Search results for: clinical education
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10437

Search results for: clinical education

5307 Prevalence, Median Time, and Associated Factors with the Likelihood of Initial Antidepressant Change: A Cross-Sectional Study

Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

Abstract:

Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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5306 A Study on the HTML5 Based Multi Media Contents Authority Tool

Authors: Heesuk Seo, Yongtae Kim

Abstract:

Online learning started in the 1990s, the spread of the Internet has been through the era of e-learning paradigm of online education in the era of smart learning change. Reflecting the different nature of the mobile to anywhere anytime, anywhere was also allows the form of learning, it was also available through the learning content and interaction. We are developing a cloud system, 'TLINKS CLOUD' that allows you to configure the environment of the smart learning without the need for additional infrastructure. Using the big-data analysis for e-learning contents, we provide an integrated solution for e-learning tailored to individual study.

Keywords: authority tool, big data analysis, e-learning, HTML5

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5305 Digital Revolution a Veritable Infrastructure for Technological Development

Authors: Osakwe Jude Odiakaosa

Abstract:

Today’s digital society is characterized by e-education or e-learning, e-commerce, and so on. All these have been propelled by digital revolution. Digital technology such as computer technology, Global Positioning System (GPS) and Geographic Information System (GIS) has been having a tremendous impact on the field of technology. This development has positively affected the scope, methods, speed of data acquisition, data management and the rate of delivery of the results (map and other map products) of data processing. This paper tries to address the impact of revolution brought by digital technology.

Keywords: digital revolution, internet, technology, data management

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5304 Use of Structural Family Therapy and Dialectical Behavior Therapy with High-Conflict Couples

Authors: Eman Tadros, Natasha Finney

Abstract:

The following case study involving a high-conflict, Children’s Services Bureau (CSB) referred couple is analyzed and reviewed through an integrated lens of structural family therapy and dialectical behavior therapy. In structural family therapy, normal family development is not characterized by a lack of problems, but instead by families’ having developed a functional structure for dealing with their problems. Whereas, in dialectical behavioral therapy normal family development can be characterized by having a supportive and validating environment, where all family members feel a sense of acceptance and validation for who they are and where they are in life. The clinical case conceptualization highlights the importance of conceptualizing how change occurs within a therapeutic setting. In the current case study, the couple did not only experience high-conflict, but there were also issues of substance use, health issues, and other complicating factors. Clinicians should view their clients holistically and tailor their treatment to fit their unique needs. In this framework, change occurs within the family unit, by accepting each member as they are, while at the same time working together to change maladaptive familial structures.

Keywords: couples, dialectical behavior therapy, high-conflict, structural family therapy

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5303 Distributive School Leadership in Croatian Primary Schools

Authors: Iva Buchberger, Vesna Kovač

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Global education policy trends and recommendations underline the importance of (distributive) school leadership as a school effectiveness key factor. In this context, the broader aim of this research (supported by the Croatian Science Foundation) is to identify school leadership characteristics in Croatian schools and to examine the correlation between school leadership and school effectiveness. The aim of the proposed conference paper is to focus on the school leadership characteristics which are additionally explained with school leadership facilitators that contribute to (distributive) school leadership development. The aforementioned school leadership characteristics include the following dimensions: (a) participation in the process of making different types of decisions, (b) influence in the decision making process, (c) social interactions between different stakeholders in the decision making process in schools. Further, the school leadership facilitators are categorized as follows: (a) principal’s activities (such as providing support to different stakeholders and developing mutual trust among them), (b) stakeholders’ characteristics (such as developed stakeholders’ interest and competence to participate in decision-making process), (c) organizational and material resources (such as school material conditions, the necessary information and time as resources for making decisions). The data were collected by a constructed and validated questionnaire for examining the school leadership characteristics and facilitators from teachers’ perspective. The main population in this study consists of all primary schools in Croatia while the sample is comprised of 100 primary schools, selected by random sampling. Furthermore, the sample of teachers was selected by an additional procedure taking into consideration the independent variables of sex, work experience, etc. Data processing was performed by standard statistical methods of descriptive and inferential statistics. Statistical program IBM SPSS 20.0 was used for data processing. The results of this study show that there is a (positive) correlation between school leadership characteristics and school leadership facilitators. Specifically, it is noteworthy to mention that all the dimensions of school leadership characteristics are in positive correlation with the categories of school leadership facilitators. These results are indicative for the education policy creators who should ensure positive and supportive environment for the school leadership development including the development of school leadership characteristics and school leadership facilitators.

Keywords: distributive school leadership, school effectiveness , school leadership characteristics, school leadership facilitators

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5302 Global Health Student Selected Components in Undergraduate Medical Education: Analysis of Student Feedback and Reflective Writings

Authors: Harriet Bothwell, Lowri Evans, Kevin Jones

Abstract:

Background: The University of Bristol provides all medical students the opportunity to undertake student selected components (SSCs) at multiple stages of the undergraduate programme. SSCs enable students to explore areas of interest that are not necessarily covered by the curriculum. Students are required to produce a written report and most use SSCs as an opportunity to undertake an audit or small research project. In 2013 Swindon Academy, based at the Great Western Hospital, offered eight students the opportunity of a global health SSC which included a two week trip to rural hospital in Uganda. This SSC has since expanded and in 2017 a total of 20 students had the opportunity to undertake small research projects at two hospitals in rural Uganda. 'Tomorrows Doctors' highlights the importance of understanding healthcare from a 'global perspective' and student feedback from previous SSCs suggests that self-assessed knowledge of global health increases as a result of this SSC. Through the most recent version of this SSC students had the opportunity to undertake projects in a wide range of specialties including paediatrics, palliative care, surgery and medical education. Methods: An anonymous online questionnaire was made available to students following the SSC. There was a response rate of 80% representing 16 out of the 20 students. This questionnaire surveyed students’ satisfaction and experience of the SSC including the level of academic, project and spiritual support provided as well as perceived challenges in completing the project and barriers to healthcare delivery in the low resource setting. This survey had multiple open questions allowing the collection of qualitative data. Further qualitative data was collected from the students’ project report. The suggested format included a reflection and all students completed these. All qualitative data underwent thematic analysis. Results: All respondents rated the overall experience of the SSC as 'good' or 'excellent'. Preliminary data suggest that students’ confidence in their knowledge of global health, diagnosis of tropical diseases and management of tropical diseases improved after completing this SSC. Thematic analysis of students' reflection is ongoing but suggests that students gain far more than improved knowledge of tropical diseases. Students reflect positively on having the opportunity to research in a low resource setting and feel that by completing these projects they will be 'useful' to the hospital. Several students reflect the stark contrast to healthcare delivery in the UK and recognise the 'privilege' of having a healthcare system that is free at the point of access. Some students noted the different approaches that clinicians in Uganda had to train in 'taking ownership' of their own learning. Conclusions: Students completing this SSC report increased knowledge of global health and tropical medicine. However, their reflections reveal much broader learning outcomes and demonstrate considerable insight in multiple topics including conducting research in the low resource setting, training and healthcare inequality.

Keywords: global health, medical education, student feedback, undergraduate

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5301 Obstructive Bronchitis and Pneumonia by a Mixed Infection of HPIV- 3, S. pneumoniae in an Immunocompromised 10M Infant: Case Report

Authors: Olga Smilevska Spasova, Katerina Boshkovska, Gorica Popova, Mirjana Popovska

Abstract:

Introduction: Pneumonia is an infection of the pulmonary parenchyma. HPIV 3 is one of four viruses that is a member of the Paramyxoviridae family designated types 1-4 that have a nonsegmented, single-stranded RNA genome with a lipid-containing envelope. They are spread from the respiratory tract by aerosolized secretions or by direct contact with secretions. Type 3 is endemic and can cause serious illness in immunocompromised patients. Illness caused by parainfluenza occurs shortly after inoculation with the virus. The level of immunoglobulin A antibody in serum is the best predictor of susceptibility to infection. Streptococcus pneumonia or pneumococcus is a Gram-positive, spherical bacteria, usually found in pairs and it is a member of the genus Streptococcus. Streptococcus pneumonia resides asymptomatically in healthy carriers typically colonizing the respiratory tract, sinuses, and nasal cavity. In individuals with weaker immune systems like young infants, pneumococcal bacterium is the most common cause of community-acquired pneumonia in the world. Case Report: The aim is to present a case of lower respiratory tract infection in an infant caused by parainfluenza virus 3, S. pneumonia and undifferentiated gram-negative bacteria that was successfully treated. The infant is with a history of recurrent episodes of wheezing in the past 3mounts.Infant of 10months presents 2weeks before admittance with high fever, runny nose, and cough. The primary pediatrician prescribed oral cefpodoxime for 10days and inhaled salbutamol. Two days before admittance in hospital the infant with high fever, cough, and difficulty breathing. At admittance, infant is pale, anxious with rapid respirations, cough, wheezing and tachycardia. On auscultation: vesicular breathing sounds with high pitched wheezing and on the right coarse crackles. Investigations: Blood analysis: RBC: 4, 7 x1012L, WBC: 8,3x109L: Neut: 42.73% Lym: 41.57%, Hgb: 9.38 g/dl MCV: 62.7fl, MCH: 20.0pg MCHC: 31.8 g/dl RDW: 18.7% Plt-307.9 x109LCRP: 2,5mg/l, serum iron-7.92umol/l, O2sat-97% on blood gas analysis, puls-125/min.X-ray of chest with hyperinflationand right pericardial consolidation. Microbiological analysis of sputum sample is positive for undifferentiated gram-negative bacteria (colonizer)–resistant to cefotaxime, ampicillin, cefoxitin, sulfamet.+trimetoprim and sensitive to amikacin, gentamicin, and ciprofloxacin. Molecular multiplex RT-PCR for 19 viruses and multiplex PCR for 7 bacteria test for respiratory pathogens positive for Parainfluenza virus 3(Ct=22.73), Streptococcus pneumonia (Ct=26.75).IED: IgG-9.31g/l, IgA-0.351g/l, IgM-0.86g/l. Therapy: Treatment was started with inhaled salbutamol, intravenous antibiotic cefotaxime as well as systemic corticosteroids. On day 7 because of slow clinical resolution of chest auscultation findings and an etiologic clue with a positive sputum sample for resistant undifferentiated gram negative bacteria, a second intravenous antibiotic was administered amikacin. The infant is discharged on day 14 with resolution of clinical findings. Conclusion: Mixed co-infections with respiratory viruses and bacteria in immunocompromised infants are likely to lead to a more severe form of community acquired pneumonia that will need hospitalization.

Keywords: HPIV- 3, infant, pneumonia, S. pneumonia, x-ray chest

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5300 Bone Fracture Detection with X-Ray Images Using Mobilenet V3 Architecture

Authors: Ashlesha Khanapure, Harsh Kashyap, Abhinav Anand, Sanjana Habib, Anupama Bidargaddi

Abstract:

Technologies that are developing quickly are being developed daily in a variety of disciplines, particularly the medical field. For the purpose of detecting bone fractures in X-ray pictures of different body segments, our work compares the ResNet-50 and MobileNetV3 architectures. It evaluates accuracy and computing efficiency with X-rays of the elbow, hand, and shoulder from the MURA dataset. Through training and validation, the models are evaluated on normal and fractured images. While ResNet-50 showcases superior accuracy in fracture identification, MobileNetV3 showcases superior speed and resource optimization. Despite ResNet-50’s accuracy, MobileNetV3’s swifter inference makes it a viable choice for real-time clinical applications, emphasizing the importance of balancing computational efficiency and accuracy in medical imaging. We created a graphical user interface (GUI) for MobileNet V3 model bone fracture detection. This research underscores MobileNetV3’s potential to streamline bone fracture diagnoses, potentially revolutionizing orthopedic medical procedures and enhancing patient care.

Keywords: CNN, MobileNet V3, ResNet-50, healthcare, MURA, X-ray, fracture detection

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5299 The Analysis of Brain Response to Auditory Stimuli through EEG Signals’ Non-Linear Analysis

Authors: H. Namazi, H. T. N. Kuan

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Brain activity can be measured by acquiring and analyzing EEG signals from an individual. In fact, the human brain response to external and internal stimuli is mapped in his EEG signals. During years some methods such as Fourier transform, wavelet transform, empirical mode decomposition, etc. have been used to analyze the EEG signals in order to find the effect of stimuli, especially external stimuli. But each of these methods has some weak points in analysis of EEG signals. For instance, Fourier transform and wavelet transform methods are linear signal analysis methods which are not good to be used for analysis of EEG signals as nonlinear signals. In this research we analyze the brain response to auditory stimuli by extracting information in the form of various measures from EEG signals using a software developed by our research group. The used measures are Jeffrey’s measure, Fractal dimension and Hurst exponent. The results of these analyses are useful not only for fundamental understanding of brain response to auditory stimuli but provide us with very good recommendations for clinical purposes.

Keywords: auditory stimuli, brain response, EEG signal, fractal dimension, hurst exponent, Jeffrey’s measure

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5298 Assessing the Self-Directed Learning Skills of the Undergraduate Nursing Students in a Medical University in Bahrain: A Quantitative Study

Authors: Catherine Mary Abou-Zaid

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This quantitative study discusses the concerns with the self-directed learning (SDL) skills of the undergraduate nursing students in a medical university in Bahrain. The nursing undergraduate student SDL study was conducted taking all 4 years and compiling data collected from the students themselves by survey questionnaire. The aim of the study is to understand and change the attitudes of self-directed learning among the undergraduate students. The SDL of the undergraduate student nurses has been noticed to be lacking and motivation to actually perform without supervision while out-with classrooms are very low. Their use of the resources available on the virtual learning environment and also within the university is not as good as it should be for a university student at this level. They do not use them to their own advantage. They are not prepared for the transition from high school to an academic environment such as a university or college. For some students it is the first time in their academic lives that they have faced sharing a classroom with the opposite sex. For some this is a major issue and we as academics need to be aware of all issues that they come to higher education with. Design Methodology: The design methodology that was chosen was a quantitative design using convenience sampling of the students who would be asked to complete survey questionnaire. This sampling method was chosen because of the time constraint. This was completed by the undergraduate students themselves while in class. The questionnaire was analyzed by the statistical package for social sciences (SPSS), the results interpreted by the researcher and the findings published in the paper. The analyzed data will also be reported on and from this information we as educators will be able to see the student’s weaknesses regarding self-directed learning. The aims and objectives of the research will be used as recommendations for the improvement of resources for the students to improve their SDL skills. Conclusion: The results will be able to give the educators an insight to how we can change the self-directed learning techniques of the students and enable them to embrace the skills and to focus more on being self-directed in their studies rather than having to be put on to a SDL pathway from the educators themselves. This evidence will come from the analysis of the statistical data. It may even change the way in which the students are selected for the nursing programme. These recommendations will be reported to the head of school and also to the nursing faculty.

Keywords: self-directed learning, undergraduate students, transition, statistical package for social sciences (SPSS), higher education

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5297 The Effect of Cross-Curriculum of L1 and L2 on Elementary School Students’ Linguistic Proficiency: To Sympathize with Others

Authors: Reiko Yamamoto

Abstract:

This paper reports on a project to integrate Japanese (as a first language) and English (as a second language) education. This study focuses on the mutual effects of the two languages on the linguistic proficiency of elementary school students. The research team consisted of elementary school teachers and researchers at a university. The participants of the experiment were students between 3rd and 6th grades at an elementary school. The research process consisted of seven steps: 1) specifying linguistic proficiency; 2) developing the cross-curriculum of L1 and L2; 3) forming can-do statements; 4) creating a self-evaluation questionnaire; 5) executing the self-evaluation questionnaire at the beginning of the school year; 6) instructing L1 and L2 based on the curriculum; and 7) executing the self-evaluation questionnaire at the beginning of the next school year. In Step 1, the members of the research team brainstormed ways to specify elementary school students’ linguistic proficiency that can be observed in various scenes. It was revealed that the teachers evaluate their students’ linguistic proficiency on the basis of the students’ utterances, but also informed by their non-verbal communication abilities. This led to the idea that competency for understanding others’ minds through the use of physical movement or bodily senses in communication in L1 – to sympathize with others – can be transferred to that same competency in communication in L2. Based on the specification of linguistic proficiency that L1 and L2 have in common, a cross-curriculum of L1 and L2 was developed in Step 2. In Step 3, can-do statements based on the curriculum were also formed, building off of the action-oriented approach from the Common European Framework of Reference for Languages (CEFR) used in Europe. A self-evaluation questionnaire consisting of the main can-do statements was given to the students between 3rd grade and 6th grade at the beginning of the school year (Step 4 and Step 5), and all teachers gave L1 and L2 instruction based on the curriculum to the students for one year (Step 6). The same questionnaire was given to the students at the beginning of the next school year (Step 7). The results of statistical analysis proved the enhancement of the students’ linguistic proficiency. This verified the validity of developing the cross-curriculum of L1 and L2 and adapting it in elementary school. It was concluded that elementary school students do not distinguish between L1 and L2, and that they just try to understand others’ minds through physical movement or senses in any language.

Keywords: cross curriculum of L1 and L2, elementary school education, language proficiency, sympathy with others

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5296 Proposal for a Mobile Application with Augmented Reality to Improve School Interest

Authors: Mamani Acurio Alex, Aguilar Alonso Igor

Abstract:

The lack of interest and the lack of motivation are related. The lack of both in school generates serious problems such as school dropout or a low level of learning. Augmented reality has been very useful in different areas, and in this research, it was implemented in the area of education. Information necessary for the correct development of this mobile application with augmented reality was searched using six different research repositories. It was concluded that the application must be immersive, attractive, and fun for students, and the necessary technologies for its construction were defined.

Keywords: augmented reality, Vuforia, school interest, learning

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5295 Variation in Maternal Mortality in Sidama National Regional State, Southern Ethiopia: A Population Based Cross Sectional Household Survey

Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

Abstract:

Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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5294 Examining French Teachers’ Teaching and Learning Approaches in Some Selected Junior High Schools in Ghana

Authors: Paul Koffitse Agobia

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In 2020 the Ministry of Education in Ghana and the National Council for Curriculum and Assessment (NaCCA) rolled out a new curriculum, Common Core Programme (CCP) for Basic 7 to 10, that lays emphasis on character building and values which are important to the Ghanaian society by providing education that will produce character–minded learners, with problem solving skills, who can play active roles in dealing with the increasing challenges facing Ghana and the global society. Therefore, learning and teaching approaches that prioritise the use of digital learning resources and active learning are recommended. The new challenge facing Ghanaian teachers is the ability to use new technologies together with the appropriate content pedagogical knowledge to help learners develop, aside the communication skills in French, the essential 21st century skills as recommended in the new curriculum. This article focusses on the pedagogical approaches that are recommended by NaCCA. The study seeks to examine French language teachers’ understanding of the recommended pedagogical approaches and how they use digital learning resources in class to foster the development of these essential skills and values. 54 respondents, comprised 30 teachers and 24 head teachers, were selected in 6 Junior High schools in rural districts (both private and public) and 6 from Junior High schools in an urban setting. The schools were selected in three regions: Volta, Central and Western regions. A class observation checklist and an interview guide were used to collect data for the study. The study reveals that some teachers adopt teaching techniques that do not promote active learning. They demonstrate little understanding of the core competences and values, therefore, fail to integrate them in their lessons. However, some other teachers, despite their lack of understanding of learning and teaching philosophies, adopted techniques that can help learners develop some of the core competences and values. In most schools, digital learning resources are not utilized, though teachers have smartphones or laptops.

Keywords: active learning, core competences, digital learning resources, pedagogical approach, values.

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5293 A Greedy Alignment Algorithm Supporting Medication Reconciliation

Authors: David Tresner-Kirsch

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Reconciling patient medication lists from multiple sources is a critical task supporting the safe delivery of patient care. Manual reconciliation is a time-consuming and error-prone process, and recently attempts have been made to develop efficiency- and safety-oriented automated support for professionals performing the task. An important capability of any such support system is automated alignment – finding which medications from a list correspond to which medications from a different source, regardless of misspellings, naming differences (e.g. brand name vs. generic), or changes in treatment (e.g. switching a patient from one antidepressant class to another). This work describes a new algorithmic solution to this alignment task, using a greedy matching approach based on string similarity, edit distances, concept extraction and normalization, and synonym search derived from the RxNorm nomenclature. The accuracy of this algorithm was evaluated against a gold-standard corpus of 681 medication records; this evaluation found that the algorithm predicted alignments with 99% precision and 91% recall. This performance is sufficient to support decision support applications for medication reconciliation.

Keywords: clinical decision support, medication reconciliation, natural language processing, RxNorm

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5292 Auricular Electroacupuncture Rescued Epilepsy Seizure by Attenuating TLR-2 Inflammatory Pathway in the Kainic Acid-Induced Rats

Authors: I-Han Hsiao, Chun-Ping Huang, Ching-Liang Hsieh, Yi-Wen Lin

Abstract:

Epilepsy is chronic brain disorder that results in the sporadic occurrence of spontaneous seizures in the temporal lobe, cerebral cortex, and hippocampus. Clinical antiepileptic medicines are often ineffective or little benefits in the small amount of patients and usually initiate severe side effects. This inflammation contributes to enhanced neuronal excitability and the onset of epilepsy. Auricular electric-stimulation (AES) can increase parasympathetic activity and stimulate the solitary tract nucleus to induce the cholinergic anti-inflammatory pathway. Furthermore, it may be a therapeutic strategy for the treatment of epilepsy. In the present study, we want to investigate the effects of AES on inflammatory mediators in kainic acid (KA)-induced epileptic seizure rats. Experimental KA injection increased expression of TLR-2 pathway associated inflammatory mediators, were further reduced by either 2Hz or 15 Hz AES in the prefrontal cortex, hippocampus, and somatosensory cortex. We suggest that AES can successfully control the epileptic seizure by down-regulation of inflammation signaling pathway.

Keywords: auricular electric-stimulation, epileptic seizures, anti-inflammation

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5291 A Contactless Capacitive Biosensor for Muscle Activity Measurement

Authors: Charn Loong Ng, Mamun Bin Ibne Reaz

Abstract:

As elderly population grows globally, the percentage of people diagnosed with musculoskeletal disorder (MSD) increase proportionally. Electromyography (EMG) is an important biosignal that contributes to MSD’s clinical diagnose and recovery process. Conventional conductive electrode has many disadvantages in the continuous EMG measurement application. This research has design a new surface EMG biosensor based on the parallel-plate capacitive coupling principle. The biosensor is developed by using a double-sided PCB with having one side of the PCB use to construct high input impedance circuitry while the other side of the copper (CU) plate function as biosignal sensing metal plate. The metal plate is insulated using kapton tape for contactless application. The result implicates that capacitive biosensor is capable to constantly capture EMG signal without having galvanic contact to human skin surface. However, there are noticeable noise couple into the measured signal. Post signal processing is needed in order to present a clean and significant EMG signal. A complete design of single ended, non-contact, high input impedance, front end EMG biosensor is presented in this paper.

Keywords: contactless, capacitive, biosensor, electromyography

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5290 Investigating University Students' Attitudes towards Infertility in Terms of Socio-Demographic Variables

Authors: Yelda Kağnıcı, Seçil Seymenler, Bahar Baran, Erol Esen, Barışcan Öztürk, Ender Siyez, Diğdem M. Siyez

Abstract:

Infertility is the inability to reproduce after twelve months or longer unprotected sexual relationship. Although infertility is not a life threatening illness, it is considered as a serious problem for both the individual and the society. At this point, the importance of examining attitudes towards infertility is critical. Negative attitudes towards infertility may postpone individuals’ help seeking behaviors. The aim of this study is to investigate university students’ attitudes towards infertility in terms of socio-demographic variables (gender, age, taking sexual health education, existence of an infertile individual in the social network, plans about having child and behaviors about health). The sample of the study was 9693 university students attending to 21 universities in Turkey. Of the 9693 students, % 51.6 (n = 5002) were female, % 48.4 (n = 4691) were male. The data was collected by Attitudes toward Infertility Scale developed by researchers and Personal Information Form. In data analysis first frequencies were calculated, then in order to test whether there were significant differences in attitudes towards infertility scores of university students in terms of socio-demographic variables, one way ANOVA was conducted. According to the results, it was found that female students, students who had sexual health education, who have sexual relationship experience, who have an infertile individual in their social networks, who have child plans, who have high caffeine usage and who use alcohol regularly have more positive attitudes towards infertility. On the other hand, attitudes towards infidelity did not show significant differences in terms of age and cigarette usage. When the results of the study were evaluated in general, it was seen that university students’ attitudes towards infertility were negative. The attitudes of students who have high caffeine and alcohols usage were high. It can be considered that these students are aware that their social habits are risky. Female students’ positive attitudes might be explained by their gender role. The results point out that in order to decrease university students’ negative attitudes towards infertility, there is a necessity to develop preventive programs in universities.

Keywords: infertility, attitudes, sex, university students

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5289 Teaching the Temperature Dependence of Electrical Resistance of Materials through Arduino Investigation

Authors: Vinit Srivastava, Abhay Singh Thakur, Shivam Dubey, Rahul Vaish, Bharat Singh Rajpurohit

Abstract:

This study examines the problem of students' poor comprehension of the thermal dependence of resistance by investigating this idea using an evidence-based inquiry approach. It suggests a practical exercise to improve secondary school students' comprehension of how materials' resistance to temperature changes. The suggested exercise uses an Arduino and Peltier device to test the resistance of aluminum and graphite at various temperatures. The study attempts to close the knowledge gap between the theoretical and practical facets of the subject, which students frequently find difficult to grasp. With the help of a variety of resistors made of various materials and pencils of varying grades, the Arduino experiment investigates the resistance of a metallic conductor (aluminum) and a semiconductor (graphite) at various temperatures. The purpose of the research is to clarify for students the relationship between temperature and resistance and to emphasize the importance of resistor material choice and measurement methods in obtaining precise and stable resistance values over dynamic temperature variations. The findings show that while the resistance of graphite decreases with temperature, the resistance of metallic conductors rises with temperature. The results also show that as softer lead pencils or pencils of a lower quality are used, the resistance values of the resistors drop. In addition, resistors showed greater stability at lower temperatures when their temperature coefficients of resistance (TCR) were smaller. Overall, the results of this article show that the suggested experiment is a useful and practical method for teaching students about resistance's relationship to temperature. It emphasizes how crucial it is to take into account the resistor material selection and the resistance measurement technique when designing and picking out resistors for various uses. The results of the study are anticipated to guide the creation of more efficient teaching methods to close the gap between science education's theoretical and practical components.

Keywords: electrical resistance, temperature dependence, science education, inquiry-based activity, resistor stability

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5288 Grading Histopathology Features of Graft-Versus-Host Disease in Animal Models; A Systematic Review

Authors: Hami Ashraf, Farid Kosari

Abstract:

Graft-versus-host disease (GvHD) is a common complication of allogeneic hematopoietic stem cell transplantation that can lead to significant morbidity and mortality. Histopathological examination of affected tissues is an essential tool for diagnosing and grading GvHD in animal models, which are used to study disease mechanisms and evaluate new therapies. In this systematic review, we identified and analyzed original research articles in PubMed, Scopus, Web of Science, and Google Scholar that described grading systems for GvHD in animal models based on histopathological features. We found that several grading systems have been developed, which vary in the tissues and criteria they assess, the severity scoring scales they use, and the level of detail they provide. Skin, liver, and gut are the most commonly evaluated tissues, but lung and thymus are also included in some systems. Our analysis highlights the need for standardized criteria and consistent use of grading systems to enable comparisons between studies and facilitate the translation of preclinical findings to clinical practice.

Keywords: graft-versus-host disease, GvHD, animal model, histopathology, grading system

Procedia PDF Downloads 61
5287 Literature Review on the Barriers to Access Credit for Small Agricultural Producers and Policies to Mitigate Them in Developing Countries

Authors: Margarita Gáfaro, Karelys Guzmán, Paola Poveda

Abstract:

This paper establishes the theoretical aspects that explain the barriers to accessing credit for small agricultural producers in developing countries and identifies successful policy experiences to mitigate them. We will test two hypotheses. The first one is that information asymmetries, high transaction costs and high-risk exposure limit the supply of credit to small agricultural producers in developing countries. The second hypothesis is that low levels of financial education and productivity and high uncertainty about the returns of agricultural activity limit the demand for credit. To test these hypotheses, a review of the theoretical and empirical literature on access to rural credit in developing countries will be carried out. The first part of this review focuses on theoretical models that incorporate information asymmetries in the credit market and analyzes the interaction between these asymmetries and the characteristics of the agricultural sector in developing countries. Some of the characteristics we will focus on are the absence of collateral, the underdevelopment of the judicial systems and insurance markets, and the high dependence on climatic factors of production technologies. The second part of this review focuses on the determinants of credit demand by small agricultural producers, including the profitability of productive projects, security conditions, risk aversion or loss, financial education, and cognitive biases, among others. There are policies that focus on resolving these supply and demand constraints and managing to improve credit access. Therefore, another objective of this paper is to present a review of effective policies that have promoted access to credit for smallholders in the world. For this, information available in policy documents will be collected. This information will be complemented by interviews with officials in charge of the design and execution of these policies in a subset of selected countries. The information collected will be analyzed in light of the conceptual framework proposed in the first two parts of this section. The barriers to access to credit that each policy attempts to resolve and the factors that could explain its effectiveness will be identified.

Keywords: agricultural economics, credit access, smallholder, developing countries

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5286 Higher Education Leadership and Creating Sites of Institutional Belonging: A Global Case Study

Authors: Lisa M. Coleman

Abstract:

The focus on disability, LGBTQ+, and internationalization has certainly been the subject of much research and programmatic across higher education. Many universities have entered into global partnerships with varying success and challenges across the various areas, including laws and policies. Attentiveness to the specific nuances of global inclusion, diversity, equity, belonging, and access (GIDBEA) and the leadership to support these efforts is crucial to the development of longstanding success across the programs. There have been a number of shifts related to diversification across student and alumni bodies. These shifts include but are not limited to how people identify gender, race, and sexuality (and the intersections across such identities), as well as trends across emerging and diverse disability communities. NYU is the most international campus in the United States, with the most campuses and sites outside of its county of origin and the most international students and exchange programs than any other university. As a result, the ongoing work related to GIDEBA is at the center of much of the leadership, administrative, and research efforts. Climate assessment work across NYU’s diverse global campus landscape will serve as the foundation to exemplify best practices related to data collection and dissemination, community and stakeholder engagement, and effective implementation of innovative strategies to close gap areas as identified. The data (quantitative and qualitative) and related research findings represent data collected from close to 22,000 stakeholders across the NYU campuses. The case study centers on specific methodological considerations, data integrity, stakeholder engagement from across student-faculty, staff, and alumni constituencies, and tactics to advance specific GIDBEA initiatives related to navigating shifting landscapes. Design thinking, incubation, and co-creation strategies have been employed to expand, leverage, actualize, and implement GIDBEA strategies that are – concrete, measurable, differentiated, and specific to global sites and regions and emerging trends.

Keywords: disability, LGBTQ+, DEI, research, case studies

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5285 The Impact of Virtual Learning Strategy on Youth Learning Motivation in Malaysian Higher Learning Instituitions

Authors: Hafizah Harun, Habibah Harun, Azlina Kamaruddin

Abstract:

Virtual reality has become a powerful and promising tool in education because of their unique technological characteristics that differentiate them from the other ICT applications. Despite the numerous interpretations of its definition, virtual reality can be concisely and precisely described as the integration of computer graphics and various input and display technologies to create the illusion of immersion in a computer generated reality. Generally, there are two major types based on the level of interaction and immersive environment that are immersive and non-immersive virtual reality. In the study of the role of virtual reality in built environment education, Horne and Thompson were reported as saying that the benefits of using visualization technologies were seen as having the potential to improve and extend the learning process, increase student motivation and awareness, and add to the diversity of teaching methods. Youngblut reported that students enjoy working with virtual worlds and this experience can be highly motivating. The impact of virtual reality on youth learning in Malaysia is currently not well explored because the technology is still not widely used here. Only a handful of the universities, such as University Malaya, MMU, and Unimas are applying virtual reality strategy in some of their undergraduate programs. From the literature, it has been identified that there are several virtual reality learning strategies currently available. Therefore, this study aims to investigate the impact of Virtual Reality strategy on Youth Learning Motivation in Malaysian higher learning institutions. We will explore the relationship between virtual reality (gaming, laboratory, simulation) and youth leaning motivation. Another aspect that we will explore is the framework for virtual reality implementation at higher learning institution in Malaysia. This study will be carried out quantitatively by distributing questionnaires to respondents from sample universities. Data analysis are descriptive and multiple regression. Researcher will carry out a pilot test prior to distributing the questionnaires to 300 undergraduate students who are undergoing their courses in virtual reality environment. The respondents come from two universities, MMU CyberJaya and University Malaya. The expected outcomes from this study are the identification of which virtual reality strategy has most impact on students’ motivation in learning and a proposed framework of virtual reality implementation at higher learning.

Keywords: virtual reality, learning strategy, youth learning, motivation

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5284 A Comparison of Transdiagnostic Components in Generalized Anxiety Disorder, Unipolar Mood Disorder and Nonclinical Population

Authors: Imaneh Abbasi, Ladan Fata, Majid Sadeghi, Sara Banihashemi, Abolfazl Mohammadee

Abstract:

Background: Dimensional and transdiagnostic approaches as a result of high comorbidity among mental disorders have captured researchers and clinicians interests for exploring the latent factors of development and maintenance of some psychological disorders. The goal of present study is to compare some of these common factors between generalized anxiety disorder and unipolar mood disorder. Methods: 27 patients with generalized anxiety disorder, 29 patients with depression disorder were recruited using SCID-I and 69 non-clinical population were selected using GHQ cut off point. MANCOVA was used for analyzing data. Results: The results show that worry, rumination, intolerance of uncertainty, maladaptive metacognitive beliefs, and experiential avoidance were all significantly different between GAD and unipolar mood disorder groups. However, there were not any significant differences in difficulties in emotion regulation and neuroticism between GAD and unipolar mood disorder groups. Discussion: Results indicate that although there are some transdiagnostic and common factors in GAD and unipolar mood disorder, there may be some specific vulnerability factors for each disorder. Further study is needed for answering these questions.

Keywords: transdiagnostic, depression, generalized anxiety disorder, emotion regulation

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5283 The Real Ambassador: How Hip Hop Culture Connects and Educates across Borders

Authors: Frederick Gooding

Abstract:

This paper explores how many Hip Hop artists have intentionally and strategically invoked sustainability principles of people, planet and profits as a means to create community, compensate for and cope with structural inequalities in society. These themes not only create community within one's country, but the powerful display and demonstration of these narratives create community on a global plane. Listeners of Hip Hop are therefore able to learn about the political events occurring in another country free of censure, and establish solidarity worldwide. Hip Hop therefore can be an ingenious tool to create self-worth, recycle positive imagery, and serve as a defense mechanism from institutional and structural forces that conspire to make an upward economic and social trajectory difficult, if not impossible for many people of color, all across the world. Although the birthplace of Hip Hop, the United States of America, is still predominately White, it has undoubtedly grown more diverse at a breath-­taking pace in recent decades. Yet, whether American mainstream media will fully reflect America’s newfound diversity remains to be seen. As it stands, American mainstream media is seen and enjoyed by diverse audiences not just in America, but all over the world. Thus, it is imperative that further inquiry is conducted about one of the fastest growing genres within one of the world’s largest and most influential media industries generating upwards of $10 billion annually. More importantly, hip hop, its music and associated culture collectively represent a shared social experience of significant value. They are important tools used both to inform and influence economic, social and political identity. Conversely, principles of American exceptionalism often prioritize American political issues over those of others, thereby rendering a myopic political view within the mainstream. This paper will therefore engage in an international contextualization of the global phenomena entitled Hip Hop by exploring the creative genius and marketing appeal of Hip Hop within the global context of information technology, political expression and social change in addition to taking a critical look at historically racialized imagery within mainstream media. Many artists the world over have been able to freely express themselves and connect with broader communities outside of their own borders, all through the sound practice of the craft of Hip Hop. An empirical understanding of political, social and economic forces within the United States will serve as a bridge for identifying and analyzing transnational themes of commonality for typically marginalized or disaffected communities facing similar struggles for survival and respect. The sharing of commonalities of marginalized cultures not only serves as a source of education outside of typically myopic, mainstream sources, but it also creates transnational bonds globally to the extent that practicing artists resonate with many of the original themes of (now mostly underground) Hip Hop as with many of the African American artists responsible for creating and fostering Hip Hop's powerful outlet of expression. Hip Hop's power of connectivity and culture-sharing transnationally across borders provides a key source of education to be taken seriously by academics.

Keywords: culture, education, global, hip hop, mainstream music, transnational

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5282 Formation of Science Literations Based on Indigenous Science Mbaru Niang Manggarai

Authors: Yuliana Wahyu, Ambros Leonangung Edu

Abstract:

The learning praxis that is proposed by 2013 Curriculum (K-13) is no longer school-oriented as a supply-driven, but now a demand-driven provider. This vision is connected with Jokowi-Kalla Nawacita program to create a competitive nation in the global era. Competition is a social fact that must be faced. Therefore the curriculum will design a process to be the innovators and entrepreneurs.To get this goal, K-13 implements the character education. This aims at creating the innovators and entrepreneurs from an early age (primary school). One part of strengthening it is literacy formations (reading, numeracy, science, ICT, finance, and culture). Thus, science literacy is an integral part of character education. The above outputs are only formed through the innovative process through intra-curricular (blended learning), co-curriculer (hands-on learning) and extra-curricular (personalized learning). Unlike the curriculums before that child cram with the theories dominating the intellectual process, new breakthroughs make natural, social, and cultural phenomena as learning sources. For example, Science in primary schoolsplaceBiology as the platform. And Science places natural, social, and cultural phenomena as a learning field so that students can learn, discover, solve concrete problems, and the prospects of development and application in their everyday lives. Science education not only learns about facts collection or natural phenomena but also methods and scientific attitudes. In turn, Science will form the science literacy. Science literacy have critical, creative, logical, and initiative competences in responding to the issues of culture, science and technology. This is linked with science nature which includes hands-on and minds-on. To sustain the effectiveness of science learning, K-13 opens a new way of viewing a contextual learning model in which facts or natural phenomena are drawn closer to the child's learning environment to be studied and analyzed scientifically. Thus, the topic of elementary science discussion is the practical and contextual things that students encounter. This research is about to contextualize Science in primary schools at Manggarai, NTT, by placing local wisdom as a learning source and media to form the science literacy. Explicitly, this study discovers the concept of science and mathematics in Mbaru Niang. Mbaru Niang is a forgotten potentials of the centralistic-theoretical mainstream curriculum so far. In fact, the traditional Manggarai community stores and inherits much of the science-mathematical indigenous sciences. In the traditional house structures are full of science and mathematics knowledge. Every details have style, sound and mathematical symbols. Learning this, students are able to collaborate and synergize the content and learning resources in student learning activities. This is constructivist contextual learning that will be applied in meaningful learning. Meaningful learning allows students to learn by doing. Students then connect topics to the context, and science literacy is constructed from their factual experiences. The research location will be conducted in Manggarai through observation, interview, and literature study.

Keywords: indigenous science, Mbaru Niang, science literacy, science

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5281 Feasibility and Acceptability of an Emergency Department Digital Pain Self-Management Intervention: An Randomized Controlled Trial Pilot Study

Authors: Alexandria Carey, Angela Starkweather, Ann Horgas, Hwayoung Cho, Jason Beneciuk

Abstract:

Background/Significance: Over 3.4 million acute axial low back pain (aLBP) cases are treated annually in the United States (US) emergency departments (ED). ED patients with aLBP receive varying verbal and written discharge routine care (RC), leading to ineffective patient self-management. Ineffective self-management increase chronic low back pain (cLPB) transition risks, a chief cause of worldwide disability, with associated costs >$60 million annually. This research addresses this significant problem by evaluating an ED digital pain self-management intervention (EDPSI) focused on improving self-management through improved knowledge retainment, skills, and self-efficacy (confidence) (KSC) thus reducing aLBP to cLBP transition in ED patients discharged with aLBP. The research has significant potential to increase self-efficacy, one of the most potent mechanisms of behavior change and improve health outcomes. Focusing on accessibility and usability, the intervention may reduce discharge disparities in aLBP self-management, especially with low health literacy. Study Questions: This research will answer the following questions: 1) Will an EDPSI focused on improving KSC progress patient self-management behaviors and health status?; 2) Is the EDPSI sustainable to improve pain severity, interference, and pain recurrence?; 3) Will an EDPSI reduce aLBP to cLBP transition in patients discharged with aLBP? Aims: The pilot randomized-controlled trial (RCT) study’s objectives assess the effects of a 12-week digital self-management discharge tool in patients with aLBP. We aim to 1) Primarily assess the feasibility [recruitment, enrollment, and retention], and [intervention] acceptability, and sustainability of EDPSI on participant’s pain self-management; 2) Determine the effectiveness and sustainability of EDPSI on pain severity/interference among participants. 3) Explore patient preferences, health literacy, and changes among participants experiencing the transition to cLBP. We anticipate that EDPSI intervention will increase likelihood of achieving self-management milestones and significantly improve pain-related symptoms in aLBP. Methods: The study uses a two-group pilot RCT to enroll 30 individuals who have been seen in the ED with aLBP. Participants are randomized into RC (n=15) or RC + EDPSI (n=15) and receive follow-up surveys for 12-weeks post-intervention. EDPSI innovative content focuses on 1) highlighting discharge education; 2) provides self-management treatment options; 3) actor demonstration of ergonomics, range of motion movements, safety, and sleep; 4) complementary alternative medicine (CAM) options including acupuncture, yoga, and Pilates; 5) combination therapies including thermal application, spinal manipulation, and PT treatments. The intervention group receives Booster sessions via Zoom to assess and reinforce their knowledge retention of techniques and provide return demonstration reinforcing ergonomics, in weeks two and eight. Outcome Measures: All participants are followed for 12-weeks, assessing pain severity/ interference using the Brief Pain Inventory short-form (BPI-sf) survey, self-management (measuring KSC) using the short 13-item Patient Activation Measure (PAM), and self-efficacy using the Pain Self-Efficacy Questionnaire (PSEQ) weeks 1, 6, and 12. Feasibility is measured by recruitment, enrollment, and retention percentages. Acceptability and education satisfaction are measured using the Education-Preference and Satisfaction Questionnaire (EPSQ) post-intervention. Self-management sustainment is measured including PSEQ, PAM, and patient satisfaction and healthcare utilization (PSHU) requesting patient overall satisfaction, additional healthcare utilization, and pain management related to continued back pain or complications post-injury.

Keywords: digital, pain self-management, education, tool

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5280 Outcome of Induction of Labour by Cervical Ripening with an Osmotic Dilator in a District General Hospital

Authors: A. Wahid Uddin

Abstract:

Osmotic dilator for cervical ripening bypasses the initial hormonal exposure necessary for a routine method of induction. The study was a clinical intervention with an osmotic dilator followed by prospective observation. The aim was to calculate the percentage of women who had successful cervical ripening using modified BISHOP score as evidenced by artificial rupture of membrane. The study also estimated the delivery interval following a single administration of osmotic dilators. Randomly selected patients booked for induction of labour accepting the intervention were included in the study. The study population comprised singleton term pregnancy, cephalic presentation, intact membranes with a modified BISHOP score of less than 6. Initial sample recruited was 30, but 6 patients left the study and the study was concluded on 24 patients. The data were collected in a pre-designed questionnaire and analysis were expressed in percentages along with using mean value for continuous variables. In 70 % of cases, artificial rupture of the membrane was possible and the mean time from insertion of the osmotic dilator to the delivery interval was 30 hours. The study concluded that an osmotic dilator could be a suitable alternative for hormone-based induction of labour.

Keywords: dilator, induction, labour, osmotic

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5279 A Comparative Study of Efficacy and Safety of Salicylic Acid, Trichloroacetic Acid and Glycolic Acid in Various Facial Melanosis

Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

Abstract:

Introduction: Chemical peeling is a popular, relatively inexpensive day procedure and generally safe method for treatment of pigmentary skin disorders and for skin rejuvenation. Chemical peels are classified by the depth of action into superficial, medium, and deep peels.Various facial pigmentary conditions have significant impact on quality of life causing psychological stress, necessitating its safe and effective treatment.Aim & Objectives:To compare the efficacy of Salicylic acid, Trichloroaceticacid & Glycolic Acid in facial melanosis(melasma,photomelanosis& post acne pigmentation).To study the side effects of above mentioned peeling agents. Method and Materials:It was a randomized parallel control single blind study consisting of total of 36 cases, 12 cases each of melasma, photo melanosis and post acne pigmentation within age group 20-50 years having fitzpatrick’s skin type4. Woods lamp examination was done to confirm the type of melasma.Patients with keloidal tendency, active herpes infection or past history of hypersensitivity to salicylic acid, trichloroaceticand glycolic acid as well aspatients on systemic isotretinoin were excluded.Clinical photographs at the beginning of therapy and then serially, were taken to assess the clinical response. Prior to application a written informed consent was obtained. A post auricular test peel was performed. Patients were divided into 3 groups, containing 12 patients each of melasma, photomelanosis and post acnepigmentation.All the three peels SA peel 20% (done once in 2 weeks), GA peel 50% (done once in 3 weeks) and TCA 15% (done once in 3 weeks) were used with total six settings for each patient. Before application of peel patients were counseled to wash the face with soap and water. Then face was dried and cleaned with spirit and acetone to remove all cutaneous oils. GA, TCA, SA were applied with cotton buds/gauze withmild strokes. After a contact period off 5-10mins neutralization was done with cold water. Post peel topical sunscreen application was mandatory. MASI was used pre and post treatment to assess melasma. Investigator’s global improvement scale- overall hyperpigmentation (4-significant, 3-moderate, 2-mild, 1-minimal, 0-no change ) and Patient’s satisfaction grading scale (>70%- excellent response, 50-70%- good response, <50%- average response) was used to assess improvement in all the three facial melanosis.Results:In our study of 12 patients of melasma, 4 (33.33%)patients showed excellent results;3 (25%) with GAand 1(8.33%) of TCA.Good response was seen in 4 (33.33%) patients;1(8.33%) each for GA & SA and 2(16.66%) for TCA.Poor response was seen in 4(33.33%) patients;1(8.33%) for TCA and 3 (25%) for SA.Of 12 patients of photomelanosis, excellent resultswas seen in 3(25%)patients of TCA. Good response was seen in 4 (33.33%) patients, 1(8.33%) each of TCA &SA and 2(16.66%) of GA.Poor responsewas seen in 5(41.66%) patients;3 (25%) for SA and 2(16.66%) of GA.Of 12 patients of post acne pigmentation, excellent responsein 3 (25%) patients;2(16.66%) of SA and 1(8.33%) of TCA.Good responsewas seen in 5(41.66%) patients;2(16.66%) of SA and GA and1(8.33%) of TCA.Poor response was seen in 4 (33.33%) patients; 2 (16.66%) for SA and TCA both. No major side effects in the form of scarring or persistant pigmentation was seen. Transient blackening of skin with burning sensation was seen in cases treated with TCA and SA. Post procedural itching and redness was noted with GA peel. Conclusion- In our study GA(50%),TCA(15%) & SA(20%) peels showed excellent response in melasma, photomelanosis and post-acne pigmentation respectively.All the 3 peeling agents were well tolerated without any significant side-effects in the above specified concentrations.

Keywords: facial melanosis, gycolic acid, salicylic acid, trichloroacetic acid

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5278 The Gender Digital Divide in Education: The Case of Students from Rural Area from Republic of Moldova

Authors: Bărbuță Alina

Abstract:

The inter-causal relationship between social inequalities and the digital divide raises the relation issue of gender and information and communication technologies (ICT) - a key element in achieving sustainable development. In preparing generations as future digital citizens and for active socio-economic participation, ICT plays a key role in respecting gender equality. Although several studies over the years have shown that gender plays an important role in digital exclusion, in recent years, many studies with a focus on economically developed or developing countries identify an improvement in these aspects and a gap narrowing. By measuring students' digital competencies level, this paper aims to identify and analyse the existing gender digital inequalities among students. Our analyses are based on a sample of 1526 middle school students residing in rural areas from Republic of Moldova (54.2% girls, mean age 14,00, SD = 1.02). During the online survey they filled in a questionnaire adapted from the (yDSI) ”The Youth Digital Skills Indicator”. The instrument measures the level of five digital competence areas indicated in The European Digital Competence Framework (DigiCom 2.3.). Our results, based on t-test, indicate that depending on gender, there are no statistically significant differences regarding the levels of digital skills in 3 areas: Information navigation and processing; Communication and interaction; Problem solving. However, were identified significant differences in the level of digital skills in the area of ”Digital content creation” [t(1425) = 4.20, p = .000] and ”Safety” [t(1421) = 2.49, p = .000], with higher scores recorded by girls. Our results contradicts the general stereotype regarding the low level of digital competence among girls, in our sample girls scores being on pear with boys and even bigger in knowledge related to digital content creation and online safety skills. Additional investigations related to boys competence on digital safety are necessary as the implication of their low scores on this dimension may suggest boys exposure to digital threats.

Keywords: digital divide, education, gender digital divide, digital literacy, remote learning

Procedia PDF Downloads 95