Search results for: qualitative observational study

Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.

Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate

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Authors: Saba Goudarzi Dehrizifar, Aysan Afradi

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The utilization of ozone treatment as a potential technique for storage pest control has gained significant attention. This approach presents an alternative to traditional chemical methods. In the current study, the mortality rates of Plodia interpunctella as a primary pest found in stored products particularly nuts, were examined after being exposed to different O3 concentration (minimum, half, and maximum) in three replicates and within 24 hours. As the concentration of O3 increased, the mortality rates of P. interpunctella also experienced a dramatic growth. A 20-member panel (men and women in different ages), formed from the society community, was selected for sensory evaluation. The pumpkin seeds samples were coded and presented randomly in identical containers. The panelists were asked to evaluate their degree of liking or disliking on a seven-point hedonic scale using descriptive categories, ranging 1-7 (1: extremely dislike, 2: very dislike, 3: dislike, 4: no difference, 5: like, 6: very like, and 7: extremely like). The results obtained from experiments on the qualitative characteristics of the studied dates through the sensory test revealed that O3 concentration did not affect their color, crispness, firmness, and overall acceptance and the half concentration of ozone on pumpkin seed had the highest consumption interest. Moreover, minimal alterations were observed in the aroma of the pumpkin seeds, which could be resolved with a short period of air exposure. Therefore, it could be concluded that the atmospheric O3 gas provided a cost-effective and environmentally friendly way for controlling the insect pests in pumpkin seeds, besides preserving their sensory and quality properties.

Keywords: zone, control, pumpkin seeds, qualitative characteristics

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Authors: Pratima Tatke, Archana Avhad, Bhanu Duggal, Meeta Rajivlochan, Sujata Saunik, Pradip Vyas, Nidhi Pandey, Aditee Dalvi, Jyothi Subramanian

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Background: Smoking is well established risk factor for the development and progression of coronary artery disease. It is strongly related to morbidity and mortality from cardiovascular causes. The aim of this study is to observe effect of smoking status on percutaneous coronary intervention(PCI) after 1 year. Methods: 2527 patients who underwent PCI at different hospital of Maharashtra(India) from 2012 to 2015 under the health insurance scheme which is launched by Health department, Government of Maharashtra for below poverty line(BPL) families which covers cardiology. Informed consent of patients was taken .They were followed by telephonic survey after 6months to 1year of PCI . Outcomes of interest included myocardial infarction, restenosis, cardiac rehospitalization, death, and a composite of events after PCI. Made group of two non smokers-1861 and smokers (including patients who quit at time of PCI )-659. Results: Statistical Analysis using Pearson’s chi square test revealed that there was trend seen of increasing incidence of death, Myocardial infarction and Restenosis in smokers than non smokers .Smokers had a greater death risk compared to nonsmoker; 5.7% and 5.1% respectively p=0.518. Also Repeat procedures (2.1% vs. 1.5% p=0.222), breathlessness (17.8% vs. 18.20% p=0.1) and Myocardial Infarction (7.3% vs. 10%) high in smoker than non smokers. Conclusion: Major adverse cardiovascular events (MACE) were observed even after successful PCI in smokers. Patients undergoing percutaneous coronary intervention should be encouraged to stop smoking.

Keywords: coronary artery diseases, major adverse cardiovascular events, percutaneous coronary intervention, smoking

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Authors: Sharadha G., Suresh Kanakkanavar

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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

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Authors: Sharon Ganzer

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Older adults want choices about where they ‘age-in-place’ and express the desire to remain in their home for as long as possible because it maintains feelings of independence and autonomy, perpetuates a sense of identity, enable people to have space for their belongings and supports connections and social engagement. When circumstances change, and alternative living arrangements are required, more and more older adults are considering a transition to a retirement village – the liminal space between home and residential care. This qualitative study explores the lived experience of older adults who relocate to a retirement village in Queensland, Australia, and the role that material culture plays in this process.

Keywords: material culture, social gerontology, concepts of home, retirement villages

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Authors: Mesfin Nigussie Ibido

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The study is designed to explore the effects of land certification in securing women’s land rights of two rural villages in Robe district at Arsi Zone of Oromia regional state. The land is very critical assets for human life survival and the backbone for rural women livelihood. Equal access and control power to the land have given a chance for rural women to participate in different economic activities and improve their bargaining ability for decision making on their rights. Unfortunately, women were discriminated and marginalized from access and control of land for centuries through customary practices. However, in many countries, legal reform is used as a powerful tool for eliminating discriminatory provisions in property rights. Among other equity and efficiency concerns, the land certification program in Ethiopia attempts to address gender bias concerns of the current land-tenure system. The existed rural land policy was recognizing a women land rights and benefited by strengthened wives awareness of their land rights and contribute to the strong involvement of wives in decision making. However, harmful practices and policy implementation problems still against women do not fully exercise a provision of land rights in a different area of the country. Thus, this study is carried out to examine the effect of land certification in securing women’s land rights by eliminating the discriminatory nature of cultural abuses of study areas. Probability and non-probability sampling types were used, and the sample size was determined by using the sampling distribution of the proportion method. Systematic random sampling method was applied by taking the nth element of the sample frame. Both quantitative and qualitative research methods were applied, and survey respondents of 192 households were conducted and administering questionnaires in the quantitative method. The qualitative method was applied by interviews with focus group discussions with rural women, case stories, Village, and relevant district offices. Triangulation method was applied in data collection, data presentation and in the analysis of findings. Study finding revealed that the existence of land certification is affected by rural women positively by advancing their land rights, but still, some women are challenged by unsolved problems in the study areas. The study forwards recommendation on the existed problems or gaps to ensure women’s equal access to and control over land in the study areas.

Keywords: decision making, effects, land certification, land right, tenure security

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Authors: Chan Yan Nok

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The present study is a qualitative study based on the coping experiences of six Hong Kong Chinese mothers who had childhood trauma from their first-person perspective. Expanding the perspective beyond the dominant discourse of “inter-generation transmission of trauma”, this study explores the experiences and meanings of child trauma embedded in their narratives through the process of thematic analysis and narrative analysis. The interviewees painted a nuanced picture of their process of coping and trauma resolution. First, acknowledgement; second, feel safe and start to tell the story of trauma; third, feel the feelings and expression of emotions; fourth, clarifying and coping with the impacts of trauma; fifth, integration and transformation; and sixth, using their new understanding of experience to have a better life. It was seen that there was no “end” within the process of trauma resolution. Instead, this is an ongoing process with positive healing trajectory. Analysis of the stories of the mothers revealed recurrent themes around continuous self-reflective awareness in the process of trauma coping. Rather than being necessarily negative and detrimental, childhood trauma could highlight the meanings of being a mother and reveal opportunities for continuous personal growth and self-enhancement. Utilizing the sense of inadequacy as a core driver in the trauma recovery process while developing a heightened awareness of the unfinished business embedded in their “automatic pattern” of behaviors, emotions, and thoughts can help these mothers become more flexible to formulate new methods in facing future predicaments. Future social work and parent education practices should help mothers deal with unresolved trauma, make sense of their impacts of childhood trauma and discover the growth embedded in the past traumatic experience. They should be facilitated in “acknowledging the reality of the trauma”, including understanding their complicated emotions arising from the traumatic experiences and voicing their struggles. In addition, helping these mothers to be aware of short-term and long-term trauma impacts (i.e., secondary responses to the trauma) and explore their effective coping strategies in “overcoming secondary responses to the trauma” are crucial for their future positive adjustment and transformation. Through affirming their coping abilities and lessons learnt from past experiences, mothers can reduce feelings of shame and powerlessness and enhance their parental capacity.

Keywords: childhood trauma, coping, mothers, self-awareness, self-reflection, trauma resolution

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Authors: Tamadu Perry Egedegu

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Rapid growth in the use of electronic data has affected both the employee and work place. Our experience shows that jobs that have multiple risk factors have a greater likelihood of causing Work Related Musculoskeletal Disorder (WRMSDs), depending on the duration, frequency and/or magnitude of exposure to each. The study investigated musculoskeletal disorder among office workers. Thus, it is important that ergonomic risk factors be considered in light of their combined effect in causing or contributing to WRMSDs. Fast technological growth in the use of electronic system; have affected both workers and the work environment. Awkward posture and long hours in front of these visual display terminals can result in work-related musculoskeletal disorders (WRMSD). The study shall contribute to the awareness creation on the causes and consequences of WRMSDs due to lack of ergonomics training. The study was conducted using an observational cross-sectional design. A sample of 109 respondents was drawn from the target population through purposive sampling method. The sources of data were both primary and secondary. Primary data were collected through questionnaires and secondary data were sourced from journals, textbooks, and internet materials. Questionnaires were the main instrument for data collection and were designed in a YES or NO format according to the study objectives. Content validity approval was used to ensure that the variables were adequately covered. The reliability of the instrument was done through test-retest method, yielding a reliability index at 0.84. The data collected from the field were analyzed with a descriptive statistics of chart, percentage and mean. The study found that the most affected body regions were the upper back, followed by the lower back, neck, wrist, shoulder and eyes, while the least affected body parts were the knee calf and the ankle. Furthermore, the prevalence of work-related 'musculoskeletal' malfunctioning was linked with long working hours (6 - 8 hrs.) per day, lack of back support on their seats, glare on the monitor, inadequate regular break, repetitive motion of the upper limbs, and wrist when using the computer. Finally, based on these findings some recommendations were made to reduce the prevalent of WRMSDs among office workers.

Keywords: work related musculoskeletal disorder, Nigeria, office computer users, ergonomic risk factor

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Authors: Geetanjali Gill

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International non-governmental organizations (INGOs) and development assistance donors have been implementing education projects in Sub-Saharan Africa and the global South that respond to gender-based inequities and that attempt to transform socio-cultural norms for greater gender equality in schools and communities. These efforts are in line with the United Nations Sustainable Development Goal number four, quality education, and goal number five, gender equality. Some INGOs and donors have also championed the use of play-based pedagogies for improved and more gender equal education outcomes. The study used the qualitative methods of life history interviews and focus groups to gauge social norm change amongst male and female adolescents, families, and teachers in primary schools that have been using gender-responsive play-based pedagogies in Rwanda, Ghana, and Mozambique. School administrators and project managers from the INGO Right to Play International were consulted in the selection of two primary schools per country (in both rural and urban contexts), as well as the selection of ten male and ten female students in grades four to six in each school, using specific parameters of social norm adherence. The parents (or guardians) and grandparents of four male and four female students in each school who were determined to be ‘outliers’ in their adherence to social norms were also interviewed. Additionally, sex-specific focus groups were held with thirty-six teachers. The study found that gender-responsive play-based pedagogies positively impactedsocio-cultural norms that shape gender relations amongst adolescents, their families, and teachers. Female and male students who spoke about their beliefs about gender equality in the roles and educational and career aspirations of men/boys and women/girls made linkages to the play-based pedagogies and approaches used by their teachers. Also, the parents and grandparents of these students were aware of generational differences in gender norms, and many were accepting of changed gender norms. Teachers who were effectively implementing gender-responsive play-based pedagogies in their classrooms spoke about changes to their own gender norms and how they were able to influence the gender norms of parents and community members. Life history interviews were found to be well-suited for the examination of changes to socio-cultural norms and gender relations. However, an appropriate framing of questions and topics specific to each target group was instrumental for the collection of data on socio-cultural norms and gender. The findings of this study can spur further academic inquiry of linkages between gender norms and education outcomes. The findings are also relevant for the work of INGOs and donors in the global South and for the development of gender-responsive education policies and programs.

Keywords: education, gender equality, ghana, international development, life histories, mozambique, rwanda, socio-cultural norms, sub-saharan africa, qualitative research

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Authors: Marwa Mamdouh Shaban, Nagat Saied Habib, Shireen Ezz El-Din Taha, Eman Mahmoud Seif El-Naser

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Background: Dental nurses and dentists were constantly exposed to a number of specific work related health risk factors which develop and intensify with years. Awareness regarding these work-related health risk factors and implementation of preventive health care measures could provide a safe work environment for all dental nurses and dentists. Aim of the study: to assess the work-related health risk factors among dental nurses and dentists and preventive health care measures applied among dental nurses and dentists. Research design: A descriptive design was utilized. Sample: Convenience sample of 50 dental nurses and 150 dentists were included in the current study. Setting: This study was conducted at the dental clinics at faculty of oral and dental medicine, Al-Kasr Al Ainy Hospital. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a-Socio-demographic data sheet, b-Work-related health risk factors questionnaire, and c-structured observational checklist. Results: The most common work risk factors prevailing among dental nurses were emotional exhaustion (82%), low back pain (76%) and latex allergy (62%) and the most common work risk factors prevailing among dentists were percutaneous exposure incident (100%), emotional exhaustion (100%) and low back pain (93.3%). Also, statistically significant negative correlation (r=-0.274, at p = 0.045) between the incidence of chemical health risk factors and application of chemical preventive measures among dental nurses. A statistically significant negative correlation (r=-0.177, at p = 0.030) between the incidences of mechanical health risk factors among dentists and application of mechanical preventive measures. Conclusion: The studied dental nurses and dentists exposed to many work related health risk factors as latex allergy, percutaneous exposure incidents, low back pain and emotional exhaustion related to inappropriate application of preventive health care measures. Recommendation: Raise awareness of dental nurses and dentists about work-related health risk factors, design and implement health education program for preventive health care measures.

Keywords: work-related risk factors, preventive measures, nurses, dentists

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Authors: Concetta Papapicco

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The spreading of new Coronavirus (COVID-19) in addition to becoming a global phenomenon, following the declaration of a pandemic state, has generated excessive access to information, sometimes not thoroughly screened, which makes it difficult to navigate a given topic because of the difficulty of finding reliable sources. As a result, there is a high level of contagion, understood as the spread of the virus, but also as the spread of information in a viral and harmful way, which prompted the World Health Organization to coin the term Infodemia to give 'a name' the phenomenon of excessive information. With neologism 'Infodemia', the World Health Organization (OMS) wanted, in these days when fear of the coronavirus is raging, point out that perhaps the greatest danger of global society in the age of social media. This phenomenon is the distortion of reality in the rumble of echoes and comments of the global community on real or often invented facts. The general purpose of the exploratory study is to investigate how the coronavirus situation is described from journalistic communication. Starting from La Repubblica online, as a reference journalistic magazine, as a specific objective, the research aims to understand the way in which journalistic communication describes the phenomenon of the COVID-19 virus spread, the spread of contagion and restrictive measures of social distancing in the Italian context. The study starts from the hypothesis that if the circulation of information helps to create a social representation of the phenomenon, the excessive accessibility to sources of information (Infodemia) can be modulated by the 'how' the phenomenon is described by the journalists. The methodology proposed, in fact, in the exploratory study is a quanti-qualitative (mixed) method. A Content Analysis with the SketchEngine software is carried out first. In support of the Content Analysis, a Diatextual Analysis was carried out. The Diatextual Analysis is a qualitative analysis useful to detect in the analyzed texts, that is the online articles of La Repubblica on the topic of coronavirus, Subjectivity, Argomentativity, and Mode. The research focuses mainly on 'Mode' or 'How' are the events related to coronavirus in the online articles of La Repubblica about COVID-19 phenomenon. The results show the presence of the contrast vision about COVID-19 situation in Italy.

Keywords: coronavirus, Italian infodemia, La Republica online, mix method

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Authors: Umar Sheikh Tahir

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Before al-Ghazālī, Islamic scholars perceived logic as an intrusive knowledge. The knowledge therefore, did not receive ample attention among scholars on how it should be adapted into Islamic sciences. General scholarship in that period rejects logic as an instrumental knowledge. This attitude became unquestionable to the scholars from different perspectives with diversification of suggestions in the pre-al-Ghazālī’s period. However, al-Ghazālī proclaimed with new perspective that transform Logic from ‘intrusive knowledge’ to a useful tool for Islamic sciences. This study explores the contributions of al-Ghazālī to epistemology regarding the use and the relevance of Logic. The study applies qualitative research methodology dealing strictly with secondary data from medieval age and contemporary sources. The study concludes that al-Ghazālī’s contributions which supported the transformation of Logic to useful tool in the Muslim world were drawn from his experience within Islamic tradition. He succeeded in reconciling Islamic tradition with the wisdom of Greek sciences.

Keywords: Al-Ghazālī, classical logic, epistemology, Islamdom and Islamic sciences

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Authors: Khatuna Buskivadze

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The aim of the present study is to investigate the sociolinguistic and classroom functions and frequency of Teacher’s Code Switching (CS) in the Content and Language Integrated (CLIL) Lesson. Nowadays, Georgian society struggles to become the part of the European world, the English language itself plays a role in forming new generations with European values. Based on our research conducted in 2019, out of all 114 private schools in Tbilisi, full- programs of CLIL are taught in 7 schools, while only some subjects using CLIL are conducted in 3 schools. The goal of the former research was to define the features of Content and Language Integrated learning (CLIL) methodology within the process of teaching English on the Example of Georgian private high schools. Taking the Georgian reality and cultural features into account, the modified version of the questionnaire, based on the classification of using CS in ESL Classroom proposed By Ferguson (2009) was used. The qualitative research revealed students’ and teacher’s attitudes towards teacher’s code-switching in CLIL lesson. Both qualitative and quantitative research were conducted: the observations of the teacher’s lessons (Recording of T’s online lessons), interview and the questionnaire among Math’s T’s 20 high school students. We came to the several conclusions, some of them are given here: Math’s teacher’s CS behavior mostly serves (1) the conversational function of interjection; (2) the classroom functions of introducing unfamiliar materials and topics, explaining difficult concepts, maintaining classroom discipline and the structure of the lesson; The teacher and 13 students have negative attitudes towards using only Georgian in teaching Math. The higher level of English is the more negative is attitude towards using Georgian in the classroom. Although all the students were Georgian, their competence in English is higher than in Georgian, therefore they consider English as an inseparable part of their identities. The overall results of the case study of teaching Math (Educational discourse) in one of the private schools in Tbilisi will be presented at the conference.

Keywords: attitudes, bilingualism, code-switching, CLIL, conversation analysis, interactional sociolinguistics.

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Authors: Mursidin Yusuf, Fitri Wulandari

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Indonesia has changed its curriculum ten times, starting from 1947 to 2022, and it might change in upcoming years. This comprehensive study delves into the global perspectives of educational leadership, with a specific focus on examining curriculum changes within the context of Indonesia. Against the backdrop of an increasingly interconnected educational landscape, the necessity to comprehend diverse leadership approaches becomes paramount. By employing a qualitative case study methodology, this research meticulously scrutinizes ten notable curriculum modifications within the Indonesian educational framework and evaluates their impacts on the sector. Utilizing document analysis, pertinent literature, and interviews with school principals, the study thoroughly explores the leadership dynamics that have influenced these alterations. The findings offer multifaceted insights into the strategies, challenges, and outcomes associated with curriculum reform initiatives in Indonesia, providing a nuanced understanding of the effects of these changes on the education sector.

Keywords: curriculum changes, educational leadership, global perspectives, Indonesia

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Authors: Bridgette Merriman, Wen Fan

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Background: Existing cancer survivorship literature explores varying physical, psychosocial, and psychological late effects experienced by survivors of childhood cancer. However, adolescent and young adult (AYA) survivors of childhood cancer are understudied compared to their adult and pediatric cancer counterparts. Furthermore, existing quality of life (QoL) research fails to account for how cancer survivorship affects survivors across the lifespan. Given that prior research suggests positive cognitive appraisals of adverse events - such as cancer - mitigate detrimental psychosocial symptomologies later in life; it is crucial to understand cancer’s impacts on AYA survivors of childhood malignancies across the life course in order to best support these individuals and prevent maladaptive psychosocial outcomes. Methods: This qualitative study adopted the life-course perspective to investigate the experiences of AYA survivors of childhood malignancies. Eligible patients included AYA 21-30 years old who were diagnosed with cancer <18 years old and off active treatment for >2 years. Participants were recruited through social media posts. Study fulfillment included taking part in one semi-structured video interview to explore areas of survivorship previously identified as being specific to AYA survivors. Interviews were transcribed, coded, and analyzed in accordance with narrative analysis and life-course theory. This study was approved by the Boston College Institutional Review Board. Results: Of 28 individuals who met inclusion criteria and expressed interest in the study, nineteen participants (12 women, 7 men, mean age 25.4 years old) completed the study. Life course theory analysis revealed that events relating to childhood cancer are interconnected throughout the life course rather than isolated events. This “trail of survivorship” includes age at diagnosis, transitioning to life after cancer, and relationships with other childhood survivors. Despite variability in objective characteristics surrounding these events, participants recalled positive experiences regarding at least one checkpoint, ultimately finding positive meaning from their cancer experience. Conclusions: These findings suggest that favorable subjective experiences at these checkpoints are critical in fostering positive conceptions of childhood malignancy for AYA survivors of childhood cancer. Ultimately, healthcare professionals and communities may use these findings to guide support resources and interventions for childhood cancer patients and AYA survivors, therein minimizing detrimental psychosocial effects and maximizing resiliency.

Keywords: medical sociology, pediatric oncology, survivorship, qualitative, life course perspective

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Authors: Michael R. Taber, Kristin Stanec

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This paper presents year-two of a longitudinal study on implementing Possibility Books into undergraduate courses to develop a student's creativity mindset: tolerating ambiguity, willingness to risk failure, curiosity, and openness to embrace possibility thinking through unexpected connections. Courses involved in this research span disciplines in the natural and social sciences and the humanities. Year one of the project developed indices from which baseline data could be analyzed. The two significant indices ( > 0.7) were "creativity mindset" and "intentional interactions." Preliminary qualitative and quantitative data analysis indicated that students found the new pedagogical intervention as a safe space to learn new strategies, recognize patterns, and define structures through innovative notetaking forms. Possibility Books in Natural Science courses were designed to develop students' conceptualization of science and math. Using Possibility Books in all disciplines provided a space for students to practice divergent thinking (i.e.,Possibilities), convergent thinking (i.e., forms that express meaning), and risk-taking (i.e., the vulnerability associated with expression). Qualitative coding of open responses on a post-survey revealed two major themes: 1) Possibility Books provided a mind space for learning about self, and 2) provided a calming opportunity to connect concepts. Quantitative analysis indicated significant correlations between focused headspace and notetaking (r = 0.555, p < 0.001), focused headspace, and connecting with others (r = 0.405, p < 0.001).

Keywords: pedagogy, science education, learning methods, creativity mindsets

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Authors: Mehtab Alam Ansari, Shamim Aktar Munshi

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The purpose of this paper is to find out the importance of digital libraries in Indian educational system, and also different types of problems faced by the digital library in modern age. This study uses both qualitative and quantitative approaches along with review of related literature. The conceptual and textual information related to the present study were collected from primary and secondary sources of information such as books and National and International journals etc. Websites were also used for collecting information. The study finds out that due to high demand of information resources so many digital libraries are established in India, e.g. IGNCA digital library, Digital Library of India, Archives of Indian Labour, Digital Library of Library and Information Science etc, and also it found that it is very helpful to the modern civilization. The digital library movement in India is rapidly increasing and the traditional libraries are now on their way to digitization in a phased manner. But digital library in India has failed to spread its root in each and every part. So many problems are facing to develop the digital libraries in present days. This study briefly explained the services, impact, and problems of digital libraries in Indian.

Keywords: digital Libraries, India, information technology, education

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Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides

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Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.

Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight

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Authors: Siobhan Hegarty, Michael Bloomfield, Kim Entholt, Dorothy Williams, Helen Kennerley

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Complex Post-Traumatic Stress Disorder (CPTSD) confers greater risk of poor outcomes than does Post-Traumatic Stress Disorder (PTSD). Despite this, the current treatment guidelines for CPTSD aim to reduce only the ‘core’ symptoms of re-experiencing, hyper-vigilance and avoidance, while not addressing the Disturbances of Self Organisation (DSO) symptoms that distinguish this novel diagnosis from PTSD. The Recovering from Child Abuse Programme (RCAP) is a group protocol, based on the principles of cognitive behavioural therapy (CBT). Preliminary evidence suggests the program is effective at reducing DSO symptoms. This pilot study is the first to investigate the potential effectiveness of the RCAP for the specific treatment of CPTSD. This study was conducted as a service evaluation in a secondary care, traumatic stress service. Treatment was delivered once a week, in two-hour sessions, to ten existing female CPTSD patients of the service, who had experienced sexual abuse in childhood. The programme was administered by two therapists and two additional facilitators, following the RCAP protocol manual. Symptom severity was measured before the administration of therapy and was tracked across a range of measures (International Trauma Questionnaire; Patient Health Questionnaire; Community Assessment of Psychic Experience; Work and Social Adjustment Scale) at five time points, over the course of treatment. Qualitative appraisal of the programme was gathered via weekly feedback forms and from audio-taped recordings of verbal feedback given during group sessions. Preliminary results suggest the programme causes a slight reduction in CPTSD and depressive symptom severity and preliminary qualitative analysis suggests that the RCAP is both helpful and acceptable to group members. Final results and conclusions will follow completed thematic analysis of results.

Keywords: Child sexual abuse, Cognitive behavioural therapy, Complex post-traumatic stress disorder, Recovering from child abuse programme

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Authors: Nazym Zhumabayeva, Aleksandr Mezin, Alexandra Knysheva

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Women's underrepresentation in STEM is critical, worsened by ineffective engagement in educational practices. UNICEF Kazakhstan and GameLab KBTU's collaborative initiatives aim to enhance female STEM participation by fostering an inclusive environment. Learning from LEVEL UP's 2023 program, which featured a hackathon, the 2024 strategy pivots towards non-competitive gamification. Although the data from last year's project showed higher than average student engagement, observations and in-depth interviews with participants showed that the format was stressful for the girls, making them focus on points rather than on other values. This study presents a gamified educational system, DPG Lab, aimed at incentivizing young women's participation in STEM through the development of digital public goods (DPGs). By prioritizing collaborative gamification elements, the project seeks to create an inclusive learning environment that increases engagement and interest in STEM among young women. The DPG Lab aims to find a solution to minimize competition and support collaboration. The project is designed to motivate female participants towards the development of digital solutions through an introduction to the concept of DPGs. It consists of a short online course, a simulation videogame, and a real-time online quest with an offline finale at the KBTU campus. The online course offers short video lectures on open-source development and DPG standards. The game facilitates the practical application of theoretical knowledge, enriching the learning experience. Learners can also participate in a quest that encourages participants to develop DPG ideas in teams by choosing missions throughout the quest path. At the offline quest finale, the participants will meet in person to exchange experiences and accomplishments without engaging in comparative assessments: the quest ensures that each team’s trajectory is distinct by design. This marks a shift from competitive hackathons to a collaborative format, recognizing the unique contributions and achievements of each participant. The pilot batch of students is scheduled to commence in April 2024, with the finale anticipated in June. It is projected that this group will comprise 50 female high-school students from various regions across Kazakhstan. Expected outcomes include increased engagement and interest in STEM fields among young female participants, positive emotional and psychological impact through an emphasis on collaborative learning environments, and improved understanding and skills in DPG development. GameLab KBTU intends to undertake a hypothesis evaluation, employing a methodology similar to that utilized in the preceding LEVEL UP project. This approach will encompass the compilation of quantitative metrics (conversion funnels, test results, and surveys) and qualitative data from in-depth interviews and observational studies. For comparative analysis, a select group of participants from the previous year's project will be recruited to engage in the DPG Lab. By developing and implementing a gamified framework that emphasizes inclusion, engagement, and collaboration, the study seeks to provide practical knowledge about effective gamification strategies for promoting gender diversity in STEM. The expected outcomes of this initiative can contribute to the broader discussion on gamification in education and gender equality in STEM by offering a replicable and scalable model for similar interventions around the world.

Keywords: collaborative learning, competitive learning, digital public goods, educational gamification, emerging regions, STEM, underprivileged groups

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Authors: Julio Macedo

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Several methodologies are now available to conceive the improvements of a process so that it becomes competitive as for example total quality, process reengineering, six sigma, define measure analysis improvement control method. These improvements are of different nature and can be external to the process represented by an optimization model or a discrete simulation model. In addition, the process stakeholders are several and have different desired performances for the process. Hence, the methodologies above do not have a tool to aid in the conception of the required improvements. In order to fill this void we suggest the use of intelligent reference models. A reference model is a set of qualitative differential equations and an objective function that minimizes the gap between the current and the desired performance indexes of the process. The reference models are intelligent so when they receive the current state of the problematic process and the desired performance indexes they generate the required improvements for the problematic process. The reference models are fuzzy cognitive maps added with an objective function and trained using the improvements implemented by the high performance firms. Experiments done in a set of students show the reference models allow them to conceive more improvements than students that do not use these models.

Keywords: continuous improvement, fuzzy cognitive maps, process competitiveness, qualitative simulation, system dynamics

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Authors: Alejandro Arnaldo Barroso Martinez

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Unlike sex, which is constituted by anatomic-physiological differences, gender is a social construction. Our thoughts and behaviors as females and males are not etched in stone by our biology but rather from how society expects us to think and behave based on our sex assignment in the womb. Social expectations, values, and roles are taken on by individuals and shape the ways considered acceptable and linked to our bodies, feelings, and interpersonal relationships. Furthermore, these evolve into dire consequences for those who do not meet these disciplinary, economic, and cultural standards. Then, the social learning of gender identity implies the individual’s psychological sense of being, and it might be highly linked to a sense of life and suicide attempts. As a result, suicide has been considered a gender issue with differences in the rates and means used by men and women worldwide. Nevertheless, there has been a misunderstanding of the meaning of being male or female in a particular context and how it becomes a risk process for suicide attempts. For this reason, the general objective of the current research is to explain how this process occurs in Cuba. From a Critical Sociology and Social Psychology, a qualitative methodology was developed through six case studies and qualitative in-depth interviews. The analysis is focused on the sequence and interplay between two dimensions of meaning: signifiers and voices. Findings show that the risk process of suicide attempts in Cuba means some patriarchal beliefs and practices as part of informal educational models and some positivist practices in mental health attention. Findings also show that community relations create a sense of belonging, and it is a protection against suicide attempts in Cuba. Those frames of signifiers and voices explain in both males and females but differently when and how they are suffering from isolation, violence, the normalization of emotional awareness, and emotional distress expression. Suicide prevention programs should take gender learning into account as a cultural process.

Keywords: social constructions, gender identity, meanings, suicide attempt

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Authors: Moureen Nanteza

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This paper examines the pragmatic inferences of locative enclitics in Luganda (JE 15). Locative enclitics are words which cannot stand alone but are attached to a verb to make meaning. Their status is ambiguous between free word and affix, hence motivating their analysis as enclitics. The enclitics are attached on the post-final position of their hosts. Although the locative enclitics occur regularly in some Bantu languages (Luganda, Runyankore-Rukiga, Runyoro-Rutooro, Lunda, Ikizu, Fwe, Chichewa, Kinyarwanda among others), they have not been widely studied in the literature. The paper looks at verbal locative enclitics only but the locative enclitics also appear in other word categories in Luganda. This study is descriptive, with a qualitative approach. The data used in this study was collected through reviewing documents in Luganda - novels and plays and also the spoken discourses. In this study, the enclitic in Luganda serves many non-locative discourse-pragmatic functions which include showing urgency, politeness, showing the idea of ‘instead of’ and also emphasis. It has also been observed that enclitics are widely used in the urban youth languages (‘Luyaaye’) but this was not the focus of the current study. The results from the study offer explanations of key areas of syntax, morphology, and pragmatics relating to the form and functions of locative enclitics and the whole system of locative marking in Luganda and other Bantu languages.

Keywords: Bantu, locative enclitics, Luganda, pragmatic inferences

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: Sobhy Fathy A. Hashesh

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This study aimed at investigating the effect of Andalus Knowledge Phases and Times (ANPT) model of learning and the effect of 'Intel Education Contribution in ANPT' on the development of students’ academic performance and emotional quotient. The society of the study composed of Andalus Private Schools, elementary school students (N=700), while the sample of the study composed of four randomly assigned groups (N=80) with one experimental group and one control group to study "ANPT" effect and the "Intel Contribution in ANPT" effect respectively. The study followed the quantitative and qualitative approaches in collecting and analyzing data to answer the study questions. Results of the study revealed that there were significant statistical differences between students’ academic performances and emotional quotients for the favor of the experimental groups. The study recommended applying this model on different educational variables and on other age groups to generate more data leading to more educational results for the favor of students’ learning outcomes.

Keywords: Al Andalus, emotional quotient, students, academic performance development

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Authors: Ly Quyet Tien

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The object of this paper is to study Vietnamese Les Rap as art to promote rights and gender in the twenty-first century. The author analyzed Vietnamese Les Rap from the point of view of a contemporary person who has witnessed the tumultuous destiny of the most suffering minority group in Vietnam’s LGBT community. He reviewed scholarly studies, and reputable newspapers on the topic and conducted face to face interviews for qualitative data. The study found that Vietnamese lesbians have composed and used rap as an effective tool to express their fight for visibility, identity, and sensibility. Research reveals that these songs did not only touch the heart of the LGBT community but also the larger public, marking the rising queer voice, contributing to a flourishing of LGBT culture, and revolutionizing the colors of Vietnamese hip hop music in the twenty-first century.

Keywords: culture, lesbian, rap, Vietnam

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Authors: Yousef Sahari, Eisa Asiri

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Hollywood films are produced in an open and liberal context, and when subtitling for a more conservative and closed society such as an Arabic society, religious words can pose a thorny challenge for subtitlers. Using a corpus of 90 Hollywood films released between 2000 and 2018 and applying insights from Descriptive Translation Studies (Toury, 1995, 2012) and the dichotomy of domestication and foreignization, this paper investigates three main research questions: (1) What are the dominant religious terms and functions in the English subtitles? (2) What are the dominant translation strategies used in the translation of religious words? (3) Do these strategies tend to be SL-oriented or TL-oriented (domesticating or foreignising)? To answer the research questions above, a quantitative and qualitative analysis of the corpus is conducted, in which the researcher adopts a self-designed, parallel, aligned corpus of ninety films and their Arabic subtitles. A quantitative analysis is performed to compare the frequencies and distribution of religious words, their functions, and the translation strategies employed by the subtitlers of ninety films, with the aim of identifying similarities or differences in addition to identifying the impact of functions of religious terms on the use of subtitling strategies. Based on the quantitative analysis, a qualitative analysis is performed to identify any translational patterns in Arabic translations of religious words and the possible reasons for subtitlers’ choices. The results show that the function of religious words has a strong influence on the choice of subtitling strategies. Also, it is found that foreignization strategies are applied in about two-thirds of the total occurrences of religious words.

Keywords: religious terms, subtitling, audiovisual translation, modern standard arabic, subtitling strategies, english-arabic subtitling

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Authors: Samaneh serraj

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Listening anxiety has a detrimental effect on language learners. Through a qualitative study on Iranian EFL learners several factors were identified as having influence on their listening anxiety. These factors were divided into three categories, i.e. individual factors (nerves and emotionality, using inappropriate strategies and lack of practice), input factors (lack of time to process, lack of visual support, nature of speech and level of difficulty) and environmental factors (instructors, peers and class environment).

Keywords: listening Comprehension, Listening Anxiety, Foreign language learners

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Authors: Mary Jane B. Suarez

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Public speaking anxiety (PSA), also known as speech anxiety, is innumerably persistent in any traditional communication classes, especially for students who learn English as a second language. The speech anxiety intensifies when communication skills assessments have taken their toll in an online or a remote mode of learning due to the perils of the COVID-19 virus. Both teachers and students have experienced vast ambiguity on how to realize a still effective way to teach and learn speaking skills amidst the pandemic. Communication skills assessments like public speaking, oral presentations, and student reporting have defined their new meaning using Google Meet, Zoom, and other online platforms. Though using such technologies has paved for more creative ways for students to acquire and develop communication skills, the effectiveness of using such assessment tools stands in question. This mixed method study aimed to determine the factors that affected the public speaking skills of students in a communication class, to probe on the assessment gaps in assessing speaking skills of students attending online classes vis-à-vis the implementation of remote and blended modalities of learning, and to recommend ways on how to address the public speaking anxieties of students in performing a speaking task online and to bridge the assessment gaps based on the outcome of the study in order to achieve a smooth segue from online to on-ground instructions maneuvering towards a much better post-pandemic academic milieu. Using a convergent parallel design, both quantitative and qualitative data were reconciled by probing on the public speaking anxiety of students and the potential assessment gaps encountered in an online English communication class under remote and blended learning. There were four phases in applying the convergent parallel design. The first phase was the data collection, where both quantitative and qualitative data were collected using document reviews and focus group discussions. The second phase was data analysis, where quantitative data was treated using statistical testing, particularly frequency, percentage, and mean by using Microsoft Excel application and IBM Statistical Package for Social Sciences (SPSS) version 19, and qualitative data was examined using thematic analysis. The third phase was the merging of data analysis results to amalgamate varying comparisons between desired learning competencies versus the actual learning competencies of students. Finally, the fourth phase was the interpretation of merged data that led to the findings that there was a significantly high percentage of students' public speaking anxiety whenever students would deliver speaking tasks online. There were also assessment gaps identified by comparing the desired learning competencies of the formative and alternative assessments implemented and the actual speaking performances of students that showed evidence that public speaking anxiety of students was not properly identified and processed.

Keywords: blended learning, communication skills assessment, public speaking anxiety, speech anxiety

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