Search results for: 'mother tongue' (muyu)

Authors: Akbar Khodavirdizadeh, Ali Nemati Babaylou, Hassan Moomivand

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The history of human access to water technique has been one of the factors in the formation of human civilizations in the ancient world. The technique that makes surface water and groundwater accessible to humans on the ground has been a clever technique in human life to reach the water. In this study, while examining the water technique of ancient Iran using the Qanats technique, the water supply system of different regions of the ancient world were also studied and compared. Six groups of the ancient region of ancient Greece (Archaic 480-750 BC and Classical 223-480 BC), Urartu in Tuspa (600-850 BC), Petra (106-168 BC), Ancient Rome (265 BC), and the ancient United States (1450 BC) and ancient Iranian water technologies were studied under water supply systems. Past water technologies in these areas: water transmission systems in primary urban centers, use of water structures in water control, use of bridges in water transfer, construction of waterways for water transfer, storage of rainfall, construction of various types of pottery- ceramic, lead, wood and stone pipes have been used in water transfer, flood control, water reservoirs, dams, channel, wells, and Qanat. The central plateau of Iran is one of the arid and desert regions. Archaeological, geomorphological, and paleontological studies of the central region of the Iranian plateau showed that without the use of Qanats, the possibility of urban civilization in this region was difficult and even impossible. Zarch aqueduct is the most important aqueduct in Yazd region. Qanat of Zarch is a plain Qanat with a gallery length of 80 km; its mother well is 85 m deep and has 2115 well shafts. The main purpose of building the Qanat of Zārch was to access the groundwater source and transfer it to the surface of the ground. Regarding the structure of the aqueduct and the technique of transferring water from the groundwater source to the surface, it has a great impact on being different from other water techniques in the ancient world. The results show that the use of water technologies in ancient is very important to understand the history of humanity in the use of hydraulic techniques.

Keywords: ancient water technologies, groundwaters, qanat, human history, Ancient Iran

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Anasarca is generalized congenital edema that is often lethal. The condition is transmitted hereditarily and is autosomal dominant, with a racial predisposition in French Bulldogs and English Bulldogs. This study aims at reporting a case of anasarca treatment in neonates. The fetuses of a one year and six months old, primiparous English Bulldog mother were diagnosed with anasarca during an ultrasound examination performed at the 55th day of pregnancy and, therefore, an elective cesarean section was scheduled to prevent fetal dystocia. At birth, all puppies presented anasarca, and one of the six was stillborn. The newborns presented cyanosis, dyspnea, bradycardia, absent reflexes, low vitality scores (3/10), and hypothermia ( < 32ºC). The weight of the puppies at the time of birth varied between 347 and 373 grams, about 100 grams above the average weight estimated for the breed. Immediate neonatal care was applied with oxygen therapy via a mask, aminophylline (0.2 ml/100 g/PV/sublingual), and slow heating. After 10 minutes, there was a significant improvement in the neonatal parameters. The anasarca was treated with the drug furosemide, administered subcutaneously, at a dose of 0.2 mg per 100 grams of weight, every three hours. The stimulation for urination of newborns was performed every 30 minutes, and weight loss was monitored every 30 minutes. Five grams of potassium chloride were administered orally for every 30 grams of weight loss to counterbalance the loss of potassium caused by the diuretic medication. After 15 hours, the neonates reached the ideal weight for the breed, around 209 to 230 grams. In total, four neonates received five doses of furosemide, while one received six doses. The puppies are currently ten months old, healthy and neutered. Anasarca should not be ignored and is considered potentially lethal and an indication for euthanasia in all cases. Early intervention is of utmost importance for the survival of these patients.

Keywords: Walrus syndrome, congenital edema, water puppy syndrome, puppies

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Authors: A. Raceviciute-Stupeliene, V. Sasyte, V. Viliene, V. Slausgalvis, J. Al-Saifi, R. Gruzauskas

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The objective of this study was to investigate the influence of special additives such as chelators, zinc sulphate and silicic acid on productivity parameters, carcass characteristics and meat quality of fattening pigs. The test started with 40 days old fattening pigs (mongrel (mother) and Yorkshire (father)) and lasted up to 156 days of age. During the fattening period, 32 pigs were divided into 2 groups (control and experimental) with 4 replicates (total of 8 pens).  The pigs were fed for 16 weeks’ ad libitum with a standard wheat-barley-soybean meal compound (Control group) supplemented with chelators, zinc sulphate and silicic acid (dosage 2 kg/t of feed, Experimental group). Meat traits in live pigs were measured by ultrasonic equipment Piglog 105. The results obtained throughout the experimental period suggest that supplementation of chelators, zinc sulphate and silicic acid tend to positively affect average daily gain and feed conversion ratio of pigs for fattening (p < 0.05). Pigs’ evaluation with Piglog 105 showed that thickness of fat in the first and second point was by 4% and 3% respectively higher in comparison to the control group (p < 0.05). Carcass weight, yield, and length, also thickness of fat showed no significant difference among the groups. The water holding capacity of meat in Experimental group was lower by 5.28%, and tenderness – lower by 12% compared with that of the pigs in the Control group (p < 0.05). Regarding pigs’ meat chemical composition of the experimental group, a statistically significant difference comparing with the data of the control group was not determined. Cholesterol concentration in muscles of pigs fed diets supplemented with chelators, zinc sulphate and silicic acid was lower by 7.93 mg/100 g of muscle in comparison to that of the control group. These results suggest that supplementation of chelators, zinc sulphate and silicic acid in the feed for fattening pigs had significant effect on pigs growing performance and meat quality.

Keywords: silicic acid, chelators, meat quality, pigs, zinc sulphate

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Authors: Büşra Durmaz, Füsun Curaoğlu

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While technology-oriented developments in the modern world change our perceptions of time and speed, they also force our food consumption patterns, such as getting pleasure from what we eat and eating slowly. The habit of eating quickly and hastily causes not only the feeling of not understanding the taste of the food eaten but also the inability to postpone the feeling of satiety and, therefore, many health problems. In this context, especially in the last ten years, in the field of industrial design, food manufacturers for healthy living and consumption have been collaborating with industrial designers on food design. The consumers of the new century, who are in an uncontrolled time intensity, receive support from small snacks as a source of happiness and pleasure in the little time intervals they can spare. At this point, especially chocolate has been a source of happiness for its consumers as a source of both happiness and pleasure for hundreds of years. However, when the portions have eaten cannot be controlled, a pleasure food such as chocolate can cause both health problems and many emotional problems, especially the feeling of guilt. Fast food, which is called food that is prepared and consumed quickly, has been increasing rapidly around the world in recent years. This study covers the process and results of a chocolate design based on the user experience of a university-industry cooperation project carried out within the scope of Eskişehir Technical University graduation projects. The aim of the project is a creative product design that will enable the user to experience chocolate consumption with a healthy eating approach. For this, while concepts such as pleasure, satiety, and taste are discussed; A survey with 151 people and semi-structured face-to-face interviews with 7 people during the experience design process within the scope of the user-oriented design approach, mainly literature review, within the scope of main topics such as mouth anatomy, tongue structure, taste, the functions of the eating action in the brain, hormones and chocolate, video A case study based on the research paradigm of Qualitative Research was structured within the scope of different research processes such as analysis and project diaries. As a result of the research, it has been reached that the melting in the mouth is the preferred experience of the users in order to spread the experience of eating chocolate for a long time based on pleasure while eating chocolate with healthy portions. In this context, researches about the production of sketches, mock-ups and prototypes of the product are included in the study. As a result, a product packaging design has been made that supports the active role of the senses such as sight, smell and hearing, where consumption begins, in order to consume chocolate by melting and to actively secrete the most important stimulus salivary glands in order to provide a healthy and long-term pleasure-based consumption.

Keywords: chocolate, eating habit, pleasure, saturation, sense of taste

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Authors: E. Machinyise

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The main purpose of this study was to investigate the attitudes of parents and teachers towards multilingual medium of instruction in lower primary schools of Zambia. In 2013, the Government of Zambia formulated a language policy which stipulates that regional familiar languages should be used as the medium of instruction (MOI) from grade one to four in all public primary schools, while English is introduced as a subject in the second grade. This study investigated the views of parents and teachers on the use of multilingual medium of instruction in lower primary schools in order to accommodate learners who are not native speakers of regional familiar languages as well as the second languages which are official languages used in class. The study revealed that most parents suggested that teachers who teach lower primary school classes should be conversant with at least the four major local languages of Zambia (Bemba, Nyanja, Tonga and Lozi). In the same vain other parents felt that teachers teaching lower grades should not only be familiar with the regional official language but should be able to speak other dialects found in the region. Teachers teaching in lower primary grade felt that although it is difficult to speak all languages of learners in class, it is important for a teacher of lower grade class to try to accommodate children who are not speakers of the familiar languages by addressing them in the language they understand. Both teachers and parents highlighted a number of advantages of teaching children in their mother tongues. Both qualitative and quantitative methods were used for the collection of data for this study. 30 teachers from selected public primary schools and 20 parents of Kapiri district and five lecturers of teacher training colleges in Central province were selected for this study. The researcher also observed class lessons in lower primary schools of Kapiri district. This study revealed that both parents and teachers are of the views that teachers teaching lower primary classes should use multilingual medium of instruction in lower primary classes so as to accommodated children of different linguistic backgrounds.

Keywords: familiar languages, medium of instruction, multilingual medium of instruction, native speakers

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Authors: Mireya Mateo Gomez

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The purpose of this study was to examine the perceptions first-generation Mexican origin mothers living in San Diego have on postpartum depression (PPD), with a special focus on social influences and cultural beliefs towards those meanings. This study also aimed to examine possible PPD help-seeking behaviors that first-generation Mexican origin mothers can perform. The Health Belief Model (HBM) and Social Ecological Model (SEM) were the guiding theoretical frameworks for this study. Data for this study were collected from three focus groups, four in-depth interviews, and the distribution of an acculturation survey (ARSMA II). There were a total of 15 participants, in which participant’s mean age was 45, and the mean age migrated to the United States being 22. Most participants identified as being married, born in Southern or Western Mexico, and with a strong Mexican identity in relation to the ARSMA survey. Participants identified four salient PPD perceptions corresponding to the interpersonal level of SEM. These four main perceptions were: 1) PPD affecting the identity of motherhood; 2) PPD being a natural part of a mother’s experience but mitigated by networks; 3) PPD being a U.S. phenomenon due to family and community breakdown; and 4) natural remedies as a preferred PPD treatment. In regard to themes relating to help seeking behaviors, participants identified seven being: 1) seeking help from immediate family members; 2) practicing home remedies; 3) seeking help from a medical professional; 4) obtaining help from a clinic or organization; 5) seeking help from God; 6) participating in PPD support groups; and 7) talking to a friend. It was evident in this study that postpartum depression is not a well discussed topic within the Mexican immigrant population. In relation to the role culture and social influences have on PPD perceptions, most participants shared hearing or learning about PPD from their family members or friends. Participants also stated seeking help from family members if diagnosed with PPD and seeking out home remedies. This study as well provides suggestions to increase the awareness of PPD among the Mexican immigrant community.

Keywords: cultural beliefs, health belief model, Mexican origin mothers, perceptions, postpartum depression social ecological model

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Authors: Aishi Kundu, Elhan Raza

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"Necessity is the mother of invention" - Rapid increase in the global human population has directed the agricultural domain toward machine learning. The basic need of human beings is considered to be food which can be satisfied through farming. Farming is one of the major revenue generators for the Indian economy. Agriculture is not only considered a source of employment but also fulfils humans’ basic needs. So, agriculture is considered to be the source of employment and a pillar of the economy in developing countries like India. This paper provides a brief review of the progress made in implementing Machine Learning in the agricultural sector. Accurate predictions are necessary at the right time to boost production and to aid the timely and systematic distribution of agricultural commodities to make their availability in the market faster and more effective. This paper includes a thorough analysis of various machine learning algorithms applied in different aspects of agriculture (crop management, soil management, water management, yield tracking, livestock management, etc.).Due to climate changes, crop production is affected. Machine learning can analyse the changing patterns and come up with a suitable approach to minimize loss and maximize yield. Machine Learning algorithms/ models (regression, support vector machines, bayesian models, artificial neural networks, decision trees, etc.) are used in smart agriculture to analyze and predict specific outcomes which can be vital in increasing the productivity of the Agricultural Food Industry. It is to demonstrate vividly agricultural works under machine learning to sensor data. Machine Learning is the ongoing technology benefitting farmers to improve gains in agriculture and minimize losses. This paper discusses how the irrigation and farming management systems evolve in real-time efficiently. Artificial Intelligence (AI) enabled programs to emerge with rich apprehension for the support of farmers with an immense examination of data.

Keywords: machine Learning, artificial intelligence, crop management, precision farming, smart farming, pre-harvesting, harvesting, post-harvesting

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Authors: Gokul Pathak, Dilip Kumar Yadav

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Background: Unsafe/unprotected and early sexual relations are highly responsible for the problems of unwanted pregnancy, child birth and other adverse consequences. Emergency contraception (EC) refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure or incorrect use. Aim and Objective: The objective of this research study was to assess the level of knowledge, attitude and behavior on emergency contraception among youth students of Lekhnath Municipality. Methodology: This institution based descriptive study was carried out in August-October 2012 on Lekhnath Municipality, Nepal. Multistage simple random sampling procedure with pretested semi structured questionnaire following self administered technique was used to collect information. Collected data was coded and entered in the EpiData 3.1 ® and exported to Statistical Package for Social Science (SPSS®) version 20.0 for analysis. Chi-square test and Spearman correlation was applied wherever required. Results: A total of 641 students (87.6 %), youth students participated in this study which incorporates 354 male and 287 female youth students, of them 54.3% were from Higher Secondary level and 45.7% were from Undergraduate level. The awareness of EC among respondents was found only 64.7%. 25.8% respondents were found to have fair knowledge level where as 74.2% had poor knowledge level. Level of knowledge was significantly associated with age, educational level, faculty and educational status of mother. The study showed 82.4% respondent’s favorable attitude towards use of EC. 21.1% respondents were found to be sexually active (29.7% male and 10.5% female) and only 28.1% of sexually active respondents had ever used any method of EC. Conclusion: Knowledge about EC was found quiet low among youth. There was significant lack of knowledge about exact time limit of using devices of EC. Similarly several misconceptions regarding EC were found very high among youth. Health education initiatives should target students as they are more likely to be sexually active.

Keywords: emergency contraception, youth, unsafe/unprotected sexual intercourse, knowledge, attitude and behavior

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Authors: Gudakesh Yadav

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Utter Pradesh, which is one of the largest states of India with unequal distribution of resources and different socioeconomic and cultural characteristics, level of different new born health care indicators varies a lot from one district to another district. State shared more than 21 percent of total live births of India; whereas, it accounts for 28 percent of total infant deaths of the country, with the 53 per thousand infant mortality rate. The present paper attempts to examine tempo-spatial changes in new born care practices during NFHS-1 to NFHS-3 and DLHS-2 to DLHS-3 in Uttar Pradesh and different regions. Descriptive statistics, rate-ratios, concentration index, multivariate and decomposition analysis has been used for the study. Findings of the study reveal that new born care practices have improved over the time in the state and across all the regions because of giving more emphasis on venerable groups like poor, rural, less educated mothers and scheduled caste & tribes but still it did not achieve the desired successes. Regional analysis of third rounds of DLHS shows that, coverage of intuitional delivery was the lowest in the central region. Performance of the southern region was the lowest in terms of initiation of breastfeeding, keeping baby warm and dry after the birth. The study calls for proper follow up of new born children to accelerate new born and child health care service and prioritises increasing antenatal check-ups and institutional delivery, which helps to improve level of other new born care services. At the policy level there is need to reach venerable groups like scheduled caste and tribes, poor and uneducated, and new mother especially in rural areas. High focused district should be allocated for better implementation of new born care promotion programme in low performing districts. Partnership with the private sector health professional is necessary to reach the every part of population.

Keywords: decomposition, inequality, initiation of breastfeeding, institutional delivery

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Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

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Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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Authors: Shuaili Ji

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The correct use of verbs is an important element of high-quality research articles, and thus for Chinese EFL learners, it is significant to master characteristics of verbs and to precisely use verbs. However, some researches have shown that there are differences in using verbs between learners and native speakers and learners have difficulty in using English verbs. This corpus-based quantitative research can enhance learners’ knowledge of English verbs and promote the quality of research article abstracts even of the whole academic writing. The aim of this study is to find the differences between learners’ and native speakers’ use of verbs and to study the factors that contribute to those differences. To this end, the research question is as follows: What are the differences between most frequently used verbs by learners and those by native speakers? The research question is answered through a study that uses corpus-based data-driven approach to analyze the verbs used by learners in their abstract writings in terms of collocation, colligation and semantic prosody. The results show that: (1) EFL learners obviously overused ‘be, can, find, make’ and underused ‘investigate, examine, may’. As to modal verbs, learners obviously overused ‘can’ while underused ‘may’. (2) Learners obviously overused ‘we find + object clauses’ while underused ‘nouns (results, findings, data) + suggest/indicate/reveal + object clauses’ when expressing research results. (3) Learners tended to transfer the collocation, colligation and semantic prosody of shǐ and zuò to make. (4) Learners obviously overused ‘BE+V-ed’ and used BE as the main verb. They also obviously overused the basic forms of BE such as be, is, are, while obviously underused its inflections (was, were). These results manifested learners’ lack of accuracy and idiomatic property in verb usage. Due to the influence of the concept transfer of Chinese, the verbs in learners’ abstracts showed obvious transfer of mother language. In addition, learners have not fully mastered the use of verbs, avoiding using complex colligations to prevent errors. Based on these findings, the present study has implications for English teaching, seeking to have implications for English academic abstract writing in China. Further research could be undertaken to study the use of verbs in the whole dissertation to find out whether the characteristic of the verbs in abstracts can apply in the whole dissertation or not.

Keywords: academic writing abstracts, Chinese EFL learners, corpus-based, data-driven, verbs

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Authors: Ashraf Mohammadzadeh, Ahmad Shah Farhat, Azin Vaezi, Aradokht Vaezi

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Background & Aim: Preterm infants born at less than 34 weeks postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking, swallowing and breathing. As a result, they are traditionally gavage fed until they are able to oral feed successfully. The aim of study was to evaluate comparative effect of orogastric and breast feeding on oxygen saturation in very low birth weight infant (<1500gm). Patients and Methods: In this clinical trial all babies admitted in the Neonatal Research Center of Imamreza Hospital, Mashhad during a 4 months period were elected. Criteria for entrance to study included birth weight ≤ 1500 grams, exclusive breastfeeding, having no special problem after 48 hours, receivinge only routine care and intake of milk was 100cc/kg/day. Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon, during which mean oxygen saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonates were monitored, and in case of hypothermia, bradycardia(less than 100 per minute) or apnea the feeding was discontinued and the study was repeated the following day. Data analysis was carried out using SPSS. Results: Fifty neonates were studied. The average birth weight was 1267.20±165.42 grams and average gestational age was 31.81±1.92 and female/male ratio was 1.2. There was no significant statistical difference in arterial oxygen saturation in orogastric and breast feeding in the morning and in the afternoon. (p=0.16 in the morning and p=0.6 in the afternoon). There was no complication of apnea, hypothermia or bradycardia. Conclusion: There was no significant statistical difference between the two methods in arterial oxygen saturation. It seems that oral feeding (which is a natural route) and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate. Also shorter period of stay in hospital is more preferred, and breast feeding should be started at the earliest possible time after birth.

Keywords: Very low birth weight (V.L.B.W), O2 Saturation, Breast Feeding, Tube Feeding

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Authors: Rosemond Mbii

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Menstruation is a critical topic. However normal menstruation is, it has become a determinant in the education of young women today. The research focuses on Breaking the silence and accessing menstrual hygiene management's challenges and experiences among rural schoolgirls in Ghana. The study's goal was to examine the menstrual hygiene practices of female students. Participants described their menstrual hygiene practices, their problems, and how they coped with their menstrual symptoms. The research used a qualitative technique through group interviews, personal interviews, and open-ended questionnaires since it is easier to understand a phenomenon from the subject's viewpoint. Sen's capacities approach and Feminist Political Ecology (FPE) were used to analyze the data. Menstruation was known to girls even before their menarche. A mother or grandmother, friends, and teachers were the primary sources of menstrual knowledge. The study also found that most girls use sanitary products made of fabrics, pads, and cotton during menstruation. Among the difficulties the girls faced, the study found were emotional upset, physical discomfort (cramps in the stomach, fatigue), embarrassment, and inadequate sanitation hygiene facilities. The girls wore many garments to avoid leaks; checked their skirts continuously, went to the bathroom with their friends to act as spics while they changed; sat differently on the chairs, and took medicine to reduce period discomfort. Introduction of a health care teacher who supplies sanitary products and medications to girls during school time. Euphemisms as a form of communication amongst girls were all coping mechanisms girls and the school developed. Another finding was that some girls continued to go to school even while having their periods, while others did not. Discomfort and menstruation cramps hampered class participation. In addition, the study revealed insufficient sanitation and hygiene for females to change sanitary products in private and manage menstrual hygiene comfortably.

Keywords: MHM (menstrual hygiene management), rural area, sanitation, menstruation, water, schoolgirl, rural area, sanitation, menstruation, water

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Authors: Claire Baudry, Jessica Pearson, Laura-Emilie Savage, George Tarbulsy

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Introduction: Over the last decade, researchers have implemented attachment-based interventions to promote parental interactive sensitivity and child development among vulnerable families. In the context of the present study, these interventions have been shown to be effective to enhance cognitive development when child outcome was measured shortly after the intervention. Objectives: The goal of the study was to investigate the effects of an attachment-based intervention on child cognitive development one year post-intervention. Methods: Thirty-five mother-child dyads referred by Child Protective Services in the province of Québec, Canada, were included in this study: 21 dyads who received 6 to 8 intervention sessions and 14 dyads not exposed to the intervention and matched for the following variables: duration of child protective services, reason for involvement with child protection, age, sex and family status. Child cognitive development was measured using the WPPSI-IV, 12 months after the end of the intervention when the average age of children was 54 months old. Findings: An independent-samples t-test was conducted to compare the scores obtained on the WPPSI-IV for the two groups. In general, no differences were observed between the two groups. There was a significant difference on the fluid reasoning scale between children exposed to the intervention (M = 95,13, SD = 16,67) and children not exposed (M = 81, SD = 9,90). T (23) = -2,657; p= .014 (IC :-25.13;3.12). This difference was found only for children aged between 48 and 92 months old. Other results did not show any significant difference between the two groups (Global IQ or subscales). Conclusions: This first set of analyses suggest that relatively little effects of attachment-based intervention remain on the level of cognitive functioning 12-months post-intervention. It is possible that the significant findings concerning fluid reasoning may be pertinent in that fluid reasoning is linked to the capacity to analyse, to solve problems, and remember information, which may be important for promoting school readiness. As the study is completed and as more information is gained from other assessments of cognitive and socioemotional outcome, a clearer picture of the potential moderate-term impact of attachment-based intervention will emerge.

Keywords: attachment-based intervention, child development, child protective services, cognitive development

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Authors: Hermann Luecken, Young Won Park, Judith M. Puetter

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Quality is known to be the accordance of product characteristics and customer requirements. Both the customer requirements and the assessment of the characteristics of the product with regard to the fulfillment of customer requirements are subject to cultural influences. Of course, the processes itself which lead to product manufacturing is also subject to cultural influences. In the first point, the cultural background of the customer influences the quality, in the second point, it is the cultural background of the employees and the company that influences the process itself. In times of globalization products are manufactured at different locations around the world, but typically the quality management system of the country in which the mother company is based is used. This leads to significantly different results in terms of productivity, product quality and process efficiency at the different locations, although the same quality management system is in use. The aim of an efficient and effective quality management system is therefore not doing the same at all locations, but to have the same result at all locations. In the past, standardization was used to achieve the same results. Recent investigations show that this is not the best way to achieve the same characteristics of product quality and production performance. In the present work, it is shown that the consideration of cultural aspects in the design of processes, production systems, and quality management systems results in a significantly higher efficiency and a quality improvement. Both Japanese and German companies were investigated with comparative interviews. The background of this selection is that in most cases the cultural difference regarding industrial processes between Germany and Japan is high. At the same time, however, the customer expectations regarding the product quality are very similar. Interviews were conducted with experts from German and Japanese companies; in particular, companies were selected that operate production facilities both in Germany and in Japan. The comparison shows that the cultural influence on the respective production performance is significant. Companies that adapt the design of their quality management and production systems to the country where the production site is located have a significantly higher productivity and a significantly higher quality of the product than companies that work with a centralized system.

Keywords: comparison of German and Japanese production systems, cultural influence on quality management, expert interviews, process efficiency

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Authors: Adamnesh A. Bogale, Dorte Thorsen

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This paper aims to learn how children/siblings left behind due to parental migration experience care and the effects of the separation. It also aims to unpack the experiences of youth migrants in rural Ethiopia. It focuses specifically on how children and youth are affected in order to highlight in which areas intervention can enhance or inadvertently undermine the development impact of migration on young people. Based on a qualitative study in South Wollo, Ethiopia, which was undertaken in three stages in 2017-19 and involved 34 households and a number of key informants, the analysis offers insights into how migration contributes to household sustainability and, in the process, alters intergenerational relationships and dynamics. Contemporary migration in Ethiopia is complex and highly gendered. For young women, the migration corridor from Ethiopia to the Middle East is the most important, whereas young men mostly engage in local migration or travel to South Africa or Sudan. Arguing that children and youths’ experience of migration must be understood in the context of the moral, affective, and material economies, the paper distinguishes between young people’s experiences of migration as children of migrants, as siblings of a migrant, and as migrants. The material shows that children and youths demonstrate different experiences in parental migration depending on age, care arrangement, and the ability to communicate with an absent mother. Migration has a different implication for younger siblings depending on their gender. The division of work and future responsibilities post marriage combine to disadvantage female siblings while male siblings are either unaffected or reaped the benefits of investments made with remittances. Finally, migration is a mechanism to change generational power relationships. As remitters, young migrants yield better recognition in the family, though not always to the degree that they can control the use of remittances. The power to make decisions is not tied only to material resources and the household; migration facilitates social change that opens space for young women to have more influence over their own lives.

Keywords: migration, youth, Ethiopia, generations

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Authors: Taju Abdela Mohammed

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Introduction: There has been a rise in awareness of violence against young women and girls, particularly when it occurs in educational environments. Gender-based violence in schools is a significant barrier. Therefore, it would be a threat to the achievement of the sustainable development goals, strive for gender equality in all our programs, right from the planning stages, to make sure we are as equitable as possible. Research on the causes, attitudes, and perceptions of gender-based violence was scant. Furthermore, there aren't many studies done on female students attending private colleges. Thus, the purpose of this study is to evaluate the frequency of gender-based violence and related variables among female students attending private colleges in Harar City, Ethiopia. Methodology: A facility-based mixed method concurrent triangulation study design was conducted among 500 randomly selected Private college female students in Harar City. Self-administered questionnaire and an in-depth interview were used to collect the data. The collected data were cleaned and analyzed using a statistical package for social science. Descriptive statistics were conducted and the results were reported using frequency, and percentile. Bivariate logistic regression was performed to identify associated factors. Adjusted odds ratios with 95% confidence intervals and p values < 0.05 were used to explain statistically significant associations. Thematic analysis was used to manually translate, transcribe, and analyze qualitative data. Result: The study showed the prevalence of gender-based violence was 338 (67.6%) (CI 0.432–0.721) Private college female students in Harar city Administration. Age less than 20 years and 20–24 years, [AOR = 0.21, 95% CI (0.03–0.81)] and [AOR = 0.12, 95% CI (0.03–0.51)], tight family control, [AOR = 5.12, 95% CI (1.43–6.9)], Witnessed father abuse mother at childhood; [AOR = 4.04, 95% CI (1.36–12.1)], had drunkenness female or boyfriend; [AOR = 2.12, 95% CI (1.60–14.05)] had significant association with gender-based violence. Conclusion: Our study shows the prevalence of gender-based violence among Private college female students is significant. This is due to the fact that gender-based violence, such as school dropout, unintended pregnancy, abortion, STDs, and psychological disorders, is abandoning young girls' lives and lowering their productivity.

Keywords: female students, gender-violence, harar, Ethiopia

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Authors: Clare Maxwell, Lorna Porcellato, Valerie Fleming, Kate Fleming

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A review of global online forums and social media reveals large numbers of mothers experiencing bottle refusal by their breastfed baby. It is difficult to determine precise numbers due to a lack of data, however, established virtual communities illustrate thousands of posts in relation to the issue. Mothers report various negative consequences of bottle refusal including delaying their return to work, time and financial outlay spent on methods to overcome it and experiencing stress, anxiety, and resentment of breastfeeding. A search of the literature revealed no studies being identified, and due to a lack of epidemiological data, a study investigating mother’s experiences of bottle refusal by their breastfed baby was undertaken. The aim of the study was to investigate UK mothers’ experiences of bottle refusal by their breastfed baby. Data were collected using an online questionnaire collecting quantitative and qualitative data. 841 UK mothers who had experienced or were experiencing bottle refusal by their breastfed baby completed the questionnaire. Data were analyzed using descriptive statistics and non-parametric testing. The results showed 61% (516/840) of mothers reported their breastfed baby was still refusing/had never accepted a bottle, with 39% (324/840) reporting their baby had eventually accepted. The most frequently reported reason to introduce a bottle was so partner/family could feed the baby 59% (499/839). 75% (634/841) of mothers intended their baby to feed on a bottle ‘occasionally’. Babies who accepted a bottle were more likely to be older at 1st attempt to introduce one than those babies who refused (Mdn = 12 weeks v 8 weeks, n = 286) (p = <0.001). Length of time taken to acceptance was 9 weeks (Mdn = 9, IQR = 18, R = 103.9, n = 306) with the older the baby was at 1st attempt to introduce a bottle being associated with a shorter length of time to acceptance (p = < 0.002). 60% (500/841) of mothers stated that none of the methods they used had worked. 26% (222/841) of mothers reported bottle refusal had had a negative impact upon their overall breastfeeding experience. 47% (303/604) reported they would have tried to introduce a bottle earlier to prevent refusal. This study provides a unique insight into the scenario of bottle refusal by breastfed babies. It highlights that bottle refusal by breastfed babies is a significant issue, which requires recognition from those communicating breastfeeding information to mothers.

Keywords: bottle feeding, bottle refusal, breastfeeding, infant feeding

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Authors: Lydia Foucan, Laurent Larifla, Emmanuelle Durand, Christine Rambhojan, Veronique Dhennin, Jean-Marc Lacorte, Philippe Froguel, Amelie Bonnefond

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In the population of Guadeloupe Island (472,124 inhabitants and 80% of subjects of African descent), overweight and obesity were estimated at 23% and 9% respectively among children. High prevalence of diabetes has been reported (~10%) in the adult population. Nevertheless, no study has investigated the contribution of gene mutations to childhood obesity in this population. We aimed to investigate rare genetic mutations in genes involved in monogenic obesity or diabetes in obese Afro-Caribbean children from Guadeloupe Island using next-generation sequencing. The present investigation included unrelated obese children, from a previous study on overweight conducted in Guadeloupe Island in 2013. We sequenced coding regions of 59 genes involved in monogenic obesity or diabetes. A total of 25 obese schoolchildren (with Z-score of body mass index [BMI]: 2.0 to 2.8) were screened for rare mutations (non-synonymous, splice-site, or insertion/deletion) in 59 genes. Mean age of the study population was 12.4 ± 1.1 years. Seventeen children (68%) had insulin-resistance (HOMA-IR > 3.16). A family history of obesity (mother or father) was observed in eight children and three of the accompanying parent presented with type 2 diabetes. None of the children had gonadotrophic abnormality or mental retardation. We detected five rare heterozygous mutations, in four genes involved in monogenic obesity, in five different obese children: MC4R p.Ile301Thr and SIM1 p.Val326Thrfs*43 mutations which were pathogenic; SIM1 p.Ser343Pro and SH2B1 p.Pro90His mutations which were likely pathogenic; and NTRK2 p.Leu140Phe that was of uncertain significance. In parallel, we identified seven carriers of mutation in ABCC8 or KCNJ11 (involved in monogenic diabetes), which were of uncertain significance (KCNJ11 p.Val13Met, KCNJ11 p.Val151Met, ABCC8 p.Lys1521Asn and ABCC8 p.Ala625Val). Rare pathogenic or likely pathogenic mutations, linked to severe obesity were detected in more than 15% of this Afro-Caribbean population at high risk of obesity and type 2 diabetes.

Keywords: childhood obesity, MC4R, monogenic obesity, SIM1

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Authors: Orly Sela

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The lecture discusses a Language Teaching program in a Teacher Education College in northern Israel. An on-line course was added to the program in order to keep on-campus attendance at a minimum, thus allowing the students to keep their full-time jobs in school. In addition, the use of educational technology to allow students to study anytime anywhere, in keeping with 21st-century innovative teaching-learning practices, was also an issue, as was the wish for this course to serve as a model which the students could then possibly use in their K-12 teaching. On the other hand, there were strong considerations against including an online course in the program. The students in the program were mostly Israeli-Arab married women with young children, living in a traditional society which places a strong emphasis on the place of the woman as a wife, mother, and home-maker. In addition, as teachers, they used much of their free time on school-related tasks. Having careers at the same time as studying was ground-breaking for these women, and using their time at home for studying rather than taking care of their families may have been simply too much to ask of them. At the end of the course, feedback was collected through an online questionnaire including both open and closed questions. The data collected shows that the students believed in online teaching-learning in principle, but had trouble implementing it in practice. This evidence raised the question of whether or not such a course should be included in a graduate program for mature, professional students, particular women with families living in a traditional society. This issue is not relevant to Israel alone, but also to academic institutions worldwide serving such populations. The lecture discusses this issue, sharing the researcher’s conclusions with the audience. Based on the evidence offered, it is the researcher’s conclusion that online education should, indeed, be offered to such audiences. However, the courses should be designed with the students’ special needs in mind, with emphasis placed on initial planning and course organization based on acknowledgment of the teaching context; modeling of online teaching/learning suited for in-service teacher education, and special attention paid to social-constructivist aspects of learning.

Keywords: course design, in-service teacher-education, mature students, online teaching/learning

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Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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Authors: Jinhee Kang, Kwangman Park, Ruhee Song, Suhee Kim, Do-Hyeon Yu, Kyoungseong Choi, Jinho Park

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Statement of the Problem: Animal blood components maintain homeostasis when animals are healthy, and changes in chemical composition of the blood and body fluids can be observed if animals have a disease. In particular, newborn calves are susceptible to disease and therefore hematologic tests and serum chemistry tests could become an important guideline to the diagnosis and the treatment of diseases. Diarrhea in newborn calves is the most damaging to cattle ranch, whether dairy or cattle fattening, and is a large part of calf atrophy and death. However, since the study on calf electrophoresis was not carried out, a survey analysis was conducted on it. Methodology and Theoretical Orientation: The calves were divided into healthy calves and disease (diarrhea) calves, and calves were classified by 1-14d, 15-28d, and more than 28d, respectively. The fecal state was classified by solid (0-value), semi-solid (1-value), loose (2-value) and watery (3-value). In the solid (0-value) and semi-solid (1-value) feces valuable pathogen was not detected, but loose (2-value) and watery (3-value) feces were detected. Findings: ALB, α-1, α-2, α-SUM, β and γ (Gamma) were examined by electrophoresis analysis of healthy calves and diarrhea calves. Test results showed that there were age differences between healthy calves and diarrheic calves. When we look at the γ-globulin at 1-14 days of age, we can see that the average calf of healthy calves is 16.8% and the average of diarrheal calves is 7.7%, when we look at the figures for the α-2 at 1-14 days, we found that healthy calves average 5.2% and diarrheal calves 8.7% higher than healthy cows. On α-1, 15-28 days, and after 28 days, healthy calves average 10.4% and diarrheal calves average 7.5% diarrhea calves were 12.6% and 12.4% higher than healthy calves. In the α-SUM, the healthy calves were 21.6%, 16.8%, and 14.5%, respectively, after 1-14 days, 15-28 days and 28 days. diarrheal calves were 23.1%, 19.5%, and 19.8%. Conclusion and Significance: In this study, we examined the electrophoresis results of healthy calves and diseased (diarrhea) calves, gamma globulin at 1-14 days of age were lower than those of healthy calves (diarrhea), indicating that the calf was unable to consume colostrum from the mother when it was a new calf. α-1, α-2, α-SUM may be associated with an acute inflammatory response as a result of increased levels of calves with diarrhea (diarrhea). Further research is needed to investigate the effects of acute inflammatory responses on additional calf-forming proteins. Information on the results of the electrophoresis test will be provided where necessary according to the item.

Keywords: alpha, electrophoretogram, serum protein, γ, gamma

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Authors: Delaram Ghodsi, Nasrin Omidvar, Hassan Eini-Zinab, Arash Rashidian, Hossein Raghfar

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Food supplementary programs are policy approaches that aim to reduce financial barriers to healthy diets and tackle food insecurity. This study aimed to evaluate the effect of the supportive section of Multidisciplinary Supplementary Program for Improvement of Nutritional Status of Children (MuPINSC) on households’ food security status and nutritional status of mothers. MuPINSC is a national integrative program in Iran that distributes supplementary food basket to malnourished or growth retarded children living in low-income families in addition to providing health services, including sanitation, growth monitoring, and empowerment of families. This longitudinal study is part of a comprehensive evaluation of the program. The study participants included 359 mothers of children aged 6 to 72 month under coverage of the supportive section of the program in two provinces of Iran (Semnan and Qazvin). Demographic and economic characteristics of families were assessed by a questionnaire. Data on food security of family was collected by locally adapted Household Food Insecurity Access Scale (HFIAS) at the baseline of the study and six month thereafter. Weight and height of mothers were measured at the baseline and end of the study and mother’s BMI was calculated. Data were analysed, using paired t-test, GEE (Generalized Estimating Equation), and Chi-square tests. Based on the findings, at the baseline, only 4.7% of families were food-secure, while 13.1%, 38.7% and, 43.5% were categorized as mild, moderate and severe food insecure. After six months follow up, the distribution of different levels of food security changed significantly (P<0.001) to 7.9%, 11.6%, 42.6%, and 38%, respectively. At the end of the study, the chance of food insecurity was significantly 20% lower than the beginning (OR=0.796; 0.653-0.971). No significant difference was observed in maternal BMI based on food security (P>0.05). The findings show that the food supplementary program for children improved household food security status in the studied households. Further research is needed to assess other factors that affect the effectiveness of this large scale program on nutritional status and household’s food security.

Keywords: food security, food supplementary program, household, malnourished children

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Authors: K. M. Damodara Gowda

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Background: Maternal health and nutrition are considered as the predominant factors influencing brain functional development. If the mother is free of illness and genetic defects, maternal nutrition would be one of the most critical factors affecting the brain development. Calorie restrictions cause significant impairment in spatial learning ability and the levels of Brain Derived Neurotrophic Factor (BDNF) in rats. But, the mechanism by which the prenatal under-nutrition leads to impairment in brain learning and memory function is still unclear. In the present study, prenatal Astaxanthin supplementation on BDNF level, spatial learning and memory performance in the offspring’s of normal, calorie restricted and Astaxanthin supplemented rats was investigated. Methodology: The rats were administered with 6mg and 12 mg of astaxanthin /kg bw for 21 days following which acquisition and retention of spatial memory was tested in a partially-baited eight arm radial maze. The BDNF level in different regions of the brain (cerebral cortex, hippocampus and cerebellum) was estimated by ELISA method. Results: Calorie restricted animals treated with astaxanthin made significantly more correct choices (P < 0.05), and fewer reference memory errors (P < 0.05) on the tenth day of training compared to offsprings of calorie restricted animals. Calorie restricted animals treated with astaxanthin also made significantly higher correct choices (P < 0.001) than untreated calorie restricted animals in a retention test 10 days after the training period. The mean BDNF level in cerebral cortex, Hippocampus and cerebellum in Calorie restricted animals treated with astaxanthin didnot show significant variation from that of control animals. Conclusion: Findings of the study indicated that memory and learning was impaired in the offspring’s of calorie restricted rats which was effectively modulated by astaxanthin at the dosage of 12 mg/kg body weight. In the same way the BDNF level at cerebral cortex, Hippocampus and Cerebellum was also declined in the offspring’s of calorie restricted animals, which was also found to be effectively normalized by astaxanthin.

Keywords: calorie restiction, learning, Memory, Cerebral cortex, Hippocampus, Cerebellum, BDNF, Astaxanthin

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Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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Authors: Feixiong Chen, Naoufel Haddour, Marie Frenea-Robin, Yves MéRieux, Yann Chevolot, Virginie Monnier

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Neonatal thrombopenia occurs when the mother generates antibodies against her baby’s platelet antigens. It is particularly critical for newborns because it can cause coagulation troubles leading to intracranial hemorrhage. In this case, diagnosis must be done quickly to make platelets transfusion immediately after birth. Before transfusion, platelet antigens must be tested carefully to avoid rejection. The majority of thrombopenia (95 %) are caused by antibodies directed against Human Platelet Antigen 1a (HPA-1a) or 5b (HPA-5b). The common method for antigen platelets detection is polymerase chain reaction allowing for identification of gene sequence. However, it is expensive, time-consuming and requires significant blood volume which is not suitable for newborns. We propose to develop a point-of-care device based on double functionalized magnetic colloids with 1) antibodies specific to antigen platelets and 2) highly sensitive electroactive molecules in order to be detected by an electrochemical microsensor. These magnetic colloids will be used first to isolate platelets from other blood components, then to capture specifically platelets bearing HPA-1a and HPA-5b antigens and finally to attract them close to sensor working electrode for improved electrochemical signal. The expected advantages are an assay time lower than 20 min starting from blood volume smaller than 100 µL. Our functionalization procedure based on amine dendrimers and NHS-ester modification of initial carboxyl colloids will be presented. Functionalization efficiency was evaluated by colorimetric titration of surface chemical groups, zeta potential measurements, infrared spectroscopy, fluorescence scanning and cyclic voltammetry. Our results showed that electroactive molecules and antibodies can be immobilized successfully onto magnetic colloids. Application of a magnetic field onto working electrode increased the detected electrochemical signal. Magnetic colloids were able to capture specific purified antigens extracted from platelets.

Keywords: Magnetic Nanoparticles , Electroactive Molecules, Antibody, Platelet

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Authors: Masahiro Nochi

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This study explores the process in which a Japanese child with congenital blindness deepens understanding of the condition of being “unable to see” and develops the idea of “blind self,” despite having no direct experience of vision. The rehabilitation activities of a child with a congenital visual impairment that were video-recorded from 1 to 6 years old were analyzed qualitatively. The duration of the video was about 80 hours. The recordings were transcribed verbatim, and the episodes in which the child used the words related to the act of “looking” were extracted. Detailed transcripts were constructed referencing the notations of conversation analysis. Characteristics of interactions in those episodes were identified and compared longitudinally. Results showed that the child used the expression "look" under certain interaction patterns and her body expressions and interaction with adults developed in conjunction with the development of language use. Four stages were identified. At the age of 1, interactions involving “look” began to occur. The child said "Look" in the sequence: the child’s “Look,” an adult’s “I’m looking,” certain performances by the child, and the adult’s words of praise. At the age of 3, the child began to behave in accordance with the spatial attributes of the act of "looking," such as turning her face to the adult’s voice before saying, “Look.” She also began to use the expression “Keep looking,” which seemed to reflect her understanding of the temporality of the act of “looking.” At the age of 4, the use of “Look” or “Keep looking” became three times more frequent. She also started to refer to the act of looking in the future, such as “Come and look at my puppy someday.” At the age of 5, she moved her hands toward the adults when she was holding something she wanted to show them. She seemed to understand that people could see the object more clearly when it was in close priximity. About that time, she began to say “I cannot see” to her mother, which suggested a heightened understanding of her own blindness. The findings indicate that as she grew up, the child came to utilize nonverbal behavior before and after the order "Look" to make the progress of the interaction with adults even more certain. As a result, actions that reflect the characteristics of the sighted person's visual experience were incorporated into the interaction chain. The purpose of "Look," with which she intended to attract the adult's attention at first, changed and became something that requests a confirmation she was unable to make herself. It is considered that such a change in the use of the word as well as interaction with sighted adults reflected her heightened self-awareness as someone who could not do what sighted people could do easily. A blind child can gradually deepen their understanding of their own characteristics of blindness among sighted people around them. The child can also develop “blind self” by learning how to interact with others even without direct visual experiences.

Keywords: blindness, child development, conversation analysis, self-concept

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Authors: Kanikanun Photchong, Phusit Phukamchanoad

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The objective of this research is to study the people’s level of participation in activities of the community, their satisfaction towards the community, the attachment they have to the community, factors that influence the attachment, as well as the characteristics of the relationships of military families’ of the Royal Guards community of Dusit District. The method used was non-probability sampling by quota sampling according to people’s age. The determined age group was 18 years or older. One set of a sample group was done per family. The questionnaires were conducted by 287 people. Snowball sampling was also used by interviewing people of the community, starting from the Royal Guards Community’s leader, then by 20 of the community’s well-respected persons. The data was analyzed by using descriptive statistics, such as arithmetic mean and standard deviation, as well as by inferential statistics, such as Independent - Samples T test (T-test), One-Way ANOVA (F-test), Chi-Square. Descriptive analysis according to the structure of the interview content was also used. The results of the research is that the participation of the population in the Royal Guards Community in various activities is at a medium level, with the average participation level during Mother’s and Father’s Days. The people’s general level of satisfaction towards the premises of the Royal Guards Community is at the highest level. The people were most satisfied with the transportation within the community and in contacting with people from outside the premises. The access to the community is convenient and there are various entrances. The attachment of the people to the Royal Guards Community in general and by each category is at a high level. The feeling that the community is their home rated the highest average. Factors that influence the attachment of the people of the Royal Guards Community are age, status, profession, income, length of stay in the community, membership of social groups, having neighbors they feel close and familiar with, and as well as the benefits they receive from the community. In addition, it was found that people that participate in activities have a high level of positive relationship towards the attachment of the people to the Royal Guards Community. The satisfaction of the community has a very high level of positive relationship with the attachment of the people to the Royal Guards Community. The characteristics of the attachment of military families’ is that they live in big houses that everyone has to protect and care for, starting from the leader of the family as well as all members. Therefore, they all love the community they live in. The characteristics that show the participation of activities within the community and the high level of satisfaction towards the premises of the community will enable the people to be more attached to the community. The people feel that everyone is close neighbors within the community, as if they are one big family.

Keywords: community attachment, community satisfaction, royal guards community, activities of the community

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Authors: Rachel Koshy, Nazrila Hairizan Bt. Nasir, Samsiah Bt. Awang, Kamaliah Bt. Mohamad Noh

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Malaysia collaborated as a ‘trailblazer’ country with PHCPI (Primary Health Care Performance Initiative) to populate the Primary Health Care (PHC) Vital Signs Profile (VSP) for the country. The PHC VSP provides an innovative snapshot of the primary health care system's performance. Four domains were assessed: system financing, system capacity, system performance, and system equity, and completed in 2019. There were two phases using a mixed method study design. The first phase involved a quantitative study, utilising existing secondary data from national and international sources. In the case of unavailability of data for any indicators, comparable alternative indicators were used. The second phase was a mixed quantitative-qualitative approach to measure the functional capacity based on governance and leadership, population health needs, inputs, population health management, and facility organisation and management. PHC spending constituted 35% of overall health spending in Malaysia, with a per capita PHC spending of $152. The capacity domain was strong in the three subdomains of governance and leadership, information system, and funds management. The two subdomains of drugs & supplies and facility organisation & management had low scores, but the lowest score was in empanelment of the population under the population health management. The PHC system performed with an access index of 98%, quality index of 84%, and service coverage of 62%. In the equity domain, there was little fluctuation in the coverage of reproductive, maternal, newborn, and child health services by mother’s level of education and under-five child mortality between urban and rural areas. The public sector was stronger in the capacity domain as compared to the private sector. This is due to the different financing, organisational structures, and service delivery mechanism. The VSP has identified areas for improvement in the effort to provide high-quality PHC for the population. The gaps in PHC can be addressed through the system approach and the positioning of public and private primary health care delivery systems.

Keywords: primary health care, health system, system domains, vital signs profile

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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