Search results for: clinical education

Authors: Ningning Liu, Gaoding Jia, Yinshan Wang, Haimei Li, Xinian Zuo, Yufeng Wang, Lu Liu, Qiujin Qian

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Background: There has been speculation that a high IQ may not necessarily provide protection against attention deficit hyperactivity disorder (ADHD), and there may be a U-shaped correlation between IQ and ADHD symptoms. However, this speculation has not been validated in the ADHD population in any study so far. Method: We conducted a study with 5,138 children who have been professionally diagnosed with ADHD and have a wide range of IQ levels. General Linear Models were used to determine the optimal model between IQ and ADHD core symptoms with sex and age as covariates. The ADHD symptoms we looked at included the total scores (TO), inattention (IA) and hyperactivity/impulsivity (HI). Wechsler Intelligence scale were used to assess IQ [Full-Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ)]. Furthermore, we examined the correlation between IQ and the execution function [Behavior Rating Inventory of Executive Function (BRIEF)], as well as between IQ and brain surface area, to determine if the associations between IQ and ADHD symptoms are reflected in executive functions and brain structure. Results: Consistent with previous research, the results indicated that FSIQ and VIQ both showed a linear negative correlation with the TO and IA scores of ADHD. However, PIQ showed an inverted U-shaped relationship with the TO and HI scores of ADHD, with 103 as the peak point. These findings were also partially reflected in the relationship between IQ and executive functions, as well as IQ and brain surface area. Conclusion: To sum up, the relationship between IQ and ADHD symptoms is not straightforward. Our study confirms long-standing academic hypotheses and finds that PIQ exhibits an inverted U-shaped relationship with ADHD symptoms. This study enhances our understanding of symptoms and behaviors of ADHD with varying IQ characteristics and provides some evidence for targeted clinical intervention.

Keywords: ADHD, IQ, execution function, brain imaging

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Authors: A. Kourou, S. Kyriakopoulos, N. Anyfanti

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A lot of children under the age of five spend their daytime hours away from their home, in a kindergarten. Caring for children is a serious subject, and their safety in case of earthquake is the first priority. Being aware of earthquakes helps to prioritize the needs and take the appropriate actions to limit the effects. Earthquakes occurring anywhere at any time require emergency planning. Earthquake planning is a cooperative effort and childcare providers have unique roles and responsibilities. Greece has high seismicity and Ionian Islands Region has the highest seismic activity of the country. The last five years Earthquake Planning and Protection Organization (EPPO), which is a national organization, has analyzed the needs and requirements of kindergartens on earthquake protection issues. In this framework it has been noticed that although the State requires child care centers to hold drills, the standards for emergency preparedness in these centers are varied, and a lot of them had not written plans for emergencies. For these reasons, EPPO supports the development of emergency planning guidance and familiarizes the day care centers’ staff being prepared for earthquakes. Furthermore, the Handbook on Day Care Earthquake Planning that has been developed by EPPO helps the providers to understand that emergency planning is essential to risk reduction. Preparedness and training should be ongoing processes, thus EPPO implements every year dozens of specific seminars on children’s disaster related needs. This research presents the results of a survey that detects the level of earthquake preparedness of kindergartens in all over the country and Ionian Islands too. A closed-form questionnaire of 20 main questions was developed for the survey in order to detect the aspects of participants concerning the earthquake preparedness actions at individual, family and day care environment level. 2668 questionnaires were gathered from March 2014 to May 2019, and analyzed by EPPO’s Department of Education. Moreover, this paper presents the EPPO’s educational activities targeted to the Ionian Islands Region that implemented in the framework of “Telemachus” Project. To provide safe environment for children to learn, and staff to work is the foremost goal of any State, community and kindergarten. This project is funded under the Priority Axis "Environmental Protection and Sustainable Development" of Operational Plan "Ionian Islands 2014-2020". It is increasingly accepted that emergency preparedness should be thought of as an ongoing process rather than a one-time activity. Creating an earthquake safe daycare environment that facilitates learning is a challenging task. Training, drills, and update of emergency plan should take place throughout the year at kindergartens to identify any gaps and to ensure the emergency procedures. EPPO will continue to work closely with regional and local authorities to actively address the needs of children and kindergartens before, during and after earthquakes.

Keywords: child care centers, education on earthquake, emergency planning, kindergartens, Ionian Islands Region of Greece

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Authors: Irina A. Martynenko, Viktoriia V. Pikalova

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At the moment, there are more than a thousand law schools in Russia. The program of preparation in each of them without exception includes English language course. It is believed that lawyers in Russia are best trained at the MGIMO University, the All-Russian State University of Justice, Kutafin Moscow State Law University, Peoples’ Friendship University of Russia, Lomonosov Moscow State University, St. Petersburg State University, Diplomatic Academy of Russian Foreign Ministry and some others. Currently, the overwhelming majority of universities operate using the two-level system of education: bachelor's plus master's degree. Foreign languages are taught at both levels. The main example of consideration used throughout this paper is Kutafin Moscow State Law University being one of the best law schools in the country. The article examines traditions of teaching legal English in Russia and highlights problem arising in this process. The authors suggest ways of solving them in the scope of modern views and practice of teaching English for specific purposes.

Keywords: Kutafin Moscow State Law University, legal English, Russia, teaching

Procedia PDF Downloads 226

Authors: Mohammed Aman Kassim

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This study aims to investigate attitudes of resort hotel managers toward environmental sustainability practice in Bishoftu Town, Ethiopia. Six resorts were selected out of twelve by using systematic sampling method and totally fifty-six managers were taken for the survey. The findings revealed that more than 99% of hotel managers possess positive attitudes but low level of performance. Owners’ attitudes and personal beliefs, government regulation and incentives for good achievement were the most important factors that motivate or influence the adoptions of environmental sustainability practices. Hotel managers’ environmental attitudes more significantly influenced by their social demographics, such as level of education and age. Therefore, in order to increase hotels commitment to become more sustainable, some measurement should be implemented, such as vigorous support of the government, cooperation with hotel associations, continuous behaviors of hotel environmental protection, and local community participation in environmental practice.

Keywords: environmental attitude, environmental sustainability, hotel managers, resorts

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Authors: Jagbir Singh Kadyan, C. A. Suman Kadyan

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The researchers attempts to establish whether a relationship exists between the social activities undertaken & the funds that has been spent by the selected corporate organisations. Corporate listed on the (NSE) National Stock Exchange of India, under different categories shall be selected as a sample for the purpose of this study. The researches shall also study the dynamics of corporate social responsibility funding, financing & management of corporate social responsibility funds by the above selected organisations in the Indian context. The rationale behind selecting & undertaking specific corporate social responsibility activities shall be analysed & interpreted to discover the real drivers of corporate social responsibility. Besides above, an attempt shall further make an effort to understand & analyse the nature of impact on the selected corporate organisations on its overall performances due to the activities undertaken under their specific corporate social responsibility programs.

Keywords: corporate social responsibility, organisational performance, national stock exchange, sustainability, society, health, education, sanitation, environment

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Authors: Wanchak Noichan, Phakchira Noichan, Nuntiya Noichun

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The objectives of this research were 1) to study the level of community engagement, 2) to compare community engagement level of motorcycle taxi drivers in Bangkok, Thailand, classified by personal factors. The sample population of this study was 400 motorcycle taxi drivers in Bangkok, Thailand, using the unknown size method of W. G. Cochran's population. The sample was chosen by probability-based randomization. A study using quantitative methods (quantitative research) use the research tools as a questionnaire. The statistics used in the research were the mean, standard deviation, t-test, and F-Test (One-Way ANOVA). The study found that (1) the sample groups have a high level of community engagement (x̄=3.65, S.D.=0.735). (2) The sample groups with different ages, education, status, and income have different levels of community commitment with statistical significance at the level of 0.05.

Keywords: community engagement, motorcycle taxi drivers, Bangkok, Thailand

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Authors: Humraaz Kaja, Kofi Mensah, Frasia Oosthuizen

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Background and Aim: Vilazodone was approved in 2011 as an antidepressant to treat the major depressive disorder. As a relatively new drug, it is not clear if all adverse effects have been identified. The aim of this study was to review the adverse effects reported to the WHO Programme for International Drug Monitoring (PIDM) in order to add to the knowledge about the safety profile and adverse effects caused by vilazodone. Method: Data on adverse effects reported for vilazodone was obtained from the database VigiAccess managed by PIDM. Data was extracted from VigiAccess using Excel® and analyzed using descriptive statistics. The data collected was compared to the patient information leaflet (PIL) of Viibryd® and the FDA documents to determine adverse drug reactions reported post-marketing. Results: A total of 9708 adverse events had been recorded on VigiAccess, of which 6054 were not recorded on the PIL and the FDA approval document. Most of the reports were received from the Americas and were for adult women aged 45-64 years (24%, n=1059). The highest number of adverse events reported were for psychiatric events (19%; n=1889), followed by gastro-intestinal effects (18%; n=1839). Specific psychiatric disorders recorded included anxiety (316), depression (208), hallucination (168) and agitation (142). The systematic review confirmed several psychiatric adverse effects associated with the use of vilazodone. The findings of this study suggested that these common psychiatric adverse effects associated with the use of vilazodone were not known during the time of FDA approval of the drug and is not currently recorded in the patient information leaflet (PIL). Conclusions: In summary, this study found several adverse drug reactions not recorded in documents emanating from clinical trials pre-marketing. This highlights the importance of continued post-marketing surveillance of a drug, as well as the need for further studies on the psychiatric adverse events associated with vilazodone in order to improve the safety profile.

Keywords: adverse drug reactions, pharmacovigilance, post-marketing surveillance, vilazodone

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Authors: Camelia Porey, Binaya Kumar Jaiswal

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BACKGROUND: Antiphospholipid antibody (APLA) syndrome is an autoimmune disorder predisposing to thrombotic complications affecting CNS either by arterial vasooclusion or venous thrombosis. Cerebral venous sinus thrombosis (CVST) secondarily causes raised intracranial pressure (ICP). However, intracranial hypertension without evidence of CVST is a rare entity. Here we present two cases of elevated ICP with absence of identifiable CVST. CASE SUMMARY: Case 1, 28-year female had a 2 months history of holocranial headache followed by bilateral painless vision loss reaching lack of light perception over 20 days. CSF opening pressure was elevated. Fundoscopy showed bilateral grade 4 papilledema. MRI revealed a partially empty sella with bilateral optic nerve tortuosity. Idiopathic intracranial hypertension (IIH) was diagnosed. With acetazolamide, there was complete resolution of the clinical and radiological abnormalities. 5 months later she presented with acute onset right-sided hemiparesis. MRI was suggestive of acute left MCA infarct.MR venogram was normal. APLA came positive with high titres of Anticardiolipin and Beta 2 glycoprotein both IgG and IgM. Case 2, 23-year female, presented with headache and diplopia of 2 months duration. CSF pressure was elevated and Grade 3 papilledema was seen. MRI showed bilateral optic nerve hyperintensities with nerve head protrusion with normal MRV. APLA profile showed elevated beta 2 glycoprotein IgG and IgA. CONCLUSION: This is an important non thrombotic complication of APLA syndrome and requires further large-scale study for insight into the pathogenesis and early recognition to avoid future complications.

Keywords: APLA syndrome, idiopathic intracranial hypertension, MR venogram, papilledema

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

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Authors: Weldegerima Gebremedhin Hagos

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Background: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequels. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. Ethiopia reported the first case of SARS-CoV-2 on 13th March 2020, with community transmission ensuing by mid-May. The aim of this study was conducted to determine the prevalence of SARS-CoV-2 infection in Tigray, Ethiopia. Methods: Facility-based correctional study designs were used on a total of 380 study participants from March 2023 up to May 2023 in two general hospitals and one comprehensive specialized hospital in Tigray, Ethiopia. A pre-structured questionnaire was used to assess information regarding the socio-demographic, clinical data and other risk factors. A nasal swap was taken by trained health professionals, and the laboratory analysis was done by RT-PCR (quant studio 7-flex, applied biosystems) in Tigrai Health Research Institute and Mekelle University Medical Microbiology Research Laboratory. Result: The mean age of the study participants was 31 (SD+/-3.5) years, with 65% being male and 35% female. The overall seropositivity of sars-cov-2 among the study participants was 5.5%. The prevalence was higher in males (6.2%) than females which were (4.7%). Sars-cov-2 infection was significantly associated with a history of lack of vaccination (p-value 0.002). There was no significant association between seropositivity and demographic factors (P > 0.05). Conclusion: The seroprevalence of SARS-CoV-2 among the study participants is high. Those study participants with a previous history of vaccination have a low probability of developing COVID-19 infection. A low SARS-CoV-2 infection rate was recorded in those who frequently use masks.

Keywords: prevalence, SARS-CoV-2, infection, risk factors

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Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

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The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

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Authors: Isil Coklar-Okutkan, Miray Akyunus

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Victim sensitivity is a form of justice sensitivity that reflects the tendency to perceive injustice to one’s disadvantage. Victim sensitivity is considered as a dysfunctional trait that predicts anger, aggression, uncooperative behavior, depression and anxiety. Indeed, exploring the mechanism of association between victim sensitivity and anger is clinically important since it can lead to externalizing and internalizing problems. This study aims to investigate the moderating role of pathological narcissism in the relationship between victim sensitivity and anger rumination. Through testing different models where subtypes of narcissism and anger rumination components are included independently, the specific mechanism of different ruminative processes in anger is investigated. The sample consisted of 311 undergraduate students from Turkey, 107 of whom were males, and 204 were females. Participants completed Justice Sensitivity Inventory-Victim Subscale, Pathological Narcissism Inventory and Anger Rumination Scale. In the proposed double moderation model, vulnerable and grandiose narcissism was the moderators in the relationship between victim justice sensitivity and anger rumination. Four separate models were tested where one of the four components of anger rumination (angry afterthoughts, thoughts of revenge, angry memories, understanding of causes) were the dependent variable in each model. Results revealed that two of the moderation models are significant. Firstly, grandiose narcissism is the only moderator in the relationship between victim sensitivity and thoughts of revenge. Secondly, vulnerable narcissism is the only moderator in the relationship between victim sensitivity and understanding causes. Accordingly, grandiose narcissism is positively associated with the thoughts of revenge, and vulnerable narcissism is positively associated with understanding causes, only when the level of victim sensitivity is high. To summarize, increased victim sensitivity leads to ruminative thoughts of revenge in individuals with grandiose narcissism, whereas it leads to rumination on causes of the incident in individuals with vulnerable narcissism. The clinical implications of the findings are discussed.

Keywords: anger rumination, victim sensitivity, grandiose narcissism, vulnerable narcissism

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Authors: M. L. McLain, R. Sreelakshmi, Abhishek, Rajeshwaran, Bhavani Rao, Kamal Bijlani, R. Jayakrishnan

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Technology enhanced learning has brought drastic changes in the field of education in the modern world. In this study we explore a novel way to improve how high school students learn by building a serious game that uses a pedagogical model developed by Robert Gagne. By integrating serious game with principles of Gagne’s learning model can provide engaging and meaningful instructions to students. The game developed in this study is a waste sorting game that can easily and succinctly demonstrate the principles of this learning model. All the tasks in the game that the player has to accomplish correspond to Gagne’s “Nine Events of Learning”. A quiz is incorporated in order to get data on the progress made by the player in understanding the concept and as well as to assess them. Additionally, an experimental study was conducted which demonstrates that game based learning using Gagne’s event is more effective than a traditional classroom setup.

Keywords: game based learning, sorting and recycling of waste, Gagne’s learning model, e-Learning, technology enhanced learning

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Authors: Piyarat Parklug, Busaba Supawattanaobodee, Penpat Pinyowattanasilp

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The radioactive iodine thyroid uptake (RAIU) has been widely used to differentiate the cause of thyrotoxicosis and treatment. Twenty-four hours RAIU is routinely used to calculate the dose of radioactive iodine (RAI) therapy; however, 2 days protocol is required. This study aims to evaluate the modification of Penpat Pinyowattanasilp equation application by the exclusion of outlier data, 3 hours RAIU less than 20% and more than 80%, to improve prediction of 24-hour uptake. The equation is predicted 24 hours RAIU (P24RAIU) = 32.5+0.702 (3 hours RAIU). Then calculating separation first and second therapeutic doses in Graves’ disease patients. Methods; This study was a retrospective study at Faculty of Medicine Vajira Hospital in Bangkok, Thailand. Inclusion were Graves’ disease patients who visited RAI clinic between January 2014-March 2019. We divided subjects into 2 groups according to first and second therapeutic doses. Results; Our study had a total of 151 patients. The study was done in 115 patients with first RAI dose and 36 patients with second RAI dose. The P24RAIU are highly correlated with actual 24-hour RAIU in first and second therapeutic doses (r = 0.913, 95% CI = 0.876 to 0.939 and r = 0.806, 95% CI = 0.649 to 0.897). Bland-Altman plot shows that mean differences between predictive and actual 24 hours RAI in the first dose and second dose were 2.14% (95%CI 0.83-3.46) and 1.37% (95%CI -1.41-4.14). The mean first actual and predictive therapeutic doses are 8.33 ± 4.93 and 7.38 ± 3.43 milliCuries (mCi) respectively. The mean second actual and predictive therapeutic doses are 6.51 ± 3.96 and 6.01 ± 3.11 mCi respectively. The predictive therapeutic doses are highly correlated with the actual dose in first and second therapeutic doses (r = 0.907, 95% CI = 0.868 to 0.935 and r = 0.953, 95% CI = 0.909 to 0.976). Bland-Altman plot shows that mean difference between predictive and actual P24RAIU in the first dose and second dose were less than 1 mCi (-0.94 and -0.5 mCi). This modification equation application is simply used in clinical practice especially patient with 3 hours RAIU in range of 20-80% in a Thai population. Before use, this equation for other population should be tested for the correlation.

Keywords: equation, Graves’disease, prediction, 24-hour uptake

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Authors: F. Saptouw, L. Reddy

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Tertiary institutions are often faced with a challenge when incorporating social awareness into course content. The information campaigns in the media often alienate the viewers and the knowledge is not readily assimilated into the students’ consciousness. This paper will present a discussion of the results of collaborative teaching projects run by the Michaelis School of fine art and the HIV/AIDS, Inclusivity and Change Unit (HAICU) at the University of Cape Town. In these projects the artistic process is employed to generate ‘praxical knowledge’ in the student body about socially relevant issues like HIV-AIDS, Gender-Based Violence (GBV) and sexual identity, specifically LGBTQI. The combination of lectures, group discussions and the creative process has been a very successful way to disseminate information amongst the student population. Evidence of the project’s success will be provided by referencing interviews, focus groups as well as surveys done with the participants. This paper will conclude by arguing for the positive role of practice-led research in developing a socially conscious public.

Keywords: art, education, HIV-AIDS, practice-led research

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Authors: Seung Ah Lee, Sunghyun Cho, Kyong Mee Chung

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Rapid population aging became a worldwide demographic phenomenon due to rising life expectancy and declining fertility rates. Considering the current increasing rate of population aging, it is assumed that Korean society enters into a ‘super-aged’ society in 10 years, in which people aged 65 years or older account for more than 20% of entire population. In line with this trend, ICT services aimed to help elderly people to improve the quality of life have been suggested. However, existing ICT services mainly focus on supporting health or nursing care and are somewhat limited to meet a variety of specialized needs and challenges of this population. It is pointed out that the majority of services have been driven by technology-push policies. Given that the usage of ICT services greatly vary on individuals’ socio-economic status (SES), physical and psychosocial needs, this study systematically categorized elderly population into sub-groups and identified their needs and characteristics related to ICT usage in detail. First, three assessment criteria (demographic variables including SES, cognitive functioning level, and emotional functioning level) were identified based on previous literature, experts’ opinions, and focus group interview. Second, survey questions for needs assessment were developed based on the criteria and administered to 600 respondents from a national probability sample. The questionnaire consisted of 67 items concerning demographic information, experience on ICT services and information technology (IT) devices, quality of life and cognitive functioning, etc. As the result of survey, age (60s, 70s, 80s), education level (college graduates or more, middle and high school, less than primary school) and cognitive functioning level (above the cut-off, below the cut-off) were considered the most relevant factors for categorization and 18 sub-groups were identified. Finally, 18 sub-groups were clustered into 3 groups according to following similarities; computer usage rate, difficulties in using ICT, and familiarity with current or previous job. Group 1 (‘active users’) included those who with high cognitive function and educational level in their 60s and 70s. They showed favorable and familiar attitudes toward ICT services and used the services for ‘joyful life’, ‘intelligent living’ and ‘relationship management’. Group 2 (‘potential users’), ranged from age of 60s to 80s with high level of cognitive function and mostly middle to high school graduates, reported some difficulties in using ICT and their expectations were lower than in group 1 despite they were similar to group 1 in areas of needs. Group 3 (‘limited users’) consisted of people with the lowest education level or cognitive function, and 90% of group reported difficulties in using ICT. However, group 3 did not differ from group 2 regarding the level of expectation for ICT services and their main purpose of using ICT was ‘safe living’. This study developed a systematic needs assessment tool and identified three sub-groups of elderly ICT users based on multi-criteria. It is implied that current cognitive function plays an important role in using ICT and determining needs among the elderly population. Implications and limitations were further discussed.

Keywords: elderly population, ICT, needs assessment, population aging

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Authors: Idha Novianti, Suci Nurhayati, Puryati, Elang Krisnadi

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Community service activities are activities of the academic community in practicing and cultivating science, knowledge, and technology to advance the general welfare and educate the nation's life as described in the Higher Education Law. Training activities on the use of GeoGebra software are an option because GeoGebra software is software that is easy to operate and complete in the presentation of graphic design. The training activity was held for 3 hours online via teams and 3 hours offline. Involving 15 junior high school mathematics teachers located around south Tangerang. As a result, all teachers were satisfied with the activity, and they had additional new knowledge and skills to teach mathematics in the topic of geometry and algebra. The existence of new knowledge made the participants increase their confidence in developing mathematical science for students at school.

Keywords: geogebra, Ms. teams, junior high school teacher, mathematics

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Authors: Aniqa Jabeen

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The aim of this study was to evaluate the effectiveness of Tc-99m MIBI (Technetium 99-methoxy-iso-butyl-isonitrile) scintigraphy to differentiate malignancies from benign lesions, which were detected on planar bone scans. Materials and Methods: 59 patients with bone lesions were enrolled in the study. The scintigraphic findings were compared with the clinical, radiological and the histological findings. Each patient initially underwent a three-phase bone scan with Tc-99m MDP (Methylene Diphosphonate) and if evidence of lesion found, the patient then underwent a dynamic and static MIBI scintigraphy after three to four days. The MDP and MIBI scans were evaluated visually and quantitatively. For quantitative analysis count ratios of lesions and contralateral normal side (L/C) were taken by region of interests drawn on scans. The Student T test was applied to assess the significant difference between benign and malignant lesions p-value < 0.05 was considered significant. Result: The MDP scans showed the increase tracer uptake, but there was no significant difference between benign and malignant uptake of the radiotracer. However significant difference (p-value 0.015), in uptake was seen in malignant (L/C = 3.51 ± 1.02) and benign lesion (L/C = 2.50±0.42) on MIBI scan. Three of thirty benign lesions did not show significant MIBI uptake. Seven malignant appeared as false negatives. Specificity of the scan was 86.66%, and its Negative Predictive Value (NPV) was 81.25% whereas the sensitivity of scan was 79.31%. In excluding the axial metastasis from the lesions, the sensitivity of MIBI scan increased to 91.66% and the NPV also increased to 92.85%. Conclusion: MIBI scintigraphy provides its usefulness by distinguishing malignant from benign lesions. MIBI also correctly identifies metastatic lesions. The negative predictive value of the scan points towards its ability to accurately diagnose the normal (benign) cases. However, biopsy remains the gold standard and a definitive diagnostic modality in musculoskeletal tumors. MIBI scan provides useful information in preoperative assessment and in distinguishing between malignant and benign lesions.

Keywords: benign, malignancies, MDP bone scan, MIBI scintigraphy

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Authors: Simon B. N. Thompson

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Retinoblastoma is a rare type of childhood genetic cancer that affects children worldwide. The diagnosis is often missed due to lack of education and difficulty in presentation of the tumor. Frequently, the tumor on the retina is noticed by photography when the red-eye flash, commonly seen in normal eyes, is not produced. Instead, a yellow or white colored patch is seen or the child has a noticeable strabismus. Early detection can be life-saving though often results in removal of the affected eye. Remaining functioning in the healthy eye when the child is young has resulted in super-vision and high or above-average intelligence. Technological advancement of cameras has helped in early detection. Brain imaging has also made possible early detection of neurological diseases and, together with the monitoring of cortisol levels and yawning frequency, promises to be the next new early diagnostic tool for the detection of neurological diseases where cortisol insufficiency is particularly salient, such as multiple sclerosis and Cushing’s disease.

Keywords: cortisol, neurological disease, retinoblastoma, Thompson cortisol hypothesis, yawning

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Authors: Tadesse Melaku Abegaz, Akshaya Srikanth Bahagavathula, Abdulla Shehab Sheab, Asim Hassen

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Objectives: Non-adherence and discontinuation of anticoagulant therapy lead to increased ischemic stroke risk and contributes to suboptimal outcomes of the anticoagulant treatment. This systematic review and meta-analysis were aimed to investigate the adherence to NOACs and adverse events in patients with AF. Methods: Original research articles conducted on patients with AF and using any NOACs (dabigatran, rivoraxaban and apixaban) reporting adherence for at least 35 days were included. Scientific databases including PubMed, Web of Science, and Google Scholar were searched using MeSH keywords to obtaining literature researched between 2008 to till June, 2016. Study characteristics, patient’s sociodemographic and clinical characteristics, medication adherence levels and bleeding events reported were recorded. Results: The overall sample size of the six studies is 1,640,157, with CHADS2 scores < 2 in 551 patients, CHADS2-VASc ≥ 2 in 62,232 AF patients. Three-forth [75.6% (95%CI= 66.5-84.8), p < 0.001] are adherent to NOACs. However, a higher rate [72.7% (62.5-82.9), p < 0.001] of adherence was observed with Dabigatran than Apixaban [59.9% (3.2-123.1), p=0.063] and Rivaroxaban [59.3% (38.7-80.0), p<0.001]. Sub-group analysis revealed that nearly 57% of the AF patients on NOACs have CHADS2 scores < 2 and 20% of these patients were non-adherent to NOACs. Overall bleeding events rate associated with NOACs non-adherent AF patients was found to be 7.5% (0.2-14.8), p=0.045. However, nearly 11.2% of AF patients experienced bleeding events were non-adherent to NOAC medications. A higher proportion of bleeding events were noticed with Dabigatran (14.7%). Conclusions: Adherence rates, while uniformly suboptimal, nevertheless varied considerably, lowest at 59.3% for rivaroxaban and 59.9% for apixaban, followed by dabigatran (75.6%). Overall bleeding events associated with NOACs rates were 7.5%. However, lower adherence to NOACs was associated with worse outcomes among patients with greater stroke risk.

Keywords: atrial fibrillation, bleeding events, meta-analysis, novel oral anticoagulants

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Authors: M. Rojo, M. Blanco, T. Lacruz, S. Solano, L. Beltran, M. Graell, A. R. Sepulveda.

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There is an association between an early accumulation of Stressful Life Events (SLE) during childhood and various physical and psychological health complications. However, there are only a few studies on this topic in children and adolescents with overweight or obesity. The general aim of the study was to evaluate the accumulation and type of SLE in 200 children from 8 to 12 years old and analyze the relationship with their emotional well-being and weight status (obesity, overweight and normal weight). The children and their families completed an interview. The evaluated variables that are included in this study are sociodemographic measures, medical/psychological history, anthropometric measures (BMI, z-BMI), and psychological variables (children's clinical interview K-SADS-PL(Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version) and battery of questionnaires). Results: Children with overweight and obesity accumulate more stressful events from an early age and have a significantly higher percentage of psychiatric diagnoses, compared to their peers with normal weight. Presenting a child psychiatric disorder is related to greater z-BMI and the total number of SLE (p < 0.001). A higher z-BMI is also related to a greater number of stressful events during childhood. There is also a positive and significant relationship between the total number of SLE and worse emotional well-being (higher levels of anxious and depressive symptoms and low self-esteem of children) (p < 0.01). Conclusion: Children with overweight and obesity grow up in a family, school, and social context where more stressors are accumulated. This is also directly associated with worse emotional well-being. It is necessary to implement multidisciplinary prevention and intervention strategies in different changes (school, family, and health). This study is included in a project funded by the Ministry of Innovation and Science (PSI2011-23127).

Keywords: childhood obesity, emotional well-being, psychopathology, stressful life events

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Authors: Arenkala Kichu

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This paper consolidates and tries to bring out the findings that investigated in Kohima and Mokokchung districts in Nagaland, which is in the northeastern part of India. The aim of this paper is to test the speaking and writing skills of the undergraduate learners who opt functional English as one of their papers. functional English is taught in just two colleges; Fazl Ali College and Kohima Colleges, out of 15 government and 36 private colleges in the state. This research (based on several observations made by Naga researchers) hypothesizes that functional English enhances competencies at the undergraduate level, which would open doors to work, learn more and better prospects. It is expected that learners in Functional English class, which follows the communicative language teaching method, might be the answers to those problems, as to why proficiency level still leaves much to be desired, in spite of the advent of the education over a hundred years ago. This type of teaching follows only in functional English class in these two colleges.

Keywords: enhancing competencies, speaking skills, undergraduate level, writing skills

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Authors: Sadaf Kalhori

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Introduction: Doxorubicin (DOX)-induced cardiotoxicity is widely known as the most severe complication of anthracycline-based chemotherapy in patients with cancer. It is unknown whether Deferiprone (DFP), could reduce the severity of DOX-induced cardiotoxicity by inhibiting free radical reactions. Thus, this study was performed to assess the protective effect of Deferiprone on DOX-induced cardiotoxicity in a rat model. Methods: The rats were divided into five groups. Group one was a control group. Group 2 was DOX (2 mg/kg/day, every other day for 12 days), and Group three to five which receiving DOX as in group 2 and DFP 75,100 and 150 mg/kg/day, for 19 days, respectively. DFP was starting 5 days prior to the first DOX injection and two days after the last DOX injection throughout the study. Electrocardiographic and hemodynamic studies, along with histopathological examination, were conducted. In addition, serum sample was taken and total cholesterol, Malone dialdehyde, triglyceride, albumin, AST, ALT, total protein, lactate dehydrogenase, total anti-oxidant and creatine kinase were assessed. Result: Our results showed the normal structure of endocardial, myocardial and pericardial in the control group. Pathologic data such as edema, hyperemia, bleeding, endocarditis, myocarditis and pericarditis, hyaline degeneration, cardiomyocyte necrosis, myofilament degeneration and nuclear chromatin changes were assessed in all groups. In the DOX group, all pathologic data was seen with mean grade of 2±1.25. In the DFP group with a dose of 75 and 100 mg, the mean grade was 1.41± 0.31 and 1±.23, respectively. In DFP group with a dose of 150, the pathologic data showed a milder change in comparison with other groups with e mean grade of 0.45 ±0.19. Most pathologic data in DFP groups showed significant changes in comparison with the DOX group (p < 0.001). Discussion: The results also showed that DFP treatment significantly improved DOX-induced heart damage, structural changes in the myocardium, and ventricular function. Our data confirm that DFP is protective against cardiovascular-related disorders induced by DOX. Clinical studies are needed to be involved to examine these findings in humans.

Keywords: cardiomyopathy, deferiprone, doxorubicin, rat

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Authors: Tanya Greathosue, Adrianna Taylor, Lori Darnel, Eileen Starr, Susie Ryder, Julie Clockston, Dawn Matera Bassett, Jess Retrum

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The United States has an identified need to improve the social work mental and behavioral health workforce shortage with a focus on culturally diverse and responsive mental and behavioral health practitioners to adequately serve its rapidly growing multicultural communities. The U.S. is experiencing rapid demographic changes. Ensuring that mental and behavioral health services are effective and accessible for diverse communities is essential for improving overall health outcomes. In response to this need, we developed a training program focused on interdisciplinary collaboration, evidence-based practices, and culturally responsive services. The success of the training program, funded by the Health Resource Service Administration (HRSA) Behavioral Health Workforce Education and Training (BHWET), has provided the foundation for stage two of our programming. In addition to HRSA/BHWET, we are receiving funding from Colorado Access, a state workforce development initiative, and Kaiser Permanente, a healthcare provider network in the United States. We have moved beyond improved learner outcomes to increasing recruitment of historically excluded, disproportionately mistreated learners, mentorship of students to improve retention, and successful, culturally responsive, diverse workforce development. These authors will utilize a pretest-posttest comparison group design and trend analysis to evaluate the success of the training program. Comparison groups will be matched based on age, gender identification, race, income, as well as prior experience in the field, and time in the degree program. This article describes our culturally responsive training program. Our goals are to increase the recruitment and retention of historically excluded, disproportionately mistreated learners. We achieve this by integrating cultural humility and sensitivity training into educational curricula for our scholars who participate in cohort classroom and seminar learning. Additionally, we provide our community partners who serve as internship sites with ongoing continuing education on how to promote and develop inclusive and supportive work environments for our learners. This work will be of value to mental and behavioral health care practitioners who serve historically excluded and mistreated populations. Participants will learn about culturally informed best practices to increase recruitment and retention of culturally diverse learners. Additionally, participants will hear how to create a culturally responsive training program that encourages an inclusive community for their learners through cohort learning, mentoring, community networking, and critical accountability.

Keywords: culturally diverse mental health practitioners, recruitment, mentorship, workforce development, underserved clinics, professional development

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Authors: S. Maddi Muhammed, Paul Davis, John Geraghty, Mabruk Derbesh

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This study discusses the probability of using electronic management in higher education institutions in Libya. This could be as sampled by creating an electronic gate at the faculties of Engineering and Computing "Information Technology" at Zaytuna University or any other university in Libya. As we all know, the competitive advantage amongst universities is based on their ability to use information technology efficiently and broadly. Universities today value information technology as part of the quality control and assurance and a ranking criterion for a range of services including e-learning and e-Registration. This could be done by developing email systems, electronic or virtual libraries, electronic cards, and other services provided to all students, faculty or staff. This paper discusses a range of important topics that explain how to apply the gate "E" with the faculties at Zaytuna University, Bani Walid colleges in Libya.

Keywords: e-management, educational institutions (EI), Libya, Zaytuna, information technology

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Authors: Amine Ben Slama, Aymen Mouelhi, Sondes Manoubi, Chiraz Mbarek, Hedi Trabelsi, Mounir Sayadi, Farhat Fnaiech

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Vertigo is a sensation of feeling off balance; the cause of this symptom is very difficult to interpret and needs a complementary exam. Generally, vertigo is caused by an ear problem. Some of the most common causes include: benign paroxysmal positional vertigo (BPPV), Meniere's disease and vestibular neuritis (VN). In clinical practice, different tests of videonystagmographic (VNG) technique are used to detect the presence of vestibular neuritis (VN). The topographical diagnosis of this disease presents a large diversity in its characteristics that confirm a mixture of problems for usual etiological analysis methods. In this study, a vestibular neuritis analysis method is proposed with videonystagmography (VNG) applications using an estimation of pupil movements in the case of an uncontrolled motion to obtain an efficient and reliable diagnosis results. First, an estimation of the pupil displacement vectors using with Hough Transform (HT) is performed to approximate the location of pupil region. Then, temporal and frequency features are computed from the rotation angle variation of the pupil motion. Finally, optimized features are selected using Fisher criterion evaluation for discrimination and classification of the VN disease.Experimental results are analyzed using two categories: normal and pathologic. By classifying the reduced features using the Support Vector Machine (SVM), 94% is achieved as classification accuracy. Compared to recent studies, the proposed expert system is extremely helpful and highly effective to resolve the problem of VNG analysis and provide an accurate diagnostic for medical devices.

Keywords: nystagmus, vestibular neuritis, videonystagmographic system, VNG, Fisher criterion, support vector machine, SVM

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Authors: Andrea Miconi

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The research will focus on the results of the Tempus European Project eMEDia dedicated to Cross-Media Journalism. The project is founded by the European Commission as it involves four European partners - IULM University, Tampere University, University of Barcelona, and the Mediterranean network Unimed - and three Tunisian Universities – IPSI La Manouba, Sfax and Sousse – along with the Tunisian Ministry for Higher Education and the National Syndicate of Journalists. The focus on Tunisian condition is basically due to the role played by digital activists in its recent history. The research is dedicated to the relationship between political participation, news-making practices and the spread of social media, as it is affecting Tunisian society. As we know, Tunisia during the Arab Spring had been widely considered as a laboratory for the analysis the use of new technologies for political participation. Nonetheless, the literature about the Arab Spring actually fell short in explaining the genesis of the phenomenon, on the one hand by isolating technologies as a casual factor in the spread of demonstrations, and on the other by analyzing North-African condition through a biased perspective. Nowadays, it is interesting to focus on the consolidation of the information environment three years after the uprisings. And what is relevant, only a close, in-depth analysis of Tunisian society is able to provide an explanation of its history, and namely of the part of digital media in the overall evolution of political system. That is why the research is based on different methodologies: desk stage, interviews, and in-depth analysis of communication practices. Networked journalism is the condition determined by the technological innovation on news-making activities: a condition upon which professional journalist can no longer be considered the only player in the information arena, and a new skill must be developed. Along with democratization, nonetheless, the so-called citizen journalism is also likely to produce some ambiguous effects, such as the lack of professional standards and the spread of information cascades, which may prove to be particularly dangerous in an evolving media market as the Tunisian one. This is why, according to the project, a new profile must be defined, which is able to manage this new condition, and which can be hardly reduced to the parameters of traditional journalistic work. Rather than simply using new devices for news visualization, communication professionals must also be able to dialogue with all new players and to accept the decentralized nature of digital environments. This networked nature of news-making seemed to emerge during the Tunisian revolution, when bloggers, journalists, and activists used to retweet each other. Nonetheless, this intensification of communication exchange was inspired by the political climax of the uprising, while all media, by definition, are also supposed to bring some effects on people’s state of mind, culture and daily life routines. That is why it is worth analyzing the consolidation of these practices in a normal, post-revolutionary situation.

Keywords: cross-media, education, Mediterranean, networked journalism, social media, Tunisia

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Authors: Ali Mohaghar, Iman Ghasemian Sahebi, Alireza Arab

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In the last decades, increasing in human and natural disaster occurrence had very irreparable effects on human life. Hence, one of the important issues in humanitarian supply chain management is identifying and prioritizing the different risks and finding suitable solutions for encountering them at the time of disaster occurrence. This study is an attempt to provide a comprehensive review of humanitarian supply chain risks in a case study of Tehran Red Crescent Societies. For this purpose, Best-Worst method (BWM) has been used for analyzing the risks of the humanitarian supply chain. 22 risks of the humanitarian supply chain were identified based on the literature and interviews with four experts. According to BWM method, the importance of each risk was calculated. The findings showed that culture contexts, little awareness of people, and poor education system are the most important humanitarian supply chain risks. This research provides a useful guideline for managers so that they can benefit from the results to prioritize their solutions.

Keywords: Best-Worst Method, humanitarian logistics, humanitarian supply chain, risk management

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

Abstract:

Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: cancer, complementary and alternative medicine , ozone therapy, palliative care, PEMF therapy

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Authors: W. S. Barber, S. L. King

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This paper reports on a pilot project to develop a collaborative partnership between a community college in rural northern Ontario, Canada, and an urban university in the greater Toronto area in Oshawa, Canada. Partner institutions will collaborate to address learning needs of university applicants whose goals are to attain an undergraduate university BA in Educational Studies and Digital Technology degree, but who may not live in a geographical location that would facilitate this pathways process. The UOIT BA degree is attained through a 2+2 program, where students with a 2 year college diploma or equivalent can attain a four year undergraduate degree. The goals reported on the project are as: 1. Our aim is to expand the BA program to include an additional stream which includes serious educational games, simulations and virtual environments, 2. Develop fully (using both synchronous and asynchronous technologies) online learning modules for use by university applicants who otherwise are not geographically located close to a physical university site, 3. Assess the digital competencies of all students, including members of local, distance and Indigenous communities using a validated tool developed and tested by UOIT across numerous populations. This tool, the General Technical Competency Use and Scale (GTCU) will provide the collaborating institutions with data that will allow for analyzing how well students are prepared to succeed in fully online learning communities. Philosophically, the UOIT BA program is based on a fully online learning communities model (FOLC) that can be accessed from anywhere in the world through digital learning environments via audio video conferencing tools such as Adobe Connect. It also follows models of adult learning and mobile learning, and makes a university degree accessible to the increasing demographic of adult learners who may use mobile devices to learn anywhere anytime. The program is based on key principles of Problem Based Learning, allowing students to build their own understandings through the co-design of the learning environment in collaboration with the instructors and their peers. In this way, this degree allows students to personalize and individualize the learning based on their own culture, background and professional/personal experiences. Using modified flipped classroom strategies, students are able to interrogate video modules on their own time in preparation for one hour discussions occurring in video conferencing sessions. As a consequence of the program flexibility, students may continue to work full or part time. All of the partner institutions will co-develop four new modules, administer the GTCU and share data, while creating a new stream of the UOIT BA degree. This will increase accessibility for students to bridge from community colleges to university through a fully digital environment. We aim to work collaboratively with Indigenous elders, community members and distance education instructors to increase opportunities for more students to attain a university education.

Keywords: aboriginal, college, competencies, digital, universities

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