Search results for: guided instruction

Authors: Zahra Ebrahimi, Abbas Moradan

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This study investigated the effect of applying different layers of activity for different Iranian intermediate EFL learner’s oral proficiency and two of its components (fluency and accura-cy) for the beneficial use of films within speaking classes. For this purpose, thirty Iranian EFL intermediate learners were selected based on availability sampling, they were divided into one experimental group and one control group, each consisting of 15 participants, who were proved to be homogeneous based on the results obtained from IELTS oral proficien-cy test prior to the treatment. Experimental Group received the treatment which was apply-ing different layers of speaking tasks according to learners’ level of fluency and accuracy. Control group received ordinal treatment of speaking classrooms. The materials for this study consisted of 11 English movies for each session, voice-recorder device, and IELTS oral proficiency tests as well as two interviews based on Ur’s oral scale for measuring fluen-cy and accuracy. The treatment was run for 12 sessions in six weeks. At the end of the treatment, all the students both in experimental and control group were given a post-test interview based on Ur’s scale. To compare and contrast the amount of progress of the learners in different groups the results of the pre-test and post-test of speaking were analysed by using T-tests. Moreover, Multivariate analysis of variance was also used to check the hypotheses. Results showed that application of different layers of activity with regard to students’ level, led to a significantly superior performance in experimental group. Thus, this study verified the positive effect of implementation of different layers of activity and tasks to achieve progress in speaking skill. It can also help to create a less stressful at-mosphere of learning in which all the students will be given specific time to speak and lead them to be autonomous learners.

Keywords: differentiated instruction, learners’ style, multiple intelligence, speaking skill, task-based activities

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Authors: Ricardo Pinto Mario Covele, Patricio V. Langa, Patrick Swanzy

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The English language has been recognized as a universal medium of instruction in academia, especially in Higher Education Institutions (HEIs) hence exerting enormous influence within the context of research and publication. By extension, the English Language has been embraced by scholars from non-English speaking countries. The purpose of this review was to synthesize the discussions using four databases. Discussion in the English language in the career development of academics, particularly in non-English speaking universities, is largely less visible. This paper seeks to fill this gap and to improve the visibility of the English language in the career development of academics focusing on non-English language speaking universities by undertaking a systematic literature review. More specifically, the paper addresses the language policy, English language learning model as a second language, sociolinguistic field and career development, methods, as well as its main findings. This review analyzed 75 relevant resources sourced from Western Cape’s Library, Scopus, Google scholar, and web of science databases from November 2020 to July 2021 using the PQRS framework as an analytical lens. The paper’s findings demonstrate that, while higher education continues to be under-challenges of English language usage, literature targeting non-English speaking universities remains less discussed than it is often described. The findings also demonstrate the dominance of English language policy, both for knowledge production and dissemination of literature challenging emerging scholars from non-English speaking HEIs. Hence, the paper argues for the need to reconsider the context of non-English language speakers in the English language in the career development of academics’ research, both as empirical fields and as emerging knowledge producers. More importantly, the study reveals two bodies of literature: (1) the instrumentalist approach to English Language learning and (2) Intercultural approach to the English Language for career opportunities, classified as the appropriate to explain the English language learning process and how is it perceived towards scholars’ academic careers in HEIs.

Keywords: English language, public and private universities, language policy, career development, non-English speaking countries

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Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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Authors: Cristian Matti, Valerie Fowles, Eva Enyedi, Piotr Pogorzelski

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The system mapping process can be defined as a knowledge service where a team of facilitators, experts and practitioners facilitate a guided conversation, enable the exchange of information and support an iterative curation process. System mapping processes rely on science-based tools to introduce and simplify a variety of components and concepts of socio-technical systems through metaphors while facilitating an interactive dialogue process to enable the design of co-created maps. System maps work then as “artifacts” to provide information and focus the conversation into specific areas around the defined challenge and related decision-making process. Knowledge management facilitates the curation of that data gathered during the system mapping sessions through practices of documentation and subsequent knowledge co-production for which common practices from data science are applied to identify new patterns, hidden insights, recurrent loops and unexpected elements. This study presents empirical evidence on the application of these techniques to explore mechanisms by which visual tools provide guiding principles to portray system components, key variables and types of data through the lens of climate change. In addition, data science facilitates the structuring of elements that allow the analysis of layers of information through affinity and clustering analysis and, therefore, develop simple indicators for supporting the decision-making process. This paper addresses methodological and empirical elements on the horizontal learning process that integrate system mapping through visual tools, interpretation, cognitive transformation and analysis. The process is designed to introduce practitioners to simple iterative and inclusive processes that create actionable knowledge and enable a shared understanding of the system in which they are embedded.

Keywords: indicators, knowledge management, system mapping, visual tools

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Authors: Emmanuel Nkemakolam Okwuduba, Fransica Chinelo Offiah

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The technique of teaching chemistry to students is one of the determining factors towards their achievement. Thus, the study investigated the relationship between classroom interaction patterns and students’ achievement in Chemistry. The purpose of this study was to identify patterns of interaction in an observed chemistry classroom, determine the amount of teacher talk, student talk and period of silence and to find out the relationship between them and the mean achievement scores of students. Five research questions and three hypotheses guided the study. The study was a correlational survey. The sample consisted of 450 (212males and 238 females) senior secondary one students and 12 (5males and 7 females) chemistry teachers drawn from 12 selected secondary schools in Awka Education Zone of Anambra state. In each of the 12 selected schools, an intact class was used. Science Interaction Category (SIC) and Chemistry Achievement Test (CAT) were developed, validated and used for data collection. Each teacher was observed three times and the interaction patterns coded using a coding sheet containing the Science Interaction Category. At the end of the observational period, the Chemistry Achievement Test (for collection of data on students’ achievement in chemistry) was administered on the students. Frequencies, percentage, mean, standard deviation and Pearson product moment correlation were used for data analysis. The result showed that the percentages of teacher talk, student talk and silence were 59.6%, 37.6% and 2.8% respectively. The Pearson correlation coefficient(r) for teacher talk, student talk and silence were -0.61, 0.76 and-0.18 respectively. The result showed negative and significant relationship between teacher talk and mean achievement scores of students; positive and significant relationship between student talk and mean achievement scores of students but there is no relationship between period of silence and mean achievement scores of students at 0.05 significant levels. The following recommendations were made based on the findings: teachers should establish high level of student talk through initiation and response as it promotes involvement and enhances achievement.

Keywords: academic achievement, chemistry, classroom, interactions patterns

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Authors: I-Yun Cheng, Min-Yu Chiang, Shwu-Jen Chang, San-Yuan Chen

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Osteoarthritis (OA) is among the most challenging joint diseases, and as far as we know, there is currently no exact and effective cure for it because it has low self-repair ability due to lack of blood vessels and low cell density in articular cartilage. So far, there have been several methods developed to treat cartilage disorder. The most common method is to treat the high molecular weight of hyaluronic acid (HA) injection, but it will degrade after a period of time, so the patients need to inject HA repeatedly. In recent years, self-healing hydrogel has drawn considerable attention because it can recover its initial mechanical properties after damaged and further increase the lifetime of the hydrogel. Here, we aim to develop a self-healable composite hydrogel combined with magnetic microspheres to trigger glutathione(GSH) release for promoting cartilage repair. We use HA-cyclodextrin (CD) as host polymer and poly(acrylic acid)-ferrocene (pAA-Fc) as guest polymer to form the self-healable HA-pAA hydrogel by host and guest interaction where various graft amount of pAA-Fc (pAA:Fc= 1:2, 1:1.5, 1:1, 2:1, 4:1) was conducted to develop different mechanical strength hydrogel. The rheology analysis showed that the 4:1 of pAA-Fc has higher mechanical strength than other formulations. On the other hand, iron oxide nanoparticle, poly(lactic-co-glycolic acid) (PLGA) and polyethyleneimine (PEI) were used to synthesize porous magnetic microspheres via double emulsification water-in-oil-in-water (W/O/W) to increase GSH loading which acted as a reductant to control the hydrogel crosslink density and promote hydrogel self-healing. The results show that the porous magnetic microspheres can be loaded with 70% of GSH and sustained release about 50% of GSH after 24 hours. More importantly, the HA-pAA composite hydrogel can self-heal rapidly within 24 hours when suffering external force destruction by releasing GSH from the magnetic microspheres. Therefore, the developed the HA-pAA composite hydrogel combined with GSH-loaded magnetic microspheres can be in-vivo guided to damaged OA surface for inducing the cartilage repair by controlling the crosslinking of self-healing hydrogel via GSH release.

Keywords: articular cartilage, magnetic microsphere, osteoarthritis, self-healing hydrogel

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Authors: Giovana Perini-Loureiro

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The purpose of this research was to identify whether the nominalizations terminating in -TION in the academic discourse of native English speakers contain the arguments required by their input verbs. In the perspective of functional linguistics, ideational metaphors, with nominalization as their most pervasive realization, are lexically dense, and therefore frequent in formal texts. Ideational metaphors allow the academic genre to instantiate objectification, de-personalization, and the ability to construct a chain of arguments. The valence of those nouns present in nominalizations tends to maintain the same elements of the valence from its original verbs, but these arguments are not always expressed. The initial hypothesis was that these arguments would also be present alongside the nominalizations, through anaphora or cataphora. In this study, a qualitative analysis of the occurrences of the five more frequent nominalized terminations in -TION in academic texts was accomplished, and thus a verification of the occurrences of the arguments required by the original verbs. The assembling of the concordance lines was done through COCA (Corpus of Contemporary American English). After identifying the five most frequent nominalizations (attention, action, participation, instruction, intervention), the concordance lines were selected at random to be analyzed, assuring the representativeness and reliability of the sample. It was possible to verify, in all the analyzed instances, the presence of arguments. In most instances, the arguments were not expressed, but recoverable, either in the context or in the shared knowledge among the interactants. It was concluded that the realizations of the arguments which were not expressed alongside the nominalizations are part of a continuum, starting from the immediate context with anaphora and cataphora; up to a knowledge shared outside the text, such as specific area knowledge. The study also has implications for the teaching of academic writing, especially with regards to the impact of nominalizations on the thematic and informational flow of the text. Grammatical metaphors are essential to academic writing, hence acknowledging the occurrence of its arguments is paramount to achieve linguistic awareness and the writing prestige required by the academy.

Keywords: corpus, functional linguistics, grammatical metaphors, nominalizations, academic English

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Authors: Abdul Nasir Zamir

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After the downfall of Ottoman Caliphate, it scattered into different small Muslim states. Muslim leaders, intellectuals, revivalists as well as modernists started trying to boost up their nation. Some Muslims are also trying to establish the caliphate. Every Muslim country has its own political system, i.e., kingship, dictatorship or democracy, etc. But these are not in their original forms as the historian or political science discussed in their studies. The laws and their practice are mixed, i.e., others with Islamic laws, e.g., Saudi Arabia (K.S.A) and the Islamic Republic of Pakistan, etc. There is great conflict among the revivalist Muslim parties (groups) and governments about political systems. The question is that the subject matter is Sharia or political system? Leaders of Modern Muslim states are alleged as disbelievers due to neglecting the revelation in their laws and decisions. There are two types of laws; Islamic laws and management laws. The conflict is that the non-Islamic laws are in practice in Muslim states. Non-Islamic laws can be gradually changed with Islamic laws with a legal and peaceful process according to the practice of former Muslim leaders and scholars. The bloodshed of Muslims is not allowed in any case. Weak Muslim state is a blessing than nothing. The political system after Muhammad and guided caliphs is considered as kingship. But during this period Muslims not only developed in science and technology but conquered many territories also. If the original aim is in practice, then the Modern Muslim states can be stabled with different political systems. Modern Muslim states are the hope of survival, stability, and development of Muslim Ummah. Islam does not allow arm clash with Muslim army or Muslim civilians. The caliphate is based on believing in one Allah Almighty and good deeds according to Quran and Sunnah. As faith became weak and good deeds became less from its standard level, caliphate automatically became weak and even ended. The last weak caliphate was Ottoman Caliphate which was a hope of all the Muslims of the world. There is no caliphate or caliph present in the world. But every Muslim country or state is like an Amarat (a part of caliphate or small and alternate form of the caliphate) of Muslims. It is the duty of all Muslims to stable these modern Muslim states with tolerance.

Keywords: caliphate, conflict resolution, modern Muslim state, political conflicts, political systems, tolerance

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Authors: Virginia Chambers, Kamryn York, Mark Marnich

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T.I.M.E. for STEM (Transforming Integrative Maker Education for STEM learning) focuses on improving the quality and effectiveness of STEM education for pre-service teachers through a focus on the integration of maker space pedagogy. This National Science Foundation-funded project primarily focuses on undergraduate pre-service teaching students majoring in elementary education. The study contributes to the knowledge about teaching and learning by developing, implementing, and assessing faculty development, interactive instruction, and STEM lesson plan development. This project offers a valuable opportunity to improve STEM thinking skills by formally integrating STEM concepts throughout the pre-service teacher curriculum using an interdisciplinary approach. T.I.M.E. for STEM utilizes a maker space laboratory at Point Park University in Pittsburgh, PA, USA. However, the project design is such that other institutions of higher education can replicate the program with or without a physical maker space lab as the project’s findings and “maker mindset” are employed. Utilizing qualitative research methodology, the project investigates the following research question: What do pre-service teachers (education students) and faculty members identify as areas of pedagogical growth in STEM learning and teaching in a makerspace environment? This research highlights the impact of makerspace pedagogy on improving STEM education learning outcomes through an interdisciplinary constructivist approach. The project is expected to have a multiplier effect as it impacts STEM disciplinary and higher education faculty, pre-service teachers, and teacher preparation programs at other universities that benefit from what is learned at Point Park University. Ultimately, the future elementary students of the well-prepared pre-service teachers steeped in maker pedagogy and STEM content will have the potential to develop higher-level thinking skills and improve their mathematics and scientific achievement, which are essential for the 21st century STEM workforce.

Keywords: maker education, STEM learning, teacher education, elementary education

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Authors: Monika Benedek

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Improvisation is an integral part of music education programmes worldwide since teachers recognize that improvisation helps to broaden stylistic knowledge, develops creativity and various musical skills, in particular, aural skills, and also motivates to learn music theory. In Hungary, where Kodály concept is a core element of music teacher education, improvisation has been relatively neglected subject in both primary school and classical music school curricula. Therefore, improvisation was an important theme of a one-year-long research project carried out at the Liszt Academy of Music in Budapest. The project aimed to develop the music teacher training programme, and among others, focused on testing how improvisation could be used as a teaching tool to improve students’ musical reading and writing skills and creative musical skills. Teacher-researchers first tested various teaching approaches of improvisation with numerous teaching modules in music lessons at public schools and music schools. Data were collected from videos of lessons and from teachers’ reflective notes. After analysing data and developing teaching modules, all modules were tested again in a pilot course in 30 contact lessons for music teachers. Teachers gave written feedback of the pilot programme, tested two modules by their choice in their own teaching and wrote reflecting comments about their experiences in applying teaching modules of improvisation. The overall results indicated that improvisation could be an innovative approach to teaching various musical subjects, in particular, solfege, music theory, and instrument, either in individual or in group instruction. Improvisation, especially with the application of relative solmisation and singing, appeared to have been a beneficial tool to develop various musicianship skills of students and teachers, in particular, the aural, musical reading and writing skills, and creative musical skills. Furthermore, improvisation seemed to have been a motivating teaching tool to learn music theory by creating a bridge between various musical styles. This paper reports on the results of the research project.

Keywords: improvisation, Kodály concept, music school, public school, teacher training

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Authors: Oliver T. Gore

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Social inequalities and inequity of outcomes in higher education (HE) persist in South Africa despite the government introducing policy that seeks to address social injustices brought about by previous apartheid policies. In addressing these social injustices, HE policy conceptualises inequalities under the concept of historical ‘disadvantage’ which is understood to be primarily race-based. The study adds on to the existing knowledge on inequalities through developing the dimensions of (dis)advantage, which have the potential to inform the South African HE policy on providing equal opportunities amongst diverse students to participate and succeed in their studies. Drawing from the capabilities approach, this study argues that (dis)advantage can be richly understood in terms of students’ capabilities, functionings and agency as opposed to a sole focus on race. The study argues that limited freedoms, lack of effective opportunities, and reduced agency for students to turn university resources into real achievements such as personal development, economic skills and social responsibility amounts to disadvantage, while the converse is also true. The study draws from qualitative interview data with honours students, university staff and Student Representative Council members from five different university departments at one South African university. This presentation uses results from 20 students and reveals what their university experiences tell us regarding students’ unfreedoms in relation to: the inability to make decisions, poor schooling backgrounds, inadequate finances, emotional stress, lack of social support, inability to understand the language of instruction, lack of safe transport and accommodation issues. Despite these unfreedoms, the data shows that the students aspired and persevered with their studies. Using theory and empirical data in conversation, the paper shows that there is a need to nuance the definition of (dis)advantage, particularly by focusing on how different forms of disadvantage intersect with each other.

Keywords: capabilities approach, (dis)advantage, higher education, social justice

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Authors: Yelba Maria Carrillo

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The focus of this research study was to explore barriers, if any, faced by parents or legal guardians who are of Latinx background and speak Spanish as a primary language or are bilingual speakers of Spanish and English; barriers that limit their understanding of and involvement in their gifted child’s academic life. This study was guided by a qualitative case study design. The primary investigator hosted focus group interviews at a Magnet Middle School in Southern California. The groups consisted of 25 parents, or legal guardians of bilingual (English/Spanish) or former English learner students enrolled in a school serving 6th-8th grades. The primary investigator interviewed Latinx Spanish-speaking parents or legal guardians of gifted students regarding their perception of their child’s giftedness, parental involvement in schools, and fostering their child’s exceptional abilities. Parents and legal guardians described children as creative, intellectual, and highly intelligent. Key themes such as student performance, language proficiency, socio-emotional, and general intellectual ability were strong indicators of giftedness. Barriers such as language and education inhibited parent and legal guardian ability to understand their child’s giftedness, which resulted in their inability to adequately contribute to the development of their children’s talents and advocate for the appropriate services for their children. However, they recognized the importance of being involved in their child’s academic life and the importance of nurturing their ‘dón’ or ‘gift.’ La Familia is the foundation and core of Latinx culture; and, without a strong foundation, children lack guidance, confidence, and awareness to tap into their gifted abilities. Providing Latinx parents with the proper tools and resources to appropriately identify gifted characteristics and traits could lead to early identification and intervention for students in schools and at home.

Keywords: gifted education, gifted Latino students, Latino parent involvement, high ability students

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Authors: Emmanuel Iyamuremye, Jean François Maniriho, Irenee Ndayambaje

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Mathematics is the foundational enabling discipline that underpins science, technology, and engineering disciplines. Science, technology, engineering, and mathematics (STEM) subjects are foreseen as the engine for socio-economic transformation. Rwanda has done reforms in education aiming at empowering and preparing students for the real world job by providing career pathways in science, technology, engineering, and mathematics related fields. While that considered so, the performance in mathematics has remained deplorable in both formative and national examinations. Therefore, this paper aims at exploring the extent to which the engage, explore, explain, elaborate and evaluate (5Es) instructional model contributing towards students’ achievement in mathematics. The present study adopted the pre-test, post-test non-equivalent control group quasi-experimental design. The 5Es instructional model was applied to the experimental group while the control group received instruction with the conventional teaching method for eight weeks. One research-made instrument, mathematics achievement test (MAT), was used for data collection. A pre-test was given to students before the intervention to make sure that both groups have equivalent characteristics. At the end of the experimental period, the two groups have undergone a post-test to ascertain the contribution of the 5Es instructional model. Descriptive statistics and analysis of covariance (ANCOVA) were used for the analysis of the study. For determining the improvement in mathematics, Hakes methods of calculating gain were used to analyze the pre-test and post-test scores. Results showed that students exposed to 5Es instructional model achieved significantly better performance in mathematics than students instructed using the conventional teaching method. It was also found that 5Es instructional model made lessons more interesting, easy and created friendship among students. Thus, 5Es instructional model was recommended to be adopted as a close substitute to the conventional teaching method in teaching mathematics in lower secondary schools in Rwanda.

Keywords: 5Es instructional model, achievement, conventional teaching method, mathematics

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Authors: Prathama Guha Chaudhuri, Arunima Datta, Ashis Mukhopadhyay

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Background: Visualization (guided imagery) is a set of techniques which induce relaxation and help people create positive mental images in order to reduce stress.It is relatively inexpensive and can even be practised by bed bound people. Studies have shown visualization to be an effective tool to improve cancer patients’ anxiety, depression and quality of life. The common images used with cancer patients in the developed world are those involving the individual’s body and its strengths. Since breast cancer patients in India are more family oriented and often their main concerns are the stigma of having cancer and subsequent isolation of their families, including their children, we figured that positive images involving acceptance and integration within family and society would be more effective for them. Method: Data was collected from 119 breast cancer patients on chemotherapy willing to undergo psychotherapy, with no history of past psychiatric illness. Their baseline stress, anxiety, depression and quality of life were assessed using validated tools. The participants were then randomly divided into three groups: a) those who received visualization therapy with standard imageries involving the body and its strengths (sVT), b) those who received visualization therapy using indigenous family oriented imageries (mVT) and c) a control group who received supportive therapy. There were six sessions spread over two months for each group. The psychological outcome variables were measured post intervention. Appropriate statistical analyses were done. Results:Both forms of visualization therapy were more effective than supportive therapy alone in reducing patients’ depression, anxiety and quality of life.Modified VT proved to be significantly more effective in improving patients’ anxiety and quality of life. Conclusion: Visualization is a valuable therapeutic option for reduction of psychological distress and improving quality of life of breast cancer patients.In order to be more effective, the images used need to be modified according to the sociocultural background and individual needs of the patients.

Keywords: breast cancer, visualization therapy, quality of life, anxiety, depression

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Authors: Constance Chivengwa, Tinashe Mandimutsira, Jephris Gere, Charles Magogo, Irene Chikanza, Jerneja Vidmar, Walter Chingwaru

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The use of traditional methods in the management of diarrhoea has remained a common practice among the indigenous African tribes of Southern Africa. Despite the widespread use of traditional medicines in Zimbabwe, very little research validating the activities of phytomedicines against diarrhoea, as claimed by the Shona people of Zimbabwe, has been reported. This study sought to determine the efficacies of the plants that are frequently used to treat stomach complaints, namely Dicoma anomala, Cassia abbreviata, Lannea edulis and Peltophorum africanum against Escherichia coli (an indicator of faecal contamination of water, and whose strains such as EHEC (O157), ETEC and EPEC, are responsible for a number of outbreaks of diarrhoea) and Salmonella spp. Ethanol and aqueous extracts from these plants were obtained, evaporated, dried and stored. The dried extracts were reconstituted and diluted 10-fold in nutrient broth (from 100 to 0.1 microgram/mL) and tested for inhibition against the bacteria. L. edulis exhibited the best antimicrobial effect (minimum inhibition concentration = 10 microgram/mL for both extracts and microorganisms). Runners up to L. edulis were C. abbreviata (20 microgram/mL for both microorganisms) and P. africanum (20 and 30 microgram/mL respectively). Interestingly, D. anomala, which is widely considered panacea in African medicinal practices, showed low antimicrobial activity (60 and 100 microgram/mL respectively). The high antimicrobial activity of L. edulis can be explained by its content of flavonoids, tannins, alkylphenols (cardonol 7 and cardonol 13) and dihydroalkylhexenones. The antimicrobial activities of C. abbreviata can be linked to its content of anthraquinones and triterpenoids. P. africanum is known to contain benzenoids, flavanols, flavonols, terpenes, xanthone and coumarins. This study therefore demonstrated that, among the plants that are used against diarrhoea in African traditional medicine, L. edulis is a clear winner against E. coli and Salmonella spp. Activity guided extraction is encouraged to establish the complement of compounds that have antimicrobial activities.

Keywords: diarrhoea, Escherichia coli, Salmonella, phytomedicine, MIC, Zimbabwe

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Authors: Luciano Tarantino, Emanuele Balzano, Aurelio Nasto

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S.R. 53 years. January 2009: HCV-related cirrhosis, Child-Pugh A5 class, EGDS no aesophageal Varices. No important comorbidities. Treated with PEG-IFN+Ribavirin (march-november 2009) with subsequent sustained virologic response. HCVRNA absent overtime. October 2016 :CT detected small HCC nodule in the VIII segment (diam.=12 mm). Treated with US guided RF-ablation. November 2016 CT: complete necrosis. Unfortunately, the patient dropped out US and CT follow-up controls.September 2018: asthenia and weight loss. CT showed a large tumor infiltrating V-VII-VI segments and complete PVTT of right portal vein and its branches . Surgical Consultation excluded indication to Liver resection and OLT . 23 october 2018: ECT of a large peri-hilar area of the tumor including the PVTT. 1 and 3 months post-treatment CT showed complete necrosis and retraction of the thrombus and residual viable tumor in the peripheral portion of the right lobe . Therefor, the patient was reevaluated for OLT and considered eligible in waiting list . March 2019: CT showed no perihilar or portal vein recurrence and distant progression in the right lobe . March 2019 : Trans-arterial-Radio-therapy (TARE) of the right lobe. Post-treatment CT demonstrated no perihilar or portal vein recurrence and extensive necrosis of the residual tumor . December 2019: CT demonstrated several recurrences of HCC infiltrating the VI and VII segment . Howewer no recurrence was observed at hepatic hilum and in portal vessels . Therefore, on February 2020 the patient received OLT. At 44 months follow-up, no complication or recurrence or liver disfunction have been observed.

Keywords: hepatocellular carcinoma, portal vein tumor thrombosis, interventional ultrasound, liver tumor ablation, liver transplantation

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Authors: Mei Sze Wong, Huanyu Mou, Wai-Tong Chien

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Background: Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Therefore, breastfeeding promotion is an important topic for infant health; whereas, different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal, or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches of educational and supportive interventions to improve breastfeeding. Outcome measures were exclusive breastfeeding, partial breastfeeding, and breastfeeding self-efficacy, being analyzed in terms of ≤ 2 months, 3-5 months, and ≥ 6 months postpartum. Method: Eleven electronic databases and the reference lists of eligible articles were searched. English or Chinese articles of randomized controlled trials on educational and supportive intervention with the above breastfeeding outcomes over recent 20 years were searched. Quality appraisal and risk of bias of the studies were checked by Effective Public Health Practice Project tool and Revised Cochrane risk-of-bias tool, respectively. Results: 13 articles that met the inclusion criteria were included; and they had acceptable quality and risk of bias. The optimal structure, format, and delivery of the interventions significantly increased exclusive breastfeeding rate at ≤ 2 months and ≥ 6 months and breastfeeding self-efficacy at ≤ 2 months included: (a) delivering from antenatal to postnatal period, (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups, (c) both individual and group basis, (d) being guided by self-efficacy theory, and (e) having ≥ 3 sessions. Conclusion: The findings showed multicomponent theory-based interventions with ≥ 3 sessions that delivered across antenatal and postnatal period; using both face-to-face teaching and telephone follow-ups can be useful to enhance exclusive breastfeeding rate for more than 6 months and breastfeeding self-efficacy over the first two months of postpartum.

Keywords: breastfeeding self-efficacy, education, exclusive breastfeeding, primiparous, support

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Authors: C. A. Roberts, J. G. Andrae, S. R. Smith, M. H. Poore, C. A. Young, D. W. Hancock, G. J. Pent

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To the author’s best knowledge, there are no published reports of effective methods for teaching fescue toxicosis and grass endophyte technology in the USA. To address this need, a group of university scientists, industry representatives, government agents, and livestock producers formed an organization called the Alliance for Grassland Renewal. One goal of the Alliance was to develop a teaching method that could be employed across all regions in the USA and all sectors of the agricultural community. The first step in developing this method was identification of experts who were familiar with the science and management of fescue toxicosis. The second step was curriculum development. Experts wrote a curriculum that addressed all aspects of toxicosis and management, including toxicology, animal nutrition, pasture management, economics, and mycology. The curriculum was created for presentation in lectures, laboratories, and in the field. The curriculum was in that it could be delivered across state lines, regardless of peculiar, in-state recommendations. The curriculum was also unique as it was unanimously supported by private companies otherwise in competition with each other. The final step in developing this teaching method was formulating a delivery plan. All experts, including university, industry, government, and production, volunteered to travel from any state in the USA, converge in one location, teach a 1-day workshop, then travel to the next location. The results of this teaching method indicate widespread success. Since 2012, experts across the entire USA have converged to teach Alliance workshops in Kansas, Oklahoma, Missouri, Kentucky, Georgia, South Carolina, North Carolina, and Virginia, with ongoing workshops in Arkansas and Tennessee. Data from post-workshop surveys indicate that instruction has been effective, as at least 50% of the participants stated their intention to adopt the endophyte technology presented in these workshops. The teaching method developed by the Alliance for Grassland Renewal has proved to be effective, and the Alliance continues to expand across the USA.

Keywords: endophyte, Epichloe coenophiala, ergot alkaloids, fescue toxicosis, tall fescue

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Authors: Neuma Chaveiro, Juliana Guimarães Faria

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Introduction: The thematic that guides this study is teacher training for the teaching of sign language in a perspective of bilingual education – specifically aimed at Brazilian public schools that offer inclusive education, and that have, among its students, deaf children who use Brazilian Sign Language as a means of communication and expression. In the Teacher Training Course for Letters/Libras at the Universidade Federal de Goiás/UFG, we developed a bilingual education project for the deaf, linked to PIBID (Institutional Scholarship for Teaching Initiation Program), funded by the Brazilian Federal Government through CAPES (Coordination for the Improvement of Higher Education Personnel). Goals: to provide the education of higher education teachers to work in public schools in basic education and to insert students from the UFG’s Letters/Libras course in the school’s daily life, giving them the opportunity for the creation and participation in methodological experiences and of teaching practices in order to overcome the problems identified in the teaching-learning process of deaf students, in a bilingual perspective, associating Libras (Brazilian Sign Language) and Portuguese. Methodology: qualitative approach and research-action, prioritizing action – reflection – action of the people involved. The Letters-Libras PIBID of the College of Letters/UFG, in this qualitative context, is guided by the assumptions of investigation-action to contribute to the education of the Libras teacher. Results: production of studies and researches in the area of education, professionalization and teaching practice for the degree holder in Letters: Libras; b) studies, research and training in bilingual education; c) clarification and discussion of the myths that permeate the reality of users of sign languages; d) involving students in the development of didactic materials for bilingual education. Conclusion: the PIBID Project Letters/Libras allows, both to the basic education school and to the teachers in training for the teaching of Libras, an integrated and collective work partnership, with discussions and changes in relation to bilingual education for the deaf and the teaching of Libras.

Keywords: deaf, sign language, teacher training, educacion

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Authors: Dalia Bhattacharjee

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Motherhood as an institution is considered as sacred. Reproduction and motherhood have always been a concern of the private space of home. However, with the emergence of technologies like the Assisted Reproductive Technologies (ARTs), this intimate area has moved into the public. A woman can now become a mother with artificial insemination done by expert medical professionals in a hospital. With this development, the meanings of motherhood and childrearing have altered. Mothers have been divided into ‘ovarian mothers’ (those who provide the eggs), ‘uterine mothers’ (those who carry out the pregnancy and give birth), and ‘social mothers’ (those who raise the child). Thus, the ART business deconstructs motherhood by defining who the biological mother is and who the social mother is and who – despite contributing parts or processes of her body to the life of the child is not a mother, but merely the donor of a product, be it the egg or the womb, which is owned by those who are favoured by the contract. The industry of commercial surrogacy in India has been estimated to be of $2.3 billion as of 2012. There are many women who work as surrogate mothers in this industry for the exchange of money. It runs like a full-fledged business guided by a highly profit oriented capitalist market. The reproductive labourers are identified as mere womb renters or victims and not as active agents in such arrangements. Such a discourse undercuts the agency exercised by the women. The present study is an ethnography into the commercial surrogacy industry in India. This journey furthers the understanding of the dilemmas faced by the reproductive labourers. The paper emphasizes on the experiences of reproduction and motherhood outside the private space of the home in the commercial surrogacy industry in India, and, argues that this multiplicity of experiences need much focus and attention, where, the consumer becomes ‘the’ citizen and the women workers continue to be victims. The study draws on the narratives of the reproductive labourers, who remain at the center, and yet, at the periphery of such arrangements. This feminist ethnography is informed by the feminist standpoint theory to account for and analyse these varied experiences which further the understanding of the dilemmas faced by the reproductive labourers.

Keywords: commercial surrogacy, ethnography, motherhood, standpoint theory

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Authors: Endalew Jibat, Feyera Senbeta, Tesfaye Zeleke, Fitsum Hagos

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Water governance considers multi-sector participation beyond the state; and for sustainable use of water resources, appropriate laws, policies, regulations, and institutions needs to be developed and put in place. Water policy, a critical and integral instrument of water governance, guided water use schemes and ensures equitable water distribution among users. The Ethiopian Central Rift Valley (CRV) is wealthy of water resources, but these water resources are currently under severe strain owing to an imbalance in human-water interactions. The main aim of the study was to examine the state of water resources governance in the CRV of Ethiopia, and the impact of the Ethiopian Water Resources Management Policy on water governance. Key informant interviews (KII), focused group discussions, and document reviews were used to gather data for the study. The NVivo 11 program was used to organize, code, and analyze the data. The results revealed that water resources governance practices such as water allocation and apportionment, comprehensive and integrated water management plans, water resources protection, and conservation activities were rarely implemented. Water resources management policy mechanisms were not fully put in place. Lack of coherence in water policy implementation, absence of clear roles and responsibilities of stakeholders, absence of transparency and accountability in irrigation water service delivery, and lack of meaningful participation of key actors in water governance decision-making were the primary shortcomings observed. Factors such as over-abstraction, deterioration of buffer zone, and chemical erosion from surrounding farming have contributed to the reduction in water volume and quality in the CRV. These challenges have influenced aquatic ecosystem services and threaten the livelihoods of the surrounding communities. Hence, reforms relating to policy coherence and enforcement, stakeholder involvement, water distribution strategies, and the application of water governance principles must be given more emphasis.

Keywords: water resources, irrigation, governance, water allocation, governance principles, stakeholders engagement, central rift valley

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Authors: Fortune Mangara

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The world is undergoing the largest wave of urban growth in history due to rapid urbanization. Africa’s fast rate of urbanization is being driven by several factors such as population growth and migration. Urbanization results in development pressure on existing infrastructure, and numerous existing buildings are being destroyed in the process. Many of these buildings are built by environmental heritage resources which are part of the city's heritage and are therefore valuable. Many built environment heritage resources are currently being destroyed due to development pressure, while others are facing the risk of destruction or abandonment. There are different approaches that inform urban development and urban conservation. The modernist and post-modernist dichotomy has played an influencing role on how development or conservation of built environment heritage resources are approached. The fragmented nature of historical urban conservation paradigms and theories are also reflected in the evolution of policy and legislation that guide urban development and conservation of built heritage resources. Urban development and conservation have a long history of being guided by separated policies and legislation. However, recent international and South African policy and legislation had started to acknowledge the importance of integrating urban development and urban conservation. Spatial planning guides urban development and can be used as an integrative tool. With the aforementioned in mind, the main research question that guides this study is: What role does spatial planning play in the coexistence of urban development and urban conservation in a city in transition? The main purpose of this research is to use spatial planning as a tool for integrating urban conservation and urban development with reference to built environmental heritage resources. A qualitative research methodology is going to be employed in which a singular case study will be used as the research design. A qualitative document analysis will be used to collect data. Potchefstroom is going to be used as a case study as it is the oldest town in the North West province therefore is rich in built environmental heritage resources.

Keywords: built environmental heritage resources, document analysis, spatial planning, urban conservation, urban development

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Authors: Jennifer Hunter, Francisco Ramirez, Neil A. Nedley, Thania Solorio, Christian Freed, Erica Kinjo

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People who have autoimmune disease are often at an increased risk for psychological disorders such as anxiety. Untreated psychological conditions can affect the development of disease and can affect one’s general quality of life. In this study, it was hypothesized that an educational community-based intervention would be useful in decreasing the anxiety levels of participants with autoimmune disease. Programs, 2-hours long each, were held weekly over a period of eight weeks. During every meeting, a 45-minute DVD presentation by a skilled physician was shown, a small group discussion was guided by trained facilitators, and weekly practical assignments were given to each participant. The focus of the program was to educate participants about healthy lifestyle behaviors such as exercise, nutrition, sleep hygiene, helpful thought patterns etc., and to provide a group environment in which each participant was supported. Participants were assessed pre-post program for anxiety using the Depression and Anxiety Assessment Test (registration TX 7-398-022), a validated mental health test based on DSM-5 criteria and demographics. Anxiety scores were classified according to the DSM-5 criteria into 4 categories: none (0-6), mild (7-10), moderate (11-19) or severe (20 or more). Out of the participants who participated in programs conducted in the manner explained above (n=431), the average age was 54.9 (SD 16.6) and 81.9% were female. At baseline, the mean group anxiety level was 9.4 (SD 5.4). Within the baseline group, anxiety levels were as follows: none (21.1%), mild (22.0%), moderate (27.1%) and severe (29.7%). After the program, mean group anxiety decreased to 4.7 (SD 4.0). Post-program anxiety levels were as follows: none (54.8%), mild (27.1%), moderate (12.5%), severe (5.6%). The decrease in overall anxiety levels was significant t(431)=19.3 p<.001, 95% CI [0.815, 1.041]. It was concluded that the eight-week intensive was beneficial in decreasing the anxiety levels of participants. A long-term follow-up study would be beneficial in determining how lasting such improvements are especially since autoimmune diseases are often chronic. Additionally, future studies that utilize a control group would aid in establishing whether the improvements seen are due to the use of this specific lifestyle-educational program.

Keywords: anxiety, auto-immune disease, community-based educational program, lifestyle

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Authors: Ncedo Cameron Xhala

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Several public sector institutions lack policy direction on how to successfully implement their large infrastructure investment projects. It is significant to improve strategic policy direction in public sector institutions in order to improve planning, management and implementation of large infrastructure investment projects. It is significant to improve an understanding of internal and external pressures that exerts pressure on large infrastructure projects. The significance is to fulfill the public sector’s mandate, align the sectors’ scarce resources, stakeholders and to improve project management processes. The study used a case study approach which was underpinned by a constructionist approach. The study used a theoretical sampling technique when selecting study participants, and was followed by a snowball sampling technique that was used to select an identified case study project purposefully. The study was qualitative in nature, collected and analyzed qualitative empirical data from the purposefully selected five subject matter experts and has analyzed the case study documents. The study used a semi-structured interview approach, analysed case study documents in a qualitative approach. The interviews were on a face-to-face basis and were guided by an interview guide with focused questions. The study used a three coding process step comprising of one to three steps when analysing the qualitative empirical data. Findings reveal that an improvement of strategic policy direction in public sector institutions improves the integration in planning, management and on implementation on large infrastructure investment projects. Findings show the importance of understanding the external and internal pressures when implementing public sector’s large infrastructure investment projects. The study concludes that strategic policy direction in public sector institutions results in improvement of planning, financing, delivery, monitoring and evaluation and successful implementation of the public sector’s large infrastructure investment projects.

Keywords: implementation, infrastructure, investment, management

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Authors: Saira Maqbool, Qaisara Parveen, Muhammad Arshad Dahar

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Improving females' involvement in management and enterprises in Pakistan requires the development of female entrepreneurs as leaders. Entrepreneurial education aims for providing students the knowledge, aptitudes and motivation to energize innovative accomplishment in various settings. Assortments of venture instruction are advertised at all stages of mentoring, from fundamental or discretionary institutes through graduate institutional platforms. The business enterprise will be considered the procedure by which a looming business visionary or business person pursues after openings without respect to the resources they directly regulate. This entails the ability of the business visionary to join every single other generation. This study explores the relationship between developing Women's Leadership skills and Entrepreneurship Education The essential reason for this consider was to analyze the role of Entrepreneurship Edification (EE) towards women's Leadership and develop entrepreneurial intentions among students. The major goal of this study was to foster entrepreneurial attitudes among PMAS Arid Agriculture University undergraduate students concerning their choice to work for themselves. This study focuses on the motivation and interest of female students in the social sciences to build entrepreneurial leadership skills. The quantitative analysis used a true-experimental, pretest-posttest control group research design. Female undergraduate students from PMAS Arid Agriculture University made up the study population. For entrepreneurial activity, a training module has been created. The students underwent a three-week training program at PMAS Arid Agriculture University, where they learned about entrepreneurial leadership abilities. The quantitative data were analyzed using descriptive statistics and T-tests. The findings indicated that students acquired entrepreneurial leadership skills and intentions after training. They have decided to launch their businesses as leaders. It is advised that other PMAS Arid Agriculture University departments use the training module and course outline because the research's usage of them has important results.

Keywords: business, entrepreneurial, intentions, leadership, women

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Authors: Cytha Nilam Chairani, Ditha Noviantika, Hidayati Amir, Nurul Khairiyah, Siti Rahmadita, Fadila Khairani

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Background: Dental caries is one of the most common diseases with high prevalence in children. The first permanent molar (FPM) has an essential role in establishing the occlusion. Nevertheless, FPM is very prone to caries because of various factors, such as their anatomical structure and early emergence in oral cavity. It is due to the little knowledge from parents and children regarding the timing of emergence of FPM in oral cavity which is still considered as primary teeth. Furthermore, the lack of knowledge from parents and children may affect their oral hygiene practice resulting to carious process. Objective: The aim of this study was to assess the status of FPM caries and its association with children’s oral hygiene practice in 9-12-year-old school children in Lubuk Kilangan Community Health Centre, Padang City. Methods: A cross-sectional study was performed in 50 school children (9-12 years old) using random sampling technique from two randomly selected schools in Lubuk Kilangan Community Health Centre, Padang City. A questionnaire was developed from other studies consisting of four closed ended questions regarding oral health practice. The data obtained were analyzed statistically using Mann-Whitney Test to assess the status of FPM caries and its association with children’s oral hygiene practice. Results: The results showed that 32% of children had FPMs sound and the remaining 68% had FPMs carious which were grouped into 1-2 FPMs carious (60%) and 3-4 FPMs carious (8%). The caries status of mandibular FPM (64%) was higher compared to maxillary FPM (10%). Conclusion: There was significant association in subject who did not visit dentist in the last 6 months which had more carious FPMs compared to subject who visited dentist (p < 0.05). There was no significant association between the status of FPM caries and knowledge of the timing eruption of FPM, oral hygiene instruction from parents and tooth brushing (p > 0.05).

Keywords: dental caries, children, first permanent molar, oral hygiene practice

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Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

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Authors: Jakub Vávra, Milan Valenta, Petr Kosek

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This article presents a perspective on the conduct of the dramatherapy process with persons with addictive behaviours with regard to the directiveness of the process. Although drama therapy as one of the creative arts approaches is rather non-directive in nature, depending on the clientele, there may be a need to structure the process more and, depending on the needs of the clients, to guide the process more directive. The specificity for people with addictive behaviours is discussed through the prism of the dramatherapeutic perspective, where we can find both a psychotherapeutic component as well as a component touching on expression and art, which is rather non-directive in nature. Within the context of practice with clients, this theme has repeatedly emerged and dramatherapists themselves have sought to find ways of coping with clients' demands and needs for structure and guidance within the dramatherapy process. Some of the outcomes from the supervision work also guided the research. Based on this insight, the research questions were approached. The first research question asks: in what ways is directive in dramatherapy manifested and manifested in the process? The second research question then complements the first and asks: to which phenomena are directivity in dramatherapy linked? In relation to the research questions, data were collected using focus groups and field notes. The qualitative approach of Content analysis and Relational analysis was chosen as the methodology. For analyzing qualitative research, we chose an Inductive coding scheme: Open coding, Axial coding, Pattern matching, Member checking, and Creating a coding scheme. In the presented partial research results, we find recurrent schemes related to directive coding in drama therapy. As an important element, directive leadership emerges in connection with safety for the client group, then in connection with the clients' order and also the department of the facility, and last but not least, to the personality of the drama therapist. By careful analysis and looking for patterns in the research results, we can see connections that are impossible to interpret at this stage but already provide clues to our understanding of the topic and open up further avenues for research in this area.

Keywords: dramatherapy, directivity, personal approach, aims of dramatherapy process, safetyness

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Authors: Karen Jacob

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Over the last decades, there has been a rise in the use of CLIL (content and language integrated learning) methodology as a way of reinforcing FL (foreign language) acquisition. CLIL techniques have also been transferred to the formal instruction-based FL classroom where through content-based lessons and project work it can very often say that teachers are ‘clilling’ in the FL classroom. When it comes to motivating students to acquire an FL, we have to take into account that English is not your run-of-the-mill FL: English is an international language (EIL). Consequently, this means that EFL students should be able to use English as an international medium of communication. This leads to the assumption that along with FL competence, speakers of EIL will need to become competent international citizens with knowledge of other societies, both contextually and geographically, and be flexible, open-minded, respectful and sensitive towards other world groups. Rather than ‘intercultural’ competence we should be referring to ‘transcultural’ competence. This paper reports the implementation of a content- and task-based approach to EFL teaching which was applied to two groups of 15 year-olds from two schools on the Spanish island of Mallorca during the school year 2015-2016. Students worked on three units of work that aimed at ‘internationalising’ the classroom by introducing topics that would encourage them to become transculturally aware of the world in which they live. In this paper we discuss the feedback given by the teachers and students on various aspects of the approach in order to answer the following research questions: 1) To what extent were the students motivated by the content and activities of the classes?; 2) Did this motivation have a positive effect on the students’ overall results for the subject; 3) Did the participants show any signs of becoming transculturally aware. Preliminary results from qualitative data show that the students enjoyed the move away from the more traditional EFL content and, as a result, they became more competent in speaking and writing. Students also appeared to become more knowledgeable and respectful towards the ‘other’. The EFL approach described in this paper takes a more qualitative approach to research by describing what is really going on in the EFL classroom and makes a conscious effort to provide real examples of not only the acquisition of linguistic competence but also the acquisition of other important communication skills that are of utmost importance in today's international arena.

Keywords: CLIL, content- and task-based learning, internationalisation, transcultural competence

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Authors: Aliseydi Bozkurt

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Objectives: Benign prostatic hyperplasia (BPH) is the most common benign disease, and prostate cancer (PC) is malign disease of the prostate gland. Transrectal ultrasound-guided biopsy (TRUS-bx) is one of the most important diagnostic tools in PC diagnosis. Identifying men at increased risk for having a biopsy detectable prostate cancer should consider prostate specific antigen density (PSAD), f/t PSA Ratio, an estimate of prostate volume. Method: We retrospectively studied 269 patients who had a prostate specific antigen (PSA) score of 4 or who had suspected rectal examination at any PSA level and received TRUS-bx between January 2015 and June 2018 in our clinic. TRUS-bx was received by 12 experienced urologists with 12 quadrants. Prostate volume was calculated prior to biopsy together with TRUS. Patients were classified as malignant and benign at the end of pathology. Age, PSA value, prostate volume in transrectal ultrasonography, corpuscle biopsy, biopsy pathology result, the number of cancer core and Gleason score were evaluated in the study. The success rates of PV, PSAD, and f/tPSA were compared in all patients and those with PSA 2.5-10 ng/mL and 10.1-30 ng/mL tp foresee prostate cancer. Result: In the present study, in patients with PSA 2.5-10 ng/ml, PV cut-off value was 43,5 mL (n=42 < 43,5 mL and n=102 > 43,5 mL) while in those with PSA 10.1-30 ng/mL prostate volüme (PV) cut-off value was found 61,5 mL (n=31 < 61,5 mL and n=36 > 61,5 mL). Total PSA values in the group with PSA 2.5-10 ng/ml were found lower (6.0 ± 1.3 vs 6.7 ± 1.7) than that with PV < 43,5 mL, this value was nearly significant (p=0,043). In the group with PSA value 10.1-30 ng/mL, no significant difference was found (p=0,117) in terms of total PSA values between the group with PV < 61,5 mL and that with PV > 61,5 mL. In the group with PSA 2.5-10 ng/ml, in patients with PV < 43,5 mL, f/t PSA value was found significantly lower compared to the group with PV > 43,5 mL (0.21 ± 0.09 vs 0.26 ± 0.09 p < 0.001 ). Similarly, in the group with PSA value of 10.1-30 ng/mL, f/t PSA value was found significantly lower in patients with PV < 61,5 mL (0.16 ± 0.08 vs 0.23 ± 0.10 p=0,003). In the group with PSA 2.5-10 ng/ml, PSAD value in patients with PV < 43,5 mL was found significantly higher compared to those with PV > 43,5 mL (0.17 ± 0.06 vs 0.10 ± 0.03 p < 0.001). Similarly, in the group with PSA value 10.1-30 ng/mL PSAD value was found significantly higher in patients with PV < 61,5 mL (0.47 ± 0.23 vs 0.17 ± 0.08 p < 0.001 ). The biopsy results suggest that in the group with PSA 2.5-10 ng/ml, in 29 of the patients with PV < 43,5 mL (69%) cancer was detected while in 13 patients (31%) no cancer was detected. While in 19 patients with PV > 43,5 mL (18,6%) cancer was found, in 83 patients (81,4%) no cancer was detected (p < 0.001). In the group with PSA value 10.1-30 ng/mL, in 21 patients with PV < 61,5 mL (67.7%) cancer was observed while only in10 patients (32.3%) no cancer was seen. In 5 patients with PV > 61,5 mL (13.9%) cancer was found while in 31 patients (86.1%) no cancer was observed (p < 0.001). Conclusions: Identifying men at increased risk for having a biopsy detectable prostate cancer should consider PSA, f/t PSA Ratio, an estimate of prostate volume. Prostate volume in PC was found lower.

Keywords: prostate cancer, prostate volume, prostate specific antigen, free/total PSA ratio

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