Search results for: outcome based curriculum

Authors: Carlos V. Gonzalez

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Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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Authors: Judson P. LaGrone

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Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

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Authors: Busra Nur Ozguler Aktel

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This research aims to understand the factors that affect the ways in which tribes perceive and respond to violent conflicts in fragile states, given that tribes are essential stakeholders in many conflict-ridden fragile states, whether Afghanistan, Iraq, Syria, Libya, Somalia, Nigeria, or Yemen. It explores the primary questions of why some tribes align with extremist groups while others align with states during civil wars and why some tribes switch alignments. It argues that tribes form and switch alignments based on their perception of threats to their traditional tribal structure (internal dynamics) and clientelist relationships (external dynamics). Put differently; threat perceptions lead them to choose either the state or extremist groups that will more likely secure their traditional structure and patronage networks. This study focuses on Iraqi tribes as a case study. It builds a theory of tribal alignment formation based on ethnographic fieldwork in the Middle East, with a particular focus on Iraqi Sunni tribes living in the Kurdish region of Iraq and Jordan. As a result of the interviews with tribal leaders and members, local journalists, researchers, and politicians, it concludes that complex (re)alignments of tribes can determine the course and outcome of the conflicts, either mitigating or escalating violence. This study contributes to the larger body of conflict management and peacebuilding literature by introducing tribes as non-state actors and exploring their interactions with other actors in civil wars.

Keywords: civil wars, tribes, alignment formation, side-switching, Iraq

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Authors: Wenru Wang

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Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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Authors: Smita Mathur

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Play is an innate, player-centric, joyful, fundamental activity of early childhood development that significantly contributes to social, emotional, and academic learning. Leveraging the power of play can enhance these domains by creating engaging, interactive, and developmentally appropriate learning experiences for young children. This research aimed to systematically examine young children’s play behaviors with a focus on four primary objectives: (1) the frequency and duration of on-task behaviors, (2) social interactions and emotional expressions during play, (3) the correlation between academic skills and play, and (4) identifying best practices for integrating play-based curricula. To achieve these objectives, a mixed-method study was conducted among young preschool-aged children in low socio-economic populations in the United States. The children were identified using purposive sampling. The children were observed during structured play in classrooms and unstructured play during outdoor playtime and in their home environments. The study sampled 97 preschool-aged children. A total of 3970 minutes of observations were coded to address the research questions. Thirty-seven percent of children lived in linguistically isolated families, and 76% lived in basic budget poverty. Children lived in overcrowded housing situations (67%), and most families had mixed citizenship status (66%). The observational study was conducted using the observation protocol during the Oxford Study Project. On-task behaviors were measured by tracking the frequency and duration of activities where children maintained focus and engagement. In examining social interactions and emotional expressions, the study recorded social interactions, emotional responses, and teacher involvement during play. The study aimed to identify best practices for integrating play-based curricula into early childhood education. By analyzing the effectiveness of different play-based strategies and their impact on on-task behaviors, social-emotional development, and academic skills, the research sought to provide actionable recommendations for educators and caregivers. The findings from study 1. Highlight play behaviors that increase on-task behaviors and academic, & social skills in young children. 2. Offers insights into teacher preparation and designing play-based curriculum 3. Research critiques observation as a data collection technique.

Keywords: play, early childhood education, social-emotional development, academic development

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Authors: Nazir Amir

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Teaching approaches to present science and mathematics content amongst academically-low-achieving students may need to be different than approaches that are adopted for the more academically-inclined students, primarily due to the different learning needs and learning styles of these students. In crafting out lessons to motivate and engage these students, teachers need to consider the backgrounds of these students and have a good understanding of their interests so that lessons can be presented in ways that appeal to them, and made relevant not just to the world around them, but also to their personal experiences. This presentation highlights how the author worked with a Professional Learning Community (PLC) of teachers in crafting out fun and feasible classroom teaching approaches to present science and mathematics content in ways that are made Relevant, Appealing, and Personal (RAP) to groups of academically-low-achieving students in Singapore. Feedback from the students and observations from their work suggest that they were engaged through the RAP-modes of instruction, and were able to appreciate the role of science and mathematics through a variety of low-cost design-based STEM (Science, Technology, Engineering, and Mathematics) activities. Such results imply that teachers teaching academically-low-achieving students, and those in under-resourced communities, could consider infusing RAP-infused instructions into their lessons in getting students develop positive attitudes towards STEM subjects.

Keywords: STEM Education, STEAM Education, Curriculum Instruction, Academically At-Risk Students, Singapore

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Authors: S. K. Subah, R. Tasnim, M. I. Jahan, M. R. Islam

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While talking about how comfortable and convenient Dhaka's bus service is, the minimum emphasis is placed on the female commuters of the Dhaka city. Recognizing the contemporary situation, the supreme focus is to develop experimental model based on statistical methods. SEM has been adopted to quantify passenger satisfaction, which is affected by the perceived service quality. The study deals with 16 observed variables and three latent variables, which were correlated to identify their significance on the regulation of perceived SQ (Service Quality). To calibrate the model, a dataset of 250 responses from female users of local buses has been utilized through survey. A questionnaire structured with SQ variables was prepared in consultation with prevailing literature, practitioners, academicians, and users. The result concludes that the attributes of safe and secured environment have the most significant impact on the overall bus service quality according to the insight of female respondents. The study outcome might be a great help for the policymakers, women's organizations, and NGOs to formulate transport policy that will ensure a women-friendly public bus service.

Keywords: bus service quality, female perception, structural equation modelling, safety-security, women friendly bus

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Authors: Jotham Mazhura

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Floriculture production is an ideal project for sustainable horticultural production in Masvingo city.Gender links in collaboration with the embasy of Sweedenare supporting the floriculture project with the aim of improving residents livelihoods in the city.World trade in floriculture such as cut flowers,live ornamental plants and foliage continue to increase and there are recognised markets opportunities across the globe.Some specific opportunitiesin an interview discussion by the consultant appointed by gender links and embasy of Sweeden highlightedsome constraints and opportunities in the project of floriculture in Masvingo city.Based on the outcome of the scoping studies this research project developed and evaluated strategies for enhancing floriculture production in Masvingo city. A survey was therefore carried out by the researcher among the existing florists farmers in the city to determine strategies to be employed to improve floriculture production.The survey was conducted to twenty florists in the city.The sample was taken by using purposive sampling which is a sampling technique based on the certain considerations, hence there were some basic creteria in selecting samples. A questionnaire in this aspect was administered to the 20 florists to determine the essential strategies to be employed to enhance floriculture production.Each respondent was given data for the business strategies and asked to rank those strategies from the most to the least important.From the research findings the following were revealed out by the respondents that is capturing marketshare,establishment of of ownership of the project,the project manager to be innovative,the business should gain competitive strategic through generic strategies market development strategy and product development strategy. Based on the observation and structured interview with respondents the average of floriculture owners had similar strategies implemented on their business.The research proved that floriculture farmers use various strategies to keep their businesses running and succeding in achieving set goals.Therefore the ressearche who happens to be the project focal person became certain that it is edeal to emply a variety of of strategies to improve floriculture oproduction

Keywords: florist, floriculture, strategy, livelihoods

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Authors: Eisa M. Al-Balhan, Mamdouh M. Soliman

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This study introduced learning styles techniques into mathematics teaching to improve mathematics achievement and motivation among Kuwaiti fourth- and fifth-grade low achievers. The study consisted of two groups. The control group (N = 212) received traditional math tutoring based on a textbook and the tutor’s knowledge of math. The experimental group (N = 209) received math tutoring from instructors trained in the Learning Style™ approach. Three instruments were used: Motivation Scale towards Mathematics; Achievement in Mathematics Test; and the manual of learning style approach indicating the individual’s preferred learning style: AKV, AVK, KAV, KVA, VAK, or VKA. The participating teachers taught to the detected learning style of each student or group. The findings show significant improvement in achievement and motivation towards mathematics in the experimental group. The outcome offers information to variables affecting achievement and motivation towards mathematics and demonstrates the leading role of Kuwait in education within the region.

Keywords: elementary school, learning style, math low achievers, SmartWired™, math instruction, motivation

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Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

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Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

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Authors: Anjula Negi, D. T. V. Raghu Ramaswamy, Rajneesh Sareen

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Road infrastructure is emphatically one of the top most critical infrastructure to the Indian economy. Road network in the country of around 3.3 million km is the second largest in the world. Nationwide statistics released by Ministry of Road, Transport and Highways reveal that every minute an accident happens and one death every 3.7 minutes. This reported scale in terms of safety is a matter of grave concern, and economically represents a national loss of 3% to the GDP. Union Budget 2016-17 has allocated USD 12 billion annually for development and strengthening of roads, an increase of 56% from last year. Thus, highlighting the importance of roads as critical infrastructure. National highway alone represent only 1.7% of the total road linkages, however, carry over 40% of traffic. Further, trends analysed from 2002 -2011 on national highways, indicate that in less than a decade, a 22 % increase in accidents have been reported, but, 68% increase in death fatalities. Paramount inference is that accident severity has increased with time. Over these years many measures to increase road safety, lessening damage to physical assets, reducing vulnerabilities leading to a build-up for resilient road infrastructure have been taken. In the context of national highway development program, policy makers proposed implementation of around 20 % of such road length on PPP mode. These roads were taken up on high-density traffic considerations and for qualitative implementation. In order to understand resilience impacts and safety parameters, enshrined in various PPP concession agreements executed with the private sector partners, such highway specific projects would be appraised. This research paper would attempt to assess such safety measures taken and the possible reasons behind an increase in accident severity through these PPP case study projects. Delving further on safety features to understand policy measures adopted in these cases and an introspection on reasons of severity, whether an outcome of increased speeds, faulty road design and geometrics, driver negligence, or due to lack of discipline in following lane traffic with increased speed. Assessment exercise would study these aspects hitherto to PPP and post PPP project structures, based on literature review and opinion surveys with sectoral experts. On the way forward, it is understood that the Ministry of Road, Transport and Highway’s estimate for strengthening the national highway network is USD 77 billion within next five years. The outcome of this paper would provide an understanding of resilience measures adopted, possible options for accessible and safe road network and its expansion to policy makers for possible policy initiatives and funding allocation in securing critical infrastructure.

Keywords: national highways, policy, PPP, safety

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Authors: Budiman Budiman

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This research aimed at describing and testing whether the students’ ability in writing analytical exposition text is increased by using comic strips at SMAN 12 Pekanbaru. The respondents of this study were the second-grade students, especially XI Science 3 academic year 2011-2012. The total number of students in this class was forty-two (42) students. The quantitative and qualitative data was collected by using writing test and observation sheets. The research finding reveals that there is a significant increase of students’ writing ability in writing analytical exposition text through comic strips. It can be proved by the average score of pre-test was 43.7 and the average score of post-test was 65.37. Besides, the students’ interest and motivation in learning are also improved. These can be seen from the increasing of students’ awareness and activeness in learning process based on observation sheets. The findings draw attention to the use of comic strips in teaching and learning is beneficial for better learning outcome.

Keywords: analytical exposition, comic strips, secondary school students, writing ability

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Authors: Muhammad Yusuf Sulfarano Barusman

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Research for the strategic formulation of competitive advantage development on Indonesian Private Higher Education Institutions (IPHEI) is mostly done using positivistic paradigm by means of analytical thinking. This study emphasized of the participatory paradigm by using synthesis as a way of thinking in order to achieve its goal. The purposes of this study are to: 1) build future scenario of the external environmental dynamics that will be encountered by IPHEI, 2) formulate a strategy that can be implemented by IPHEI through developing the organization's competitive advantage in the future. The used research methodology is Participatory Prospective Analysis (PPA). The results showed that the future scenario of external environmental conditions that will be encountered by IPHEI in the future can be described in three conditions, namely: optimistic, moderate, and pessimistic scenarios. The strategic formulation from the research results is based on four internal factors as its foundation (the effectiveness of leadership, the availability of funds and financing, the effectiveness of human resource management strategy, and the relevance of curriculum). A set of resulted strategic formulation is knowledge of the experts that needed to be followed up wisely so that their use can be optimized for the development of IPHE organizational competitive advantage in the future.

Keywords: competitive advantage, participatory prospective analysis, PPA, private higher education institutions, PHEI, strategic formulation

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Authors: Madhuri S. Ghate, Rahul P. Chavhan, Shriya S. Nahar

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Learning objective: •To describe Magnetic Resonance Imaging (MRI) imaging appearances of typical and atypical uterine fibroids with emphasis on differentiating it from other similar conditions. •To classify uterine fibroids according to International Federation of Gynecology and Obstetrics (FIGO) Sub-classifications system and emphasis on its clinical significance. •To show cases with atypical imaging appearances atypical fibroids Material and methods: MRI of Pelvis had been performed in symptomatic women of child bearing age group on 1.5T and 3T MRI using T1, T2, STIR, FAT SAT, DWI sequences. Contrast was administered when degeneration was suspected. Imaging appearances of Atypical fibroids and various degenerations in fibroids were studied. Fibroids were classified using FIGO Sub-classification system. Its impact on surgical decision making and clinical outcome were also studied qualitatively. Results: Intramural fibroids were most common (14 patients), subserosal 7 patients, submucosal 5 patients . 6 patients were having multiple fibroids. 7 were having atypical fibroids. (1 hyaline degeneration, 1 cystic degeneration, 1 fatty, 1 necrosis and hemorrhage, 1 red degeneration, 1 calcification, 1 unusual large bilobed growth). Fibroids were classified using FIGO system. In uterus conservative surgeries, the lesser was the degree of myometrial invasion of fibroid, better was the fertility outcome. Conclusion: Relationship of fibroid with mucosal and serosal layers is important in the management of symptomatic fibroid cases. Risk to fertility involved in uterus conservative surgeries in women of child bearing age group depends on the extent of myometrial invasion of fibroids. FIGO system provides better insight into the degree of myometrial invasion. Knowledge about the atypical appearances of fibroids is important to avoid diagnostic confusion and untoward treatment.

Keywords: degeneration, FIGO sub-classification, MRI pelvis, uterine fibroids

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Authors: Karen V. Lee

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The background and significance of this study involve communication in education by a faculty advisor exploring story and music that informs others about a disabled teacher. Social issues draw deep reflection about the emotional turmoil. As a musician becoming a teacher is a passionate yet complex endeavor, the faculty advisor shares a poetic but painful story about a disabled teacher being inducted into the teaching profession. The qualitative research method as theoretical framework draws on autoethnography of music and story where the faculty advisor approaches a professor for advice. His musicianship shifts her forward, backward, and sideways through feelings that evoke and provoke curriculum to remove communication barriers in education. They discover they do not transfer knowledge from educational method classes. Instead, the autoethnography embeds musical language as a metaphorical conduit for removing communication barriers in teacher education. Sub-themes involve communication barriers and educational technologies to ensure teachers receive social, emotional, physical, spiritual, and intervention disability resources that evoke visceral, emotional responses from the audience. Major findings of the study discover how autoethnography of music and story bring the authors to understand wider political issues of the practicum internship for teachers with disabilities. An epiphany reveals the irony of living in a culture of both uniformity and diversity. They explore the constructs of secrecy, ideology, abnormality, and marginalization by evoking visceral and emotional responses from the audience. As the voices harmonize plot, climax, characterization, and denouement, they dramatize meaning that is episodic yet incomplete to highlight the circumstances surrounding the disabled protagonist’s life. In conclusion, the qualitative research method argues for embracing storied experiences that depict communication in education. Scholarly significance embraces personal thoughts and feelings as a way of understanding social phenomena while highlighting the importance of removing communication barriers in education. The circumstance about a teacher with a disability is not uncommon in society. Thus, the authors resolve to removing barriers in education by using stories to transform the personal and cultural influences that provoke new ways of thinking about the curriculum for a disabled teacher.

Keywords: communication in education, communication barriers, autoethnography, teaching

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Authors: Isaac Benning

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Using technology to expand the learning space is critical for a productive mathematical discourse. This is a case study of two teachers who developed and enacted GeoGebra-based mathematics lessons following their engagement in a two-year professional development. The didactical and semiotic affordance of GeoGebra in widening the learning space for a productive mathematical discourse was explored. The approach of thematic analysis was used for lesson artefact, lesson observation, and interview data. The results indicated that constructing tools in GeoGebra provided a didactical milieu where students used them to explore mathematical concepts with little or no support from their teacher. The prompt feedback from the GeoGebra motivated students to practice mathematical concepts repeatedly in which they privately rethink their solutions before comparing their answers with that of their colleagues. The constructing tools enhanced self-discovery, team spirit, and dialogue among students. With regards to the semiotic construct, the tools widened the physical and psychological atmosphere of the classroom by providing animations that served as virtual concrete to enhance the recording, manipulation, testing of a mathematical idea, construction, and interpretation of geometric objects. These findings advance the discussion of widening the classroom for a productive mathematical discourse within the context of the mathematics curriculum of Ghana and similar Sub-Saharan African countries.

Keywords: GeoGebra, theory of didactical situation, semiotic mediation, mathematics laboratory, mathematical discussion

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Authors: Kristy Howells, Catherine Meehan

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This position paper presents current research findings into the proposed gap between teachers’ and practitioners’ thinking and acting about physical activity health and well-being in childhood. Within the new Primary curriculum, there is a focus on sustained physical activity within a Physical Education and healthy lifestyles in Personal, Health, Social and Emotional lessons, but there is no curriculum guidance about what sustained physical activity is and how it is defined. The current health guidance on birth to five suggests that children should not be inactive for long periods and specify light and energetic activities, however there is the a suggested period of time per day for young children to achieve, but the guidance does not specify how this should be measured. The challenge therefore for teachers and practitioners is their own confidence and understanding of what “good / moderate intensity” physical activity and healthy living looks like for children and the children understanding what they are doing. There is limited research about children from birth to eight years and also the perceptions and attitudes of those who work with this age group of children, however it was found that children at times can identify different levels of activity and it has been found that children can identify healthy foods and good choices for healthy living at a basic level. Authors have also explored teachers’ beliefs about teaching and learning and found that teachers could act in accordance to their beliefs about their subject area only when their subject knowledge, understanding and confidence of that area is high. It has been proposed that confidence and competence of practitioners and teachers to integrate ‘well-being’ within the learning settings has been reported as being low. This may be due to them not having high subject knowledge. It has been suggested that children’s life chances are improved by focusing on well-being in their earliest years. This includes working with parents and families, and being aware of the environmental contexts that may impact on children’s wellbeing. The key is for practitioners and teachers to know how to implement these ideas effectively as these key workers have a profound effect on young children as role models and due to the time of waking hours spent with them. The position paper is part of a longitudinal study at Canterbury Christ Church University and currently we will share the research findings from the initial questionnaire (online, postal, and in person) that explored and evaluated the knowledge, competence and confidence levels of practitioners and teachers as to the structure and planning of sustained physical activity and healthy lifestyles and how this progresses with the children’s age.

Keywords: health, perceptions, physical activity, well-being

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Authors: Teklay Gebrecherkos, Dawit Wolday, Muhamud Abdulkader

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Background: COVID-19 symptomatology in Africa appears significantly less serious than in the industrialized world. Our hypothesis for this phenomenon, being a different, more activated immune system due to parasite infections contributes to reduced COVID-19 outcome. We investigated this hypothesis in an endemic area in sub sub-saharan Africa. Methods: Ethiopian COVID-19 patients were enrolled and screened for intestinal parasites, between July 2020 and March 2021. The primary outcome was the proportion of patients with severe COVID-19. SARS-CoV-2 infection was confirmed by RT-PCR on samples obtained from nasopharyngeal swabs, while direct microscopic examination, modified Ritchie concentration, and Kato-Katz methods were used to identify parasites and ova from a fresh stool sample. Ordinal logistic regression models were used to estimate the association between parasite infection and COVID-19 severity. Models were adjusted for sex, age, residence, education level, occupation, body mass index, and comorbidities. Data were analyzed using STATA version 14. P-value <0.05 was considered statistically significant. Results: A total of 751 SARS-CoV-2 infected patients were enrolled, of whom 284 (37•8%) had an intestinal parasitic infection. Only 27/255 (10•6%) severe COVID-19 patients were co-infected with intestinal parasites, while 257/496 (51•8%) non-severe COVID-19 patients appeared parasite positive (p<0.0001). Patients co-infected with parasites had lower odds of developing severe COVID-19, with an adjusted odds ratio (AOR) of 0•14 (95% CI 0•09–0•24; p<0•0001) for all parasites, AOR 0•20 ([95% CI 0•11–0•38]; p<0•0001) for protozoa, and AOR 0•13 ([95% CI 0•07–0•26]; p<0•0001) for helminths. When stratified by species, co-infection with Entamoeba spp., Hymenolopis nana, and Schistosoma mansoni implied a lower probability of developing severe COVID-19. There were 11 deaths (1•5%), and all were among patients without parasites (p=0•009). Conclusions: Parasite co-infection is associated with a reduced risk of severe COVID-19 in African patients. Parasite-driven immunomodulatory responses may mute hyper-inflammation associated with severe COVID-19.

Keywords: COVID-19, SARS-COV-2, intestinal parasite, RT-PCR, co-infection

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Authors: Shahinaz El-Shourbagy El-Shourbagy, Ahmed M. E Ossman Ossman, Ashraf El-Mohamady El-Mohamady

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Objective: To investigate if there is a role of sildenafil citrate (Viagra) in the treatment of infertile couples for idiopathic cause. Design: An observational study. Setting: Infertility outpatient clinic of Tanta University Hospital Egypt. Patient(s): 50 unexplained infertility women {endometrial thickness (EM) and the mean resistance index (RI)} compared to 50 fertile control group attended for check-up in the same period and receiving no treatment. Intervention(s): unexplained infertility women were given 25 mg of sildenafil citrate suppositories four times per day for seven days starting from the 5th day of the menstrual cycle for three cycles. Main Outcome Measures: EM and RI of endometrial spiral artery were assessed by transvaginal color-pulsed Doppler ultrasound in unexplained infertility women before and after sildenafil citrate treatment and compared with control. The conception rate and pregnancy outcome were recorded in the two groups. Result(s): Women with unexplained infertility had significantly thinner endometrium and a higher spiral artery resistance index, meaning lower peri-implantation blood flow than the fertile controls. Sildenafil citrate treated women showed a statistically significant increase in endometrial thickness (p < 0.001) and a significant decrease in the mean spiral artery resistance index (p < 0.001) giving a better conception rate. Conclusion: Sildenafil citrate suppositories treatment enhance the endometrial blood flow through decreasing spiral artery resistance index 'RI' and consequently improve endometrial growth and receptivity in cases of unexplained infertility thus giving a better conception rate.

Keywords: Unexplained infertility, endometrial blood flow, endome¬trial receptivity, color-pulsed Doppler ultrasound; RI (resis¬tance index, Sildenafil citrate (Viagra)

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Authors: Jonathan Magala

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Context: Adolescents in Uganda face significant challenges related to sexual health due to inadequate sexual information. This lack of information puts young people at risk of early pregnancies, sexually transmitted infections, and poverty. Therefore, it is essential to understand the sources, content, and challenges of acquiring sexual information among secondary school-going adolescents in Uganda. Research Aim: The aim of this study was to establish the sources, content, and challenges of acquiring sexual information among secondary school-going adolescents in Luwero Town Council, Uganda. Methodology: This study used a cross-sectional approach with both qualitative and quantitative methods. Questionnaires and in-depth interviews were conducted with 384 school-going adolescents aged between 13-19 years in Luwero Town Council, Uganda. Findings: The results of the study revealed that adolescents receive sexual information from various sources, with schools being the most common source, followed by parents and religious institutions being the least utilized. Adolescents received information on various topics related to sexuality, including puberty and sexual changes, pregnancy and reproduction, STD information, abstinence, and family planning. However, the content of sexual information was inadequate in addressing the challenges facing adolescents, and there were generation gaps, lack of role models, peer influence, and government policies. The male character from all the sources was the least in offering sexual information to adolescents. Theoretical Importance: The study's findings highlight the need for policy implementation to strengthen sexual education in school curriculum, as the sources of sexual information and the content are inadequate. The various topics should be addressed in schools to provide comprehensive education on sexual health for adolescents. Data Collection and Analysis Procedures: Data collection involved questionnaires and in-depth interviews with school-going adolescents. The data gathered were analyzed using descriptive statistics and thematic analysis. Questions Addressed: The study aimed to answer questions about the sources of sexual information among school-going adolescents, the content of sexual information provided, the challenges faced in accessing the information, and the importance of sex education policy implementation. Conclusion: The study concludes that schools are a popular source of sexual information among school-going adolescents in Uganda. However, the content of the information provided is inadequate in addressing the challenges that adolescents face regarding their sexual health. Therefore, policy implementation is essential in strengthening sexual education in the school curriculum and addressing various topics related to sexual health.

Keywords: adolescents, sexual information, schools, reproductive health

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Authors: Sanjeev Singh

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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.

Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection

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Authors: R. Suresh, C. B. Singh, A. K. Sarda

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Background: Over the decades, several surgical techniques have been developed to treat anal fistulas with variable success rates and complications. Large amount of work has been done in radiofrequency excision of the fistula for several years but no work has been done for ablating the tract. Therefore one can consider for obliteration ofanal fistula by Radiofrequency ablation (RFA). Material and Methods: A randomized controlled clinical trial was conducted at Lok Nayak Hospital, where a total of 40 patients were enrolled in the study and they were randomly assigned to Group I (fistulectomy)(n=20) and Group II (RFA) (n=20). Aim of the study was to compare the efficacy of RFA of fistula versus fistulectomy in the treatment of a low anal fistula and to evaluate RFA as an effective alternative to fistulectomy with respect to time taken for wound healing as primary outcome and post-operative pain, time taken to return to work as secondary outcomes. Patients with simple low anal fistulas, single internal and external opening, not more than two secondary tracts were included. Patients with high complex fistula, fistulas communicating with cavity, fistula due to condition like tuberculosis, Crohn's, malignancy were excluded from the study. Results: Both groups were comparable with respect to age, sex ratio, type of fistula. Themean healing time was significantly shorter in group II (41.02 days) than in group I(62.68 days).The mean operative time was significantly shorter in groupII (21.40 min) than in group I(28.50 min). The mean time taken to return to work was significantly shorter in group II(8.30 days)than in group I(12.01 days).There was no significant difference in the post operative hospital stay, mean postoperative pain score, wound infection and recurrence between the two groups. Conclusion: The patients who underwent RFA of fistula had shorter wound healing time, operative time and time taken to return to work when compared to those who underwent fistulectomy and therefore RFA shows outcome comparable to fistulectomy in the treatment of low anal fistula.

Keywords: fistulectomy, low anal fistula, radio frequency ablation, wound healing

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Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

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Background: The worldwide increase in pediatric presumptive tuberculosis (TB) is the most life-threatening challenge in effectively controlling TB. The objective of this study was to determine the proportion of presumptive TB and the factors associated with it. Methods: A cross-sectional study was conducted between March and November 2013 at ICDDR-Bangladesh. Two hundred twelve pulmonary and extra-pulmonary specimens were collected from 84 suspected pediatric patients diagnosed with TB based on their clinical symptoms/radiological findings. Presumptive TB and confirmed TB were considered presumptive TB and non-presumptive TB and were isolated by smear-microscopy, culture, and GeneXpert. Logistic regression was used to analyze associations between outcome and predictor variables. Results: The proportion of presumptive TB was 85.7%, and 14.3% of non-presumptive TB. In presumptive TB, vaccine scars, family TB history, and school-going children were 16.6%, 33.3%, and 56.9%, respectively. In contrast, vaccine scars and family TB history were 8.3%, and school-going children were 58.3% in non-presumptive TB. Significant factors did not appear in the logistic regression analysis. Conclusion: Despite the high proportion of presumptive TB, there was no statistically significant between presumptive TB and non-presumptive TB.

Keywords: presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis

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Authors: Liang Weichien

Abstract:

Without adequate information and mitigation plan for natural disaster, the risk to urban populated areas will increase in the future as populations grow, especially in Taiwan. Taiwan is recognized as the world's high-risk areas, where an average of 5.7 times of floods occur per year should seek to strengthen coherence and consensus in how cities can plan for flood and climate change. Therefore, this study aims at understanding the vulnerability to flooding in Taipei city, Taiwan, by creating indicators and calculating the vulnerability of each study units. The indicators were grouped into sensitivity and adaptive capacity based on the definition of vulnerability of Intergovernmental Panel on Climate Change. The indicators were weighted by using Principal Component Analysis. However, current researches were based on the assumption that the composition and influence of the indicators were the same in different areas. This disregarded spatial correlation that might result in inaccurate explanation on local vulnerability. The study used Geographically Weighted Principal Component Analysis by adding geographic weighting matrix as weighting to get the different main flood impact characteristic in different areas. Cross Validation Method and Akaike Information Criterion were used to decide bandwidth and Gaussian Pattern as the bandwidth weight scheme. The ultimate outcome can be used for the reduction of damage potential by integrating the outputs into local mitigation plan and urban planning.

Keywords: flood vulnerability, geographically weighted principal components analysis, GWPCA, highly urbanized area, spatial correlation

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Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

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Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

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Authors: E. N. Jansen van Vuuren

Abstract:

When visiting Foundation Phase (FP) students during their Teaching Practice at schools in rural Mpumalanga, the lack of music education is evident through the absence of musical sounds, with the exception of a limited repertoire of songs that are sung by all classes everywhere you go. The absence of music teaching resources such as posters and music instruments add to the perception that generalist teachers in the FP are not teaching music. Pre-service students also acknowledge that they have never seen a music class being taught during their teaching practice visits at schools. This lack of music mentoring impacts the quality of teachers who are about to enter the workforce and ultimately results in the perpetuation of no music education in many rural schools. The situation in more affluent schools present a contrasting picture with music education being given a high priority and generalist teachers often being supported by music specialists, paid for by the parents. When student teachers start their music course, they have limited knowledge to use as a foundation for their studies. The aim of the study was to ascertain the music knowledge that students gained throughout their school careers so that the curriculum could be adapted to suit their needs. By knowing exactly what pre-service teachers know about music, the limited tuition time at tertiary level can be used in the most suitable manner and concentrate on filling the knowledge gaps. Many scholars write about the decline of music education in South African schools and mention reasons, but the exact music knowledge void amongst students does not feature in the studies. Knowing the parameters of students’ music knowledge will empower lecturers to restructure their curricula to meet the needs of pre-service students. The research question asks, “what is the extent of the music void amongst rural pre-service teachers in a B.Ed. FP course at an African university?” This action research was done using a pragmatic paradigm and mixed methodology. First year students in the cohort studying for a B.Ed. in FP were requested to complete an online baseline assessment to determine the status quo. This assessment was compiled using the CAPS music content for Grade R to 9. The data was sorted using the elements of music as a framework. Findings indicate that students do not have a suitable foundation in music education despite supposedly having had music tuition from grade R to grade 9. Knowing the content required to fill the lack of knowledge provides academics with valuable information to amend their curricula and to ensure that future teachers will be able to provide rural learners with the same foundations in music as those received by learners in more affluent schools. It is only then that the rich music culture of the African continent will thrive.

Keywords: generalist educators, music education, music curriculum, pre-service teachers

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Authors: Kornanong Yuenyongchaiwat, Duangnate Pepatsitipong, Panthip Sangprasert

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High blood pressure and diabetes have been suggested as being non-communicable disease (NCDs), and there is one of the components of the definition of metabolic syndrome. Therefore, the purpose of this study was to evaluate the effect of a 12-week pedometer based community walking intervention on change in resting blood pressure and blood glucose in participants with overweight in the community setting. Method: Participants were recruited both males and females who had a sedentary lifestyle aged 35-59 years (mean aged 49.67 years). A longitudinal quasi-experimental study was designed with 35 overweight participants who had body mass index ≥ 25 kg/m2. These volunteers were assigned to the 12-week pedometer-based walking program (an accumulated at least 10,000 steps a day). Blood pressure and blood glucose were measured initially before and after 12-week intervention. Results: Systolic blood pressure and heart rate were significantly lower in 30 individuals who had accumulated 10,000 steps d-1 in the intervention group at 12 week follow-up (-13.74 mmHg and 5.3 bpm, respectively). In addition, reduction in blood glucose (-14.89 mmol) in the intervention participants was statistically significant (p < .001). A regression analysis indicated that reductions in systolic blood pressure were significantly related to the increase in steps per day. Conclusion: The accumulation of least 10,000 steps d-1 resulted in decreased resting systolic blood pressure and blood glucose in overweight participants. This has also shown that an increase in physical activity in overweight participants with sedentary lifestyle by accumulating at least 10,000 steps a day can reduce the risk of cardiovascular disease (e.g., hypertension and diabetes).

Keywords: blood glucose, blood pressure, diabetes, hypertension, physical activity, walking

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Authors: Robert Cui

Abstract:

COVID-19 has drastically changed the way students interact and engage with their environments. Students, in particular, have been forced to change from in-person to online learning. How can we ensure that students continue to remain motivated even as their mode of education transitions to online learning? In this study conducted on high school students from a small private school (n = 50), we investigate the factors that predict student motivation during online learning. Using the framework of self-determination theory, we examine the three facets of student motivation during online learning: engagement, autonomy, and competence. We find that students' perception of their peers' engagement with the curriculum, feelings of parental academic expectations, perceptions of favoritism by the teacher, and perceived clarity of instruction given by the teacher all predict student engagement in online learning. Student autonomy is predicted by the amount of parental control a student feels, the clarity of instruction given by the teacher, and also the amount to which a student is perceiving their peers to be paying attention. Finally, competence is predicted by favoritism a student perceives from a teacher and also the amount of which a student is perceiving their peers to be paying attention. Based on these findings, we provide insights on how three important stakeholders –parents, teachers, and peers can enhance students' motivation during online learning.

Keywords: academic performance, motivation, online learning, parental influence, teacher, peers

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Authors: Varinder Kaur, Amanjit Kaur, Simran Kaur, Samriti Vaid

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Coating of fabrics with anti-microbial dyes is an adaptable technique of protection from various diseases. Natural dyes, which are known to possess antibacterial properties, can be used for antibacterial finishing of fibers like cotton, wool, bamboo and so many. Dyeing of fabrics with natural dyes normally requires the use of mordants so that dyes can stay on the fabric as well as into interstices of the fabric during multiple washings. In this study, the mordants used are alum and chitosan for ensuring a reasonable color fastness to light and washing. Chitosan is a natural polysaccharide having significant biological and chemical properties such as biodegradability, biocompatibility, bioactivity, microbial activity and polycationicity. The metal ion of alum mordant can act as electron acceptor for electron donor to form coordination bond with the dye molecule, making them insoluble in water. The dyeing of bamboo fabric using a natural dye extracted from turmeric has been studied using conventional dyeing method. Natural dye was extracted using water as solvent by Soxhlet extraction method. The extracted color was characterized by spectroscopic studies like UV/visible and further tested for antimicrobial activity. The effect of mordants on the dyeing outcome in terms of colour depth as well as fastness properties of the dyeing was investigated. It has been found that employing the conventional dyeing technique at 100 oC, the mordanted samples were deeper in depth than their unmordanted counterparts. The results of fastness properties of the dyed fabrics were fair to good. Turmeric extract was found to enhance microbial resistance of bamboo as well as was itself as a good cause of coloration. These textiles dyed with the turmeric as natural dye can be very useful in developing clothing for infants, elderly and infirm people to protect them against common infections. The outcome of this study will provide a new feature to the interface of dyeing and pharmaceutical industry.

Keywords: antimicrobial activity, bamboo fabric, natural dye, turmeric

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Authors: Sonia Mastrangelo

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The Miller Umwelt Assessment Scale is a useful tool for obtaining information about the developmental capacities of children on the autism spectrum. The assessment, made up of 19 tasks in the areas of: body organization, contact with surroundings, expressive and receptive communication, representation, and social-emotional development, has been used with much success over the past 40 years. While many assessments are difficult to administer to children on the autism spectrum, the simplicity of the MUAS reveals key strengths and challenges for both low and high functioning children on the spectrum. The results guide parents and clinicians in providing a curriculum and/or home program that moves children up the developmental ladder.

Keywords: autism spectrum disorder, assessment, reading intervention, Miller method

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