Search results for: education improvement

Authors: N. B. Chandrakala

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Domestic violence is one of the most under-reported crimes. Problem with domestic violence is that it is not even considered as abuse in many parts of the world especially certain parts of Asia, Africa and Middle East. It is viewed as “doing the needful”. Domestic violence could be in form of emotional harassment, physical injury or psychological abuse perpetrated by one of the family members to another. It is a worldwide phenomenon mainly targeting women. The acts of violence have terrible negative impact on women. It is also an infringement of women’s rights and can be safely termed as human rights abuse. In cases pertaining to domestic violence, male adults often misuses his authority and power to control another using physical or psychological means. Violence and other forms of abuse are common in domestic violence. Sexual assaults, molestation and battering are common in these cases. Domestic violence is a human rights issue and a serious deterrent to development. Domestic violence could also take place in subtle forms like making the person feel worthless or not giving the victims any personal space or freedom. The problematic aspect is cases of domestic violence are very rarely reported. The majority of the victims are women but children are also made to suffer silently. They are abused and neglected. Their innocent minds are adversely affected with the incidents of domestic violence. According to a report by World Health Organization (WHO), sexual trafficking, female feticide, dowry death, public humiliation and physical torture are some of the most common forms of domestic violence against Indian women. Such acts belie our growth and claim as an economic superpower. It is ironic that we claim to be one of the most rapidly advancing countries in the world and yet we have done hardly anything of note against social hazards like domestic violence. Laws are not that stringent when it comes to reporting acts of domestic violence. Even if the report is filed it turns out to be a long drawn process and not every victim has that much resource to fight till the end. It is also a social taboo to make your family matters public. The big challenge in front now is to enforce it in true sense. Steps that are actually needed; tough laws against domestic violence, speedy execution and change in the mindset of society only then we can expect to have some improvement in such inhuman cases. An effective response to violence must be multi-sectoral; addressing the immediate practical needs of women experiencing abuse; providing long-term follow up and assistance; and focusing on changing those cultural norms, attitudes and legal provisions that promote the acceptance of and even encourage violence against women, and undermine women's enjoyment of their full human rights and freedoms. Hence the responses to the problem must be based on integrated approach. The effectiveness of measures and initiatives will depend on coherence and coordination associated with their design and implementation.

Keywords: domestic violence, human rights, sexual assaults, World Health Organization

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Authors: Dinesh N. Kurup, Celine Perriera

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The economic development of any country is based on the policies adopted by the government from time to time. If these policies are framed by the opinion of the people of the country, there is need for having strong knowledge base, right from the school level. There should be emphasis to provide in education, an ability to take informed decisions regarding socio-scientific issues. It would be better to adopt this practice in high school classrooms to build capacity among future citizens. This study is an attempt to provide a different approach of teaching and learning in classrooms at the high school level in Indian schools for providing opportunity for informed decision making regarding nuclear power use. A unit of work based on the 5E instructional model about the use of nuclear energy is used to build knowledge base and find out the effectiveness in terms of its influence for taking decisions as a future citizen. A sample of 120 students from three high schools using different curricula and teaching and learning methods were chosen for this study. This research used a design based research method. A pre and post questionnaire based on the theory of reasoned action, structured observations, focus group interviews and opportunity for decision making were used during the intervention. The data analysed qualitatively and quantitatively, and the qualitative data were coded into categories based on responses. The results of the study show that students were able to make informed decisions and could give reasons for their decisions. They were enthusiastic in formulating policy making based on their knowledge base and have strong held views and reasoning for their choice.

Keywords: informed decision making, socio-scientific issues, nuclear energy use, policy making

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Authors: Mira Kadric

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The proposed paper deals with a new developed approach for interpreting teaching, combining traditional didactics with a new element. The fundamental principle of the approach is taken from the theatre pedagogy (Augusto Boal`s Theatre of the Oppressed) and includes the discussion on social power relations. From the point of view of education sociology this implies strengthening students’ individual potential for self-determination on a number of levels, especially in view of the present increase in social responsibility. This knowledge constitutes a starting point and basis for the process of self-determined action. This takes place in the context of a creative didactic policy which identifies didactic goals, provides clear sequences of content, specifies interdisciplinary methods and examines their practical adequacy and ultimately serves not only individual translators and interpreters, but all parties involved. The goal of the presented didactic model is to promote independent work and problem-solving strategies; this helps to develop creative potential and self-confident behaviour. It also conveys realistic knowledge of professional reality and thus also of the real socio-political and professional parameters involved. As well as providing a discussion of fundamental questions relevant to Translation and Interpreting Studies, this also serves to improve this interdisciplinary didactic approach which simulates interpreting reality and illustrates processes and strategies which (can) take place in real life. This idea is illustrated in more detail with methods taken from the Theatre of the Oppressed created by Augusto Boal. This includes examples from (dialogue) interpreting teaching based on documentation from recordings made in a seminar in the summer term 2014.

Keywords: augusto boal, didactic model, interpreting teaching, theatre of the oppressed

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Authors: Ofole Ndidi

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Context: Empirical studies show that through dual primary attachment mothers and fathers contribute to children’s development and behaviours. While the contribution of mothers is well documented in past researches, fathers’ involvement in Nigeria has received much less attention. As such, exploring fathers’ involvement in sexual behaviours will provide insight for policy implementation and programming designed to delay sexual debut among sexually inexperienced young people in Nigeria. Objective of study: This study examined the extent to which father involvement (father’s parenting style, attitude, father-child communication, father’s marital status, and father’s socio-economic status) could predict delay in sexual debut of a representative sample of Nigeria adolescents in lower secondary. Materials and Methods: Multistage sampling technique was adopted to draw a cross section of 1023 adolescents with the age range of 10-23 years and mean years of 12±2.1 who reported sexually inexperience from six geographical zones in Nigeria. Multiple Regressions was used to analyze the data collected with four standardized self-report measures at 0.05 level of significance. Results: Findings of this study revealed that the independent variables (father’s parenting style, paternal attitudes, paternal–child communication, paternal marital status and paternal socio–economic status) contributed significantly to the delay of sexual debut. However, fathers’ attitude made the most potent contribution (β = 0.255, P < 0.05). Conclusions: The outcomes of this study have implications for programs that are designed to reduce high-risk behaviors among adolescents. It concluded that sexuality education and interventions should involve the fathers in a more integrated and collaborative fashion.

Keywords: father, sexual debut, adolescents, Nigeria

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Authors: Martha Karunakar

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There exists a wide divide between the urban and the rural students in a vast country like India. This dichotomy is seen in the resources available to them, like the learning facilities, the infra-structure, the learning ambience and meeting of their basic needs of food, clothing and shelter. This paper discusses the effect of English language teaching as a Bridge course on a select batch of rural students at an Engineering college in Chennai, one of the four Metros of India. The study aims to understand how the teacher input and the teacher- peer-student interaction facilitates the acquisition of the basic structures of the English language to a group that is minimally exposed to the language. The objective in conducting the Bridge Course is to integrate these rural students into the mainstream and empower them in terms of English speaking ability; to enable them to comprehend their respective engineering classes where the medium of instruction is English and also to be able to interact with their urban peers. This program is conducted prior to the start of a regular academic session to equip them face the rigors of engineering education. The study is placed within the framework of Interaction theory in second language acquisition. The study evaluates the impact of linking theory and practice by implementing meaningful interaction not only within classrooms but also in the common areas. By providing intensive comprehensible input, it is anticipated that participant’s level of English language improves. The teaching methods and classroom activities included individual and group participation, encompassing all the four skills of listening, speaking, reading and writing (LSRW). The diagnostic tests that were administered before the commencement of the course and the exit test after the completion were used to record the impact of the training.

Keywords: comprehensible input, interaction, rural students, teaching English

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Authors: Tariq Ahamad, Mohammed S. Al-Kahtani, Taisir Eldos

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Optical communications technology has made enormous and steady progress for several decades, providing the key resource in our increasingly information-driven society and economy. Much of this progress has been in finding innovative ways to increase the data carrying capacity of a single optical fiber. In this research article we have explored basic issues in terms of security and reliability for secure and reliable information transfer through the fiber infrastructure. Conspicuously, one potentially enormous source of improvement has however been left untapped in these systems: fibers can easily support hundreds of spatial modes, but today’s commercial systems (single-mode or multi-mode) make no attempt to use these as parallel channels for independent signals. Bandwidth, performance, reliability, cost efficiency, resiliency, redundancy, and security are some of the demands placed on telecommunications today. Since its initial development, fiber optic systems have had the advantage of most of these requirements over copper-based and wireless telecommunications solutions. The largest obstacle preventing most businesses from implementing fiber optic systems was cost. With the recent advancements in fiber optic technology and the ever-growing demand for more bandwidth, the cost of installing and maintaining fiber optic systems has been reduced dramatically. With so many advantages, including cost efficiency, there will continue to be an increase of fiber optic systems replacing copper-based communications. This will also lead to an increase in the expertise and the technology needed to tap into fiber optic networks by intruders. As ever before, all technologies have been subject to hacking and criminal manipulation, fiber optics is no exception. Researching fiber optic security vulnerabilities suggests that not everyone who is responsible for their networks security is aware of the different methods that intruders use to hack virtually undetected into fiber optic cables. With millions of miles of fiber optic cables stretching across the globe and carrying information including but certainly not limited to government, military, and personal information, such as, medical records, banking information, driving records, and credit card information; being aware of fiber optic security vulnerabilities is essential and critical. Many articles and research still suggest that fiber optics is expensive, impractical and hard to tap. Others argue that it is not only easily done, but also inexpensive. This paper will briefly discuss the history of fiber optics, explain the basics of fiber optic technologies and then discuss the vulnerabilities in fiber optic systems and how they can be better protected. Knowing the security risks and knowing the options available may save a company a lot embarrassment, time, and most importantly money.

Keywords: in-house networks, fiber optics, security risk, money

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Authors: Dumith Kulasekara

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This paper examines the representation of the body that particularly stresses the anatomical organs and the psychic conditions in contemporary art. The paper looks closely at the works that address personal and social meanings implying psychic conditions by bringing the internal hidden anatomical organs of the body to the surface of the visual language. The paper argues that contemporary artists conceptualize the idea of the body as a site of generating psychic conditions by excavating the body as material, subject, and object in art practice. The paper conceptualizes this excavating process of the body acts similarly to the idea of dissecting the corporeal body to understand its internal organism that again shapes the materiality of the surface of the body. In doing so, the paper brings together this argument, knowledge produced in the historical and contemporary anatomical education in art and science, and psychoanalytical approaches to the theme to develop new interpretations of representing psyche in the anatomical-bodied. The present paper defines this new form of body conceptually and materially addresses the issues related to psychic conditions: sexual desires, gender, traumas, and memories. The paper suggests that representation of the anatomical-bodied brings a new direction of the multidisciplinary approach introduced by artists to visualize the body and psyche in the contemporary context. The paper also presents an in-depth- discussion on technological, scientific, and philosophical knowledge employed in representing the idea of the body in addressing different psychic conditions to challenge the experiencing the body in contemporary art. Therefore, the paper focuses on examining the theme in the different forms of visual language and contexts in contemporary art. Finally, this research aims to offer a theoretical and conceptual background to curate an exhibition on the title of the anatomical-bodied and psyche in contemporary art with the body of work discussed in this paper.

Keywords: anatomy, body, contemporary art, psyche, psychoanalysis, representation, trauma

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Authors: Oscar Javier Montiel Mendez

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The link between knowledge-creativity-innovation-entrepreneurship is well established, and broadly emphasized the importance of national innovation systems (NIS) as an approach stresses that the flow of information and technology among people, organizations and institutions are key to its process. Understanding the linkages among the actors involved in innovation is relevant to NIS. Creativity is supposed to fuel NIS, mainly focusing on a personal, group or organizational level, leaving aside the fourth one, as a national system. It is suggested that NIS takes Creativity for granted, an ex-ante stage already solved through some mechanisms, like programs for nurturing it at elementary and secondary schools, universities, or public/organizational specific programs. Or worse, that the individual already has this competence, and that the elements of the NIS will communicate between in a way that will lead to the creation of S curves, with an impact on national systems/programs on entrepreneurship, clusters, and the economy. But creativity constantly appears at any time during NIS, being the key input. Under an initial, exploratory, focused and refined literature review, based on Csikszentmihalyi’s systemic model, Amabile's componential theory, Kaufman and Beghetto’s 4C model, and the OECD’s (Organisation for Economic Co-operation and Development) NIS model (expanded), an NCS theoretical model is elaborated. Its suggested that its implementation could become a significant factor helping strengthen local, regional and national economies. The results also suggest that the establishment of a national creativity system (NCS), something that appears not been previously addressed, as a strategic/vital companion for a NIS, installing it not only as a national education strategy, but as its foundation, managing it and measuring its impact on NIS, entrepreneurship and the rest of the ecosystem, could make more effective public policies. Likewise, it should have a beneficial impact on the efforts of all the stakeholders involved and should help prevent some of the possible failures that NIS present.

Keywords: national creativity system, national innovation system, entrepreneurship ecosystem, systemic creativity

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Authors: Shiao-Wei Chu

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In order to enhance the ability of their graduates to compete in an increasingly globalized economy, the majority of universities in Taiwan require students to pass Freshman English in order to earn a bachelor's degree. However, many college students show low motivation in English class for several important reasons, including exam-oriented lessons, unengaging classroom activities, a lack of opportunities to use English in authentic contexts, and low levels of confidence in using English. Students’ lack of motivation in English classes is evidenced when students doze off, work on assignments from other classes, or use their phones to chat with others, play video games or watch online shows. Cooperative learning aims to address these problems by encouraging language learners to use the target language to share individual experiences, cooperatively complete tasks, and to build a supportive classroom learning community whereby students take responsibility for one another’s learning. This study includes approximately 50 student participants in a low-proficiency Freshman English class. Each week, participants will work together in groups of between 3 and 4 students to complete various in-class interactive tasks. The instructor will employ a reward system that incentivizes students to be responsible for their own as well as their group mates’ learning. The rewards will be based on points that team members earn through formal assessment scores as well as assessment of their participation in weekly in-class discussions. The instructor will record each team’s week-by-week improvement. Once a team meets or exceeds its own earlier performance, the team’s members will each receive a reward from the instructor. This cooperative learning approach aims to stimulate EFL freshmen’s learning motivation by creating a supportive, low-pressure learning environment that is meant to build learners’ self-confidence. Students will practice all four language skills; however, the present study focuses primarily on the learners’ reading comprehension. Data sources include in-class discussion notes, instructor field notes, one-on-one interviews, students’ midterm and final written reflections, and reading scores. Triangulation is used to determine themes and concerns, and an instructor-colleague analyzes the qualitative data to build interrater reliability. Findings are presented through the researcher’s detailed description. The instructor-researcher has developed this approach in the classroom over several terms, and its apparent success at motivating students inspires this research. The aims of this study are twofold: first, to examine the possible benefits of this cooperative approach in terms of students’ learning outcomes; and second, to help other educators to adapt a more cooperative approach to their classrooms.

Keywords: freshman English, cooperative language learning, EFL learners, learning motivation, zone of proximal development

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Authors: Brittany Richardson, Ying Wang

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For physical therapy, exercise prescription, athlete training, and regular fitness training, it is crucial to perform health assessments or fitness assessments periodically. An accurate assessment is propitious for tracking recovery progress, preventing potential injury and making long-range training plans. Assessments include necessary measurements, height, weight, blood pressure, heart rate, body fat, etc. and advanced evaluation, muscle group strength, stability-mobility, and movement evaluation, etc. In the current standard assessment procedures, the accuracy of assessments, especially advanced evaluations, largely depends on the experience of physicians, coaches, and personal trainers. And it is challenging to track clients’ progress in the current assessment. Unlike the tradition assessment, in this paper, we present a deep learning based face recognition algorithm for accurate, comprehensive and trackable assessment. Based on the result from our assessment, physicians, coaches, and personal trainers are able to adjust the training targets and methods. The system categorizes the difficulty levels of the current activity for the client or user, furthermore make more comprehensive assessments based on tracking muscle group over time using a designed landmark detection method. The system also includes the function of grading and correcting the form of the clients during exercise. Experienced coaches and personal trainer can tell the clients' limit based on their facial expression and muscle group movements, even during the first several sessions. Similar to this, using a convolution neural network, the system is trained with people’s facial expression to differentiate challenge levels for clients. It uses landmark detection for subtle changes in muscle groups movements. It measures the proximal mobility of the hips and thoracic spine, the proximal stability of the scapulothoracic region and distal mobility of the glenohumeral joint, as well as distal mobility, and its effect on the kinetic chain. This system integrates data from other fitness assistant devices, including but not limited to Apple Watch, Fitbit, etc. for a improved training and testing performance. The system itself doesn’t require history data for an individual client, but the history data of a client can be used to create a more effective exercise plan. In order to validate the performance of the proposed work, an experimental design is presented. The results show that the proposed work contributes towards improving the quality of exercise plan, execution, progress tracking, and performance.

Keywords: exercise prescription, facial recognition, landmark detection, fitness assessments

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Authors: Agnieszka Antończyk, MałGorzata Ochota, Wojciech Niżański, ZdzisłAw Kiełbowicz

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The goal of the cesarean section (CS) is the delivery of healthy, vigorous pups with the provision of surgical plane anesthesia, appropriate analgesia, and rapid recovery of the dam. In human medicine, spinal or epidural anesthesia is preferred for a cesarean section as associated with a lower risk of neonatal asphyxia and the need for resuscitation. Nevertheless, the specificity of veterinary patients makes the application of regional anesthesia as a sole technique impractical, thus to obtain patient compliance the general anesthesia is required. This study aimed to compare the influence of balanced (inhalant with epidural) and inhalant anesthesia on neonatal umbilical cord blood gas (UCBG) parameters and vitality (modified Apgar scoring). The bitches (31) undergoing elective CS were enrolled in this study. All females received a single dose of 0.2 mg/kg s.c. Meloxicam. Females were randomly assigned into two groups: Gr I (Isoflurane, n=16) and Gr IE (Isoflurane plus Epidural, n=15). Anesthesia was induced with propofol at 4-6 mg/kg to effect, and maintained with isoflurane in oxygen; in IE group epidural anesthesia was also done using lidocaine (3-4 mg/kg) into the lumbosacral space. CSs were performed using a standard mid-line approach. Directly after the puppy extraction, the umbilical cord was double clamped before the placenta detachment. The vessels were gently stretched between forceps to allow blood sampling. At least 100 mcl of mixed umbilical cord blood was collected into a heparinized syringe for further analysis. The modified Apgar scoring system (AS) was used to objectively score neonatal health and vitality immediately after birth (before first aid or neonatal care was instituted), at 5 and 20 min after birth. The neonates were scored as normal (AS 7-10), weak (AS 4-6), or critical (AS 0-3). During surgery, the IE group required a lower isoflurane concentration compared to the females in group I (MAC 1.05±0.2 and 1.4±0.13, respectively, p<0.01). All investigated UCBG parameters were not statistically different between groups. All pups had mild acidosis (pH 7.21±0.08 and 7.21±0.09 in Gr I and IE, respectively) with moderately elevated pCO2 (Gr I 57.18±11.48, Gr IE 58.74±15.07), HCO3- on the lower border (Gr I 22.58±3.24, Gr IE 22.83±3.6), lowered BE (Gr I -6.1±3.57, Gr IE -5.6±4.19) and mildly elevated level of lactates (Gr I 2.58±1.48, Gr IE2.53±1.03). The glucose levels were above the reference limits in both groups of puppies (74.50±25.32 in Gr I, 79.50±29.73 in Gr IE). The initial Apgar score results were similar in I and IE groups. However, the subsequent measurements of AS revealed significant differences between both groups. Puppies from the IE group received better AS scores at 5 and 20 min compared to the I group (6.86±2.23 and 8.06±2.06 vs 5.11±2.40 and 7.83±2.05, respectively). The obtained results demonstrated that administration of epidural anesthesia reduced the requirement for isoflurane in dams undergoing cesarean section and did not affect the neonatal umbilical blood gas results. Moreover, newborns from the epidural anesthesia group were scored significantly higher in AS at 5 and 20 min, indicating their better vitality and quicker improvement post-surgery.

Keywords: apgar scoring, balanced anesthesia, cesarean section, umbilical blood gas

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Authors: Richard Kajjura, Joyce Kikafunda, Roger Whitehead

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Introduction: Indigenous complementary recipes for children (6-23 months) are bulky and inextricably linked. The potential contribution of indigenous complementary foods to infant’s vitamin A and iron needs is not well investigated in Uganda. Less is known whether children in Uganda are living with or without adequate supply of vitamin A and iron nutrients. In this study, vitamin A and iron contents were assessed in the complementary foods fed to infants aged 6-11 months in a Peri-urban setting in Kampala District in Central Uganda. Objective: Assessment of vitamin A and iron contents of indigenous complementary foods of children as fed and associated demographic factor. Method: In a cross sectional study design, one hundred and three (153) households with children aged 6-11 months were randomly selected to participate in the assessment. Complementary food samples were collected from the children’s mothers/caretakers at the time of feeding the child. The mothers’ socio-demographic characteristics of age, education, marital status, occupation and sex collected a semi-qualitative questionnaire. The Vitamin A and iron contents in the complementary foods were analyzed using a UV/VIS spectrophotometer for vitamin A and Atomic Absorption spectrophotometer for iron samples. The data was analyzed using Gene-stat software program. Results: The mean vitamin A content was 97.0± 72.5 µg while that of iron was 1.5 ± 0.4 mg per 100g of food sample as fed. The contribution of indigenous complementary foods found was 32% for vitamin A and 15% iron of the recommended dietary allowance. Age of children was found to be significantly associated Vitamin A and Iron supply potential. Conclusion: The contribution of indigenous complementary foods to infant’s vitamin A and iron needs was low. Complementary foods in Uganda are more likely to be deficient in vitamin A and iron content. Nutrient dense dietary supplementation should be intervened in to make possible for Ugandan children attain full growth potential.

Keywords: indigenous complementary food, infant, iron, vitamin A

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Authors: Gadanya, A.M., Ponfa, S., Jibril, M.M., Abubakar, S. M.

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Background: Edible insects such as grasshopper are important sources of food for humans, and have been consumed as traditional foods by many indigenous communities especially in Africa, Asia, and Latin America. These communities have developed their skills and techniques in harvesting, preparing, consuming, and preserving edible insects, widely contributing to the role played by the use of insects in human nutrition. Aim/ objective: This study was aimed at determining the effect of insect enriched sprouted soyabean /millet based food on some gut health markers in albino rats. Methods. Four different formulations of Complementary foods (i.e Complementary Food B (CFB): sprouted millet (SM), Complementary Food C (CFC): sprouted soyabean (SSB), Complementary Food D (CFD): sprouted soybean and millet (SSBM) in a ratio of (50:50) and Complementary Food E (CFE): insect (grasshopper) enriched sprouted soybean and millet (SSBMI) in a ratio of (50:25:25)) were prepared. Proximate composition and short chain fatty acid contents were determined. Thirty albino rats were divided into5 groups of six rats each. Group 1(CDA) were fed with basal diet and served as a control group, while groups 2,3,4 and 5 were fed with the corresponding complimentary foods CFB, CFC, CFD and CFE respectively daily for four weeks. Concentrations of fecal protein, serum total carotenoids and nitric oxide were determined. DNA extraction for molecular isolation and characterization were carried out followed by PCR, the use of mega 11 software and NCBI blast for construction of the phylogenetic tree and organism identification respectively. Results: Significant increase (P<0.05) in percentage ash, fat, protein and moisture contents, as well as short chain fatty acid (acetate, butyrate and propionate) concentrations were recorded in the insect enriched sprouted composite food (CFE) when compared with the CFA, CFB, CFC and CFD composite food. Faecal protein, carotenoid and nitric oxide concentrations were significantly lower (P>0.05) in group 5 in comparison to groups 1to 4. Ruminococcus bromii and Bacteroidetes were molecularly isolated and characterized by 16s rRNA from the sprouted millet/sprouted soybean and the insect enriched sprouted soybean/sprouted millet based food respectively. The presence of these bacterial strains in the feaces of the treated rats is an indication that the gut of the treated rats is colonized by good gut bacteria, hence, an improved gut health. Conclusion: Insect enriched sprouted soya bean/sprouted millet based complementary diet showed a high composition of ash, fat, protein and fiber. Thus, could increase the availability of short chain fatty acids whose role to the host organism cannot be overemphasized. It was also found to have decrease the level of faecal protein, carotenoid and nitric oxide in the serum which is an indication of an improvement in the immune system function.

Keywords: gut-health, insect, millet, soybean, sprouted

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Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

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Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic blood pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2. and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population, we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Our study even with some limitations might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: hypertension, age, exercise, obesity and gender

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Authors: Laid Fekih

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Background: Depression affects people in all communities across the world and in all aspects of their lives. Its spread varies from one country to another, can happen at any age and get rid of it is not easy. There is no clear policy in Algeria's higher education institutions to detect and treat these disorders or pay particular attention to those at risk. Identifying the prevalence of depression among Algerian students, its correlation with different variables, and studying gender differences in the light of a range of variables is necessary to develop an appropriate plan to raise the level of hope and love of life among students. Method: Random samples of 1500 University of Tlemcen students (967 girls and 533 boys), aged 19 to 24 years completed a self-administered questionnaire that included Beck's Depression Inventory ®-II (BDI®-II), (School Health Promotion: The Mood part), Other questions included in this survey focused on demographic characteristics including gender, age and year of study, academic performance (Annual Average Score (0-20) AAS), were examined. Results: The rate of depression (moderate, severe and extreme) varied from 03% to 13% among university students in Tlemcen University. There was no difference in the rates of depression in male and female students, which means that male and female students do have similar rates of depression. The rate of depression in the first-year of the study shows a higher score relative to students of other years. Depression has a negative relationship with academic performance, which means that depressed students have many difficulties in academic tasks at university. Conclusion: Depression among university students is an important center of interest in the world, not only because of the ease with which they can be followed, or the difficulties encountered during their studies and their technical courses but for the link between the level of depression and the quality of care of mental health services, especially if many students with mood and emotional problems don't meet the criteria for psychotherapy.

Keywords: depression, epidemiology, university students, academic performance

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Authors: Elham Fariborzi, Hoda Anvari Kazemabad

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Today, ICT plays an important role in all matters and it affects the development of creative cities. According to virtual space in this technology, it use especially for expand terms like smart schools, Virtual University, web-based training and virtual classrooms that is in parallel with the traditional teaching. Nowadays, the educational systems in different countries such as Iran are changing and start increasing creativity in the learning environment. It will contribute to the development of innovative ideas and thinking of the people in this environment; such opportunities might be cause scientific discovery and development issues. The creativity means the ability to generate ideas and numerous, new and suitable solutions for solving the problems of real and virtual individuals and society, which can play a significant role in the development of creative current physical cities or virtual borders ones in the future. The purpose of this paper is to study strategies to increase creativity in a virtual learning to develop a creative city. In this paper, citation/ library study was used. The full description given in the text, including how to create and enhance learning creativity in a virtual classroom by reflecting on performance and progress; attention to self-directed learning guidelines, efficient use of social networks, systematic discussion groups and non-intuitive targeted controls them by involved factors and it may be effective in the teaching process regarding to creativity. Meanwhile, creating a virtual classroom the style of class recognizes formally the creativity. Also the use of a common model of creative thinking between student/teacher is effective to solve problems of virtual classroom. It is recommended to virtual education’ authorities in Iran to have a special review to the virtual curriculum for increasing creativity in educational content and such classes to be witnesses more creative in Iran's cities.

Keywords: virtual learning, creativity, e-learning, bioinformatics, biomedicine

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Authors: Marvelyn F. Carolino, Charlene R. Cunanan, Gellien Faith O. Masongsong, Berlinda A. Ofrecio

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This study delves into the language usage differences among men, women, and individuals with other gender preferences. It specifically centers on the sociolinguistic aspects within the English majors at the College of Education of Rizal Technological University-Pasig, spanning from the first-year to fourth-year levels. The researchers employed a triangulation approach for data collection, utilizing a validated self-made questionnaire, interviews, and observations. The results revealed that language usage among different genders is influenced by a combination of cultural norms, social dynamics, and technological factors. Cultural norms significantly shape how respondents use language, as they conform to expected speech patterns based on their gender. Social factors, such as peer pressure, were found to impact language usage for individuals of all genders. This influence was viewed as constructive for personal development rather than inhibiting performance or communication. In terms of technological factors, respondents strongly agreed that the time spent on social media and educational applications influenced their language use. These platforms provided opportunities to expand and enhance their vocabulary. Additionally, the study employed hypothesis testing through the z-test formula to assess the impact of demographic profiles on language usage differences among genders. The results indicated that gender, economic status, locality, and ethnicity did not show statistically significant differences in language use. This lack of significant variation in findings was attributed to the relatively homogeneous demographic profile of respondents, primarily composed of females with low-income backgrounds and Tagalog ethnicity. This demographic similarity likely minimized the diversity of responses.

Keywords: gender, language, sociolinguistics, differences

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Authors: Abera Kotu, Girma Tesema, Mitiku Tadesse

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This study investigated ACE supported instruction and pre-service mathematics teachers’ mental construction in solving equations and inequalities. A mixed approach with concurrent parallel design was employed. It was conducted on two intact groups of regular first-year pre-service mathematics teachers at Fiche College of Teachers’ Education in which one group was assigned as an intervention group and the other group as a comparison group using the lottery method. There were 33 participants in the intervention and 32 participants in the comparison. Six pre-service mathematics teachers were selected for interview using purposive sampling based on pre-test results. An instruction supported with ACE cycle was given to the intervention group for two weeks duration of time. Written tasks, interviews, and observations were used to collect data. Data collected from written tasks were analyzed quantitatively using independent samples t-test and effect size. Data collected from interviews and observations were analyzed narratively. The findings of the study uncovered that ACE-supported instruction has a moderate effect on Pre-service Mathematics Teachers’ levels of conceptualizations of action, process, object, ad schema. Moreover, the ACE supported group out scored and performed better than the usual traditional method supported groups across the levels of conceptualization. The majority of pre-service mathematics teachers’ levels of conceptualizations were at action and process levels and their levels of conceptualization were linked with genetic decomposition more at action and object levels than object and schema. The use of ACE supported instruction is recommended to improve pre-service mathematics teachers’ mental construction.

Keywords: ACE teaching cycle, APOS theory, mental construction, genetic composition

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Authors: Sri Sai Ramya Bojedla, Falguni Pati

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Nature provides the best of solutions to humans. One such incredible gift to regenerative medicine is silk. The literature has publicized a long appreciation for silk owing to its incredible physical and biological assets. Its bioactive nature, unique mechanical strength, and processing flexibility make us curious to explore further to apply it in the clinics for the welfare of mankind. In this study, Antheraea mylitta and Bombyx mori silk fibroin microfibers are developed by two economical and straightforward steps via degumming and hydrolysis for the first time, and a bioactive composite is manufactured by mixing silk fibroin microfibers at various concentrations with polycaprolactone (PCL), a biocompatible, aliphatic semi-crystalline synthetic polymer. Reconstructive surgery in any part of the body except for the maxillofacial region deals with replacing its function. But answering both the aesthetics and function is of utmost importance when it comes to facial reconstruction as it plays a critical role in the psychological and social well-being of the patient. The main concern in developing adequate bone graft substitutes or a scaffold is the noteworthy variation in each patient's bone anatomy. Additionally, the anatomical shape and size will vary based on the type of defect. The advent of additive manufacturing (AM) or 3D printing techniques to bone tissue engineering has facilitated overcoming many of the restraints of conventional fabrication techniques. The acquired patient's CT data is converted into a stereolithographic (STL)-file which is further utilized by the 3D printer to create a 3D scaffold structure in an interconnected layer-by-layer fashion. This study aims to address the limitations of currently available materials and fabrication technologies and develop a customized biomaterial implant via 3D printing technology to reconstruct complex form, function, and aesthetics of the facial anatomy. These composite scaffolds underwent structural and mechanical characterization. Atomic force microscopic (AFM) and field emission scanning electron microscopic (FESEM) images showed the uniform dispersion of the silk fibroin microfibers in the PCL matrix. With the addition of silk, there is improvement in the compressive strength of the hybrid scaffolds. The scaffolds with Antheraea mylitta silk revealed higher compressive modulus than that of Bombyx mori silk. The above results of PCL-silk scaffolds strongly recommend their utilization in bone regenerative applications. Successful completion of this research will provide a great weapon in the maxillofacial reconstructive armamentarium.

Keywords: compressive modulus, 3d printing, maxillofacial reconstruction, natural fiber reinforced composites, silk fibroin microfibers

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Authors: M. J. Eichner, Y. S. Sarhan

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Overall study purpose has been the evaluation of ‘Vertical Villages’ as a new sustainable building typology, reducing significantly negative impacts of rapid urbanization processes in third world capital cities. Commonly in fast-growing cities, housing and job supply, educational and recreational opportunities, as well as public transportation infrastructure, are not accommodating rapid population growth, exposing people to high noise and emission polluted living environments with low-quality neighborhoods and a lack of recreational areas. Like many others, Egypt’s capital city Cairo, according to the UN facing annual population growth rates of up to 428.000 people, is struggling to address the general deterioration of urban living conditions. New settlements typologies and urban reconstruction approach hardly follow sustainable urbanization principles or socio-ecologic urbanization models with severe effects not only for inhabitants but also for the local environment and global climate. The authors prove that ‘Vertical Village’ buildings can offer a sustainable solution for increasing urban density with at the same time improving the living quality and urban environment significantly. Inserting them within high-density urban fabrics the ecologic and socio-cultural conditions of low-quality neighborhoods can be transformed towards districts, considering all needs of sustainable and social urban life. This study analyzes existing building typologies in Cairo’s «low quality - high density» districts Ard el Lewa, Dokki and Mohandesen according to benchmarks for sustainable residential buildings, identifying major problems and deficits. In 3 case study design projects, the sustainable transformation potential through ‘Vertical Village’ buildings are laid out and comparative studies show the improvement of the urban microclimate, safety, social diversity, sense of community, aesthetics, privacy, efficiency, healthiness and accessibility. The main result of the paper is that the disadvantages of density and overpopulation in developing countries can be converted with ‘Vertical Village’ buildings into advantages, achieving attractive and environmentally friendly living environments with multiple synergies. The paper is documenting based on scientific criteria that mixed-use vertical building structures, designed according to sustainable principles of low rise housing, can serve as an alternative to convert «low quality - high density» districts in megacities, opening a pathway for governments to achieve sustainable urban transformation goals. Neglected informal urban districts, home to millions of the poorer population groups, can be converted into healthier living and working environments.

Keywords: sustainable, architecture, urbanization, urban transformation, vertical village

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Authors: Mashaal Hooda

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The rationale for conducting this action research was to increase students' Academic Achievement (AA) contexts of studying/researching by employing the Goal Setting intervention (GS). The purposive sample consisted of 10 female undergraduate students at a university in Dubai. The intervention was introduced through workshop classes conducted online. The pre-intervention consisted of discussions concentrating on participants' research contexts amidst a pandemic. The GS moderators were implemented in the class, followed by scaffolding and mentoring interactions and self-reflective accounts of students' actions and feelings of using the intervention to better plan and structure their dissertation tasks. The research incorporated a Mixed Methods Methodology (MMM). Quantitative data collection took place through surveys, while qualitative data were collected using semi-structured interviews. Triangulation of the emergent themes showed a positive increase in students achievable GS, self-regulatory study skills, feedback-seeking behaviours, research organisation and synthesis, self-reflection and Academic Resilient (AR) attitudes amalgamate to enhance students' AA outcomes. Though, students' intrinsic motivational levels to study and research observed minor changes only. Nonetheless, the pebble in the shoe was removed as students AA contexts improved in undertaking better actionable steps for their research. Therefore, the GS intervention enabled students to set, balance, and achieve academic goals while catering to their academic anxieties, mental health concerns, and adaptability to the e-learning platforms amidst the COVID-19 pandemic. Despite the wide-scale changes the pandemic brought to the teaching and learning communities, the GS intervention served as a targeted intervention to help students maintain their achievement contexts in a goal-oriented way.

Keywords: academic achievement, acadeic resilience, COVID-19, goal setting

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Authors: Paul Feyi Waboso

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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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Authors: Bishal Saha, Musah Ahmed Rufai Muhyedeen, Jubeyer Hossain Joy, Muhammad Muhitur Rahman, Mohammad Shahedur Rahman, Md Arif Hasan, Syed Masiur Rahman

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Greenhouse gas (GHG) emission is one of the critical problems of today’s world. Many countries have been taking many short- and long-term plans to reduce climate change mitigation. However, the potential of behavioral changes in addressing this problem is promising, as reported by many researchers. This paper presents a comprehensive literature review that focuses on ways to influence people’s behavior in their homes, workplace, and transportation to mitigate the emission directly or indirectly. This study will investigate different theories pertinent to planned behavior and the key elements for modifying behavior like biophilia, reinforcement to use optimum energy and recyclable products, proper application of greenhouse tax, modern technology, and sustainable design adaptation, transportation sharing, social and community norms, proper education and information, and financial incentives. There is a number of challenges associated with behavioral changes. Behavioral interventions have different actions varied by their type and need to combine various policy tools and great social marketing. Many interventions can reduce GHG emissions without any compromise with household well-being. This study will develop a landscape of prevailing theories of environmental psychology by identifying and reviewing the key themes and findings of this field of study. It will support especially the developing countries to reduce GHG emissions without significant capital investment. It is also expected that the behavioral changes will lead to the successful adoption of climate-friendly policies easily. This study will also generate new research questions and directions.

Keywords: behavioral changes, climate change mitigation, environmental psychology, greenhouse gas emission

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Authors: Tope Olubodun

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Background: Family planning practices help individuals and couples avoid unwanted pregnancies, regulate intervals between pregnancies, and determine the number of children in the family. Family planning is an effective intervention for promoting maternal health, but its acceptability and utilization are impeded by many factors in Southwest Nigeria. Aim: This study was conducted to assess women’s knowledge and practice of family planning in two rural communities in Ogun State, Southwest Nigeria, and to determine factors associated with the utilization of family planning among these women. Methods: This was a cross-sectional study conducted among 561 women of reproductive age selected by multistage sampling. The data collection was done using interviewer-administered questionnaires. Data obtained were analyzed using IBM SPSS Statistics version 20. Frequencies were generated, and chi-square test was used to explore associations. The level of significance was set at 0.05. Result: The majority of the respondents were aware of family planning 410 (73.1%). The method most commonly known was male condom 348 (62.0%), then pills 276 (49.2%) and injectables 231(41.3%). The commonest sources of information on family planning were health workers 158 (26.8%), outreaches 162 (27.5%) and TV/radio 136 (23.1%). Respondents that had used family planning, however, only constituted forty–five percent. The methods commonly used were injectables 104 (39.2%) and pills 85 (32.1%). Reasons for choosing not to use family planning include the desire for more children 78 (26.3%), because spouse does not support family planning 56 (18.9%), fear of unbearable side effects 44 (14.9%), and poor knowledge of the methods of family planning as well as where the services can be obtained 39 (13.2%). There is a statistically significant association between age, ethnicity, education, occupation, average monthly income, and use of family planning. Conclusion: Campaigns that promote male involvement in family planning, use of family planning for child spacing, and dispelling of fears is recommended to improve the practice of family planning among such a group of women.

Keywords: family planning, rural, knowledge, practice

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Authors: Okike Benjamin

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Terrorism is the use of violence and threat to intimidate or coerce a person, group, society or even government especially for political purposes. Terrorism may be a way of resisting government by some group who may feel marginalized. It could also be a way of expressing displeasure over the activities of government. On 26th December, 2009, US placed Nigeria as a terrorist nation. Recently, the occurrences of terrorism in Nigeria have increased considerably. In Jos, Plateau state, Nigeria, there was a bomb blast which claimed many lives on the eve of 2010 Christmas. Similarly, there was another bomb blast in Mugadishi (Sani Abacha) Barracks Mammy market on the eve of 2011 New Year. For some time now, it is no longer news that bomb exploded in some Northern part of Nigeria. About 25 years ago, stopping terrorism in America by the Americans relied on old-fashioned tools such as strict physical security at vulnerable places, intelligence gathering by government agents, or individuals, vigilance on the part of all citizens, and a sense of community in which citizens do what could be done to protect each other. Just as technology has virtually been used to better the way many other things are done, so also this powerful new weapon called computer technology can be used to detect and prevent terrorism not only in Nigeria, but all over the world. This paper will x-ray the possible causes and effects of bomb blast, which is an act of terrorism and suggest ways in which Explosive Detection Devices (EDDs) and computer software technology could be deployed to reduce the occurrences of terrorism in Nigeria. This become necessary with the abduction of over 200 schoolgirls in Chibok, Borno State from their hostel by members of Boko Haram sect members on 14th April, 2014. Presently, Barrack Obama and other world leaders have sent some of their military personnel to help rescue those innocent schoolgirls whose offence is simply seeking to acquire western education which the sect strongly believe is forbidden.

Keywords: terrorism, bomb blast, computer technology, explosive detection devices, Nigeria

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Authors: Renato Roda

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With the emergence of the so-called 'Knowledge Society', the implementation of policies to attract, grow and retain talents, in an academic context as well, has become critical –both in the perspective of didactics and research and as far as administration and institutional management are concerned. At the same time, the contemporary philanthropic entities/organizations, which are evolving from traditional types of social support towards new styles of aid, envisaged to go beyond mere monetary donations, face the challenge of brand-new forms of complexity in supporting such specific dynamics of the global human capital market. In this sense, it becomes unavoidable for the philanthropic foundation, while carrying out their daily charitable tasks, to resort to innovative ways to facilitate the acquisition and the promotion of talents by academic and research institutions. In order to deepen such a specific perspective, this paper features the case of Turin, former 'factory city' of Italy’s North West, headquarters -and main reference territory- of Italy’s largest and richest private formerly bank-based philanthropic foundation, the Fondazione Compagnia di San Paolo. While it was assessed and classified as 'medium' in the city Global Talent Competitiveness Index (GTCI) of 2020, Turin has nevertheless acquired over the past months status of impact laboratory for a whole series of innovation strategies in the competition for the acquisition of excellence human capital. Leading actors of this new city vision are the foundations with their specifically adjusted financial engagement and a consistent role of stimulus towards innovation for research and education institutions.

Keywords: human capital, post-Fordism, private foundation, war on talents

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Authors: Zakir Hossain

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Nowadays reading e-books on laptops, smartphones, and tablets have become a new leisure activity for Vietnamese youth. Since 2011 the copyrighted e-book market began to develop in Vietnam with the participation of five local enterprises. Over the last five years, thousands of e-books were published including the first online early education book series for children from 0 to 6 years old. Research shows that 61% Vietnamese find reading e-books is comfortable, and 45% feel convenient buying books online. More than half of the Vietnamese consider reading online far better than buying printed books, and surprisingly people over age 30 desire reading online while those under 18 prefer reading printed books. Hence with a market of more than 40 million regular internet users including 22 million smartphone users, Vietnam has ample opportunities to develop the e-book market and contribute a great deal to the diversity of the local reading culture which is essential for Building a Lifelong Learning Society, a state ambition of Vietnam by 2020. However, the e-book market in Vietnam is still in its infancy and is growing far too slowly than e-book producers had expected. All five e-book enterprises are facing numerous challenges. While the big profit that e-book technology can bring has been clearly recognised in other countries, e-books in Vietnam only make up less than 1% share of the book market. The objective of the study is to identify the difficulties and barriers to the development of the e-book market in Vietnam through an extensive literature review available in English. The study revealed that illegal e-books due to copyright infringement and an inconvenient payment system to purchase e-books are the major obstacles. The great potential of e-books in Vietnam is a reality but requires government enforcement of copyright protection laws, a new area of focus for the e-book market. Furthermore, Vietnamese readers should change their habits from using free and illegal e-books to develop the e-publishing industry in Vietnam.

Keywords: copyright, e-book, e-book reading, e-publishing, Vietnam

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Authors: Nasrin Badrkhani

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Teaching is an interaction between the teacher, student, and the concept being taught, especially within the classroom setting. As society increasingly values thoughtful and creative individuals, there is a growing need to adopt modern, active teaching methods. These methods should engage students in activities that foster problem-solving, creativity, cooperation, and scientific thinking skills. Modern teaching methods emphasize student involvement, gradual and continuous learning (process-centered approaches), and holistic evaluation of students' abilities and talents. A shift from teacher-centered to student-centered teaching is crucial. Among these modern methods are group work, role-playing, group discussions, and activities that engage students in evaluating societal values. This research employs a survey and a 38-question Likert scale questionnaire to explore teachers' perspectives on the impact of modern teaching methods on the quality of education. The study also examines the relationship between these perspectives and variables such as gender, major, and teaching experience. The statistical population consists of high school teachers in Shiraz, Iran, with sampling done using the Morgan table. Discriminant analysis was used for the initial analysis of the questions, and Cronbach's Alpha test was employed for the final examination. SPSS Software was used for statistical analysis, including T-tests and one-way ANOVA. The results indicate that teachers in this city generally have positive attitudes towards the use of modern teaching methods, except when it comes to engaging in judgments concerning societal values. There is no significant difference in viewpoints based on gender or educational background. The findings are consistent with similar studies conducted both within Iran and internationally.

Keywords: learning, modern methods, student, teacher, teaching

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Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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Authors: Susan Evans, Janna Gordon-Elliott, Katarzyna Wyka, Virginia Mutch

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During the rise of the COVID-19 pandemic, healthcare workers needed an intervention that could address their profound acute stress. Mindfulness-based stress reduction (MBSR) is a program that has long established effectiveness for mental and physical health outcomes. In recent years, MBSR has been modified such that the duration of both class time and number of sessions has been abbreviated, and its delivery has been adapted for online dissemination, thus increasing the likelihood that individuals who could most benefit from the program would do so. We sought to investigate whether a brief, online version of MBSR could be feasible and acceptable for health care workers (HCW) in acute stress in response to the COVID-19 pandemic. Participants were recruited via an email sent to all hospital employees, which spans residents, physicians, nurses, housekeeping, lab technicians, administrators, and others. Participating HCW were asked about their previous experience with mindfulness and asked to commit to a minimum of 3 sessions. They were then provided with four weekly 1-hour sessions online that included the major mindfulness exercises taught during traditional MBSR programs (i.e., body scan, sitting meditation, mindful eating, and yoga). Participants were provided with supporting slides, videos, demonstrations and asked to track their practice. Hospital staff enrolled in the program; by the end of the first day of recruitment, 40 had applied; by the start date, about 100 were enrolled, and n attended a minimum of 3 sessions, supporting feasibility. Hospital staff also participated and practiced the mindfulness exercises (n=42), thus supporting acceptability. Participants reported that the program was logical, successful, and worth recommending both before starting the program and after completing it (M= 22.02 and M=21.76, respectively, possible range 0-27). There was a slight decline in the belief in improvement in health and well-being due to the program (ES=.37, p=.021). Secondary hypotheses regarding participants’ self-reported stress and levels of mindfulness were also supported, such that participants reported improvements in perceived stress (ES=.45, p=.006), compassion satisfaction, burnout, and secondary traumatic stress (ES=.41, ES=.31, ES=.35, respectively, p<.05). Participants reported significant improvements in the describing facet of mindfulness (ES=.49, p=.004), while all other facets (observing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience) remained unchanged pre- to post-program. Results from this study suggest that an abridged, online version of MBSR is feasible and accessible to health care workers in acute stress and provides benefits expected from traditional MBSR programs. The lack of a randomized control group limits generalizability. We intend to provide a structure, framework, and lessons learned to hospital administrators and clinical staff seeking to support their employees in acute stress.

Keywords: acute stress, health care workers, mindfulness, online interventions

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