Search results for: clinical education

Authors: Mahsa Houshdar, Seyed Mehdi Samimi Ardestani , ُSeyed Saeed Sadr

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Introduction: Online Medicare is a method in which parts of a medical process - whether its diagnostics, monitoring or the treatment itself will be done by using online services. This system has been operated in one boy’s high school, one girl’s high school and one high school in deprived aria. Method: At the first step the students registered for using the system. It was not mandatory and not free. They participated in estimating depression scale, anxiety scale and clinical interview by online medical care system. During this estimation, we could find the existence and severity of depression and anxiety in each one of the participants, also we could find the consequent needs of each one, such as supportive therapy in mild depression or anxiety, need to visited by psychologist in moderate cases, need to visited by psychiatrist in moderate-severe cases, need to visited by psychiatrist and psychologist in severe cases and need to perform medical lab examination tests. The lab examination tests were performed on persons specified by the system. The lab examinations were included: serum level of vitamin D, serum level of vitamin B12, serum level of calcium, fasting blood sugar, HbA1c, thyroid function tests and CBC. All of the students were solely treated by vitamins or minerals therapy and/ or treatment of medical problem (such as hypothyroidism). After a few months, we came back to high schools and estimated the existence and severity of depression and anxiety in treated students. With comparing these results, the affectability of the system could be prof. Results: Totally, we operate this project in 1077 participants in 243 of participant, the lab examination test were performed. In girls high schools: the existence and severity of depression significantly deceased (P value= 0.018<0.05 & P value 0.004< 0.05), but results about anxiety was not significant. In boys high schools: the existence and severity of depression significantly decreased (P value= 0.023<0.05 & P value = 0.004< 0.05 & P value= 0.049< 0.05). In boys high schools: the existence and severity of anxiety significantly decreased (P value= 0.041<0.05 & P value = 0.046< 0.05 &) but in one high school results about anxiety was not significant. In high school in deprived area the students did not have any problem paying for participating in the project, but they could not pay for medical lab examination tests. Thus, operation of the system was not possible in deprived area without a sponsor. Conclusion: This online medical system was successful in creating medical and psychiatric profile without attending physician. It was successful in decreasing depression without using antidepressants, but it was partially successful in decreasing anxiety.

Keywords: depression, diabetes, online medicare, vitamin D deficiency

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Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: A. J. Otjen

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Native American communities are struggling with unemployment and depressed economies. A major cause is a lack of business knowledge, education, and cultural desire. And yet, in the history of the American West, Native Americans were considered the best traders and negotiators for everything from furs to weapons to buffalo. To improve these economies, there has been an effort to reintroduce that heritage to todays and tomorrows generation of tribal members, such Crow, Cheyenne, and Blackfeet. Professors at the College of Business Montana State University-Billings (MSUB) teach tribal students in Montana to create business plans. These plans have won national small business plan competitions. The teaching and advising method used at MSUB is uniquely successful as theses business students are now five time national champions. This article reviews the environment and the method of learning to achieve a winning small business plan with Native American students. It discusses the five plans that became national champions. And it discusses the problems and solutions discovered in the process of achieving results. Students who participated in this endeavor have graduated and become CPAs, MBAs, and gainfully employed in their chosen professions. They have also worked to improve the economies of their native lands and homes. By educating members of these communities with business strategy and plan development, they are better able to impact their own economies.

Keywords: entrepreneurship, native American economies, small businesses, unemployment

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Authors: Sylvie Ekanga Lumumba

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Background and Significance of the Study: Over the past three decades, the perception of sexual violence has changed significantly, it is now recognized that men and boys are victims of sexual violence. However, the body of research on male victims and particularly on their attackers is much more limited. Research on the above is thus more than required. To contribute to the above quest for further studies, the researcher conducted this study on sexual violence perpetrated against men and boys by women, in the Municipality of Ibanda, Town of Bukavu, Province of South Kivu, Democratic Republic of Congo. The main study objectives were the following: to investigate on the statement of sexual violence perpetrated against men and boys in the Municipality of Ibanda, to investigate into its consequences and the statement of medical and psycho-social care given to victims. Methodology: Data were collected using valid and reliable Survey Questionnaire and Interview Schedule. Study population: the 85,882 men and boys from the Municipality of Ibanda. Sampling: led to 150 men and boys, received discreetly by the researcher during November-December 2015. Major findings: First, findings related to sexual abuse and its procedure: 74.2% of men and boys were victims of sexual violence perpetrated by a woman, more than a year ago. 13.3% however, were victims for less than a year now. 79.7% of victims have experienced sexual violence by a sexual act; 3.9% through the intention of the woman to cause the death of the victim, by serious injury to the genitals. The Second group of findings related to the consequences of sexual violence revealed that HIV/AIDS is the most important physical consequence experienced by 77.3 % of victims. Physical psychological consequences are: urinary or defecation problems (72.7%); while key psycho-emotional and behavioral consequence is: living a state of deep shame and humiliation: 68.8%. As for sexual consequences: 71.1% indicated a chronic avoidance of sexual activity and 57% reported sexual dysfunctions. The third group of findings is related to medical and psycho-social care: repetitively, more than 80% of male victims affirmed that with the help of friends and traditional healers, they took care of themselves for all the eight WHO phases of clinical care of rape victims, this was hence not effectively done. Concluding Statement: for this study, the statement of sexual violence of men and boys by women in the Eastern Congo and its consequences are not researched upon and are underestimated; the study also revealed that the care of male victims is grossly ill-conducted, as opposed to female victims care. It therefore calls for further research and further vulgarization of the research results, to convince other stakeholders (politicians for example) to immediately take action.

Keywords: sexual violence, men and boys, medical care, psycho-social care

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Authors: Mubina Rauf

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Critical thinking is a highly valued outcome of university education. There is an agreement in literature that it is demonstrated through the abilities to highlight issues and assumptions, find links between ideas and concepts, make correct inferences, evaluate evidence or authority and deduce conclusions (Tsui, 2002). Although Critical thinking plays a significant role in developing all academic skills, its role in developing writing skills is significant (Kurfiss, 1988). SAW (student academic writing) is an observable output of critical thinking (Wilson K. , 2016). When students apply critical thinking to their writing, they present clear, accurate, significant and logical arguments constructing their own voice in the form of an essay or dissertation (Matsuda, 2001). This presentation will show how a rubric can be used to find evidence of critical thinking in SAW. Participants will experience how evidence-based written arguments supported by background knowledge and authorial voice can develop students into efficient critical thinkers. Participants will have an opportunity to use the rubric to find the evidence of critical thinking in SAW samples. This presentation is intended for classroom teachers with or without the basic knowledge of implementing critical thinking in academic settings. Participants will also learn tips how various features of critical thinking can be developed among students. After the session, the participants will be able to use or adapt the rubric according to their needs to find evidence of critical thinking in SAW within their context.

Keywords: critical thinking, Rubric, student academic writing, argumentation, text analysis

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Authors: Philippa Saunders, Claire Fletcher

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INTRODUCTION: Prostate cancer is the most prevalent malignancy affecting Western males. It is initially an androgen-dependent disease: androgens bind to the androgen receptor and drive the expression of genes that promote proliferation and evasion of apoptosis. Despite reduced androgen dependence in advanced prostate cancer, androgen receptor signaling remains a key driver of growth. Androgen deprivation therapy (ADT) is, therefore, a first-line treatment approach and works well initially, but resistance inevitably develops. Abiraterone and Enzalutamide are drugs widely used in ADT and are androgen synthesis and androgen receptor signaling inhibitors, respectively. The shortage of other treatment options means acquired resistance to these drugs is a major clinical problem. MicroRNAs (miRs) are important mediators of post-transcriptional gene regulation and show altered expression in cancer. Several have been linked to the development of resistance to ADT. Manipulation of such miRs may be a pathway to breakthrough treatments for advanced prostate cancer. This study aimed to validate ADT resistance-implicated miRs and their clinically relevant targets. MATERIAL AND METHOD: Small RNA-sequencing of Abiraterone- and Enzalutamide-resistant C42 prostate cancer cells identified subsets of miRs dysregulated as compared to parental cells. Real-Time Quantitative Reverse Transcription PCR (qRT-PCR) was used to validate altered expression of candidate ADT resistance-implicated miRs 195-5p, 497-5p and 29a-5p in ADT-resistant and -responsive prostate cancer cell lines, patient-derived xenografts (PDXs) and primary prostate cancer explants. RESULTS AND DISCUSSION: This study suggests a possible role for miR-497-5p in the development of ADT resistance in prostate cancer. MiR-497-5p expression was increased in ADT-resistant versus ADT-responsive prostate cancer cells. Importantly, miR-497-5p expression was also increased in Enzalutamide-treated, castrated (ADT-mimicking) PDXs versus intact PDXs. MiR-195-5p was also elevated in ADT-resistant versus -responsive prostate cancer cells, while there was a drop in miR-29a-5p expression. Candidate clinically relevant targets of miR-497-5p in prostate cancer were identified by mining AGO-PAR-CLIP-seq data sets and may include AVL9 and FZD6. CONCLUSION: In summary, this study identified microRNAs that are implicated in prostate cancer resistance to androgen deprivation therapy and could represent novel therapeutic targets for advanced disease.

Keywords: microRNA, androgen deprivation therapy, Enzalutamide, abiraterone, patient-derived xenograft

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Authors: Tania Camarillo Contreras, Yana Kuchirko

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Women’s sexuality, despite it being a core part of human functioning, has historically been stigmatized, silenced, and regulated and silenced across many cultures. The regulation of women’s bodies and desires has often been accomplished via gender ideologies and norms that ascribe power to men over women. Within Latino communities, gender ideologies like marianismo provide scripts by which women are expected to adhere submissiveness, purity, and putting others’ needs before their own. Prior work on sexuality-related topics among Latinas has almost exclusively examined the roles of risky behavior, partner violence, and gender roles on psychological and health outcomes. it know little about positive aspects of Latinas’ sexuality, such as their perspectives on sexual excitation and inhibition. Moreover, we know little about Latina’s sexuality in relation to marianismo. In this study, it ask the following questions (1) What are Latina’s perspectives on sexual excitation/inhibition? Do they vary by demographic variables (e.g., education, religiosity); (2) Does endorsement of marianismo among Latina women predict their perspectives on sexual excitation/sexual inhibition? and (3) Does endorsement of double standard (mediator variable) mediate the relation between marianismo (Independent) and sexual excitation/sexual inhibition? The results of this study shed light on effects of culturally specific gender ideologies like marianismo on women’s sexualities and have implications for culturally informed and gender-affirming policies seeking to better support Latinas’ sexual health.

Keywords: cultural beliefs, latinas, marianismo, sexuality, sexual inhibition

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Authors: Jacqueline Żammit

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Online learning has become more popular as a substitute for traditional classroom instruction because of the COVID-19 epidemic. The study aimed to investigate how adult Maltese language learners evaluated the benefits and drawbacks of online instruction. 35 adult participants provided data through semi-structured interviews with open-ended questions. NVivo software was used to analyze the interview data using the thematic analysis method in order to find themes and group the data based on common responses. The advantages of online learning that the participants mentioned included accessing subject content even without live learning sessions, balancing learning with household duties, and lessening vulnerability to problems like fatigue, time-wasting traffic, school preparation, and parking space constraints. Conversely, inadequate Internet access, inadequate IT expertise, a shortage of personal computers, and domestic distractions adversely affected virtual learning. Lack of an Internet connection, IT expertise, a personal computer, or a phone with Internet access caused inequality in access to online learning sessions. Participants thought online learning was a way to resume academic activity, albeit with drawbacks. In order to address the challenges posed by online learning, several solutions are proposed in the research's conclusion.

Keywords: adult learners, online education, e-learning, challenges of online learning, benefits ofonline learning

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Authors: E. K. Linsenmayer

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Traditional international relations theorists define state security, the principal national interest, as a state’s military force. However, many political theorists argue the current definition of security is not comprehensive and therefore, problematic. This paper argues that women’s physical security is not only linked but also necessary to achieve state security. In today’s unipolar political international system, the United States continues to accredit national security to its military. However, in one of the most militarized countries, women remain insecure. Through a case study method of the United States, this paper illuminates a necessary political prescription: the empowerment of women through an inside-out, feminist theoretical approach that makes state security attainable. The research through empirical testing, drawing from several databases, shows the positive effects of women’s physical security on state security. Women’s physical security is defined in terms of equal legal practices, health, education, and female representation in the government. State security is measured by the relative peace of a state, its involvement in conflict and a state’s relations with neighboring states. This paper shows that empowering women, 50% of the world’s population, is necessary for ending the current vicious circle of militarization, war, and insecurity. Without undoing gender power dynamics at the individual and societal level, security at all levels remains unattainable.

Keywords: gender inequality, politics, state security, women's security

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Authors: Kangana Sengar, Sanjay Deb, Ramesh Dawar

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Introduction: Ki-67 can be a useful marker in determining proliferative activity in patients with multiple myeloma (MM). However, using Ki-67 alone results in the erroneous inclusion of non-myeloma cells leading to false high counts. We have used Dual IHC (immunohistochemistry) staining with Ki-67 and CD138 to enhance specificity in assessing proliferative activity of bone marrow plasma cells. Aims and objectives: To estimate the proportion of proliferating (Ki-67 expressing) plasma cells in patients with MM and correlation of Ki-67 with other known prognostic parameters. Materials and Methods: Fifty FFPE (formalin fixed paraffin embedded) blocks of trephine biopsies of cases diagnosed as MM from 2010 to 2015 are subjected to H & E staining and Dual IHC staining for CD 138 and Ki-67. H & E staining is done to evaluate various histological parameters like percentage of plasma cells, pattern of infiltration (nodular, interstitial, mixed and diffuse), routine parameters of marrow cellularity and hematopoiesis. Clinical data is collected from patient records from Medical Record Department. Each of CD138 expressing cells (cytoplasmic, red) are scored as proliferating plasma cells (containing a brown Ki¬67 nucleus) or non¬proliferating plasma cells (containing a blue, counter-stained, Ki-¬67 negative nucleus). Ki-67 is measured as percentage positivity with a maximum score of hundred percent and lowest of zero percent. The intensity of staining is not relevant. Results: Statistically significant correlation of Ki-67 in D-S Stage (Durie & Salmon Stage) I vs. III (p=0.026) and ISS (International Staging System) Stage I vs. III (p=0.019), β2m (p=0.029) and percentage of plasma cells (p < 0.001) is seen. No statistically significant correlation is seen between Ki-67 and hemoglobin, platelet count, total leukocyte count, total protein, albumin, S. calcium, S. creatinine, S. LDH, blood urea and pattern of infiltration. Conclusion: Ki-67 index correlated with other known prognostic parameters. However, it is not determined routinely in patients with MM due to little information available regarding its relevance and paucity of studies done to correlate with other known prognostic factors in MM patients. To the best of our knowledge, this is the first study in India using Dual IHC staining for Ki-67 and CD138 in MM patients. Routine determination of Ki-67 will help to identify patients who may benefit with more aggressive therapy. Recommendation: In this study follow up of patients is not included, and the sample size is small. Studying with larger sample size and long follow up is advocated to prognosticate Ki-67 as a marker of survival in patients with multiple myeloma.

Keywords: bone marrow, dual IHC, Ki-67, multiple myeloma

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Authors: Robin Lok Wang Ma

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The purpose of this paper is to investigate how engineering students’ motivation and interests are maintained in their journeys. In recent years, different pedagogies of teaching, including entrepreneurship, experiential and lifelong learning, as well as dream builder, etc., have been widely used for education purposes. University advocates hands-on practice, learning by experiencing and experimenting throughout different courses. Students are not limited to gaining knowledge via traditional lectures, laboratory demonstrations, tutorials, and so on. The capability to identify both complex problems and their corresponding solutions in daily life are one of the criteria/skill sets required for graduates to obtain their careers at professional organizations and companies. A project-based course, namely Mechatronic Design and Prototyping, was developed for students to design and build a physical prototype for solving existing problems in their daily lives, thereby encouraging them as an entrepreneur to explore further possibilities to commercialize their designed prototypes and launch them to the market. Feedbacks from students show that they are keen to propose their own ideas freely with guidance from the instructor instead of using either suggested or assigned topics. Proposed ideas of the prototypes reflect that if students’ interests are maintained, they acquire the knowledge and skills they need, including essential communication, logical thinking, and, more importantly, problem solving for their lifelong learning journey.

Keywords: problem solving, lifelong learning, entrepreneurship, engineering

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Authors: Oktia Woro Kasmini Handayani, Sri Ratna Rahayu, Efa Nugroho, Bertakalswa Hermawati

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The double burden of nutrition problem must be faced by Indonesia as developing country. The implemented program did not improve the nutritional status, therefore need to consider to utilize local potential. The objective of this research was to find out the effectivity of magnification model of early detect through local potential utilization in urban region, Semarang, Central Java, Indonesia. The research used an experimental design with the quantitative-qualitative approach. The population was all toddlers under five within the research region, sample determination by purposive sampling, as many as 216 toddlers. Quantitative data analysis used effectively criteria by Sugiono. Qualitative data was analyzed using NVivo. The optimization of local potential in the effort of nutrition status improvement shows number of nutrition case found was increased 225% (very effective), number of cases treated was increased 175% (very effective), number of cases counselled was increased 200% (effective), and number of cases that have improvement increase 75% (effective). The local potential need to be utilized in the effort of nutrition program improvement one of it is through the community empowerment, particularly health care and health high education institution as partner.

Keywords: early detection, nutrition status, local potential, health cadre

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Authors: Mimoun Melliti

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In the wake of the global pandemic, educational systems worldwide faced unprecedented challenges and had to swiftly adapt to new conditions. This necessitated a fundamental shift in assessment processes, as traditional in-person exams became impractical. The present paper aims to investigate how educational systems have adapted to the new conditions imposed by the outbreak of the pandemic. This paper serves as a case study documenting the various decisions, conditions, experiments, and outcomes associated with transitioning the assessment processes of a higher education institution to a fully online format. The participants of this study consisted of 4666 students from health, engineering, science, and humanities disciplines, who were enrolled in general English (Eng101/104) and English for specific purposes (Eng102/113) courses at a preparatory year institution in Saudi Arabia. The findings of this study indicate that online assessment can be effectively implemented given the fulfillment of specific requirements. These prerequisites encompass the presence of competent staff, administrative flexibility, and the availability of necessary infrastructure and technological support. The significance of this case study lies in its comprehensive description of the various steps and measures undertaken to adapt to the "new normal" situation. Furthermore, it evaluates the impact of these measures and offers detailed recommendations for potential similar future scenarios.

Keywords: hybrid learning, testing, adaptive teaching, EFL

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Authors: Gayathri Sadanala, Shibam Pokhrel, Owen Murphy

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In the ever-evolving landscape of education, Virtual Reality (VR) environments offer a promising avenue for enhancing student engagement and learning experiences. However, understanding and predicting student behavior within these immersive settings remain challenging tasks. This paper presents a comprehensive study on the predictive modeling of student behavior in VR using machine learning techniques. We introduce a rich data set capturing student interactions, movements, and progress within a VR orientation program. The dataset is divided into training and testing sets, allowing us to develop and evaluate predictive models for various aspects of student behavior, including engagement levels, task completion, and performance. Our machine learning approach leverages a combination of feature engineering and model selection to reveal hidden patterns in the data. We employ regression and classification models to predict student outcomes, and the results showcase promising accuracy in forecasting behavior within VR environments. Furthermore, we demonstrate the practical implications of our predictive models for personalized VR-based learning experiences and early intervention strategies. By uncovering the intricate relationship between student behavior and VR interactions, we provide valuable insights for educators, designers, and developers seeking to optimize virtual learning environments.

Keywords: interaction, machine learning, predictive modeling, virtual reality

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Authors: Amir Seyfoori, Ehsan Samiei, Mohsen Akbari

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The use of microtechnology for detection and high yield isolation of circulating tumor cells (CTCs) has shown enormous promise as an indication of clinical metastasis prognosis and cancer treatment monitoring. The Immunomagnetic assay has been also coupled to microtechnology to improve the selectivity and efficiency of the current methods of cancer biomarker isolation. In this way, generation and configuration of the local high gradient magnetic field play essential roles in such assay. Additionally, considering the intrinsic heterogeneity of cancer cells, real-time analysis of isolated cells is necessary to characterize their responses to therapy. Totally, on-chip isolation and monitoring of the specific tumor cells is considered as a pressing need in the way of modified cancer therapy. To address these challenges, we have developed a bi-layer magnetic-based microfluidic chip for enhanced CTC detection and capturing. Micromagnet arrays at the bottom layer of the chip were fabricated using a new method of magnetic nanoparticle paste deposition so that they were arranged at the center of the chain microchannel with the lowest fluid velocity zone. Breast cancer cells labelled with EPCAM-conjugated smart microgels were immobilized on the tip of the micromagnets with greater localized magnetic field and stronger cell-micromagnet interaction. Considering different magnetic nano-powder usage (MnFe2O4 & gamma-Fe2O3) and micromagnet shapes (ellipsoidal & arrow), the capture efficiency of the systems was adjusted while the higher CTC capture efficiency was acquired for MnFe2O4 arrow micromagnet as around 95.5%. As a proof of concept of on-chip tumor cell monitoring, magnetic smart microgels made of thermo-responsive poly N-isopropylacrylamide-co-acrylic acid (PNIPAM-AA) composition were used for both purposes of targeted cell capturing as well as cell monitoring using antibody conjugation and fluorescent dye loading at the same time. In this regard, magnetic microgels were successfully used as cell tracker after isolation process so that by raising the temperature up to 37⁰ C, they released the contained dye and stained the targeted cell just after capturing. This microfluidic device was able to provide a platform for detection, isolation and efficient real-time analysis of specific CTCs in the liquid biopsy of breast cancer patients.

Keywords: circulating tumor cells, microfluidic, immunomagnetic, cell isolation

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Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan

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Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.

Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents

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Authors: Valerie Triggs, Michele Sorensen

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As two university professors in postsecondary faculties of social work and education, we have observed that students often recognize the importance of learning facts about colonization but have difficulty grappling with how they themselves might be implicated in reconciliation or how they might respond to these facts in meaningful ways. The detachment observed between students and factual information results in the initiation of a research study centered around an approach to teaching the course. This involved transitioning its pedagogical format to embrace a/r/tographic methods of teaching, learning, and inquiry. By taking seriously the arguments of various Indigenous scholars for learning from the land and by working alongside traditional Indigenous knowledge, we chose to engage a speculative approach to course design and teaching, which actually used the land as one of the course texts. We incorporated art practices that involved connecting bodies with land as well as using land materials in various creative and aesthetic projects while being informed by Medicine Keepers, Indigenous and settler artists, and knowledge-keeper helpers. In this study, we share some of the unanticipated themes that arose when students began to allow land and artmaking, both aesthetically and intuitively, through both joy and sorrow, to affect a reimagining and repositioning of selves and relations. We found that time and engagement with land and art began to build more empathic understanding and foster personal and professional practices grounded in respect, relevance, reciprocity, and responsibility.

Keywords: reconciliation, decolonization, artmaking, respect

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Authors: Rahayu Azkiya

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Career guidance is an integral part of education that aims to help students understand their interests, talents, and potential and provide direction in choosing an appropriate career path. Approximately 76 million people are working out of 17 million people with disabilities in 2022, and this number has become a focal point as career guidance is crucial among people with special needs. Therefore, this study explores how the career guidance program is implemented and what challenges are faced by teachers. This study employs a qualitative case study in one of the senior high schools for special needs (SMLB) in Depok, Indonesia. Meanwhile, the data analysis was done through thematic analysis. Data has been obtained through the interviews of two teachers who focused on the physically impaired and deaf. The results of this study show that (1) the school has implemented career guidance well, the students were selected in the first year to look for their talents and interests, and for the second and third years, students are trained to master their abilities. (2) There are still many challenges teachers face in implementing career guidance programs, such as a need for more human resources for both students and teachers, high curriculum demands, and simple facilities that hinder student progress. Therefore, this research shows that every child is unique, so schools must meet the standards of student needs and re-evaluate the various challenges that teachers and students still face. This research is expected to serve as an analysis material for the government's policy towards special needs schools in Indonesia.

Keywords: Students with Special Needs, Career Guidance Program, Implementation, Challenges

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Authors: Angela Maria Fenu

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The aim of this study was to better characterize the nature of word association responses in people with aphasia. The participants selected for the experimental group were 4 individuals with mild Broca’s aphasia. The control group consisted of 51 cognitively intact age- and gender-matched individuals. The participants were asked to perform a word association task in which they had to say the first word they thought of when hearing each cue. The cue words (n= 16) were the translation in Italian of the set of English cue words of a published study. The participants from the experimental group were administered the word association test every two weeks for a period of two months when they received speech-language therapy A combination of analytical approaches to measure the data was used. To analyse different patterns of word association responses in both groups, the nature of the relationship between the cue and the response was examined: responses were divided into five categories of association. To investigate the similarity between aphasic and non-aphasic subjects, the stereotypy of responses was examined.While certain stimulus words (nouns, adjectives) elicited responses from Broca’s aphasics that tended to resemble those made by non-aphasic subjects; others (adverbs, verbs) showed the tendency to elicit responses different from the ones given by normal subjects. This suggests that some mechanisms underlying certain types of associations are degraded in aphasics individuals, while others display little evidence of disruption. The high number of paradigmatic associations given in response to a noun or an adjective might imply that the mechanisms, largely semantic, underlying paradigmatic associations are relatively preserved in Broca’s aphasia, but it might also mean that some words are more easily processed depending on their grammatical class (nouns, adjectives). The most significant variation was noticed when the grammatical class of the cue word was an adverb. Unlike the normal individuals, the experimental subjects gave the most idiosyncratic associations, which are often produced when the attempt to give a paradigmatic response fails. In turn, the failure to retrieve paradigmatic responses when the cue is an adverb might suggest that Broca’s aphasics are more sensitive to this grammatical class.The findings from this study suggest that, from research on word associations in people with aphasia, important data can arise concerning the specific lexical retrieval impairments that characterize the different types of aphasia and the various treatments that might positively influence the kinds of word association responses affected by language disruption.

Keywords: aphasia therapy, clinical linguistics, word-association behaviour, mental lexicon

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Authors: Erdinc Ozturk, Gizem Akcan

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The aim of this study was to determine some psychosocial variables that predict childhood trauma and dissociation in university students. These psychosocial variables were perceived social support, relationship status, gender and life satisfaction. 250 (125 males, 125 females) university students (bachelor, master and postgraduate degree) were enrolled in this study. They were chosen from universities in Istanbul at the education year of 2016-2017. Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ), Multidimensional Perceived Social Support Scale, Life Satisfaction Scale and Relationship Scales Questionnaire were used to assess related variables. Demographic information form was given to students in order to have their demographic information. Frequency distribution, multiple linear regression, and t-test analysis were used for statistical analysis. As together, perceived social support, relationship status and life satisfaction were found to have predictive value on trauma among university students. However, as together, these psychosocial variables did not have predictive value on dissociation. Only, trauma and relationship status had significant predictive value on dissociation. Moreover, there was significant difference between males and females in terms of trauma; however, dissociation scores of participants were not significantly different in terms of gender.

Keywords: childhood trauma, dissociation, perceived social support, relationship status, life satisfaction

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Authors: Jatesh Kathpalia, Subhash Chander

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Violence against women has spread into a global epidemic. This has debilitating effect over the performance of women. Due to deep-rooted values, traditional Indian culture women fear the consequences of reporting violence and declare an unwillingness to subject themselves to the shame of being identified as battered women. Main interest was to study types of domestic violence which women face and to encourage them to report the matter. The study involved understanding the nature, extent and types of domestic violence. Two hundred rural women respondents were selected at random, interview schedule was prepared, and victims afflicted with domestic violence were identified. Data were collected and analyzed for different forms of domestic violence faced by women. 60% of the respondents faced domestic violence in different forms. Out of 120 women who were affected, 92.5% faced emotional, 90.8% faced verbal, 49.1% faced economic and 58.3% faced physical violence. 45.0% faced violence within three months of the marriage. Out of these, only 6.6% reported the violence to the police. Frequently faced forms of violence were slapping (27.1%), beating (24.3%) and starvation (25.7%). Number of women who were not allowed to spend money of their own stood at 30.5%. About 50% victims of emotional violence were facing constant criticism by their in-laws. Significant association was found between age, education and socio-economic status of the respondents and domestic violence. Rural women in Haryana face grave problem of domestic violence which need to be curbed for improving condition of women in society.

Keywords: domestic violence against women, economic, emotional, physical and verbal violence, marriage, rural women

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Authors: Dasha Karzunina, Laura Bridgestock

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Our oral presentation will be based on our qualitative and quantitative findings into motivations and challenges faced by international and UK students when choosing a university abroad. The insight was gathered through a series of over 60 focus groups held with prospective university students all over the world, including masters and PhD applicants. We spoke to students face-to-face in Latin America, North American, India, China, South East Asia and the major European cities. A survey was carried out alongside, to gather additional insight on their priorities and attitudes to universities’ reputation, collecting over 1,800 responses. The session’s aims are to break down some of the myths about the perspectives of international students and inform university leaders interested in recruiting more highly talented students from abroad and those currently working with international students. As a provider of one of the most demanded resources in higher education, QS World University Rankings, we specialize in understanding universities’ performance, their institutional brand and the impact of rankings on student recruitment. We therefore feel we are well placed to carry out and present this research. We hope for our findings to act as a bridge between bright students and their future universities abroad. We intend for our session to be interactive and so are happy to go into more depth on any of the destinations we visited, depending on what the audience is most interested in and which questions we receive.

Keywords: international student recruitment, market research, rankings, study abroad

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Authors: Zainuddin Abuhamid Muhammad Ghozali, Andrew Whitworth

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Islamic boarding school or pesantren is a distinctive education institution in Indonesia focusing on religious teachings. Its stance in restricting access to the internet raises a question about its students’ development of digital literacy. Inspired by Luckin’s ecology of resource model, this study aims to map out the digital literacy situation of the institution based on the availability of learning resources, such as digital facilities, digital accessibility, and digital competence. This study was carried out through a survey method involving 50 teachers from pesantrens across the nation. The result shows that pesantrens have provided students with digital facilities at a moderate level, yet the accessibility to using them is still limited. They also incorporated digital competencies into their curriculum, with an emphasis on digital ethics. The study also identifies different patterns of pesantrens’ behavior based on types and educational levels, where certain school types and educational levels tend to give a stricter policy compared to others or vice versa. The restriction of digital resources in pesantren indicated that they had done a filtration process to design their learning environment. The filtration was mainly motivated by sociocultural factors, where they drew concern for the negative impact of the internet. Notably, this restriction also contributes to students’ poor development of digital literacy.

Keywords: digital literacy, ecology of resources, Indonesia, Islamic boarding school

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Authors: Amal Saafan, Kareem Al Sofy, Sameh AbdelGhani, Magdy Amin

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Background: Acinetobacter spp. resistance towards β-lactam antibiotics is mediated mainly by different classes of β-lactamases production; detection of some genes responsible for production of β-lactamases is the objective of the study. Methods: One hundred fifty bacterial isolates were recovered from blood, sputum, and urine specimens from different hospitals in Egypt. Sixty-nine isolate were identified as Acinetobacter baumannii using traditional biochemical tests, CHROM agar, MicroScan and PCR amplification of blaoxa-51like gene. Acinetobacterbaumannii isolates were grouped into carbapenem resistant group (GP1), cefotaxime, ceftazidime and cefoxitin resistant group (GP2) and carbapenem and cephalosporin non-resistant group (GP3). Carbapenemase activity was screened using modified Hodge test (MHT) for GP1.Metallo-β-lactamases screening was performed for MHT positive isolates using double disk synergy test (DDST) and combined disk test (CDT). Amp C activity was screened using Amp C disk test with Tris-EDTA, DDST, and CDT for GP2. Finally, PCR amplification of blaoxa-51like, blaoxa-23like, blaIMP-like, blaVIM-like, and blaADC-like genes was performed for isolates that showed, at least, two positive results of three for both AmpC and carbapenemases phenotypic screening tests (obvious activity), in addition to GP3 (for comparison). Detection of blaoxa-51like and blaADC-like genes preceded by ISAba1 was also performed. Results: Antibiogram of 69 pure Acinetobacter baumannii isolates resulted in 57, 64, and 2 isolates enrolled into GP1, GP2, and GP3, respectively. Carbapenemase activity was shown by 49(85.9%) isolate using MHT. Metallo-β-lactamases screening revealed 32(65.3%) and 35(71.4%) using DDST and CDT, respectively.AmpC activity was shown by 43(67.2%) and 50 (78.1%) isolates using AmpC disk test with Tris-EDTA, and both DDST and CDT, respectively. Twenty-seven isolates showed obvious activity, all of them (100%) were harboring blaoxa-51like and blaADC-like genes, while blaoxa-23like, blaIMP-like andblaVIM-like genes were harbored by 23(85.2%), 9 (33.%) and no isolate respectively. Only 12 (44.4%) isolates harbored blaoxa-51like and blaADC-like genes preceded by ISAba1. GP3 isolates showed only positive blaoxa-51like and blaADC-like genes. Conclusion: It is not possible to correlate resistance with presence of blaoxa-51like and blaADC-like genes and presence of ISAba1 was immediate as transcriptional promoter. A blaoxa-23like gene played an important role in carbapenem resistance when compared with blaIMP-like and blaVIM-like gene.

Keywords: acinetobacter, beta-lactams, resistance, antimicrobial agents

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Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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Authors: Muhammad Dawood Idrees, Arsalan Ansari

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Construction industry is considered as one of the most dangerous industry because workers' safety is always a major concern due to extensive number of accidents, injuries, and casualties at worksites. There are various causes of accidents at construction sites, several factors are influencing on the perception of safety of workers and psychological factors are one of them. Perception of safety varies from region to region and it also varies by demographics of workers, such as gender, age, education, job level, etc. However, research on different level of workers, such as labor and managerial staff to evaluate the impact of psychological factor is limited. Objective of this research is to evaluate the effect of psychological factors with different job level of workers. An extensive literature review was conducted to find the casual relationship between psychological factors and perception of safety, and a hypothetical structure model was developed based upon literature review. A survey instrument based upon psychological factors was developed and data was obtained from several construction sites. Structure Equation Modeling (SEM) technique was adopted in order to examine the effect of psychological factors on the perception of safety of workers with different job levels of workers. The results of this analysis reveal that job security and organizational relationships are most affecting factors in labor staff, therefore job satisfaction, mental stress, and workload are dominant in managerial staff.

Keywords: accidents, job level of workers, perception of safety, structural equation modeling

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Authors: Christine Marie Cocchiola

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This study assesses the relationship between coercive control and subjugation. Coercive control is the foundation of most domestic violence and a serious public health problem, having significant legal and social justice ramifications. Beyond the physical, it oftentimes is preceded by or motivated by a need for control. Subjugation, as a personality trait and a maladaptive schema, leads individuals to minimize their own needs or wants and, thereby, often to a loss of autonomy, a dismissal of what one might know to be true. This includes a dismissal of the trademarks of an abusive relationship. Subjugation may contribute to a person engaging in or remaining in a coercively controlling relationship. One hundred fifty-four female survivors of domestic violence participated in this study, assessing their own level of subjugation. Participants were limited to individuals who experienced non-physical abuse in their relationships. Subjugation was attributed as a “concern” or greater in 137 of the 154 participants. 11 participants were interviewed to determine their personal experiences in this abusive relationship. Common themes emerged from interviews, including that the participants worked diligently to fix these abusive relationships by regulating their own behaviors and attempting to please the offender. The results indicate a continued need for advocacy and support of this vulnerable population. Further education is indicated for mental health professionals and for individuals in or having left an abusive relationship on how to identify signs of subjugation, thereby empowering individuals to avoid future experiences of abuse.

Keywords: coercive control, intimate partner violence, subjugation, schemas, gender oppression, autonomy, gaslighting

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Authors: Lorraine Ramos

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The question of heritage language learners in foreign language classrooms has been widely debated in second language education, especially with Spanish in a U.S. Instructors of Spanish as a foreign language have brought pedagogical focus to Spanish heritage language students in order to retain, develop and maintain their first language. This paper proposes a thorough examination of the use of conceptual metaphors within autobiographical linguistic narratives as a key indicator of the writing development of advanced Spanish-language students. By pairing genre theory from Systemic Functional Linguistics with metaphor theory, this paper will examine the metaphors used by 3rd and 4th year university Spanish students within the narrative genre from a corpus of 16, 091 words. The investigation has found that heritage language students use a variety of bicultural metaphors, transferred from both languages to conceptualize their linguistic development, in addition to using metaphor in specific narrative stages as a literary strategy. Since it has been found that the metaphors used were transcultural, the use of conceptual metaphors in heritage language learners can be further examined to help these students achieve their linguistic and academic goals in the Spanish by transferring from their knowledge in English. In conclusion, by closely examining the function of student discourse through their multicultural metaphoric competence, this study provides important insights on how to enable instructors to best further their students’ writing development in the target language.

Keywords: academic writing development, heritage language learners, language attitudes and ideologies, metaphor

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Authors: Joana PaScoa Pinheiro, David Goncalves Ferreira, Filipe Ramos, Joaquim Soares Do Brito, Samuel Martins, Marco Sarmento

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Introduction: The SARS-CoV-2 (COVID-19) pandemic was identified in January 2020 in China, in the city of Wuhan. The increase in the number of cases over the following months was responsible for the restructuring of hospitals and departments in order to accommodate admissions related to COVID-19. Essential services, such as trauma, had to readapt to maintain their functionality and thus guarantee quick and safe access in case of an emergency. Objectives: This study describes the impact of COVID-19 on a Level III Trauma Center and particularly on the clinical management of hospitalized patients with spine injuries. Study Design & Methods: This is a retrospective cohort study whose results were obtained through the medical records of patients with spine injuries who underwent surgical intervention in the years 2019 and 2020 (period from March 1st to December 31st). A comparison between the two groups was made. In the study patients with injuries in the context of trauma were included who underwent surgery in the periods previously described. Patients hospitalized with a spine injury in a non-traumatic context and/or were not surgically treated were excluded. Results: In total, 137 patients underwent trauma spine surgery of which 71 in 2019 (51.8%) were without significant differences in intergroup comparisons. The most frequent injury mechanism in 2019 was motor vehicle crash (47.9%) compared to 2020 which was of a person falling from a height between 2-4 meters (37.9%). Cervical trauma was reported to be the most frequent spine injury in both years. There was a significant decrease in the need for intensive care in 2020, 51.4% vs 30.3%, p = .015 and the number of complications was also lower in 2020 (1.35% vs 0.98%), including the number of deaths, being the difference marginally significant. There were no significant differences regarding time for presentation to surgery or in the total days of hospitalization. Conclusions: The restructuring made in the trauma unit at a Level III Trauma Center in the context of the current COVID-19 pandemic was effective, with no significant differences between the years of 2019 vs 2020 when compared with the time for presentation to surgery or the number of days of hospitalization. It was also found that lockdown rules in 2020 were probably responsible for the decrease in the number of road traffic accidents, which justifies a significant decrease in the need for intensive care as well as in the number of complications in patients hospitalized in the context of spine trauma.

Keywords: trauma, spine, impact, covid-19

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Authors: Joe Voshall, Leigha Shoup

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In 2022, the Ohio Peace Officer Training Council and the Attorney General required officers to complete a minimum of 24 hours of continued professional training for the year. Much of the training was based on Mental Health or similarly related topics. This includes Officer Wellness and Officer Mental Health. It is becoming clearer that the stigma of Officer / First Responder Mental Health is a topic that is becoming more prevalently faced. To assist officers and first responders in facing mental health issues, we are developing new training. This training will aid in recognizing mental health-related issues in officers/first responders and citizens, as well as further using the same information to better respond and interact with one another and the public. In general, society has many varying views of mental health, much of which is largely over-sensationalized by television, movies, and other forms of entertainment. There has also been a stigma in law enforcement / first responders related to mental health and being weak as a result of on-the-job-related trauma-induced struggles. It is our hope this new training will assist officers and first responders in not only positively facing and addressing their mental health but using their own experience and education to recognize signs and symptoms of mental health within individuals in the community. Further, we hope that through this recognition, officers and first responders can use their experiences and more in-depth understanding to better interact within the field and with the public. Through recognition and better understanding of mental health issues and more positive interaction with the public, additional achievements are likely to result. This includes in the removal of bias and stigma for everyone.

Keywords: law enforcement, mental health, officer related mental health, trauma

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