Search results for: training implications

Authors: Paolino Di Felice

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The background and significance of this study come from papers already appeared in the literature which measured the impact of public services (e.g., hospitals, schools, ...) on the citizens’ needs satisfaction (one of the dimensions of QOL studies) by calculating the distance between the place where they live and the location on the territory of the services. Those studies assume that the citizens' dwelling coincides with the centroid of the polygon that expresses the boundary of the administrative district, within the city, they belong to. Such an assumption “introduces a maximum measurement error equal to the greatest distance between the centroid and the border of the administrative district.”. The case study, this abstract reports about, investigates the implications descending from the adoption of such an approach but at geographical scales greater than the urban one, namely at the three levels of nesting of the Italian administrative units: the (20) regions, the (110) provinces, and the 8,094 municipalities. To carry out this study, it needs to be decided: a) how to store the huge amount of (spatial and descriptive) input data and b) how to process them. The latter aspect involves: b.1) the design of algorithms to investigate the geometry of the boundary of the Italian administrative units; b.2) their coding in a programming language; b.3) their execution and, eventually, b.4) archiving the results in a permanent support. The IT solution we implemented is centered around a (PostgreSQL/PostGIS) Geo DataBase structured in terms of three tables that fit well to the hierarchy of nesting of the Italian administrative units: municipality(id, name, provinceId, istatCode, regionId, geometry) province(id, name, regionId, geometry) region(id, name, geometry). The adoption of the DBMS technology allows us to implement the steps "a)" and "b)" easily. In particular, step "b)" is simplified dramatically by calling spatial operators and spatial built-in User Defined Functions within SQL queries against the Geo DB. The major findings coming from our experiments can be summarized as follows. The approximation that, on the average, descends from assimilating the residence of the citizens with the centroid of the administrative unit of reference is of few kilometers (4.9) at the municipalities level, while it becomes conspicuous at the other two levels (28.9 and 36.1, respectively). Therefore, studies such as those mentioned above can be extended up to the municipal level without affecting the correctness of the interpretation of the results, but not further. The IT framework implemented to carry out the experiments can be replicated for studies referring to the territory of other countries all over the world.

Keywords: quality of life, distance measurement error, Italian administrative units, spatial database

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Authors: Carlos Roberto De Rolt, Julio da Silva Dias, Rafael Tezza, Luca Foschini, Matteo Mura

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The seasonal population fluctuation presents a challenge to touristic cities since the number of inhabitants can double according to the season. The aim of this work is to develop a model that correlates the waste collected with the population of the city and also allow cooperation between the inhabitants and the local government. The model allows public managers to evaluate the impact of the seasonal population fluctuation on waste generation and also to improve planning resource utilization throughout the year. The study uses data from the company that collects the garbage in Florianópolis, a Brazilian city that presents the profile of a city that attracts tourists due to numerous beaches and warm weather. The fluctuations are caused by the number of people that come to the city throughout the year for holidays, summer time vacations or business events. Crowdsensing will be accomplished through smartphones with access to an app for data collection, with voluntary participation of the population. Crowdsensing participants can access information collected in waves for this portal. Crowdsensing represents an innovative and participatory approach which involves the population in gathering information to improve the quality of life. The management of crowdsensing solutions plays an essential role given the complexity to foster collaboration, establish available sensors and collect and process the collected data. Practical implications of this tool described in this paper refer, for example, to the management of seasonal tourism in a large municipality, whose public services are impacted by the floating of the population. Crowdsensing and big data support managers in predicting the arrival, permanence, and movement of people in a given urban area. Also, by linking crowdsourced data to databases from other public service providers - e.g., water, garbage collection, electricity, public transport, telecommunications - it is possible to estimate the floating of the population of an urban area affected by seasonal tourism. This approach supports the municipality in increasing the effectiveness of resource allocation while, at the same time, increasing the quality of the service as perceived by citizens and tourists.

Keywords: big data, dashboards, floating population, smart city, urban management solutions

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Authors: Rahat Zaman

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The present study was conducted to investigate psychological well-being and positive and negative affect among adults. The sample comprised 221 adults; the sample was collected from all over Pakistan. Psychological well-being was measured with the help of the psychological well-being scale developed by Ryff and Keyes (1995). Lifestyle was measured with the help of the Health Promoting Lifestyle Profile Scale developed by Walker et al. (1995). Positive and negative effects were measured by PANAS, developed by Watson, Clark, and Tellegen (1998). To check the properties of scale, the alpha reliability coefficient was calculated. To test the hypotheses of the research, correlation, independent sample t-rest, and ANOVA were computed. It was hypothesized that there would be a positive relationship between psychological well-being and lifestyles and positive affect. The results show that psychological well-being, lifestyle, and positive affect are positively related. This also supports our hypothesis. The research also searched for relationships in the study variables according to the demographics of the sample. The respondents varied according to their dominant affect levels with respect to their psychological well-being and lifestyles. The research found significant differences for the genders in life appreciation, nutrition, and negative affect. Single and married individuals differed significantly on autonomy, environmental mastery, life appreciation, nutrition, and stress management. Individuals showed significant differences with respect to their living situation, joint and nuclear family members showed significant differences in personal growth, autonomy, health responsibilities, social support, physical activities, and stress management. The sample showed significant differences in environmental mastery, personal growth, purpose in life, life appreciation, health responsibilities, physical activities, stress management, and negative affect when divided in socioeconomic status. Age-wise analysis showed significant differences in autonomy, personal growth, purpose in life, life appreciation, nutrition, and stress management. Provincially significant differences were found in life appreciation, nutrition, social support, physical activities, and stress management, and both positive and negative effects were experienced. Implications of the results are discussed.

Keywords: wellbeing, healthy lifestyle, self acceptance, positive

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Authors: Ann Enright

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More than ever, animal shelters need to identify ways to reduce the number of animals entering shelter facilities and the incidence of euthanasia. Managing animal overpopulation using euthanasia can have detrimental health and emotional consequences for the shelter staff involved. There are also community expectations with moral and financial implications to consider. To achieve the goals of reducing animal intake and the incidence of euthanasia, shelter best practice involves combining programs, procedures and partnerships to increase live release rates (LRR), reduce the incidence of disease, length of stay (LOS) and shelter intake whilst overall remaining financially viable. Analysing daily processes, tracking outcomes and implementing simple strategies enabled shelter staff to more effectively focus their efforts and achieve amazing results. The objective of this retrospective study was to assess the effect of implementing the capacity for care (C4C) management model. Data focusing on the average daily number of animals on site for a two year period (2016 – 2017) was exported from a shelter management system, Customer Logic (CL) Vet to Excel for manipulation and comparison. Following the implementation of C4C practices the average daily number of animals on site was reduced by >50%, (2016 average 103 compared to 2017 average 49), average LOS reduced by 50% from 8 weeks to 4 weeks and incidence of disease reduced from ≥ 70% to less than 2% of the cats on site at the completion of the study. The total number of stray cats entering the shelter due to council contracts reduced by 50% (486 to 248). Improved cat outcomes were attributed to strategies that increased adoptions and reduced euthanasia of poorly socialized cats, including foster programs. To continue to achieve improvements in LRR and LOS, strategies to decrease intake further would be beneficial, for example, targeted sterilisation programs. In conclusion, the study highlighted the benefits of using C4C as a management tool, delivering a significant reduction in animal intake and euthanasia with positive emotional, financial and community outcomes.

Keywords: animal welfare, capacity for care, cat, euthanasia, length of stay, managed intake, shelter

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Authors: Paola Utreras, Yazmina Olmos, Loreto Sanhueza

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This work has the purpose of study and incorporate Problem Based Learning (PBL) for engineering students, through the analysis of several thermal images of dwellings located in different geographical points of the Region de los Ríos, Chile. The students analyze how heat is transferred in and out of the houses and how is the relation between heat transfer and climatic conditions that affect each zone. As a result of this activity students are able to acquire significant learning in the unit of heat and temperature, and manage to reverse previous conceptual errors related with energy, temperature and heat. In addition, student are able to generate prototype solutions to increase thermal efficiency using low cost materials. Students make public their results in a report using scientific writing standards and in a science fair open to the entire university community. The methodology used to measure previous Conceptual Errors has been applying diagnostic tests with everyday questions that involve concepts of heat, temperature, work and energy, before the unit. After the unit the same evaluation is done in order that themselves are able to evidence the evolution in the construction of knowledge. As a result, we found that in the initial test, 90% of the students showed deficiencies in the concepts previously mentioned, and in the subsequent test 47% showed deficiencies, these percent ages differ between students who carry out the course for the first time and those who have performed this course previously in a traditional way. The methodology used to measure Significant Learning has been by comparing results in subsequent courses of thermodynamics among students who have received problem based learning and those who have received traditional training. We have observe that learning becomes meaningful when applied to the daily lives of students promoting internalization of knowledge and understanding through critical thinking.

Keywords: engineering students, heat flow, problem-based learning, thermal images

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Authors: Yan Ping Chen, Hau Yin Chung

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The Ideal Profile Method (IPM) is a newly developed descriptive sensory analysis conducted by consumers without previous training. To perform this test, both the perceived and the ideal intensities from the judgements of consumers on products’ attributes, as well as their hedonic ratings were collected for formulating an ideal product (the most liked one). In addition, Ideal Profile Analysis (IPA) was conducted to check the consistency of the ideal data at both the panel and consumer levels. In this test, 12 commercial plain sufus bought from Hong Kong local market were tested by 113 consumers according to the IPM, and rated on 22 attributes. Principal component analysis was used to profile the perceived and the ideal spaces of tested products. The consistency of ideal data was then checked by IPA. The result showed that most consumers shared a common ideal. It was observed that the sensory product space and the ideal product space were structurally similar. Their first dimensions all opposed products with intense fermented related aroma to products with less fermented related aroma. And the predicted ideal profile (the estimated liking score around 7.0 in a 9.0-point scale) got higher hedonic score than the tested products (the average liking score around 6.0 in a 9.0-point scale). For the majority of consumers (95.2%), the stated ideal product considered as a potential ideal through checking the R2 coefficient value. Among all the tested products, sample-6 was the most popular one with consumer liking percentage around 30%. This product with less fermented and moldy flavour but easier to melt in mouth texture possessed close sensory profile according to the ideal product. This experiment validated that data from untrained consumers could be guided as useful information. Appreciated sensory characteristics could be served as reference in the optimization of the commercial plain sufu.

Keywords: ideal profile method, product development, sensory evaluation, sufu (fermented soybean curd)

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Authors: Taku Numao, Kazu Amimoto, Tomoko Shimada, Kyohei Ichikawa

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Background: Unilateral spatial neglect (USN) is a common syndrome following damage to one hemisphere of the brain (usually the right side), in which a patient fails to report or respond to stimulation from the contralesional side. These symptoms are not due to primary sensory or motor deficits, but instead, reflect an inability to process input from that side of their environment. Prism adaptation (PA) is a therapeutic treatment for USN, wherein a patient’s visual field is artificially shifted laterally, resulting in a sensory-motor adaptation. However, patients with USN also tend to perceive a left-leaning subjective vertical in the frontal plane. The traditional PA cannot be used to correct a tilt in the subjective vertical, because a prism can only polarize, not twist, the surroundings. However, this can be accomplished using a head mounted display (HMD) and a web-camera. Therefore, this study investigated whether an HMD system could be used to correct the spatial perception of USN patients in the frontal as well as the horizontal plane. We recruited healthy subjects in order to collect data for the refinement of USN patient therapy. Methods: Eight healthy subjects sat on a chair wearing a HMD (Oculus rift DK2), with a web-camera (Ovrvision) displaying a 10 degree leftward rotation and a 10 degree counter-clockwise rotation along the frontal plane. Subjects attempted to point a finger at one of four targets, assigned randomly, a total of 48 times. Before and after the intervention, each subject’s body-centre judgment (BCJ) was tested by asking them to point a finger at a touch panel straight in front of their xiphisternum, 10 times sight unseen. Results: Intervention caused the location pointed to during the BCJ to shift 35 ± 17 mm (Ave ± SD) leftward in the horizontal plane, and 46 ± 29 mm downward in the frontal plane. The results in both planes were significant by paired-t-test (p<.01). Conclusions: The results in the horizontal plane are consistent with those observed following PA. Furthermore, the HMD and web-camera were able to elicit 3D effects, including in both the horizontal and frontal planes. Future work will focus on applying this method to patients with and without USN, and investigating whether subject posture is also affected by the HMD system.

Keywords: head mounted display, posture, prism adaptation, unilateral spatial neglect

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Authors: Ginger Egberts, Marianne Schaaphok, Fred Vermolen, Paul van Zuijlen

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A few years ago, a promising morphoelastic model was developed for the simulation of contraction formation after burn injuries. Contraction can lead to a serious reduction in physical mobility, like a reduction in the range-of-motion of joints. If this is the case in a healing burn wound, then this is referred to as a contracture that needs medical intervention. The morphoelastic model consists of a set of partial differential equations describing both a chemical part and a mechanical part in dermal wound healing. These equations are solved with the numerical finite element method (FEM). In this method, many calculations are required on each of the chosen elements. In general, the more elements, the more accurate the solution. However, the number of elements increases rapidly if simulations are performed in 2D and 3D. In that case, it not only takes longer before a prediction is available, the computation also becomes more expensive. It is therefore important to investigate alternative possibilities to generate the same results, based on the input parameters only. In this study, a surrogate neural network has been designed to mimic the results of the one-dimensional morphoelastic model. The neural network generates predictions quickly, is easy to implement, and there is freedom in the choice of input and output. Because a neural network requires extensive training and a data set, it is ideal that the one-dimensional FEM code generates output quickly. These feed-forward-type neural network results are very promising. Not only can the network give faster predictions, but it also has a performance of over 99%. It reports on the relative surface area of the wound/scar, the total strain energy density, and the evolutions of the densities of the chemicals and mechanics. It is, therefore, interesting to investigate the applicability of a neural network for the two- and three-dimensional morphoelastic model for contraction after burn injuries.

Keywords: biomechanics, burns, feasibility, feed-forward NN, morphoelasticity, neural network, relative surface area wound

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Authors: Steven M. Graham, Anne V. Magee

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Most world religions have sacred texts and traditions that provide instruction about and definitions of marriage, family, and family duties and responsibilities. Given that religious fundamentalism (RF) is defined as the belief that these sacred texts and traditions are literally and completely true to the exclusion of other teachings, RF should be predictive of the attitudes one holds about these topics. The goals of the present research were to: (1) explore the extent to which people think that men and women can be happy without marriage, a significant sexual relationship, a long-term romantic relationship, and having children; (2) determine the extent to which RF is associated with these beliefs; and, (3) to determine how RF is associated with considering certain elements of a relationship to be necessary for thinking of that relationship as a marriage. In Study 1, participants completed a reliable and valid measure of RF and answered questions about the necessity of various elements for a happy life. Higher RF scores were associated with the belief that both men and women require marriage, a sexual relationship, a long-term romantic relationship, and children in order to have a happy life. In Study 2, participants completed these same measures and the pattern of results replicated when controlling for overall religiosity. That is, RF predicted these beliefs over and above religiosity. Additionally, participants indicated the extent to which a variety of characteristics were necessary to consider a particular relationship to be a marriage. Controlling for overall religiosity, higher RF scores were associated with the belief that the following were required to consider a relationship a marriage: religious sanctification, a sexual component, sexual monogamy, emotional monogamy, family approval, children (or the intent to have them), cohabitation, and shared finances. Interestingly, and unexpectedly, higher RF scores were correlated with less importance placed on mutual consent in order to consider a relationship a marriage. RF scores were uncorrelated with the importance placed on legal recognition or lifelong commitment and these null findings do not appear to be attributable to ceiling effects or lack of variability. These results suggest that RF constrains views about both the importance of marriage and family in one’s life and also the characteristics required to consider a relationship a proper marriage. This could have implications for the mental and physical health of believers high in RF, either positive or negative, depending upon the extent to which their lives correspond to these templates prescribed by RF. Additionally, some of these correlations with RF were substantial enough (> .70) that the relevant items could serve as a brief, unobtrusive measure of RF. Future research will investigate these possibilities.

Keywords: attitudes about marriage, fertility intentions, measurement, religious fundamentalism

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Authors: Winncy Du, Jeremy Nguyen, Harpinder Dhillon, Reinardus Justin Halim, Clayton Haske, Trent Hughes, Marissa Ortiz, Rozy Saini

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Stroke often causes death or cerebro-vascular (CV) brain damage. Most patients with CV brain damage lost their motor control on their limbs. This paper focuses on developing a reliable, safe, and non-invasive EEG-based robot-assistant stroke rehabilitation system to help stroke survivors to rapidly restore their motor control functions for their limbs. An electroencephalogram (EEG) recording device (EPOC Headset) and was used to detect a patient’s brain activities. The EEG signals were then processed, classified, and interpreted to the motion intentions, and then converted to a series of robot motion commands. A six-axis articulated robot (AdeptSix 300) was employed to provide the intended motions based on these commends. To ensure the EEG device, the computer, and the robot can communicate to each other, an Arduino microcontroller is used to physically execute the programming codes to a series output pins’ status (HIGH or LOW). Then these “hardware” commends were sent to a 24 V relay to trigger the robot’s motion. A lookup table for various motion intensions and the associated EEG signal patterns were created (through training) and installed in the microcontroller. Thus, the motion intention can be direct determined by comparing the EEG patterns obtaibed from the patient with the look-up table’s EEG patterns; and the corresponding motion commends are sent to the robot to provide the intended motion without going through feature extraction and interpretation each time (a time-consuming process). For safety sake, an extender was designed and attached to the robot’s end effector to ensure the patient is beyond the robot’s workspace. The gripper is also designed to hold the patient’s limb. The test results of this rehabilitation system show that it can accurately interpret the patient’s motion intension and move the patient’s arm to the intended position.

Keywords: brain waves, EEG sensor, motion control, robot-assistant stroke rehabilitation

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Authors: Alabi Olufemi, Adeyanju Taiwo, Oloruntoba Oluwasegun, Adeleye Bobola, Alabi Oyekemi

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The pastoral system is a predominant form of cattle production in Nigeria, characterized by extensive grazing on communal lands. However, this system is challenged by various factors, including tick infestation, which significantly affects cattle health and welfare hence this investigation which aims to provide an in-depth understanding of tick infestation in the context of Nigerian pastoral systems, emphasizing its impact on cattle health and welfare. The country harbors a diverse array of tick species that affect cattle. These ticks belong to different genera, including Rhipicephalus, Amblyomma, and Hyalomma, among others. Each species has unique characteristics, life cycles, and host preferences, contributing to the complexity of tick infestation dynamics in pastoral settings. Tick infestation has numerous detrimental effects on cattle health. The direct effects include blood loss, anemia, skin damage due to feeding, and the transmission of pathogens that cause diseases such as anaplasmosis, babesiosis, and theileriosis. Indirectly, tick infestation can lead to reduced productivity, weight loss, and increased susceptibility to other diseases.The welfare of cattle in Nigerian pastoral systems is significantly impacted by tick infestation. Infested cattle often exhibit signs of distress, including restlessness, reduced grazing activity, and altered behavior. Furthermore, the discomfort caused by tick bites can lead to chronic stress, compromising the overall welfare of the animals. Effective tick control is crucial for mitigating the impact of infestation on cattle health and welfare. Strategies such as acaricide application, pasture management, genetic selection for tick resistance cattle, and vaccination against tick-borne diseases are commonly used. Tick infestation presents a significant challenge to cattle production under the pastoral system in Nigeria. It not only impacts cattle health but also compromises their welfare. Addressing the issue of tick infestation requires a multifaceted approach that integrates effective control strategies with sustainable management practices. Further research is needed to develop tailored interventions that account for the unique characteristics of Nigerian pastoral systems, ultimately ensuring the well-being and productivity of cattle in these settings.

Keywords: tick infestation, pastoral system, welfare, cattle

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Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen

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Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.

Keywords: anesthesia nurses, burnout, job, turnover intention

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Authors: Maryam Kheirollahpour, Mahmoud Danaee, Amir Faisal Merican, Asma Ahmad Shariff

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Background: The presence of nonlinearity among the risk factors of eating behavior causes a bias in the prediction models. The accuracy of estimation of eating behaviors risk factors in the primary prevention of obesity has been established. Objective: The aim of this study was to explore the potential of a hybrid model of structural equation modeling (SEM) and Artificial Neural Networks (ANN) to predict eating behaviors. Methods: The Partial Least Square-SEM (PLS-SEM) and a hybrid model (SEM-Artificial Neural Networks (SEM-ANN)) were applied to evaluate the factors affecting eating behavior patterns among university students. 340 university students participated in this study. The PLS-SEM analysis was used to check the effect of emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) on different categories of eating behavior patterns (EBP). Then, the hybrid model was conducted using multilayer perceptron (MLP) with feedforward network topology. Moreover, Levenberg-Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The Tangent/sigmoid function was used for the input layer while the linear function applied for the output layer. The coefficient of determination (R²) and mean square error (MSE) was calculated. Results: It was proved that the hybrid model was superior to PLS-SEM methods. Using hybrid model, the optimal network happened at MPLP 3-17-8, while the R² of the model was increased by 27%, while, the MSE was decreased by 9.6%. Moreover, it was found that which one of these factors have significantly affected on healthy and unhealthy eating behavior patterns. The p-value was reported to be less than 0.01 for most of the paths. Conclusion/Importance: Thus, a hybrid approach could be suggested as a significant methodological contribution from a statistical standpoint, and it can be implemented as software to be able to predict models with the highest accuracy.

Keywords: hybrid model, structural equation modeling, artificial neural networks, eating behavior patterns

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Authors: Mashael AlSalem

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While research into language assessment has expanded in recent years, few if any studies to date have targeted the nature of thought processes used by teachers when constructing classroom-based assessment. This study reports on teachers’ conceptions of English grammar assessment and their classroom assessment practices in their Saudi higher educational facilities. A mixed-method approach using both qualitative and quantitative research instruments was employed to elicit teachers’ perceptions of English grammar assessment and their relationship to their current practices. Participants of the study included EFL teachers from 4 different educational facilities: King Saudi University, Princess Noura University, Imam Mouhamed Islamic University, and Institute of Public Administration. Data collection involved questionnaire (N=100), semi-structured interviews (N=30), retrospective thinking (N=20), and document analysis (N=20). Activity theory is used as an interpretive framework to explore and investigate the entire system of constructing classroom-based assessment. Preliminary findings reveal several similarities and differences between the participants’ stated beliefs and their current practices of assessing English grammar. Findings also showed that teacher participant’s beliefs about how English grammar should be assessed are influenced mostly by prior learning experience as well as their teaching instruction practices. Their practices, on the other hand, was more guided by educational policies and lack of teacher training in the field of assessment, among other factors. This research makes a significant contribution to knowledge in three different areas: it enriches the literature on language teacher cognition; it builds on the body of research on language classroom assessment, and it expands on the possibilities to use AC to investigate the relationship between teachers’ beliefs and practices.

Keywords: activity theory, classroom-based assessment, language teacher cognition, mixed method approach

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Authors: Yi-Hsuan Gloria Lo

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The educational objective of vocational high schools (VHSs) is to equip VHS students with practical skills and knowledge that can be applied in the job-related market. However, with the increasing number of technological universities over the past two decades, the majority of VHS students have chosen to receive higher education rather than enter the job market. VHS English education has been confronting a dilemma: Should an English for specific purposes (ESP) approach, which aligns with the educational goal of VHS education, be taken or should an English for general purposes (EGP) approach, which prepares VHS students for advanced studies in universities, be followed? While ESP theorists proposed that that ESP can be taught to secondary learners, little was known about VHS students’ perspective on this ESP-versus-EGP dilemma. Scant research has investigated different facets of students’ needs (necessities, wants, and lacks) for both ESP and EGP in terms of the four language skills and the factors that contribute to any differences. To address the gap in the literature, 100 VHS students responded to statements related to their necessities, wants, and lacks in learning ESP and EGP on a 6-point Likert scale. Six VHS students were interviewed to tap into the reasons for different facets of the needs for learning EGP and ESP. The statistical analysis indicates that at this stage of learning English, VHS subjects believed that EGP was more necessary than ESP; EGP was more desirable than ESP. However, they reported that they were more lacking in ESP than in EGP learning. Regarding EGP, the results show that the VHS subjects rated speaking as their most necessary skill, speaking as the most desirable skill, and writing as the most lacking skill. A significant difference was found between perceived learning necessities and lacks and between perceived wants and lacks. No statistical difference was found between necessities and wants. In the aspect of ESP, the results indicate that the VHS subjects marked reading as their most necessary skill, speaking as the most desirable skill, and writing as the most lacking skill. A significant difference exists between their perceived necessities and lacks and between their wants and lacks. However, there is no statistically significant difference between their perceived lacks and wants. Despite the lack of a significant difference between learning necessities and wants, the qualitative interview data reveal that the reasons for their perceived necessities and wants were different. The findings of the study confirm previous research that demonstrates that ‘needs’ is a multiple and conflicting construct. What VHS students felt most lacking was not necessarily what they believed they should learn or would like to learn. Although no statistical difference was found, different reasons were attributed to their perceived necessities and wants. Both theoretical and practical implications have been drawn and discussed for ESP research in general and teaching ESP in VHSs in particular.

Keywords: vocational high schools (VHSs), English for General Purposes (EGP), English for Specific Purposes (ESP), needs analysis

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Authors: Sandra Maria Cerqueira Da Silva

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In Brazil, women are the majority of the country's population. They have advanced in terms of years of education and professional training. However, this has not prevented the differences in the labor market from being sustained, particularly the wage gap and inequalities concerning the access to command positions and promotions, i.e., in the gender relations and treatment. One of the conditions which constitute a barrier to career advancement is the necessary support chain to support women when they are in the labor market. Therefore, the purpose of this research is to demonstrate, describe, and criticize some of the current conformations of support chains and how these compete to promote the phenomenon known as glass ceiling in the country. However, this support may come even from inside a woman's own home, with a fairer division of household activities between men and women. Such behavior can free an entire network of women within the same family. In addition, it can serve as pressure to structure better conditions for women as a whole, improving the living conditions of the poor population. This can occur through programs and projects for qualification and retraining of adult women. In answer to the question that guides this study, it is concluded that a family support system is critical to the success of women in management positions. To meet this demand, one of the ways could be the development of specific gender policies by the public authorities, in accordance with the emerging global economic policies, in order to provide and structure the necessary support. This would respond to feminist manifestations - which should go on pointing needs – although the legislative assembly should also propose ideas to change this picture. This is a qualitative research, with a poststructuralist approach, featuring a cutout corpus of three interviews carried out with women holding leadership positions in the academia. Questions related to this very discussion are many. New studies could address points as the promotion of qualification and expansion of skills of women in subaltern condition. There is also need to investigate possible support systems, considering the inequalities and local economic conditions.

Keywords: gender and labor market, glass ceiling, post-structuralism, support chain

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Authors: Binh Thanh Ta, Elizabeth Sturgiss

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Central to patient-centered care is the idea of treating a patient as a person and understanding their perspectives regarding their health conditions and care preferences. Surprisingly, little is known about how GPs can understand their patients’ perspectives. This paper addresses the challenge of understanding patient perspectives in behavior change consultations by adopting Conversation Analysis (CA), which is an empirical research approach that allows both researchers and the audience to examine patients’ perspectives as displayed in GP-patient interaction. To understand people’s perspectives, CA researchers do not rely on what they say but instead on how they demonstrate their endogenous orientations to social norms when they interact with each other. Underlying CA is the notion that social interaction is orderly by all means. (It is important to note that social orders should not be treated as exogenous sets of rules that predetermine human behaviors. Rather social orders are constructed and oriented by social members through their interactional practices. Also, note that these interactional practices are the resources shared by all social members). As CA offers tools to uncover the orderliness of interactional practices, it not only allows us to understand the perspective of a particular patient in a particular medical encounter but, more importantly, enables us to recognise the shared interactional practice for signifying a particular perspective. Drawing on the 10 video-recorded consultations on behavior change in primary care, we have discovered the orderliness of patient laughter when reporting health behaviors, which signifies their orientation to the problematic nature of the reported behaviors. Among 24 cases where patients reported their health behaviors, we found 19 cases in which they laughed while speaking. In the five cases where patients did not laugh, we found that they explicitly framed their behavior as unproblematic. This finding echoes the CA body research on laughter, which suggests that laughter produced by first speakers (as opposed to laughing in response to what has been said earlier) normally indicates some sort of problems oriented to the self (e.g. self-tease, self-depreciation, etc.). This finding points to the significance of understanding when and why patients laugh; such understanding would assist GPs to recognise whether patients treat their behavior as problematic or not, thereby producing responses sensitive to patient perspectives.

Keywords: patient centered care, laughter, conversation analysis, primary care, behaviour change consultations

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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Authors: Anne Öman

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Today in Sweden and in other countries, a variety of digital artefacts, such as laptops, tablets, interactive whiteboards, are being used at all school levels. From an educational perspective, digital artefacts challenge traditional teaching because they provide a range of modes for expression and communication and are not limited to the traditional medium of paper. Digital technologies offer new opportunities for representations and physical interactions with objects, which put forward the role of the body in interaction and learning. From a multimodal perspective the emphasis is on the use of multiple semiotic resources for meaning- making and the study presented here has examined the differential use of semiotic resources by pupils interacting in a digitally designed task in a primary school context. The instances analyzed in this paper come from a case study where the learning task was to create an advertising film in a film-software. The study in focus involves the analysis of a single case with the emphasis on the examination of the classroom setting. The research design used in this paper was based on a micro ethnographic perspective and the empirical material was collected through video recordings of small-group work in order to explore pupils’ communication within the group activity. The designed task described here allowed students to build, share, collaborate upon and publish the redesigned products. The analysis illustrates the variety of communicative modes such as body position, gestures, visualizations, speech and the interaction between these modes and the representations made by the pupils. The findings pointed out the importance of embodied communication during the small- group processes from a learning perspective as well as a pedagogical understanding of pupils’ representations, which were similar from a cultural literacy perspective. These findings open up for discussions with further implications for the school practice concerning the small- group processes as well as the redesigned products. Wider, the findings could point out how multimodal interactions shape the learning experience in the meaning-making processes taking into account that language in a globalized society is more than reading and writing skills.

Keywords: communicative learning, interactive learning environments, pedagogical issues, primary school education

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Authors: Natalia Carolina Encalada Castillo

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As part of an intended radical policy change compared to former administrations in Ecuador, the transformation of the institutionality of international cooperation during the period of President Rafael Correa was considered as a key element for the construction of the state of 'Good Living'. This intention led to several regulatory changes in the reception of cooperation for development, and even the departure of some foreign cooperation agencies. Moreover, Ecuador launched the initiative to become a donor of cooperation towards other developing countries through the ‘South-South Cooperation’ approach. All these changes were institutionalized through the Ecuadorian System of International Cooperation as a new framework to establish rules and policies that guarantee a sovereign management of foreign aid. Therefore, this research project has been guided by two questions: What were the factors that motivated the transformation of the institutionality of international cooperation in Ecuador from 2007 to 2017? and, what were the implications of this transformation in terms of the international role of the country? This paper seeks to answer these questions through Role Theory within a Constructivist meta-theoretical perspective, considering that in this case, changes at the institutional level in the field of cooperation, responded not only to material motivations but also to interests built on the basis of a specific state identity. The latter was only possible to affirm through specific roles such as ‘sovereign recipient of cooperation’ as well as ‘donor of international cooperation’. However, the performance of these roles was problematic as they were not easily accepted by the other actors in the international arena or in the domestic level. In terms of methodology, these dynamics are analyzed in a qualitative way mainly through interpretive analysis of the discourse of high-level decision-makers from Ecuador and other cooperation actors. Complementary to this, document-based research of relevant information as well as interviews have been conducted. Finally, it is concluded that even if material factors such as infrastructure needs, trade and investment interests, as well as reinforcement of state control and monitoring of cooperation flows, motivated the institutional transformation of international cooperation in Ecuador; the essential basis of these changes was the search for a new identity for the country to be projected in the international arena. This identity started to be built but continues to be unstable. Therefore, it is important to potentiate the achievements of the new international cooperation policies, and review their weaknesses, so that non-reimbursable cooperation funds received as well as ‘South-South cooperation’ actions, contribute effectively to national objectives.

Keywords: Ecuador, international cooperation, Role Theory, state identity

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Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda

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The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.

Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency

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Authors: Hui Ling Chen

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This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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Authors: Dewan Ali Ahsan

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Hilsa (Tenualosa ilisha) is one of the most important anadromous fish species of the trans-boundary ecosystem of Bangladesh, India and Myanmar. Hilsa is not only an economically important species specially for Bangladesh and India, but also for the integral part of the culture of the Bangladesh and India. This flag-ship species in Bangladesh contributed alone of 10.82% of the total fish production of the country and about 75% of world’s total catch of hilsa comes from Bangladesh alone. As hilsa is an anadromous fish, it migrates from the Bay of Bengal to rivers for spawning, nursing and growing and for all of these purposes hilsa needs freshwaters. Ripe broods prefer turbid, fast flowing freshwater for spawning but young prefer clear and slow flowing freshwater. Climate change (salinity intrusion, sea level rise, temperature rise, impact of fresh water flow), unplanned developmental activities and other anthropogenic activities all together are severely damaging the hilsa stock and its habitats. So, climate change and human interferences are predicted to have a range of direct and indirect impacts on marine and freshwater hilsa fishery, with implications for fisheries-dependent economies, coastal communities and fisherfolk. The present study identified that salinity intrusion, siltation in river bed, decrease water flow from upstream, fragmentation of river in dry season, over exploitation, use of small mesh nets are the major reasons to affect the upstream migration of hilsa and its sustainable management. It has been also noticed that Bangladesh government has taken some actions for hilsa management. Government is trying to increase hilsa production not only by conserving jatka (juvenile hilsa) but also protecting the brood hilsa during the breeding seasons by imposing seasonal ban on fishing, restricted mesh size etc. Unfortunately, no such management plans are available for Indian and Myanmar territory. As hilsa is a highly migratory trans-boundary fish in the Bay of Bengal (and all of these countries share the same stock), it is essential to adopt a joint management policy (by Bangladesh-India-Myanmar) for the sustainable management for the hilsa stock.

Keywords: hilsa, climate change, south-east Asia, fishery management

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Authors: Sayyed-Javad Ziaolhagh, Mojtaba Hokmabadi

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Introduction: Childhood obesity is a serious medical condition that affects children and adolescents even in the central nervous system. Semaphorins also play a role in the inflammatory process of the nervous system. On the other hand, it has been stated that garlic and stevia extracts following aerobic exercise are effective on immune system inflammation in addition to aerobic activity. Materials and Methods: For 15 weeks, 50 3-week-old male Wistar rats were fed with conventional rodent chow for control and a high-fat diet to induce obesity. Obese rats then were randomly assigned into 7 groups (n=5) based on the Lee index: healthy control (C), obese (OBS), obese + garlic (OBS+GAR), obese + Stevia (OBS+STV), obese + aerobic exercise (OBS+EXE), obese + garlic + aerobic exercise (OBS+GAR+EXE), and obese + stevia + aerobic exercise (OBS+STV+EXE). Training groups completed a progressive aerobic running program (at 8-15 m/min, 5-20 min/day, 5 days/week), and Stevia and garlic extract group (250 mg/kg/day, 5 days/week) were given orally once a day. Real-time PCR was used to determine the levels of Semaphorin 4A, and Plexin D1 gene expressions in the hypothalamus. Fold change analysis with ANOVA was performed for statistical analysis, with a significance threshold of P<0.05. Results: Body weight increased significantly in OBS compared to C (p= 0.013), but was not significantly changed in all treatment rats. Moreover, Semaphorin 4A was significantly increased in obese compared to control group (p= 0.041) and after 8 weeks, stevia extract (p=0.006), aerobic exercise (p=0.012) and garlic extract + aerobic exercise (p=0.008) significantly decreased compared to obese rats. In addition, Plexin D1 genes were also found in the hypothalamus of both obese and control rats but were insignificantly up-regulated when compared with the obese group (p=0.950). Conclusion: High-fat diet caused neuroinflammation by elevation of sema4A in obese rats and stevia, stevia with aerobic and garlic with aerobic could reduce this inflammation in rats. Also, none of them could alter Plexin D1.

Keywords: sema 4A, plexin D1, garlic, stevia

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Authors: Benedicta Asante, Brenna Bath, Olugbenga Adebayo, Catherine Trask

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Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, reports of injuries and fatal accidents in the industry demand notice particularly common and debilitating musculoskeletal disorders such as low back pain (LBP). WCWs are likely exposed to diverse work-related hazards that could contribute to LBP. However, to our knowledge there has never been a systematic review or other synthesis of LBP findings within this workforce. The aim of this systematic review was to determine the prevalence and risk factors of LBP among WCWs. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back pain’ and ‘waste collection workers’. Articles were screened at title, abstract, and full-text stages by two reviewers. Data were extracted on study design, sampling strategy, socio-demographic, geographical region, and exposure definition, definition of LBP, risk factors, response rate, statistical techniques, and LBP prevalence. Risk of bias (ROB) was assessed based on Hoy Damien’s ROB scale. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; thirteen full-text articles met the study criteria at the full-text stage. Seven articles (54%) reported prevalence within 12 months of LBP between 42-82% among WCW. The major risk factors for LBP among WCW included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Summary data and syntheses of findings was presented in trend-lines and tables to establish the several prevalence periods based on age and region distribution. Public health implications: LBP is a major occupational hazard among WCWs. In light of these risks and future growth in this industry, further research should focus on more detail ergonomic exposure assessment and LBP prevention efforts.

Keywords: low back pain, scavenger, waste collection workers, waste pickers

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Authors: Adel Khorramrouz, Monireh Ahmadi Bani, Ehsan Norouzi, Morvarid Lalenoor

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Background: Plantar pressure distribution measurement has been used for a long time to assess foot disorders. Plantar pressure is an important component affecting the foot and ankle function and Changes in plantar pressure distribution could indicate various foot and ankle disorders. Morphologic and mechanical properties of the foot may be important factors affecting the plantar pressure distribution. Accurate and early measurement may help to reduce the prevalence of pes planus. With recent developments in technology, new techniques such as machine learning have been used to assist clinicians in predicting patients with foot disorders. Significance of the study: This study proposes a neural network learning-based flat foot classification methodology using static foot pressure distribution. Methodologies: Data were collected from 895 patients who were referred to a foot clinic due to foot disorders. Patients with pes planus were labeled by an experienced physician based on clinical examination. Then all subjects (with and without pes planus) were evaluated for static plantar pressures distribution. Patients who were diagnosed with the flat foot in both feet were included in the study. In the next step, the leg length was normalized and the network was trained for plantar pressure mapping images. Findings: From a total of 895 image data, 581 were labeled as pes planus. A computational neural network (CNN) ran to evaluate the performance of the proposed model. The prediction accuracy of the basic CNN-based model was performed and the prediction model was derived through the proposed methodology. In the basic CNN model, the training accuracy was 79.14%, and the test accuracy was 72.09%. Conclusion: This model can be easily and simply used by patients with pes planus and doctors to predict the classification of pes planus and prescreen for possible musculoskeletal disorders related to this condition. However, more models need to be considered and compared for higher accuracy.

Keywords: foot disorder, machine learning, neural network, pes planus

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Authors: Todd Pennington, Carol Wilkinson, Keven Prusak

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Traditional models of student teaching practices typically involve the placement of a student teacher with an experienced mentor teacher. However, due to the ever-decreasing number of quality placements, an alternative triad approach is the paired placement of student teachers with one mentor teacher in a community of practice. This study examined the paired-placement of student teachers in physical education to determine the benefits and drawbacks after a 14-week student teaching experience. PETE students (N = 22) at a university in the United States were assigned to work in a triad with a student teaching partner and a mentor teacher, making up eleven triads for the semester. The one exception was a pair that worked for seven weeks at an elementary school and then for seven weeks at a junior high school, thus having two mentor teachers and participating in two triads. A total of 12 mentor teachers participated in the study. All student teachers and mentor teachers volunteered and agreed to participate. The student teaching experience was structured so that students engaged in: (a) individual teaching (one teaching the lesson with the other observing), (b) co-planning, and (c) peer coaching. All students and mentor teachers were interviewed at the conclusion of the experience. Using interview data, field notes, and email response data, the qualitative data was analyzed using the constant comparative method. The benefits of the paired placement experience emerged into three categories (a) quality feedback, (b) support, and (c) collaboration. The drawbacks emerged into four categories (a) unrealistic experience, (b) laziness in preparation, (c) lack of quality feedback, and (d) personality mismatch. Recommendations include: providing in-service training prior to student teaching to optimize the triad experience, ongoing seminars throughout the experience specifically designed for triads, and a hybrid model of paired placement for the first half of student teaching followed by solo student teaching for the second half of the experience.

Keywords: community of practice, paired placement, physical education, student teaching

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Authors: Rieski Prihastuti, Meliana Depo, Trisno A. Wibowo, Misinem

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On October 19, 2017, Yogyakarta Islamic Hospital reported 38 garment employees with nausea, vomiting, headache, abdominal pain, and diarrhea after they had lunch on October 18, 2017, to Sleman District Health Office. Objectives of this study were to ensure the outbreak and identify source and route of transmission. Case-control study was conducted to analyze food items that caused the outbreak. A case was defined as a person who got symptoms such as abdominal pain, diarrhea, nausea with/without vomiting, fever, and headache after they had lunch on October 18, 2017. Samples included leftover lunch box, vomit, tap water and drinking water had been sent to the laboratory. Data were analyzed descriptively as frequency table and analyzed by using chi-square in bivariate analysis. All of 196 garment employee was included in this study. The common symptoms of this outbreak were abdominal pain (84.4%), diarrhea (72.8%), nausea (61.6%), headache (52.8%), vomiting (12.8%), and fever (6.4%) with median incubation period 13 hours (range 1-34 hours). Highest attack rate and odds ratio was found in grilled chicken (Attack Rate 58,49%) with Odds Ratio 11,023 (Confidence Interval 95% 1.383 - 87.859; p value 0,005). Almost all samples showed mold, except drinking water. Based on its sign and symptoms, also incubation period, diarrheal Bacillus cereus and Clostridium perfringens were suspected to be the causative agent of the outbreak. Limitation of this study was improper sample handling and no sample of food handler and stools in the food caterer. Outbreak investigation training needed to be given to the hospital worker, and monitoring should be done to the food caterer to prevent another outbreak.

Keywords: disease outbreak, foodborne disease, food poisoning, outbreak

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Authors: Vrinda Hari Ankolekar, Anne D. Souza, Mamatha Hosapatna

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Introduction: Precise anatomical assessment of femoral neck anteversion (FNA) and the neck shaft angles (NSA) would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. FNA of greater than 20 degrees is considered excessive femoral anteversion, whereas a torsion angle of fewer than 10 degrees is considered femoral retroversion. Excessive femoral torsion is not uncommon and has been associated with certain neurologic and orthopedic conditions. The enlargement and maturation of the hip joint increases at the 20th week of gestation and the NSA ranges from 135- 140◦ at birth. Material and methods: 48 femurs were tagged according to the GA and two photographs for each femur were taken using Nikon digital camera. Each femur was kept on a horizontal hard desk and end on an image of the upper end was taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. The images were transferred to the computer and were stored in TIFF format. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. 1. Calculation of FNA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. The angle made by this line with the horizontal plane was measured as FNA. 2. Calculation of NSA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. A vertical line was drawn passing through the tip of the greater trochanter to the inter-condylar notch. The angle formed by these lines was calculated as NSA. Results: The paired t-test for the inter-observer variability showed no significant difference between the values of two observers. (FNA: t=-1.06 and p=0.31; NSA: t=-0.09 and p=0.9). The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t-test was applied to compare the mean angles between the second and third trimesters which did not show any statistical significance. This shows that the FNA and NSA of femur did not vary significantly during the third trimester. The FNA and NSA were correlated with the GA using Pearson’s correlation. FNA appeared to increase with the GA (r=0.5) but the increase was not statistically significant. A decrease in the NSA was also noted with the GA (r=-0.3) which was also statistically not significant. Conclusion: The present study evaluates the FNA and NSA of the femur in fetuses and correlates their development with the GA during second and third trimesters. The FNA and NSA did not vary significantly during the third trimester.

Keywords: anteversion, coxa antetorsa, femoral torsion, femur neck shaft angle

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Authors: Haleh Dadgostar, Sara Kaviani, Hanieh Adib, Ali Mazaherinezhad, Masoud Solaymani-Dodaran, Fahimeh Soheilipour, Abdolreza Pazouki

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Background and Objectives: Effectiveness of various exercise protocols in weight reduction after bariatric surgery has not been sufficiently explored in the literature. We compared the effect of minimally supervised home-based and closely supervised Gym based exercise programs on weight reduction and insulin resistance after bariatric surgery. Methods: Women undergoing gastric bypass surgery were invited to participate in an exercise program and were randomly allocated into two groups. They were either offered a minimally supervised home-based (MSHB) or closely supervised Gym-based (CSGB) exercise program. The CSGB protocol constitute two sessions per week of training under ACSM guidelines. In the MSHB protocol participants received a notebook containing a list of recommended aerobic and resistance exercises, a log to record their activity and a schedule of follow up phone calls and clinic visits. Both groups received a pedometer. We measured their weight, BMI, lipid profile, FBS, and insulin level at the baseline and after 20 weeks of exercise and were compared at the end of the study. Results: A total of 80 patients completed our study (MSHB=38 and CSGB=42). The baseline comparison showed that the two groups are similar. Using the ANCOVA method of analysis the mean change in BMI (covariate: BMI at the beginning of the study) was slightly better in CSGB compared with the MSHB (between-group mean difference: 3.33 (95%CI 4.718 to 1.943, F: 22.844 p < 0.001)). Conclusion: Our results showed that both MSHB and CSGB exercise methods are somewhat equally effective in improvement of studied factors in the two groups. With considerably lower costs of Minimally Supervised Home Based exercise programs, these methods should be considered when adequate funding are not available.

Keywords: postoperative exercise, insulin resistance, bariatric surgery, morbid obesity

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