management. The results revealed that communities’ capacity were as follows, before flood disaster, the community leaders held a meeting with the community committees in order to plan disaster response and determined evacuation routes, and the villagers moved their belongings to higher places and prepared vehicles for evacuation. During flood disaster, the communities arranged motorboats for transportation and villagers evacuated to a temporary evacuation center. Moreover, the communities asked for survival bags, motorboats, emergency toilets, and drinking water from the local administrative organizations and the 22nd Military Circle. After flood disaster, the villagers cleaned and fixed their houses and also collaborated in cleaning the temple, school, and other places in the community. The recommendation approaches for sustainable flood disaster management consisted of structural measures, such as the establishment of reservoirs and building higher houses, and non-structural measures such as raising awareness and fostering self-reliance, establishing disaster management plans, rehearsal of disaster response procedures every year, and transferring disaster knowledge among younger generations. Moreover, local administrative organizations should formulate strategic plans that focus on disaster management capacity building at the community level, particularly regarding non-structural measures. Ubon Ratchathani provincial offices of disaster prevention and mitigation should continually monitor and evaluate the outcomes of community based disaster risk management program, including allocating more flood disaster management-related resources among local administrative organizations and communities.

Keywords: capacity building, community based disaster risk management, flood disaster management, Thailand

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Authors: Ann Ukachi Madukwe, Juliana Chinwendu Njoku

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Marital conflict, conceptualized in this study as the ongoing lack of peace and satisfaction in a marital union which threatens marital stability, has become quite prevalent in modern Igbo communities. The frequent incidences of spousal battery, spousal sexual abuse, domestic violence, long term separation and in some cases outright divorce are worrisome indicators of the endemic challenge marital conflict poses in most Igbo communities. This study examined marital expectations, marital infidelity (self and spouse), and neuroticism as predictors of marital conflict. Marital expectation was described as a married person’s appraisal of how well their pre-marital desires were being met by their spouses and within the marriage relationship. It assessed different aspects of personal and interpersonal positive outcomes in a marital union. Marital infidelity referred to the likelihood that married individuals or their spouses could have indulged in intimate activities like passionate kisses and romantic dates with someone other than their spouses. Participants reported on themselves as well as their spouses. The last predictor variable neuroticism was measured as a personality trait that addresses issues of emotional instability especially as it relates to a person’s interactions. Neurotic persons were considered to have high emotional reactivity; they would have strong emotional response to issues that emotionally stable persons might overlook. Participants comprised of Igbo male and female spouses selected from Imo state using randomized cluster sampling method. The study utilized the cross sectional survey design and Stepwise linear multiple regression for data analyses. Findings showed that though marital infidelity by spouse was generally below average and spouses marital expectations were being fulfilled; marital expectations followed by marital infidelity – spouse proved to be significant predictors of marital conflict. Marital conflict reduced as marital expectations got fulfilled and increased as the level of likelihood of marital infidelity by the spouse increased. Spouses in this study also reported an increased level of neuroticism, with males being more neurotic than females. Neuroticism was found to be the least significant predictor of marital conflict compared to marital expectations and marital infidelity – spouse. Finally, the article made recommendations to spouses and marital counsellors regarding especially the need to manage the neurotic tendencies of Igbo spouses.

Keywords: Igbo spouses, marital conflict, marital expectations, Nigeria

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Authors: Nicole Marella G. Tan, Al Joseph R. Molina, Raisa Celine R. Rosete, Soraya Elisse E. Escandor, Blythe N. Ke, Veronica Marie E. Ramos, Apolinario Ericson B. Berberabe, Jose Jonas D. del Rosario, Regina Pascua-Berba, Eileen Liesl A. Cubillan, Winlove P. Mojica

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Emergency risk and health communications play a vital role in any pandemic response. However, the Philippine General Hospital (PGH) lacked a system of information delivery that could effectively fulfill the hospital’s communication needs as a COVID-19 referral hospital. This study aimed to describe the establishment of a communication framework for information dissemination within a tertiary government hospital during the COVID-19 pandemic and evaluated the perceived usefulness of its outputs. This is a mixed quantitative-qualitative study with two phases. Phase 1 documented the formation and responsibilities of the Information Education Communication (IEC) Committee. Phase 2 evaluated its output and outcomes through a hospital-wide survey of 528 healthcare workers (HCWs) using a pre-tested questionnaire. In-depth explanations were obtained from five focused group discussions (FGD) amongst various HCW subgroups. Descriptive analysis was done using STATA 16 while qualitative data were synthesized thematically. Communication practices in PGH were loosely structured at the beginning of the pandemic until the establishment of the IEC Committee. The IEC Committee was well-represented by concerned stakeholders. Nine types of infographics tackled different aspects of the hospital’s health operations after thorough inputs from concerned offices. Internal and external feedback mechanisms ensured accurate infographics. Majority of the survey respondents (98.67%) perceived these as useful in their work or daily lives. FGD participants cited the relevance of infographics to their occupations, suggested improvements, and hoped that these efforts would be continued in the future. Sustainability and comprehensive reach were the main concerns in this undertaking. The PGH COVID-19 IEC framework was developed through trial and testing as there were no existing formal structures to communicate health risks and to properly direct the HCWs in the chaotic time of a pandemic. It is a continuously evolving framework which is perceived as useful by HCWs and is hoped to be sustained in the future.

Keywords: COVID-19, pandemic, health communication, infographics, social media

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Authors: Chen-Jung Chen, Yi-Chang Chen

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While traditional virtual reality and augmented reality only allow for small movement learning and cannot provide a truly immersive teaching experience to give it the illusion of movement, the new technology of both content creation and immersive interactive simulation of the metaverse can just reach infinite close to the natural teaching situation. However, the mixed reality virtual classroom of metaverse has not yet explored its theory, and it is rarely implemented in the situational simulation teaching of nursing education. Therefore, in the first year, the study will intend to use grounded theory and case study methods and in-depth interviews with nursing education and information experts. Analyze the interview data to investigate the uniqueness of metaverse development. The proposed analysis will lead to alternative theories and methods for the development of nursing education. In the second year, it will plan to integrate the metaverse virtual situation simulation technology into the alternate teaching strategy in the pediatric nursing technology course and explore the nursing students' use of this teaching method as the construction of personal technology and experience. By leveraging the unique features of distinct teaching platforms and developing processes to deliver alternative teaching strategies in a nursing technology teaching environment. The aim is to increase learning achievements without compromising teaching quality and teacher-student relationships in the post-pandemic era. A descriptive and convergent mixed methods design will be employed. Sixty third-grade nursing students will be recruited to participate in the research and complete the pre-test. The students in the experimental group (N=30) agreed to participate in 4 real-time mixed virtual situation simulation courses in self-practice after class and conducted qualitative interviews after each 2 virtual situation courses; the control group (N=30) adopted traditional practice methods of self-learning after class. Both groups of students took a post-test after the course. Data analysis will adopt descriptive statistics, paired t-tests, one-way analysis of variance, and qualitative content analysis. This study addresses key issues in the virtual reality environment for teaching and learning within the metaverse, providing valuable lessons and insights for enhancing the quality of education. The findings of this study are expected to contribute useful information for the future development of digital teaching and learning in nursing and other practice-based disciplines.

Keywords: metaverse, post-pandemic era, online virtual classroom, immersive teaching

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Authors: Alice Huffman, Joseph Hartland, Sam Gibbs

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Dermatology is often a neglected specialty in low-resource settings, despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV positive patients. African countries have the highest HIV infection rates and skin conditions are frequently misdiagnosed and mismanaged, because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV positive patients. A literature search within Embase, Medline and Google scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff a list of 15 skin conditions was included and a booklet created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff, alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.

Keywords: dermatology, HIV, Malawi, skin disease

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Authors: Jagannath Koravadi, Archith Gupta

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In a world with constantly growing energy prices, and growing concerns about the global climate changes caused by increased energy consumption, it is becoming more and more essential to save energy wherever possible. Refrigeration systems are one of the major and bulk energy consuming systems now-a-days in industrial sectors, residential sectors and household environment. Refrigeration systems with considerable cooling requirements consume a large amount of electricity and thereby contribute greatly to the running costs. Therefore, a great deal of attention is being paid towards improvement of the performance of the refrigeration systems in this regard throughout the world. The Coefficient of Performance (COP) of a refrigeration system is used for determining the system's overall efficiency. The operating cost to the consumer and the overall environmental impact of a refrigeration system in turn depends on the COP or efficiency of the system. The COP of a refrigeration system should therefore be as high as possible. Slight modifications in the technical elements of the modern refrigeration systems have the potential to reduce the energy consumption, and improvements in simple operational practices with minimal expenses can have beneficial impact on COP of the system. Thus, the challenge is to determine the changes that can be made in a refrigeration system in order to improve its performance, reduce operating costs and power requirement, improve environmental outcomes, and achieve a higher COP. The opportunity here, and a better solution to this challenge, will be to incorporate modifications in conventional refrigeration systems for saving energy. Energy efficiency, in addition to improvement of COP, can deliver a range of savings such as reduced operation and maintenance costs, improved system reliability, improved safety, increased productivity, better matching of refrigeration load and equipment capacity, reduced resource consumption and greenhouse gas emissions, better working environment, and reduced energy costs. The present work aims at fabricating a working model of a refrigerator that will provide for effective heat recovery from superheated refrigerant with the help of an efficient de-superheater. The temperature of the refrigerant and water in the de-super heater at different intervals of time are measured to determine the quantity of waste heat recovered. It is found that the COP of the system improves by about 6% with the de-superheater and the power input to the compressor decreases by 4 % and also the refrigeration capacity increases by 4%.

Keywords: coefficiency of performance, de-superheater, refrigerant, refrigeration capacity, heat recovery

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Authors: Davod Ahmadigheidari, Isabel Alvarez, Kate Sinclair, Marnie Davidson, Patrick Cortbaoui, Hugo Melgar-Quiñonez

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The burden of collecting water tends to disproportionately fall on women and girls in low-income countries. Specifically, women spend between one to eight hours per day fetching water for domestic use in Sub-Saharan Africa. While there has been research done on the global time burden for collecting water, it has been mainly focused on water quality parameters; leaving the relationship between water fetching and health outcomes understudied. There is little available evidence regarding the relationship between water fetching and maternal child care practices. The main objective of this study was to help fill the aforementioned gap in the literature. Data from two surveys in Ethiopia and Malawi conducted by CARE Canada in 2016-2017 were used. Descriptive statistics indicate that women were predominantly responsible for collecting water in both Ethiopia (87%) and Malawi (99%) respectively, with the majority spending more than 30 minutes per day on water collection. With regards to child care practices, in both countries, breastfeeding was relatively high (77% and 82%, respectively); and treatment for malnutrition was low (15% and 8%, respectively). However, the same consistency was not found for weighing; in Ethiopia only 16% took their children for weighting in contrast to 94% in Malawi. These three practices were summed to create one variable for regressions analyses. Unadjusted logistic regression findings showed that only in Ethiopia was time fetching water significantly associated with child care practices. Once adjusted for covariates, this relationship was no longer found to be significant. Adjusted logistic regressions also showed that the factors that did influence child care practices differed slightly between the two countries. In Ethiopia, a lack of access to community water supply (OR= 0.668; P=0.010), poor attitudes towards gender equality (OR= 0.608; P=0.001), no access to land and (OR=0.603; P=0.000), significantly decreased a women’s odd of using positive childcare practices. Notably, being young women between 15-24 years (OR=2.308; P=0.017), and 25-29 (OR=2.065; P=0.028) increased probability of using positive childcare practices. Whereas in Malawi, higher maternal age, low decision-making power, significantly decreased a women’s odd of using positive childcare practices. In conclusion, this study found that even though amount of time spent by women fetching water makes a difference for childcare practices, it is not significantly related to women’s child care practices when controlling the covariates. Importantly, women’s age contributes to child care practices in Ethiopia and Malawi.

Keywords: time fetching water, community water supply, women’s child care practices, Ethiopia, Malawi

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Authors: Meredith Rossi, Lesley Lee, Mary Wear, Mary Van Baalen, Bradley Rhodes

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The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. A better understanding of the individual, population, and mission impacts of astronaut occupational exposures is critical to providing clinical care, targeting occupational surveillance efforts, and planning for future space exploration. The ability to characterize the risk of latent health conditions is a significant component of this understanding. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA-Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential long-term health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging populations are necessary to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography); and expanded monitoring will increase NASA’s ability to better characterize conditions resulting from astronaut occupational exposures. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of expanding the medical monitoring of former NASA astronauts under the Astronaut Occupational Health program. Increasing the breadth of monitoring services will ultimately enrich the existing evidence base of occupational health risks to astronauts. Such an expansion would therefore improve the understanding of the health of the astronaut population as a whole, and the ability to identify, mitigate, and manage such risks in preparation for deep space exploration missions.

Keywords: astronaut, long-term health, NASA, occupational health, surveillance

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Authors: Ryotaro Ishikawa

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INTRODUCTION: Post-traumatic stress disorder (PTSD) is a psychiatric label for a collection of psychological symptoms following a traumatic event. PTSD is as a result of a traumatic experience such as rape or sexual assault. A victim may have PTSD if she/he has experienced the following symptoms for at least a month: a) Stressor, b) Intrusion symptoms, c) Avoidance, d) Negative alterations in cognitions and mood, e) Alterations in arousal and reactivity. Studies on the cognitive theory of PTSD emphasized the roles of (a) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (b) disorganized trauma memories in the development of PTSD. Mental contamination is primarily caused by experiences involving humans (e.g. violators or perpetrators) as opposed to substances (e.g. dirt or bodily fluids). Feelings of mental contamination may evoke following experiences of ill-treatment, sexual assault, domination, degradation, manipulation, betrayal, or humiliation. Some studies have demonstrated that traumatic thoughts related to sexual assault are particularly strong predictors of mental contamination. Treatment protocols based on cognitive-behavioral therapy appear to be beneficial in reducing the severity of PTSD and mental contamination. Studies on the cognitive theory of PTSD emphasized the roles of (A) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (B) disorganized trauma memories in the development of PTSD. We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. METHOD: The single-arm trial is a group setting CBT intervention. The primary outcome is the self-rated Posttraumatic Stress Diagnostic Scale, with secondary measurements of depressive severity and mental pollution questionnaire. Assessments are conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. RESULTS: Participants are eligible for the study and complete the outcome measures at all assessment points. In our hypothesis, receiving CBT would lead to improvements in primary and secondary PTSD severity. CONCLUSION: We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. Our treatment would achieve favorable treatment outcomes for PTSD with mental contamination in Japanese clinical settings.

Keywords: CBT, cognitive theory, PTSD, mental pollution

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Authors: Alejandra Letelier, Anja Heilmann, Richard G. Watt, Stephen Jivraj, Georgios Tsakos

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Background: Socioeconomic position (SEP) influences adult health. People who experienced material disadvantages in childhood or adulthood tend to have higher adult disease levels than their peers from more advantaged backgrounds. Even so, life is a dynamic process and contains a series of transitions that could lead people through different socioeconomic paths. Research on social mobility takes this into account by adopting a trajectory approach, thereby providing a long-term view of the effect of SEP on health. Aim: The aim of this research examines the effects of intergenerational social mobility on adult general health, oral health and functioning in a population aged 50 and over in England. Methods: This study is based on the secondary analysis of data from the English Longitudinal Study of Ageing (ELSA). Using cross-sectional data, nine social trajectories were created based on parental and adult occupational socio-economic position. Regression models were used to estimate the associations between social trajectories and the following outcomes: adult self-rated health, self-rated oral health, oral health related quality of life, total tooth loss and grip strength; while controlling for socio-economic background and health related behaviours. Results: Associations with adult SEP were generally stronger than with childhood SEP, suggesting a stronger influence of proximal rather than distal SEP on health and oral health. Compared to the stable high group, being in the low SEP groups in childhood and adulthood was associated with poorer health and oral health for all examined outcome measures. For adult self-rated health and edentulousness, graded associations with social mobility trajectories were observed. Conclusion: Intergenerational social mobility was associated with self-rated health and total tooth loss. Compared to only those who remained in a low SEP group over time reported worse self-rated oral health and oral health related quality of life, and had lower grip strength measurements. Potential limitations in relation to data quality will be discussed.

Keywords: social determinants of oral health, social mobility, socioeconomic position and oral health, older adults oral health

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Authors: Bilal Ahmed, Muhammad Rafiq, Choongjae Im

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The tech-savvy Gen Z's transfer towards interactive concept learning is hammering the demand for online collaborative learning environments, renovating conventional education approaches. The authors propose a novel approach to enhance learning outcomes to improve retention in 3D interactive education by connecting virtual reality (VR) and non-VR devices in the classroom and distance learning. The study evaluates students' experiences with VR interconnectivity devices in human anatomy lectures using real-time 3D interactive data visualization. Utilizing the renowned "Guo & Pooles Inventory" and the "Flow for Presence Questionnaires," it used an experimental research design with a control and experimental group to assess this novel connecting strategy's effectiveness and significant potential for in-person and online educational settings during the sessions. The experimental group's interactions, engagement levels, and usability experiences were assessed using the "Guo & Pooles Inventory" and "Flow for Presence Questionnaires," which measure their sense of presence, engagement, and immersion throughout the learning process using a 5-point Likert scale. At the end of the sessions, we used the "Perceived Usability Scale" to find our proposed system's overall efficiency, effectiveness, and satisfaction. By comparing both groups, the students in the experimental group used the integrated VR environment and VR to non-VR devices, and their sense of presence and attentiveness was significantly improved, allowing for increased engagement by giving students diverse technological access. Furthermore, learners' flow states demonstrated increased absorption and focus levels, improving information retention and Perceived Usability. The findings of this study can help educational institutions optimize their technology-enhanced teaching methods for traditional classroom settings as well as distance-based learning, where building a sense of connection among remote learners is critical. This study will give significant insights into educational technology and its ongoing progress by analyzing engagement, interactivity, usability, satisfaction, and presence.

Keywords: interactive learning environments, human-computer interaction, virtual reality, computer- supported collaborative learning

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Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

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Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

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Authors: Dorit Alt, Nirit Raichel

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Although university teaching is claimed to have a special task to support students in adopting ways of thinking and producing new knowledge anchored in scientific inquiry practices, it is argued that students' habits of learning are still overwhelmingly skewed toward passive acquisition of knowledge from authority sources rather than from collaborative inquiry activities.This form of instruction is criticized for encouraging students to acquire inert knowledge that can be used in instructional settings at best, however cannot be transferred into real-life complex problem settings. In order to overcome this critical inadequacy between current educational goals and instructional methods, the LLAF consortium (including 16 members from 8 countries) is aimed at developing updated instructional practices that put a premium on adaptability to the emerging requirements of present society. LLAF has created a practical guide for teachers containing updated pedagogical strategies and assessment tools, based on the constructivist approach for learning that put a premium on adaptability to the emerging requirements of present society. This presentation will be limited to teachers' education only and to the contribution of the project in providing a scale designed to measure the extent to which the constructivist activities are efficiently applied in the learning environment. A mix-method approach was implemented in two phases to construct the scale: The first phase included a qualitative content analysis involving both deductive and inductive category applications of students' observations. The results foregrounded eight categories: knowledge construction, authenticity, multiple perspectives, prior knowledge, in-depth learning, teacher- student interaction, social interaction and cooperative dialogue. The students' descriptions of their classes were formulated as 36 items. The second phase employed structural equation modeling (SEM). The scale was submitted to 597 undergraduate students. The goodness of fit of the data to the structural model yielded sufficient fit results. This research elaborates the body of literature by adding a category of in-depth learning which emerged from the content analysis. Moreover, the theoretical category of social activity has been extended to include two distinctive factors: cooperative dialogue and social interaction. Implications of these findings for the LLAF project are discussed.

Keywords: constructivist learning, higher education, mix-methodology, structural equation modeling

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Authors: Laura Rodriguez Amaya

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Advances in science, technology, engineering, and mathematics (STEM) are viewed as important to countries’ national economies and their capacities to be competitive in the global economy. However, many countries experience low numbers of students entering these disciplines. To strengthen the professional STEM pipelines, it is important that students are retained in these disciplines at universities. Scholars agree that to retain students in universities’ STEM degrees, it is necessary that STEM course content shows the relevance of these academic fields to their daily lives. By increasing students’ understanding on the importance of these degrees and careers, students’ motivation to remain in these academic programs can also increase. An effective way to make STEM content relevant to students’ lives is the use of geospatial technologies and geovisualization in the classroom. The Geospatial Revolution, and the science and technology associated with it, has provided scientists and engineers with an incredible amount of data about Earth and Earth systems. This data can be used in the classroom to support instruction and make content relevant to all students. The purpose of this study was to find out the prevalence use of geospatial technologies and geovisualization as teaching practices in a USA university. The Teaching Practices Inventory survey, which is a modified version of the Carl Wieman Science Education Initiative Teaching Practices Inventory, was selected for the study. Faculty in the STEM disciplines that participated in a summer learning institute at a 4-year university in the USA constituted the population selected for the study. One of the summer learning institute’s main purpose was to have an impact on the teaching of STEM courses, particularly the teaching of gateway courses taken by many STEM majors. The sample population for the study is 97.5 of the total number of summer learning institute participants. Basic descriptive statistics through the Statistical Package for the Social Sciences (SPSS) were performed to find out: 1) The percentage of faculty using geospatial technologies and geovisualization; 2) Did the faculty associated department impact their use of geospatial tools?; and 3) Did the number of years in a teaching capacity impact their use of geospatial tools? Findings indicate that only 10 percent of respondents had used geospatial technologies, and 18 percent had used geospatial visualization. In addition, the use of geovisualization among faculty of different disciplines was broader than the use of geospatial technologies. The use of geospatial technologies concentrated in the engineering departments. Data seems to indicate the lack of incorporation of geospatial tools in STEM education. The use of geospatial tools is an effective way to engage students in deep STEM learning. Future research should look at the effect on student learning and retention in science and engineering programs when geospatial tools are used.

Keywords: engineering education, geospatial technology, geovisualization, STEM

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Authors: Stefanie Behncke

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This paper analyses the effects of different macroprudential policy measures that have recently been implemented in Switzerland. Among them is the activation and the increase of the countercyclical capital buffer (CCB) and a tightening of loan-to-value (LTV) requirements. These measures were introduced to limit systemic risks in the Swiss mortgage and real estate markets. They were meant to affect mortgage growth, mortgage risks, and banks’ capital buffers. Evaluation of their quantitative effects provides insights for Swiss policymakers when reassessing their policy. It is also informative for policymakers in other countries who plan to introduce macroprudential instruments. We estimate the effects of the different macroprudential measures with a Differences-in-Differences estimator. Banks differ with respect to the relative importance of mortgages in their portfolio, their riskiness, and their capital buffers. Thus, some of the banks were more affected than others by the CCB, while others were more affected by the LTV requirements. Our analysis is made possible by an unusually informative bank panel data set. It combines data on newly issued mortgage loans and quantitative risk indicators such as LTV and loan-to-income (LTI) ratios with supervisory information on banks’ capital and liquidity situation and balance sheets. Our results suggest that the LTV cap of 90% was most effective. The proportion of new mortgages with a high LTV ratio was significantly reduced. This result does not only apply to the 90% LTV, but also to other threshold values (e.g. 80%, 75%) suggesting that the entire upper part of the LTV distribution was affected. Other outcomes such as the LTI distribution, the growth rates of mortgages and other credits, however, were not significantly affected. Regarding the activation and the increase of the CCB, we do not find any significant effects: neither LTV/LTI risk parameters nor mortgage and other credit growth rates were significantly reduced. This result may reflect that the size of the CCB (1% of relevant residential real estate risk-weighted assets at activation, respectively 2% at the increase) was not sufficiently high enough to trigger a distinct reaction between the banks most likely to be affected by the CCB and those serving as controls. Still, it might be have been effective in increasing the resilience in the overall banking system. From a policy perspective, these results suggest that targeted macroprudential policy measures can contribute to financial stability. In line with findings by others, caps on LTV reduced risk taking in Switzerland. To fully assess the effectiveness of the CCB, further experience is needed.

Keywords: banks, financial stability, macroprudential policy, mortgages

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Authors: Maggie Hui

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Risk management is not a new concept; however, it is an uncharted area as applied to the translation process and translator training. Risk managers are responsible for managing risk, i.e. adopting strategies with the intention to minimize loss and maximize gains in spite of uncertainty. Which risk strategy to use often depends on the frequency of an event (i.e. probability) and the severity of its outcomes (i.e. impact). This is basically the way translation/localization project managers handle risk management. Although risk management could involve both positive and negative impacts, impact seems to be always negative in professional translators’ management models, e.g. how many days of project time are lost or how many clients are lost. However, for analysis of translation performance, the impact should be possibly positive (e.g. increased readability of the translation) or negative (e.g. loss of source-text information). In other words, the straight business model of risk management is not directly applicable to the study of risk management in the rendition process. This research aims to explore trainee translators’ risk managing while translating in a simulated setting that involves translator-client relations. A two-cycle experiment involving two roles, the translator and the simulated client, was carried out with a class of translation students to test the effects of the main variable of peer-group interaction. The researcher made use of a user-friendly screen-voice recording freeware to record subjects’ screen activities, including every word the translator typed and every change they made to the rendition, the websites they browsed and the reference tools they used, in addition to the verbalization of their thoughts throughout the process. The research observes the translation procedures subjects considered and finally adopted, and looks into the justifications for their procedures, in order to interpret their risk management. The qualitative and quantitative results of this study have some implications for translator training: (a) the experience of being a client seems to reinforce the translator’s risk aversion; (b) there is a wide gap between the translator’s internal risk management and their external presentation of risk; and (c) the use of role-playing simulation can empower students’ learning by enhancing their attitudinal or psycho-physiological competence, interpersonal competence and strategic competence.

Keywords: risk management, role-playing simulation, translation pedagogy, translator-client relations

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Authors: Giovana Longo-Silva, Risia Cristina Egito de Menezes, Renan Serenini, Márcia de Oliveira Lima, Júlia Souza de Melo, Larissa de Lima Soares

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Introduction: Sleep duration and quality have been increasingly recognized as important factors affecting overall health and well-being, including their potential impact on body weight and composition. Previous research has shown inconsistent results regarding the association between sleep patterns and body mass index (BMI), particularly among diverse populations such as Brazilian adults. Understanding these relationships is crucial for developing targeted interventions to address obesity and related health issues. Objective: This study aimed to investigate the association between sleep duration, insomnia, and BMI among Brazilian adults using data from a large national survey focused on chronic nutrition and sleep habits. Materials and Methods: The study included 2050 participants from a population-based virtual survey. BMI was calculated using self-reported weight and height measurements. Participants also reported usual bedtime and wake time on weekdays and weekends and whether they experienced symptoms of insomnia. The average sleep duration across the entire week was calculated as follows: [(5×sleep duration on weekdays) + (2×sleep duration on weekends)]/7. Linear regression analyses were conducted to assess the association between sleep duration, insomnia, and BMI, adjusting for potential confounding factors, including age, sex, marital status, physical exercise duration, and diet quality. Results: After adjusting for confounding variables, the study found that BMI decreased by 0.19 kg/m² for each additional hour of sleep duration (95% CI = -0.37, -0.02; P = 0.03). Conversely, individuals with insomnia had a higher BMI, with an increase of 0.75 kg/m² (95% CI = 0.28, 1.22; P = 0.002) compared to those without insomnia. Conclusions: The findings suggest a significant association between sleep duration, insomnia, and BMI among Brazilian adults. Longer sleep duration was associated with lower BMI, while insomnia was associated with higher BMI. These results underscore the importance of considering sleep patterns in strategies aimed at preventing and managing obesity in this population. Further research is needed to explore the underlying mechanisms and potential interventions targeting sleep-related factors to promote healthier body weight outcomes.

Keywords: sleep, obesity, chronobiology, nutrition

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Authors: S. Tandon, A. Oussoren

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Clothing is a need for all humans. Besides serving the commonly understood function of protection, it also is a means of self-expression and adornment. However, most clothing for people with disabilities is developed to respond to their functional needs merely. Such clothing aggravates feelings of inadequacy and lowers their self-esteem. Investigations into apparel-related barriers faced by women with disabilities and their expectations and desires about clothing pointed to a huge void in terms of well-designed inclusive clothing. The incredible stories and experiences shared by the participants in this research highlighted the fact that people with disabilities wanted to feel, dress, and look at how they wanted to look by wearing what they wanted to wear. Clothing should be about self-expression – reflecting their moods, taste, and style and not limited to fulfilling merely their functional needs. Inclusive Design for Regaining Lost Identity was undertaken to design and develop accessible clothing that is inclusive and fashionable to foster psycho-social well-being and to enhance the self-esteem of women with disabilities. The research explored inclusive design solutions for the saree – a traditional Indian garment for women. The saree is an elaborate garment that requires precise draping, which makes the saree complicated to wear and inconvenient to carry, particularly for women with physical disabilities. For many women in India, the saree remains the customary dress, especially for work and occasions, yet minimal advancement has been made to enhance its accessibility and ease of use. The project followed a qualitative research approach whilst incorporating a combination of methods, which consisted of a questionnaire, an interview, and co-creation workshops. The research adhered to the principles of applied research such that the designed products aim to solve a problem that is functional and purposeful. In order to reduce the complications and to simplify the wrapping of the garment fabric around the body, different combinations of pre-stitching of the layers of the saree were created to investigate the outcomes. The technology of 3D drawing and printing was employed to develop feasible fasteners keeping in mind the participants’ movement limitations and to enhance their agency with these newly designed fasteners. The underlying principle of the project is that every individual should be able to access life the way they wish to and should not have to compromise their desires due to their disability.

Keywords: accessibility, co-creation, design ethics, inclusive

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Authors: Tigist Mekonnen Melesse

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Since rural households are basically entitled to food through own production, improving productivity might lead to enhance the welfare of rural population through higher food availability at the household level and lowering the price of agricultural products. Increasing agricultural productivity through the use of improved technology is one of the desired outcomes from sensible food security and agricultural policy. The ultimate objective of this study was to evaluate the potential impact of improved agricultural technology adoption on smallholders’ crop productivity and welfare. The study is conducted in Ethiopia covering 1500 rural households drawn from four regions and 15 rural villages based on data collected by Ethiopian Rural Household Survey. Endogenous treatment effect model is employed in order to account for the selection bias on adoption decision that is expected from the self-selection of households in technology adoption. The treatment indicator, technology adoption is a binary variable indicating whether the household used improved seeds and chemical fertilizer or not. The outcome variables were cereal crop productivity, measured in real value of production and welfare of households, measured in real per capita consumption expenditure. Results of the analysis indicate that there is positive and significant effect of improved technology use on rural households’ crop productivity and welfare in Ethiopia. Adoption of improved seeds and chemical fertilizer alone will increase the crop productivity by 7.38 and 6.32 percent per year of each. Adoption of such technologies is also found to improve households’ welfare by 1.17 and 0.25 percent per month of each. The combined effect of both technologies when adopted jointly is increasing crop productivity by 5.82 percent and improving welfare by 0.42 percent. Besides, educational level of household head, farm size, labor use, participation in extension program, expenditure for input and number of oxen positively affect crop productivity and household welfare, while large household size negatively affect welfare of households. In our estimation, the average treatment effect of technology adoption (average treatment effect on the treated, ATET) is the same as the average treatment effect (ATE). This implies that the average predicted outcome for the treatment group is similar to the average predicted outcome for the whole population.

Keywords: Endogenous treatment effect, technologies, productivity, welfare, Ethiopia

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Authors: Rebecca K. Blais, Lindsey Monteith, Hallie Tannahill

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Military sexual trauma (MST) includes sexual harassment or assault that occurred during military service. Studies conducted to date on the association of MST with mental health and suicide outcomes are generally circumscribed to either active duty or veteran samples, precluding a thorough analysis of developmental trajectories of distress following MST within the context of ongoing (vs. discharged from) military service. The Military Social Science Laboratory has collected data on mixed service samples of men and women service members, addressing this important literature gap. The purpose of this study was to examine the association of MST, suicide risk, PTSD, depression, alcohol use, and posttraumatic cognitions using two separate samples, which collectively allow for a comprehensive examination of the development of distress following MST. The first sample consisted of 1389 men and women service members and veterans with varying levels of MST severity, including no MST, harassment-only MST, and assault MST. The second sample consisted of 400 men and women service members, all reporting the highest severity of MST, assault MST. In both samples, roughly half reported being discharged from service. Participants completed self-report measures of MST exposure severity, suicide ideation, suicide risk, PTSD, depression, alcohol misuse, and posttraumatic cognitions, as well as perceptions of how the military responded to their MST. Relative to those still serving in the US military, veterans were more likely to endorse suicidal ideation, higher PTSD symptoms, and higher depression symptoms if they felt the military mishandled their experience of MST (referred to as perceived institutional betrayal). However, among those reporting the most severe MST, veterans reported lower alcohol misuse and more adaptive posttraumatic cognitions. These findings suggest that those separated from the military experience different posttraumatic aftermath following MST relative to those who are currently serving in the military. Such findings suggest critical differences in the developmental trajectory of distress, necessitating different interventions to successfully reduce distress and dysfunction. Additional analyses will explore the impact of gender on these associations and explore full mechanistic models of distress grouped by discharged status.

Keywords: military sexual trauma, PTSD, suicide, developmental trajectories, depression

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Authors: Muhammad Bilal, Amelia Jane Llyod, Habsah Mohamad, Jia Hui Wong, Abdul Aziz Mohamed Yusoff, Jafri Malin Abdullah, Jingli Zhang

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Epilepsy is one of the major brain afflictions occurs with uncontrolled excitation of cortex; disturbed 50 million of world’s population. About 25 percent of patients subjected to adverse effects from antiepileptic drugs (AEDs) such as depression, nausea, tremors, gastrointestinal symptoms, osteoporosis, dizziness, weight change, drowsiness, fatigue are commonly observed indications; therefore, new drugs are required to cure epilepsy. GABA is principle inhibitory neurotransmitter, control excitation of the brain. Mutation or dysfunction of GABA receptor is one of the primary causes of epilepsy, which is confirmed from many acquired models of epilepsy like traumatic brain injury, kindling, and status epilepticus models of epilepsy. GABA receptor has 3 distinct types such as GABA (A), GABA (B), GABA(C).GABA (A) receptor has 20 different subunits, α1β2γ2 subunits composition of GABA (A) receptor is the most used combination of subunits for screening of compounds against epilepsy. We expressed α1β2γ2s subunits of GABA (A) Receptor in Xenopus leavis oocytes and examined the enhancement potential of 4-Hydroxybenzoic acid compound on GABA (A) receptor via two-electrode voltage clamp current recording technique. Bamboo shoots are the young, tender offspring of bamboo, which are usually harvested after a cultivating period of 2 weeks. Proteins, acids, fat, starch, carbohydrate, fatty acid, vitamin, dietary fiber, and minerals are the major constituent found systematically in bamboo shoots. These shoots reported to have anticancer, antiviral, antibacterial activity, also possess antioxidant properties due to the presence of phenolic compounds. Student t-test analysis suggested that 4- hydroxybenzoic acid positively allosteric GABA (A) receptor, increased normalized current amplitude to 1.0304±0.0464(p value 0.032) compared with vehicle. 4-Hydrobenzoic acid, a compound from Dendrocalamus Asper bamboo shoot gives new insights for future studies on bamboo shoots with motivation for extraction of more compounds to investigate their effects on human and rodents against epilepsy, insomnia, and anxiety.

Keywords: α1β2γ2S, antiepileptic, bamboo shoots, epilepsy GABA (A) receptor, two-microelectrode voltage clamp, xenopus laevis oocytes

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Authors: Deddi Nordiawan

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Effective public policy creation required a strong budget system, both in terms of design and implementation. Performance-based Budget is an evolutionary approach with two substantial characteristics; first, the strong integration between budgeting and planning, and second, its existence as guidance so that all activities and expenditures refer to measurable performance targets. There are four processes in the government that should be followed in order to make the budget become performance-based. These four processes consist of the preparation of a vision according to the bold aspiration, the formulation of outcome, the determination of output based on the analysis of organizational resources, and the formulation of Value Creation Map that contains a series of programs and activities. This is consistent with the concept of logic model which revealed that the budget performance should be placed within a relational framework of resources, activities, outputs, outcomes and impacts. Through the issuance of Law 17/2003 regarding State Finance, local governments in Indonesia have to implement performance-based budget. Central Government then issued Government Regulation 58/2005 which contains the detail guidelines how to prepare local governments budget. After a decade, implementation of performance budgeting in local government is still not fully meet expectations, though the guidance is completed, socialization routinely performed, and trainings have also been carried out at all levels. Accordingly, this study views the practice of performance-based budget at local governments as a problematic situation. This condition must be approached with a system approach that allows the solutions from many point of views. Based on the fact that the infrastructure of budgeting has already settled, the study then considering the situation as complexity. Therefore, the intervention needs to be done in the area of human activity system. Using Soft Systems Methodology, this research will reconstruct the process of performance-based budget at local governments is area of human activity system. Through conceptual models, this study will invite all actors (central government, local government, and the parliament) for dialogue and formulate interventions in human activity systems that systematically desirable and culturally feasible. The result will direct central government in revise the guidance to local government budgeting process as well as a reference to build the capacity building strategy.

Keywords: soft systems methodology, performance-based budgeting, Indonesia, public policy

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Authors: Yuqing Zou, Chunrui Zou, Yichong Cao

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Previous research has revealed relationships between self-efficacy (SE), engagement, and academic achievement among students in Western countries, but these relationships remain unknown in college math courses among college students in China. In addition, previous research has shown that test anxiety has a direct effect on engagement and academic achievement. However, how test anxiety affects the relationships between SE, engagement, and academic achievement is still unknown. In this study, the authors aimed to explore the mediating roles of behavioral engagement (BE), emotional engagement (EE), and cognitive engagement (CE) in the association between SE and academic achievement and the moderating role of test anxiety in college math courses. Our hypotheses are that the association between SE and academic achievement was mediated by engagement and that test anxiety played a moderating role in the association. To explore the research questions, the authors collected data through self-reported surveys among 147 students at a northwestern university in China. Self-reported surveys were used to collect data. The motivated strategies for learning questionnaire (MSLQ) (Pintrich, 1991), the metacognitive strategies questionnaire (Wolters, 2004), and the engagement versus disaffection with learning scale (Skinner et al., 2008) were used to assess SE, CE, and BE and EE, respectively. R software was used to analyze the data. The main analyses used were reliability and validity analysis of scales, descriptive statistics analysis of measured variables, correlation analysis, regression analysis, and structural equation modeling (SEM) analysis and moderated mediation analysis to look at the structural relationships between variables at the same time. The SEM analysis indicated that student SE was positively related to BE, EE, and CE and academic achievement. BE, EE, and CE were all positively associated with academic achievement. That is, as the authors expected, higher levels of SE led to higher levels of BE, EE, and CE, and greater academic achievement. Higher levels of BE, EE, and CE led to greater academic achievement. In addition, the moderated mediation analysis found that the path of SE to academic achievement in the model was as significant as expected, as was the moderating effect of test anxiety in the SE-Achievement association. Specifically, test anxiety was found to moderate the association between SE and BE, the association between SE and CE, and the association between EE and Achievement. The authors investigated possible mediating effects of BE, EE, and CE in the associations between SE and academic achievement, and all indirect effects were found to be significant. As for the magnitude of mediations, behavioral engagement was the most important mediator in the SE-Achievement association. This study has implications for college teachers, educators, and students in China regarding ways to promote academic achievement in college math courses, including increasing self-efficacy and engagement and lessening test anxiety toward math.

Keywords: academic engagement, self-efficacy, test anxiety, academic achievement, college math courses, behavioral engagement, cognitive engagement, emotional engagement

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Authors: M. Haruna, O. O. Onafowokan, G. Holt, K. Anderson, R. G. Middleton

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Background: Requirements for satisfactory outcomes following total hip arthroplasty (THA) include restoration of femoral offset, version, and leg length. Various techniques have been described for restoring these biomechanical parameters, with leg length restoration being the most predominantly described. We describe a “quartered head technique” (QHT) which uses a stepwise series of femoral head osteotomies to identify and preserve the centre of rotation of the femoral head during THA in order to ensure reconstruction of leg length, offset and stem version, such that hip biomechanics are restored as near to normal as possible. This study aims to identify whether using the QHT during hip arthroplasty effectively restores leg length and femoral offset to within acceptable parameters. Methods: A retrospective review of 206 hips was carried out, leaving 124 hips in the final analysis. Power analysis indicated a minimum of 37 patients required. All operations were performed using an anterolateral approach by a single surgeon. All femoral implants were cemented, collarless, polished double taper CPT® stems (Zimmer, Swindon, UK). Both cemented, and uncemented acetabular components were used (Zimmer, Swindon, UK). Leg length, version, and offset were assessed intra-operatively and reproduced using the QHT. Post-operative leg length and femoral offset were determined and compared with the contralateral native hip, and the difference was then calculated. For the determination of leg length discrepancy (LLD), we used the method described by Williamson & Reckling, which has been shown to be reproducible with a measurement error of ±1mm. As a reference, the inferior margin of the acetabular teardrop and the most prominent point of the lesser trochanter were used. A discrepancy of less than 6mm LLD was chosen as acceptable. All peri-operative radiographs were assessed by two independent observers. Results: The mean absolute post-operative difference in leg length from the contralateral leg was +3.58mm. 84% of patients (104/124) had LLD within ±6mm of the contralateral limb. The mean absolute post-operative difference in offset from contralateral leg was +3.88mm (range -15 to +9mm, median 3mm). 90% of patients (112/124) were within ±6mm offset of the contralateral limb. There was no statistical difference noted between observer measurements. Conclusion: The QHT provides a simple, inexpensive yet effective method of maintaining femoral leg length and offset during total hip arthroplasty. Combining this technique with pre-operative templating or other techniques described may enable surgeons to reduce even further the discrepancies between pre-operative state and post-operative outcome.

Keywords: leg length discrepancy, technical tip, total hip arthroplasty, operative technique

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Authors: Gurjeet Khurana, Surender Singh, Poonam Arora, Praveendra K. Sachan

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Introduction: Post-operative quality of recovery is the key outcome in the perspective of anesthesiologist. It is directly related to patient satisfaction. This is unsurprising, considering most aspects of a poor quality recovery after surgery will impair satisfaction with care. This study was thus undertaken to evaluate effects of Dexamethasone and Lignocaine on Quality of Recovery using QoR- 40 questionnaire and compare their effects. Material and methods: After obtaining the ethical committee approval and written informed consent, 67 patients of 18-60 years, ASA grade I and II scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. Group I of 34 patients received 2mg/kg lignocaine diluted to 10ml with normal saline. Group 2 of 33 patients received 0.1 mg/kg I/V Dexamethasone diluted to 10ml with normal saline. QoR-40 was assessed on pre-operative day, and again QoR-40 was assessed at 24 hr post-operative day-1. Postoperative pain scores, nausea and vomiting and shoulder pain were secondary outcomes. Results: The Global QoR-40 was more than 180 at 24 hr in both the groups. The Dexamethasone group had higher Global QoR-40 than lignocaine group 187.94 v/s 182.85. Amongst dimensions of QoR-40 Dexamethasone had statistically better physical comfort, physical independence, and pain relief as compared to Lignocaine. Positive items had excellent responses in Dexamethasone group. Headache, backache and sore throat were also less severe in Dexamethasone group as compared to Lignocaine group. Dexamethasone group had lower VAS compared to lignocaine group. Similarly, there was less fentanyl consumption in dexamethasone group (364.08 ± 127.31) in postoperative period when compared to the lignocaine group (412.31 ± 147.8). Group receiving dexamethasone had 36% increase in appetite compared to lignocaine group (17.6%), which facilitated early oral feeding. Frequency of PONV was less in group-2 at different time interval as compared to group 1. Total episode of PONV were 18 in group 1 and 7 in group 2. Statistically significant difference was seen among two groups (p value= 0.007). Use of antiemetic was more in group 1 as compared to group 2 at all the times, though it was not statistically significant at different time intervals. Antiemetics were administered to 18 patients in group 1 as compared to 5 patients in group 2 postoperatively. Statistically significant difference (p value= 0.011) was seen in total antiemetic consumption. Conclusion: Our study demonstrated that pre-operative administration of a single dose of dexamethasone enhanced the quality of recovery after laparoscopic cholecystectomy as compared to Lignocaine bolus dose.

Keywords: dexamethasone, lignocaine, QoR-40 questionnaire, quality of recovery

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Authors: Zhou Congling

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The integration of private tutoring has emerged as an indispensable facet in the acquisition of language proficiency beyond formal educational settings. Notably, there has been a discernible surge in the demand for private English tutoring, specifically geared towards the preparation for internationally recognized gatekeeping examinations, such as IELTS, TOEFL, GMAT, and GRE. This trajectory has engendered an escalating need for English Language Teaching Assistants (ELTAs) operating within the realm of Private Tutoring Schools (PTSs). The objective of this study is to unravel the intricate process by which these ELTAs formulate their professional identities in the nascent stages of their careers as English educators, as well as to delineate their perceptions regarding their professional trajectories. The construct of language teacher identity is inherently multifaceted, shaped by an amalgamation of individual, societal, and cultural determinants, exerting a profound influence on how language educators navigate their professional responsibilities. This investigation seeks to scrutinize the experiential and influential factors that mold the identities of ELTAs in PTSs, particularly post the culmination of their language-oriented academic programs. Employing a qualitative narrative inquiry approach, this study aims to delve into the nuanced understanding of how ELTAs conceptualize their professional identities and envision their future roles. The research methodology involves purposeful sampling and the conduct of in-depth, semi-structured interviews with ten participants. Data analysis will be conducted utilizing Barkhuizen’s Short Story Analysis, a method designed to explore a three-dimensional narrative space, elucidating the intricate interplay of personal experiences and societal contexts in shaping the identities of ELTAs. The anticipated outcomes of this study are poised to contribute substantively to a holistic comprehension of ELTA identity formation, holding practical implications for diverse stakeholders within the private tutoring sector. This research endeavors to furnish insights into strategies for the retention of ELTAs and the enhancement of overall service quality within PTSs.

Keywords: China, English language teacher, narrative inquiry, private tutoring school, teacher identity

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Authors: S. Yeo, M. Mathur

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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.

Keywords: pregnancy, obesity, caesarean, infection

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Authors: Marta Blavia

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Magiciens de la terre, organized in 1989 by the Centre Pompidou, became 'the first worldwide exhibition of contemporary art' by presenting artists from Western and non-Western countries, including three Chinese artists. For the first time, West turned its eyes to other countries not as exotic sources of inspiration, but as places where contemporary art was also being created. One year later, Chine: demain pour hier was inaugurated as the first Chinese avant-garde group-exhibition in Occident. Among the artists included was Cai Guo-Qiang who, like many other Chinese artists, had left his home country in the eighties in pursuit of greater creative freedom. By exploring artistic non-Western perspectives, both landmark exhibitions questioned the predominance of the Eurocentric vision in the construction of history art. But more than anything else, these exhibitions laid the groundwork for the rise of the so-called phenomenon 'global contemporary art'. All the same time, 1989 also was a turning point in Chinese art history. Because of the Tiananmen student protests, The Chinese government undertook a series of measures to cut down any kind of avant-garde artistic activity after a decade of a relative openness. During the eighties, and especially after the Tiananmen crackdown, some important artists began to leave China to move overseas such as Xu Bing and Ai Weiwei (USA); Chen Zhen and Huang Yong Ping (France); or Cai Guo-Qiang (Japan). After emigrating abroad, Chinese overseas artists began to develop projects in accordance with their new environments and audiences as well as to appear in numerous international exhibitions. With their creations, that moved freely between a variety of Eastern and Western art sources, these artists were crucial agents in the emergence of global contemporary art. As other Chinese artists overseas, Cai Guo-Qiang’s career took off during the 1990s and early 2000s right at the same moment in which Western art world started to look beyond itself. Little by little, he developed a very personal artistic language that redefines Chinese ideas, symbols, and traditional materials in a new world order marked by globalization. Cai Guo-Qiang participated in many of the exhibitions that contributed to shape global contemporary art: Encountering the Others (1992); the 45th Venice Biennale (1993); Inside Out: New Chinese Art (1997), or the 48th Venice Biennale (1999), where he recreated the Chinese monumental social realist work Rent Collection Courtyard that earned him the Golden Lion Award. By examining the different stages of Cai Guo-Qiang’s artistic path as well as the transnational dimensions of his creations, this paper aims at offering a comprehensive survey on the construction of the discourse of global contemporary art.

Keywords: Cai Guo-Qiang, Chinese artists overseas, emergence global art, transnational art

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Authors: Jutta Ransmayr

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The digital age has long arrived at Austrian schools, so both society and educationalists demand that digital means should be integrated accordingly to day-to-day school routines. Therefore, the Austrian school-leaving exam (A-levels) can now be written either by hand or by using a computer. However, the choice of writing medium (pen and paper or computer) for written examination papers, which are considered 'high-stakes' exams, raises a number of questions that have not yet been adequately investigated and answered until recently, such as: What effects do the different conditions of text production in the written German A-levels have on the component of normative linguistic accuracy? How do the spelling skills of German A-level papers written with a pen differ from those that the students wrote on the computer? And how is the teacher's assessment related to this? Which practical desiderata for German didactics can be derived from this? In a trilateral pilot project of the Austrian Center for Digital Humanities (ACDH) of the Austrian Academy of Sciences and the University of Vienna in cooperation with the Austrian Ministry of Education and the Council for German Orthography, these questions were investigated. A representative Austrian learner corpus, consisting of around 530 German A-level papers from all over Austria (pen and computer written), was set up in order to subject it to a quantitative (corpus-linguistic and statistical) and qualitative investigation with regard to the spelling and punctuation performance of the high school graduates and the differences between pen- and computer-written papers and their assessments. Relevant studies are currently available mainly from the Anglophone world. These have shown that writing on the computer increases the motivation to write, has positive effects on the length of the text, and, in some cases, also on the quality of the text. Depending on the writing situation and other technical aids, better results in terms of spelling and punctuation could also be found in the computer-written texts as compared to the handwritten ones. Studies also point towards a tendency among teachers to rate handwritten texts better than computer-written texts. In this paper, the first comparable results from the German-speaking area are to be presented. Research results have shown that, on the one hand, there are significant differences between handwritten and computer-written work with regard to performance in orthography and punctuation. On the other hand, the corpus linguistic investigation and the subsequent statistical analysis made it clear that not only the teachers' assessments of the students’ spelling performance vary enormously but also the overall assessments of the exam papers – the factor of the production medium (pen and paper or computer) also seems to play a decisive role.

Keywords: exam paper assessment, pen and paper or computer, learner corpora, linguistics

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