Search results for: patient education

Authors: C. Noknoi, W. Boripunt, K. Boomid, S. Suwitphanwong

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This research studies the factors influencing the wages of native workers in Thailand's construction industry. The sample used comprised some 156 native construction workers from Songkhla Province, Thailand. The utilized research instrument was a questionnaire, with the data being analyzed according to frequency, percentage, and regression analysis. The results revealed that in general, native Thai construction workers are generally married males aged between 26 and 37 years old. They typically have four to six years of education, are employed as laborers with an average salary of 4,000–9,200 baht per month, and have fewer than five years of work experience. Most Thai workers work five days a week. Each establishment typically has 10–30 employees, with fewer than 10 of these being migrant workers in general. Most Thai workers are at a 20% to 40% risk from work, and they have never changed employer. The average wage of Thai workers was found to be 10,843.03 baht per month with a standard deviation of 4,898.31 baht per month. Hypothesis testing revealed that position, work experience, and the number of times they had switched employer were the factors most affecting the wages of native Thai construction workers. These three factors alone explain the salaries of Thai construction workers at 51.9%.  

Keywords: construction industry, native workers, Thailand, wages

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Authors: Zofia Hammerin, Goran Basic, Disa Bergnehr

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Ever since the Ottawa charter in 1986, health promotion through schools has been stressed across the globe. Both in the global and national discourse, schools are made responsible not only for providing education but also for working with pupil health and well-being. In Sweden, where the study is set, it is emphasized in national directives that promoting pupil health should be part of the school practice. Since the Swedish school system is decentralized, these directives need to be interpreted and recontextualized locally. This study aims to explore how the student comes across in Swedish local health policy documents. The data consists of 37 such documents called student health plans collected from different high schools throughout Sweden. The analysis was inspired by critical discourse analysis, and tentative results are divided into two main themes; the invisible actor and the passive recipient. The pupil is largely invisible in the documents, and the discourse instead focuses on school health service staff and, to some extent, the teachers. When the pupils are visible, they mainly come across as passive recipients of health promoting actions. Since participation, taking action, and feeling empowered are key aspects of health promotion, the findings could impact the pupils’ possibilities for health and well-being.

Keywords: health promotion, high school, student, sweden

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Authors: Somruedee Pongsena

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The purpose of this study is to follow up on the graduated students of Bachelor of Science in Applied Statistics from Suan Sunandha Rajabhat University (SSRU) during the 1999 – 2012 academic years and to provide the fundamental guideline for developing the current curriculum according to Thai Qualifications Framework for Higher Education (TQF: HEd). The sample was collected from 75 graduates by interview and online questionnaire. The content covered 5 subjects: ethics and moral, knowledge, cognitive skills, interpersonal skills and responsibility, numerical analysis as well as communication and information technology skills. Data were analyzed by using statistical methods as percentiles, means, standard deviation, t-tests, and F-tests. The findings showed that samples were mostly females younger than 26 years old. The majority of graduates had income in the range of 10,001-20,000 Baht and their experience range was 2-5 years. In addition, overall opinions from receiving knowledge to apply to work were at agree; mean score was 3.97 and standard deviation was 0.40. In terms of opinion difference, the hypothesis' testing results indicate gender only had different opinion at a significant level of 0.05.

Keywords: follow-up, graduates, knowledge, opinion, work performance.

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Authors: Narges Nemati, Mohammadreza Fallahpour, Hossein Bozorgian

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Reading is one of the receptive skills which has an important role in improving other skills like writing and speaking. Furthermore, language learners can acquire plenty of vocabularies and become more acquainted with written expression through reading. Also, negative attitudes toward reading can cause negligible reading comprehension, which could prompt poor performance in the English language. Considering the fact that reading instruction was discussed as a low priority skill in the field of EFL teacher education, this study attempted to investigate EFL teachers’ attitudes toward reading instruction. Therefore, to serve the purpose of this study, a mixed-method approach was utilized by inviting 100 Iranian EFL teachers who taught at English language institutes of Iran to fill out a validated questionnaire on teachers’ attitude toward reading. Subsequently, 10 participants were randomly selected for further observations and interview sessions to evaluate the differences between their stated attitude and their actual practices. The findings from analyzing questionnaires, observations, and interviews revealed that EFL teachers’ stated attitude toward reading instruction was positive; whereas, due to some reasons like lack of time, scarcity of interesting passages, and lack of interest in reading long passages, teachers did not show positive actual attitude toward teaching reading skill.

Keywords: English as foreign language classroom, English language, reading skill, teachers' attitude

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Authors: Spencer Jay Knafelc

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Some mental health practitioners and theorists have suggested that we approach remedying psychological problems by centering and intervening upon patients’ narrations. Such theorists and their corresponding therapeutic approaches see persons as narrators of their lives, where the stories they tell constitute and reflect their sense-making of the world. Psychological problems, according to these approaches to therapy, are often the result of problematic narratives. The solution is the construction of more salubrious narratives through therapy. There is trouble lurking within the history of these narrative approaches. These thinkers tend to denigrate the importance of truth, insisting that narratives are not to be thought of as aiming at truth, and thus the truth of our self-narratives is not important. There are multiple motivations for the tendency to eschew truth’s importance within the tradition of narrative approaches to therapy. The most plausible and interesting motivation comes from the observation that, in general, all dominant approaches to therapy are equally effective. The theoretical commitments of each approach are quite different and are often ostensibly incompatible (psychodynamic therapists see psychological problems as resulting from unconscious conflict and repressed desires, Cognitive-Behavioral approaches see them as resulting from distorted cognitions). This strongly suggests that there must be some cases in which therapeutic efficacy does not depend on truth and that insisting that patient’s therapeutic narratives be true in all instances is a mistake. Lewis’ solution is to suggest that narratives are metaphors. Lewis’ account appreciates that there are many ways to tell a story and that many different approaches to mental health treatment can be appropriate without committing us to any contradictions, providing us with an ostensibly coherent way to treat narratives as non-literal, instead of seeing them as tools that can be more or less apt. Here, it is argued that Lewis’ metaphor approach fails. Narratives do not have the right kind of structure to be metaphors. Still, another way to understand Lewis’ view might be that self-narratives, especially when articulated in the language of any specific approach, should not be taken literally. This is an idea at the core of the narrative theorists’ tendency to eschew the importance of the ordinary understanding of truth. This very tendency will be critiqued. The view defended in this paper more accurately captures the nature of self-narratives. The truth of one’s self-narrative is important. Not only do people care about having the right conception of their abilities, who they are, and the way the world is, but self-narratives are composed of beliefs, and the nature of belief is to aim at truth. This view also allows the recognition of the importance of developing accurate representations of oneself and reality for one’s psychological well-being. It is also argued that in many cases, truth factors in as a mechanism of change over the course of therapy. Therapeutic benefit can be achieved by coming to have a better understanding of the nature of oneself and the world. Finally, the view defended here allows for the recognition of the nature of the tension between values: truth and efficacy. It is better to recognize this tension and develop strategies to navigate it as opposed to insisting that it doesn’t exist.

Keywords: philosophy, narrative, psychotherapy, truth

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Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

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The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

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Authors: Yolanda Ramírez, Ángel Tejada, Agustín Baidez

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In the higher education setting, there is a current trend in society toward greater openness and transparency. The economic, social and political changes that have occurred in recent years in public sector universities (particularly the New Public Management, the Bologna Process and the emergence of the “third mission”) call for a wider disclosure of value created by universities to support fundraising activities, to ensure accountability in the use of public funds and the outcomes of research and teaching, as well as close relationships with industries and territories. The paper has two purposes: 1) to explore the intellectual capital (IC) disclosure in Spanish universities through their websites, and 2) to identify university profiles. This study applies a content analysis to analyze the institutional websites of Spanish public universities and a cluster analysis. The analysis reveals that Spanish universities’ website content usually relates to human capital, while structural and relational capitals are less widely disclosed. Our research identifies three behavioral profiles of Spanish universities with regard to the online disclosure of IC (universities more proactive, universities less proactive and universities adopt a middle position in this regard. The results can serve as encouragement to university managers to enhance online IC disclosure to meet the information needs of university stakeholders.

Keywords: universities, intellectual capital, disclosure, internet

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Authors: S. Sakhri

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Background: The use of Zoledronic acid (ZA) is an established place in the treatment of malignant tumors with a predilection for the skeleton of interest (in particular metastasis). Although the main target of Zoledronic acid was osteoclasts, there are preclinical data suggest that Zoledronic acid may have an antitumor effect on cells other than osteoclasts, including tumor cells. Antitumor activity, including the inhibition of tumor cell growth and the induction of apoptosis of tumor cells, inhibition of tumor cell adhesion and invasion, and anti-angiogenic effects have been demonstrated. Methods. From (2012 to 2014), 438 patients were included respondents the inclusion criteria, respectively. This is a prospective study over a 4 year period. Of all patients (N=438), 432 received neoadjuvant chemotherapy with Zoledronic acid. The primary end point was the pathologic complete response in advancer breast cancer stage. The secondary end point is to evaluate Clinical response according to RECIST criteria; estimate the bone density before and at the end of chemotherapy in women with locally advanced breast cancer, Toxicity Evaluation and Overall survival using Kaplan-Meier and log test. Result: The Objective response rate was 97% after (C4) with 3% stabilizations and 99, 3% of which 0.7% C8 after stabilization. The clinical complete response was 28% after C4 respectively, and 46.8% after C8, the pathologic complete response rate was 40.13% according to the classification Sataloff. We observed that the pathologic complete response rate was the most raised in the group including Her2 (luminal Her2 and Her2) the lowest in the triple negative group as classified by Sataloff. We found that the pCR is significantly higher in the age group (35-50 years) with 53.17%. Those who have more than 50 years in 2nd place with 27.7% and the lower in young woman 35 years pCR was 19%, not statistically significant, -The pCR was also in favor of the menopausal group in 51, 4%, and 48, 55% for non-menopausal women. The average duration of overall survival was also significantly in the subgroup (Luminal -Her2, Her2) compared with triple negative. It is 47.18 months in the luminal group vs. 38.95 in the triple negative group. -Was observed in our study a difference in quality of life between (C1) was the admission of the patient, and after (C8), we found an increase in general signs and a deterioration in the psychological state C1, in contrast to the C8 these general signs and mental status improves, up to 12, and 24 months. Conclusion The results of this study suggest that the addition of ZA to néoadjuvant CT has potential anti-cancer benefit in patients (Luminal -Her2, Her2) compared with triple negative with or without menopause status.

Keywords: HER2+, RH+, breast cancer, tyrosine kinase

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Authors: Alexandra Aslanidou

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The General Data Protection Regulation (GDPR), concerning the protection of natural persons within the European Union with regard to the processing of personal data and on the free movement of such data, became applicable in the European Union (EU) on 25 May 2018 and transformed the way personal data were being treated under the Data Protection Directive (DPD) regime, generating sweeping organizational changes to both public sector and business. A social practice that is considerably influenced in the way of its day-to-day operations is Human Resource (HR) management, for which the importance of GDPR cannot be underestimated. That is because HR processes personal data coming in all shapes and sizes from many different systems and sources. The significance of the proper functioning of an HR department, specifically in human-centered, service-oriented environments such as the education field, is decisive due to the fact that HR operations in schools, conducted effectively, determine the quality of the provided services and consequently have a considerable impact on the success of the educational system. The purpose of this paper is to analyze the decisive role that GDPR plays in HR departments that operate in schools and in order to practically evaluate the aftermath of the Regulation during the first months of its applicability; a comparative use cases analysis in five highly dynamic schools, across three EU Member States, was attempted.

Keywords: general data protection regulation, human resource management, educational system

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Authors: Bifeng Zhu, Zhekai Wang, Chaoyang Sun, Bart Dewancker

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Under the tide of promoting sustainable development in the world, American universities that have been committed to sustainable practice and innovation, not only have its sustainable campus construction been in the forefront of the world, but also have developed STARS (The Sustainability Tracking, Assessment & Rating System), which is widely used in the world and highly recognized. At the same time, in the process of global sustainable campus construction, energy problem is often regarded as one of the most important sustainable aspects, even equivalent to the sustainability of campus. Therefore, the relationship between campus energy and sustainability is worth discussing. In this study, four American universities with the highest level evaluated by STARS are selected as examples to compare and analyze the campus energy consumption and the use of new energy, GHG emissions and the overall sustainability of the campus, in order to explore the relationship between campus energy and sustainable construction. It is found that the advantages of sustainable campus construction in the United States are mainly focused on the "software" of management, education, activities, etc. Although different energy-saving measures have been taken in campus energy, the construction results are quite different. Moreover, as an important aspect of sustainable campus, energy can not fully represent the sustainability of campus, but because of the various measures it takes, it can greatly promote the sustainable construction of the whole campus. These measures and construction experiences are worthy of summary and promotion, and have positive reference significance for other universities even communities around the world.

Keywords: sustainable campus, energy consumption, STARS assessment, GHG emissions

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Authors: P. O. Eniola, S. O. Odebode

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Charcoal production constitutes serious environmental problems to most developing countries of the world. Hence, the study assessed perceived environmental effects of charcoal production (CP) among the rural dwellers in rainforest and guinea savannah (GS) zones of Nigeria. Multi-stage sampling procedure was used to select 83 and 85 charcoal producers in GS and rainforest zones respectively. Eighteen statements on perceived environmental effects of charcoal production were collected. Data was collected through the use of structured interview schedule and analysed using both descriptive and inferential statistics. Descriptive analysis showed that the mean age was 43 years, 90.5% males, 90.6% married and 35.3% of respondents had no formal education. The majority (80.0%) of the respondents make use of earth mound method of CP and 52.9% of respondents produced between 32-32000kg of charcoal per annum. Respondents (62.7%) perceived that charcoal production could lead to erosion, 62.4% reduce the available trees for future use (62.4%) and reduce available air in the environment (54.1%). A significant difference existed in the perceived environmental effects of charcoal production between rainforest and guinea savannah agro-ecological zones (F=14.62). There is a need for the government to quickly work on other available and affordable alternative household energy sources.

Keywords: deforestation, energy, earth mound method, environment

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Authors: Moise Alin Ionuț Cornel

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In a pilot lesson of prevention of consumption drugs in a classroom of teenager`s where the school want them to know how to manage their thoughts and emotions to protect themself an to be strong in an possible environment of drugs consumption. At this classroom was applied the RAIN(Recognize, Accept, Investigation,Non-identify) spiritual method and the balance model from positive and transcultural psychotherapy (PPT) in a manner of a game play for them to understand the methods in an individual experience. The balance model from PPT with his 4 parts and used in 3 ways, and the RAIN spiritual method was used to see how the teenager`s can bring clarity about theirs individual self and how they spend the time and energy in the daily life. The 3 ways of how they can used this model was explained like a analogy with the 3 periods of the SAKURA (Japanese cherry) flourish (kaika, mankai and chiru). The teenager`s received a new perspective and in the same time new tools from the spiritual point of view combined with the psychotherapeutic point of view to manage their thoughts, emotions, time and energy in the form of a psychoeducational game to be able to prevent the use of drugs.

Keywords: addiction, drugs consumption prevention education, psychotherapy, Self, Spirituality, teenagers

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Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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Authors: Andrzej Mitura, Krzysztof Kecik, Michal Augustyniak

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This paper presents a numerical and experimental research of a nonlinear two degrees of freedom system. The tested system consists of a mechanical oscillator (the primary subsystem) with the attached pendulum (the secondary subsystem). The oscillator is suspended on a linear (or nonlinear) coil spring and a nonlinear magnetorheorogical damper and it is excited kinematically. Added pendulum can be used to reduce vibration of a primary subsystem or to energy harvesting. The numerical and experimental investigations showed that the pendulum can perform several types of motion, for example: chaotic motion, constant position in lower or upper (stable inverted pendulum), rotation, symmetrical or asymmetrical swinging vibrations. The main objective of this study is to determine an influence of system parameters for increasing the zone when the pendulum rotates. As a final effect a semi-active control method to change the pendulum solution on the rotation is proposed. To the implementation of this method the magnetorheorogical damper is applied. Continuous rotation of the pendulum is desirable for recovery of energy. The work is financed by Grant no. 0234/IP2/2011/71 from the Polish Ministry of Science and Higher Education in years 2012-2014.

Keywords: autoparametric vibrations, chaos and rotation control, magnetorheological damper

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Authors: Teboho Moja, Frans Swanepoel, Okunade Samuel Kehinde

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Knowledge production is key to development worldwide. However, some countries are producers of knowledge used globally, whilst others are mainly consumers of that knowledge. There is a correlation between knowledge production and funding levels for research. Countries in Africa recognize the need to provide research funding at levels that would enhance knowledge production but struggle in balancing many competing needs. African countries have committed to funding research at the level of 1% of their GDP on research and development (R&D), which is the recommended percentage to be earmarked for education; however, many countries have not been able to fulfill this. In 2015-2016 Science Granting Councils in 15 out of 54 African states came together to form a Science Granting Council Initiative to strengthen the research capacity in their countries and to support research and evidence-based policies that will contribute to the continent’s economic and social development. The members of the SGCI work collaboratively; however, there is a challenge in addressing research problems that cut across national boundaries as many governments are more interested in prioritizing national issues given their limited resources. This article focuses on the governance structures of those science granting councils to understand and explore reasons for the continuing underfunding of research, the impact of research, and the perceived direct benefit of research outcomes in informing policy and in benefitting the broader society.

Keywords: research, Science Granting Council, funding, European Research Council, African Research Council

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Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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Authors: Sarah E. Nelson, Casey Weiner, Alexander Sigmon, Jun Hua, Haris I. Sair, Jose I. Suarez, Robert D. Stevens

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Graph-theoretical information from structural connectomes indicated significant connectivity changes and improved acute prognostication in a Random Forest (RF) model in aneurysmal subarachnoid hemorrhage (aSAH), which can lead to significant morbidity and mortality and has traditionally been fraught by poor methods to predict outcome. This study’s hypothesis was that structural connectivity changes occur in canonical brain networks of acute aSAH patients, and that these changes are associated with functional outcome at six months. In a prospective cohort of patients admitted to a single institution for management of acute aSAH, patients underwent diffusion tensor imaging (DTI) as part of a multimodal MRI scan. A weighted undirected structural connectome was created of each patient’s images using Constant Solid Angle (CSA) tractography, with 176 regions of interest (ROIs) defined by the Johns Hopkins Eve atlas. ROIs were sorted into four networks: Default Mode Network, Executive Control Network, Salience Network, and Whole Brain. The resulting nodes and edges were characterized using graph-theoretic features, including Node Strength (NS), Betweenness Centrality (BC), Network Degree (ND), and Connectedness (C). Clinical (including demographics and World Federation of Neurologic Surgeons scale) and graph features were used separately and in combination to train RF and Logistic Regression classifiers to predict two outcomes: dichotomized modified Rankin Score (mRS) at discharge and at six months after discharge (favorable outcome mRS 0-2, unfavorable outcome mRS 3-6). A total of 56 aSAH patients underwent DTI a median (IQR) of 7 (IQR=8.5) days after admission. The best performing model (RF) combining clinical and DTI graph features had a mean Area Under the Receiver Operator Characteristic Curve (AUROC) of 0.88 ± 0.00 and Area Under the Precision Recall Curve (AUPRC) of 0.95 ± 0.00 over 500 trials. The combined model performed better than the clinical model alone (AUROC 0.81 ± 0.01, AUPRC 0.91 ± 0.00). The highest-ranked graph features for prediction were NS, BC, and ND. These results indicate reorganization of the connectome early after aSAH. The performance of clinical prognostic models was increased significantly by the inclusion of DTI-derived graph connectivity metrics. This methodology could significantly improve prognostication of aSAH.

Keywords: connectomics, diffusion tensor imaging, graph theory, machine learning, subarachnoid hemorrhage

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Authors: Adama NS Bah

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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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Authors: Xiaoting Shi, Xiaomei Ma

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In higher education, students' self-assessment and peer assessment of compositions in writing classes can effectively improve their ability of evaluative judgment. However, students' self-assessment and peer assessment are not advocated by most teachers because of the significant difference in scoring compared with teacher assessment. This study used a multi-faceted Rasch model to explore whether an English writing checklist containing 30 descriptors can effectively improve rating consistency among self-assessment, peer assessment and teacher assessment. Meanwhile, a questionnaire was adopted to survey students’ and teachers’ attitudes toward self-assessment and peer assessment using the writing checklist. Results of the multi-faceted Rasch model analysis show that the writing checklist can effectively distinguish the students’ writing ability (separate coefficient = 2.05, separate reliability = 0.81, chi-square value (df = 32) = 123.4). Moreover, the results revealed that the checklist could improve rating consistency among self-assessment, peer assessment and teacher assessment. (separate coefficient = 1.71, separate reliability = 0.75, chi-square value (df=4) = 20.8). The results of the questionnaire showed that more than 85% of students and all teachers believed that the checklist had a good advantage in self-assessment and peer assessment, and they were willing to use the checklist to conduct self-assessment and peer assessment in class in the future.

Keywords: english writing, self-assessment, peer assessment, writing checklist

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Authors: Fahri Benli, Sitalakshmi Venkartraman, Ye Wei, Fiona Wahr

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A flipped classroom which is a form of blended learning shifts the focus from a teacher-centered approach to a learner-centered approach. However, not all learners are ready to take the active role of knowledge and skill acquisition through a flipped classroom and they continue to delve in a passive mode of learning. This challenges educators in designing, scaffolding and facilitating in-class activities for students to have active learning experiences in a flipped classroom environment. Experiential learning theories have been employed by educators in the past in physical classrooms based on the principle that knowledge could be actively developed through direct experience. However, with more of online teaching witnessed recently, there are inherent limitations in designing and simulating an experiential learning activity for an online environment. In this paper, we explore enhancing experiential learning using smart digital tools that could be employed in a flipped classroom within a higher education setting. We present the use of smart collaborative tools online to enhance the experiential learning activity to teach higher-order cognitive concepts of business process modelling as a case study.

Keywords: experiential learning, flipped classroom, smart software tools, online learning higher-order learning attributes

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Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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Authors: Alev Erenler, Yeliz Yazici

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It is undoubtful that the development in the technology has been increasing the importance of engineering day by day along with the interest of the profession also. Like in any other genre, the success in engineering career is directly related to the amount of the satisfaction from the profession. Having satisfaction is an important factor for both having psychological health and efficiency. In this concept, the engineers from all steps, like students from different grades, working in related professions and the candidates of engineering have been included in order to define the expectations of the profession and the levels if professional satisfaction. In the concept of the study, the factors such as; the graduated university, the university which has been attending at, the grades of the participants, the reasons behind the choosing the university, the order of the choices and demographic values have planned to examine. It is thought that these factors have a meaningful effect on the professional expectations. It is also aimed to find the similar participants from the working life, and the data is to be compared to candidates of engineering in terms if differentiation of expectations. The related data will be gathered by the help of the scale prepared and developed by the researchers special for this study, titled as ' the professional expectation scale for engineers'. The data is to be analyzed in SPSS program, and the results will be interpreted in relation with the literature.

Keywords: engineering education, engineers' professional expectations, engineering students' professional expectations, students’ university choices

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Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

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Authors: Moses Onyemaechi Ede, Chinedu Ifedi Okeke

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This study examined the prevalence of suicidal behavioural experience in a tertiary institution and its implication for childhood development. In pursuance of the objectives, two specific purposes, two research questions, and two null hypotheses guided this study. This is a descriptive design that utilized university student populations (N= 36,000 students) in the University of Nigeria Nsukka. The sample of the study was made up of 100 students. An accidental sampling technique was used to arrive at the sample. A self-developed questionnaire titled Suicidal Behaviour Questionnaire (SBQ) was used for this study. The data collected was analyzed using mean and percentages. The result showed that university students do not experience suicidal behaviours. It also showed that suicidal experiences are not prevalent. There is no significant influence of gender on the responses of male and female tertiary institution students based on their suicidal behavioural experiences. There is no significant influence of gender on the mean responses of male and female tertiary institution students on the prevalence of suicidal experiences. Based on the findings, it is recommended that there should be the teaching of suicide education and prevention in schools as well as mounting of bulletins on suicidology by the Guidance Counsellors.

Keywords: suicide, behavioural experiences, tertiary institution, childhood development

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Authors: Udaykumar R., M. S. Ganachari

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In order to engage community pharmacies in Tuberculosis care, a survey has been conducted in Belgaum city, Karnataka state, India. After the survey divided into two groups one is control group and another one is intervention group. One is dispensing of anti-tuberculosis drugs, and another one is non-availability of anti-tuberculosis drugs. Those community pharmacists who are voluntarily interesting for becoming DOTS (Directly observed treatment short course) provider and RNTCP (Revised national tuberculosis control programme) objectives. Structured training is conducted for community pharmacist who are dispensing anti-tuberculosis drugs. The training module includes record maintaining, reporting to the RNTCP, Medication adherence etc. In case of non-availability of anti-tuberculosis drugs, the district RNTCP has been given training for community pharmacist by providing free of drugs to the community pharmacies. So, community pharmacies can dispense anti-tuberculosis drugs to the patients. The target of this study is Private community pharmacies. A simple random sampling method is used and 550 private community pharmacy shops has been involved in Belgaum city of Karnataka state, India. Significance of the Study: This study mainly focused on training of DOTS (Directly observed treatment short course) to the private community pharmacist. Indian Govt. Considers Private Providers as Assets for TB Control and Care to Achieve National Strategic Plan for TB Elimination 2017-2025. The Govt. has not fully tapped the Potential of Private Pharmacies to Fight TB. Providing DOTS as per patient’s convenience through community DOT Providers with periodic monitoring may reduce the treatment Default. We explore RNTCP objectives interventions that can have directly managed by private community pharmacy shop. Objectives: Survey of anti-tuberculosis drugs in Community pharmacy shop in Belgaum city. Interested community pharmacist who are willing to become DOTS (Directly observed treatment short course) Provider. Major Findings:Most of the community pharmacist are dispensing anti-tuberculosis drugs without having knowledge of DOTS therapy and RNTCP objectives. No community pharmacist is aware of RNTCP and Tuberculosis burden in India. Most of the Pharmacist agreed to come for RNTCP Training module for the community pharmacist. Some of the community pharmacist not dispensing anti-tuberculosis drugs and they agreed to become official DOTS provider. Concluding Statement: Awareness of role of community pharmacist on tuberculosis control and care has been neglected. More than 50% of tuberculosis patients seeking treatments from privatesector. In this study finds the major gap between government and private sector on tuberculosis treatment.

Keywords: community pharmacist, directly observed treatment short course(DOTS), revised national tuberculosis control programme (RNTCP), private pharmacies, anti-tuberculosis drugs

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Authors: Abdelbasit Gadour

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This study explores the function of schools’ psychosocial services within Libyan mainstream schools in relation to children’s special educational needs (SEN). This is with the aim to examine the role of school social workers and psychologists in the assessment procedure of children with special educational needs. A semi-structured interview was used in this study, with 21 professionals working in the schools’ psychosocial services, of whom thirteen were school social workers (SSWs) and eight were school psychologists (SPs). The results of the interviews with SSWs and SPs provided insights into how SEN children are identified, assessed, and dealt with by school professionals. It appears from the results that what constitutes a problem has not changed significantly, and the link between learning difficulties and behavioral difficulties is also evident from this study. Children with behavior difficulties are more likely to be referred to school psychosocial services than children with learning difficulties. Yet, it is not clear from the interviews with SSWs and SPs whether children are excluded merely because of their behavior problems. Instead, they would surely be expelled from the school if they failed academically. Furthermore, the interviews with SSWs and SPs yield a rather unusual source accountable for children’s SEN; school-related difficulties were a major factor in which almost all participants attributed children’s learning and behavior problems to teachers’ deficiencies, followed by school lack of resources.

Keywords: psychologist, school, social workers, special education

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Authors: E. Mendoza, D. Jackson-Maldonado, G. Avecilla-Ramírez, A. Mondaca

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Assessing language proficiency is a major issue in psycholinguistic research. There are multiple tools that measure language dominance and language proficiency in hearing bilinguals, however, this is not the case for Deaf bilinguals. Specifically, there are few, if not none, assessment tools useful in the description of the multilingual abilities of Mexican Deaf signers. Because of this, the linguistic characteristics of Mexican Deaf population have been poorly described. This paper attempts to explain the necessary changes done in order to adapt the Bilingual Language Profile (BLP) to Mexican Sign Language (LSM) and written/oral Spanish. BLP is a Self-Evaluation tool that has been adapted and translated to several oral languages, but not to sign languages. Lexical, syntactic, cultural, and structural changes were applied to the BLP. 35 Mexican Deaf signers participated in a pilot study. All of them were enrolled in Higher Education programs. BLP was presented online in written Spanish via Google Forms. No additional information in LSM was provided. Results show great heterogeneity as it is expected of Deaf populations and BLP seems to be a useful tool to create a bilingual profile of the Mexican Deaf population. This is a first attempt to adapt a widely tested tool in bilingualism research to sign language. Further modifications need to be done.

Keywords: deaf bilinguals, assessment tools, bilingual language profile, mexican sign language

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Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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Authors: Benjamin Arazi

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Blockchain is the technology behind cryptocurrencies like Bitcoin. It revolutionizes the meaning of trust in the sense of offering total reliability without relying on any central entity that controls or supervises the system. The Wall Street Journal states: “Blockchain Marks the Next Step in the Internet’s Evolution”. Blockchain was listed as #1 in Linkedin – The Learning Blog “most in-demand hard skills needed in 2020”. As stated there: “Blockchain’s novel way to store, validate, authorize, and move data across the internet has evolved to securely store and send any digital asset”. GSMA, a leading Telco organization of mobile communications operators, declared that “Blockchain has the potential to be for value what the Internet has been for information”. Motivated by these seminal observations, this paper presents the foundations of a Blockchain-based “Internet of Assets” academic program that joins under one roof leading application areas that are characterized by the transfer of assets over communication lines. Two such areas, which are pillars of our economy, are Fintech – Financial Technology and mobile communications services. The next application in line is Healthcare. These challenges are met based on available extensive professional literature. Blockchain-based assets communication is based on extending the principle of Bitcoin, starting with the basic question: If digital money that travels across the universe can ‘prove its own validity’, can this principle be applied to digital content. A groundbreaking positive answer here led to the concept of “smart contract” and consequently to DLT - Distributed Ledger Technology, where the word ‘distributed’ relates to the non-existence of reliable central entities or trusted third parties. The terms Blockchain and DLT are frequently used interchangeably in various application areas. The World Bank Group compiled comprehensive reports, analyzing the contribution of DLT/Blockchain to Fintech. The European Central Bank and Bank of Japan are engaged in Project Stella, “Balancing confidentiality and auditability in a distributed ledger environment”. 130 DLT/Blockchain focused Fintech startups are now operating in Switzerland. Blockchain impact on mobile communications services is treated in detail by leading organizations. The TM Forum is a global industry association in the telecom industry, with over 850 member companies, mainly mobile operators, that generate US$2 trillion in revenue and serve five billion customers across 180 countries. From their perspective: “Blockchain is considered one of the digital economy’s most disruptive technologies”. Samples of Blockchain contributions to Fintech (taken from a World Bank document): Decentralization and disintermediation; Greater transparency and easier auditability; Automation & programmability; Immutability & verifiability; Gains in speed and efficiency; Cost reductions; Enhanced cyber security resilience. Samples of Blockchain contributions to the Telco industry. Establishing identity verification; Record of transactions for easy cost settlement; Automatic triggering of roaming contract which enables near-instantaneous charging and reduction in roaming fraud; Decentralized roaming agreements; Settling accounts per costs incurred in accordance with agreement tariffs. This clearly demonstrates an academic education structure where fundamental technologies are studied in classes together with these two application areas. Advanced courses, treating specific implementations then follow separately. All are under the roof of “Internet of Assets”.

Keywords: blockchain, education, financial technology, mobile telecommunications services

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Authors: Jessica A. Hellings, Piyushkumar Jani

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Background: Systemic autoimmune disorders are increasingly implicated in neuropsychiatric illness, especially in the setting of treatment resistance in individuals of all ages. Gluten allergy in fullest extent results in celiac disease, affecting multiple organs including central nervous system (CNS). Clinicians often lack awareness of the association between neuropsychiatric illness and gluten allergy, partly since many such research studies are published in immunology and gastroenterology journals. Methods: Following a Pubmed literature search and online searches on celiac disease websites, 40 articles are critically reviewed in detail. This work reviews celiac disease, gluten intolerance and current evidence of their relationship to neuropsychiatric and systemic illnesses. The review also covers current work-up and diagnosis, as well as dietary interventions, gluten restriction outcomes, and future research directions. Results: Gluten allergy in susceptible individuals damages the small intestine, producing a leaky gut and malabsorption state, as well as allowing antibodies into the bloodstream, which attack major organs. Lack of amino acid precursors for neurotransmitter synthesis together with antibody-associated brain changes and hypoperfusion may result in neuropsychiatric illness. This is well documented; however, studies in neuropsychiatry are often small. In the large CATIE trial, subjects with schizophrenia had significantly increased antibodies to tissue transglutaminase (TTG), and antigliadin antibodies, both significantly greater gluten antibodies than in control subjects. On later follow up, TTG-6 antibodies were identified in these subjects’ brains but not in their intestines. Significant evidence mostly from small studies also exists for gluten allergy and celiac-related depression, anxiety disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, ataxia, and epilepsy. Dietary restriction of gluten resulted in remission in several published cases, including for treatment-resistant schizophrenia. Conclusions: Ongoing and larger studies are needed of the diagnosis and treatment efficacy of the gluten-free diet in neuropsychiatric illness. Clinicians should ask about the patient history of anemia, hypothyroidism, irritable bowel syndrome and family history of benefit from the gluten-free diet, not limited to but especially in cases of treatment resistance. Obtaining gluten antibodies by a simple blood test, and referral for gastrointestinal work-up in positive cases should be considered.

Keywords: celiac, gluten, neuropsychiatric, translational

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