Search results for: hiv/aids related knowledge
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15771

Search results for: hiv/aids related knowledge

4611 Thin Films of Glassy Carbon Prepared by Cluster Deposition

Authors: Hatem Diaf, Patrice Melinon, Antonio Pereira, Bernard Moine, Nicholas Blanchard, Florent Bourquard, Florence Garrelie, Christophe Donnet

Abstract:

Glassy carbon exhibits excellent biological compatibility with live tissues meaning it has high potential for applications in life science. Moreover, glassy carbon has interesting properties including 'high temperature resistance', hardness, low density, low electrical resistance, low friction, and low thermal resistance. The structure of glassy carbon has long been a subject of debate. It is now admitted that glassy carbon is 100% sp2. This term is a little bit confusing as long sp2 hybridization defined from quantum chemistry is related to both properties: threefold configuration and pi bonding (parallel pz orbitals). Using plasma laser deposition of carbon clusters combined with pulsed nano/femto laser annealing, we are able to synthesize thin films of glassy carbon of good quality (probed by G band/ D disorder band ratio in Raman spectroscopy) without thermal post annealing. A careful inspecting of Raman signal, plasmon losses and structure performed by HRTEM (High Resolution Transmission Electron Microscopy) reveals that both properties (threefold and pi orbitals) cannot coexist together. The structure of the films is compared to models including schwarzites based from negatively curved surfaces at the opposite of onions or fullerene-like structures with positively curved surfaces. This study shows that a huge collection of porous carbon named vitreous carbon with different structures can coexist.

Keywords: glassy carbon, cluster deposition, coating, electronic structure

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4610 Exploring Affordable Care Practs in Nigeria’s Health Insurance Discourse

Authors: Emmanuel Chinaguh, Kehinde Adeosun

Abstract:

Nigerians die untimely, with 55.75 years of life expectancy, which is 17.45 below the world average of 73.2 (Worldometer, 2020). This is due, among other factors, to the country's limited access to high-quality healthcare. To increase access to good and affordable healthcare services, the National Health Insurance Authority (NHIA) Bill 2022 – which repealed the National Health Insurance Scheme Act 2004 – was passed into law. Applying Jacob Mey’s (2001) pragmatics act (pract) theory, this study explores how NHIA seeks to actualise these healthcare goals by characterising the general situational prototype or pragmemes and pragmatic acts in institutional communications. Data was sourced from the NHIA operational guidelines, which has 147 pages and four sections, and shared posters on NHIA Nigeria Twitter Handle with 14,200 followers. Digital humanities tools, like AntConc and Voyant, were engaged in the data analysis for text encoding and data visualisation. This study identifies these discourse tokens in the data: advertisement and programmes, standards and accreditation, records and information, and offences and penalties. Advertisement and programmes pract facilitating, propagating, prospecting, advising and informing; standards and accreditation, and records and information pract stating, informing and instructing; and offences and penalties pract stating and sanctioning. These practs combined to advance the goals of affordable care and universal accessibility to quality healthcare services. The pragmatic acts were marked by these pragmatic tools: shared situational knowledge (SSK), relevance (REL), reference (REF) and inference (INF). This paper adds to the understanding of health insurance discourse in Nigeria as a mediated social practice that promotes the health of Nigerians.

Keywords: affordable care, NHIA, Nigeria’s health insurance discourse, pragmatic acts.

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4609 Online Information Seeking: A Review of the Literature in the Health Domain

Authors: Sharifah Sumayyah Engku Alwi, Masrah Azrifah Azmi Murad

Abstract:

The development of the information technology and Internet has been transforming the healthcare industry. The internet is continuously accessed to seek for health information and there are variety of sources, including search engines, health websites, and social networking sites. Providing more and better information on health may empower individuals, however, ensuring a high quality and trusted health information could pose a challenge. Moreover, there is an ever-increasing amount of information available, but they are not necessarily accurate and up to date. Thus, this paper aims to provide an insight of the models and frameworks related to online health information seeking of consumers. It begins by exploring the definition of information behavior and information seeking to provide a better understanding of the concept of information seeking. In this study, critical factors such as performance expectancy, effort expectancy, and social influence will be studied in relation to the value of seeking health information. It also aims to analyze the effect of age, gender, and health status as the moderator on the factors that influence online health information seeking, i.e. trust and information quality. A preliminary survey will be carried out among the health professionals to clarify the research problems which exist in the real world, at the same time producing a conceptual framework. A final survey will be distributed to five states of Malaysia, to solicit the feedback on the framework. Data will be analyzed using SPSS and SmartPLS 3.0 analysis tools. It is hoped that at the end of this study, a novel framework that can improve online health information seeking is developed. Finally, this paper concludes with some suggestions on the models and frameworks that could improve online health information seeking.

Keywords: information behavior, information seeking, online health information, technology acceptance model, the theory of planned behavior, UTAUT

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4608 Service Flow in Multilayer Networks: A Method for Evaluating the Layout of Urban Medical Resources

Authors: Guanglin Song

Abstract:

(Objective) Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. (Methods) A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city.(Conclusion) The findings reveal that:1.there exists overall maldistribution and over-concentration of healthcare resources in Study Area, characterized by structural imbalance; 2.the low rate of primary care utilization in Study Area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem; 3.gradual optimization of the healthcare facility layout in Study Area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance.(Prospects) This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. Provide some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: flow of public services, urban networks, healthcare facilities, spatial planning, urban networks

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4607 A Possible Connection Between Taste Change and Zinc Deficiency after Bariatric Surgery: A Literature Review

Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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4606 Improvement plan for Integrity of Intensive Care Unit Patients Withdrawn from Life-Sustaining Medical Care

Authors: Shang-Sin Shiu, Shu-I Chin, Hsiu-Ju Chen, Ru-Yu Lien

Abstract:

The Hospice and Palliative Care Act has undergone three revisions, making it less challenging for terminal patients to withdraw life support systems. However, the adequacy of care before withdraw is a crucial factor in end-of-life medical treatment. The author observed that intensive care unit (ICU) nursing staff often rely on simple flowcharts or word of mouth, leading to inadequate preparation and failure to meet patient needs before withdraw. This results in confusion or hesitation among those executing the process. Therefore, there is a motivation to improve the withdraw of patient care processes, establish standardized procedures, ensure the accuracy of removal execution, enhance end-of-life care self-efficacy for nursing staff, and improve the overall quality of care. The investigation identified key issues: the lack of applicable guidelines for ICU care for withdraw from life-sustaining, insufficient education and training on withdraw and end-of-life care, scattered locations of withdraw-related tools, and inadequate self-efficacy in withdraw from life-sustaining care. Solutions proposed include revising withdraw care processes and guidelines, integrating tools and locations, conducting educational courses, and forming support groups. After the project implementation, the accuracy of removal cognition improved from 78% to 96.5%, self-efficacy in end-of-life care after removal increased from 54.7% to 93.1%, and the correctness of care behavior progressed from 27.7% to 97.8%. It is recommended to regularly conduct courses on removing life support system care and grief consolation to enhance the quality of end-of-life care.

Keywords: the intensive care unit (ICU) patients, nursing staff, withdraw life support systems, self-efficacy

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4605 A Plant-Insect Association for Enhancing Survival of an Ecosystem Engineer Termite Species in a Semi-Arid Savanna

Authors: G. Nampa, M. Ndlovu

Abstract:

Mutualistic relationships amongst organisms drive diversity in terrestrial ecosystems. Yet, few mutual associations have been documented in the semi-arid savannas of Africa. The levels and benefits of association between Carissa bispinosa, a medium-sized evergreen thorny shrub, and Trinervitermes trinervoides, an ecosystem engineer termite species, were studied at a semi-arid savanna setting in Nylsvley nature reserve, South Africa. It was hypothesized that there would be a close plant-insect association since termite mounds provide nutrients for plant growth and, in return, the thorny shrubs protect mounds from predation and also provide a temperature buffer. Comparative plant and mounds measurements were taken from associated and isolated occurrences seasonally. Soil particle size, macro- and micronutrients were also evaluated from mounds and the adjacent topsoil matrix General Additive Mixed Models were used to assess internal mound temperatures in relation to prevailing ambient and plant shade temperatures. Findings revealed that plants growing on mounds were significantly taller with a wider canopy and remained greener in the dry season with more fruits. On the other hand, termite mounds under plants were less prone to be damaged by aardvarks and pangolins and had a significantly wider diameter than exposed mounds. All soil macronutrients except for calcium and phosphorous were enriched in mounds relative to the matrix. Only Manganese was enriched in mounds while the other micronutrients (Cu, Fe, Zn and B) were not. Termite mounds under plants maintained a better constant and higher mean internal temperature during winter compared to exposed mounds. To our best knowledge, the study has revealed a previously undocumented survival mechanism that termites use to escape extreme temperatures and predation in semi-arid savannas.

Keywords: mound, mutualism, soil nutrients, termites, thermoregulation

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4604 Subsurface Structures Related to the Hydrocarbon Migration and Accumulation in the Afghan Tajik Basin, Northern Afghanistan: Insights from Seismic Attribute Analysis

Authors: Samim Khair Mohammad, Takeshi Tsuji, Chanmaly Chhun

Abstract:

The Afghan Tajik (foreland) basin, located in the depression zone between mountain axes, is under compression and deformation during the collision of India with the Eurasian plate. The southern part of the Afghan Tajik basin in the Northern part of Afghanistan has not been well studied and explored, but considered for the significant potential for oil and gas resources. The Afghan Tajik basin depositional environments (< 8km) resulted from mixing terrestrial and marine systems, which has potential prospects of Jurrasic (deep) and Tertiary (shallow) petroleum systems. We used 2D regional seismic profiles with a total length of 674.8 km (or over an area of 2500 km²) in the southern part of the basin. To characterize hydrocarbon systems and structures in this study area, we applied advanced seismic attributes such as spectral decomposition (10 - 60Hz) based on time-frequency analysis with continuous wavelet transform. The spectral decomposition results yield the (averaging 20 - 30Hz group) spectral amplitude anomaly. Based on this anomaly result, seismic, and structural interpretation, the potential hydrocarbon accumulations were inferred around the main thrust folds in the tertiary (Paleogene+Neogene) petroleum systems, which appeared to be accumulated around the central study area. Furthermore, it seems that hydrocarbons dominantly migrated along the main thrusts and then concentrated around anticline fold systems which could be sealed by mudstone/carbonate rocks.

Keywords: The Afghan Tajik basin, seismic lines, spectral decomposition, thrust folds, hydrocarbon reservoirs

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4603 A Levinasian Perspective on the Field of Applied Ethics

Authors: Payman Tajalli, Steven Segal

Abstract:

Applied ethics is an area of ethics which is looked upon most favorably as the most appropriate and useful for educational purposes; after all if ethics finds no application would any investment of time, effort and finance by the educational institutions be warranted? The current approaches to ethics in business and management often entail appealing to various types of moral theories and to this end almost every major philosophical approach has been enlisted. In this paper, we look at ethics through the philosophy of Emmanuel Levinas to argue that since ethics is ‘first philosophy’ it can neither be rule-based nor rule-governed, not something that can be worked out first and then applied to a given situation, hence the overwhelming emphasis on ‘applied ethics’ as a field of study in business and management education is unjustified. True ethics is not applied ethics. This assertion does not mean that teaching ethical theories and philosophies need to be abandoned rather it is the acceptance of the fact that an increase in cognitive awareness of such theories and ethical models and frameworks, or the mastering of techniques and procedures for ethical decision making, will not affect the desired ethical transformation in our students. Levinas himself argued for an ethics without a foundation, not one that required us to go ‘beyond good and evil’ as Nietzsche contended, rather an ethics which necessitates going ‘before good and evil'. Such an ethics does not provide us with a set of methods or techniques or a decision tree that enable us determine the rightness of an action and what we ought to do, rather it is about a way of being, an ethical posture or approach one takes in the inter-subjective relationship with the other that holds the promise of ethical conduct. Ethics in this Levinasian sense then is one of infinite and unconditional responsibility for the other person in relationship, an ethics which is not subject to negotiation, calculation or reciprocity, and as such it could neither be applied nor taught through conventional pedagogy with its focus on knowledge transfer from the teacher to student, and to this end Levinas offers a non-maieutic, non-conventional approach to pedagogy. The paper concludes that from a Levinasian perspective on ethics and education, we may need to guide our students to move away from the clear and objective professionalism of the management and applied ethics towards the murky individual spiritualism. For Levinas, this is ‘the Copernican revolution’ in ethics.

Keywords: business ethics, ethics education, Levinas, maieutic teaching, ethics without foundation

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4602 The Extent of Land Use Externalities in the Fringe of Jakarta Metropolitan: An Application of Spatial Panel Dynamic Land Value Model

Authors: Rahma Fitriani, Eni Sumarminingsih, Suci Astutik

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In a fast growing region, conversion of agricultural lands which are surrounded by some new development sites will occur sooner than expected. This phenomenon has been experienced by many regions in Indonesia, especially the fringe of Jakarta (BoDeTaBek). Being Indonesia’s capital city, rapid conversion of land in this area is an unavoidable process. The land conversion expands spatially into the fringe regions, which were initially dominated by agricultural land or conservation sites. Without proper control or growth management, this activity will invite greater costs than benefits. The current land use is the use which maximizes its value. In order to maintain land for agricultural activity or conservation, some efforts are needed to keep the land value of this activity as high as possible. In this case, the knowledge regarding the functional relationship between land value and its driving forces is necessary. In a fast growing region, development externalities are the assumed dominant driving force. Land value is the product of the past decision of its use leading to its value. It is also affected by the local characteristics and the observed surrounded land use (externalities) from the previous period. The effect of each factor on land value has dynamic and spatial virtues; an empirical spatial dynamic land value model will be more useful to capture them. The model will be useful to test and to estimate the extent of land use externalities on land value in the short run as well as in the long run. It serves as a basis to formulate an effective urban growth management’s policy. This study will apply the model to the case of land value in the fringe of Jakarta Metropolitan. The model will be used further to predict the effect of externalities on land value, in the form of prediction map. For the case of Jakarta’s fringe, there is some evidence about the significance of neighborhood urban activity – negative externalities, the previous land value and local accessibility on land value. The effects are accumulated dynamically over years, but they will fully affect the land value after six years.

Keywords: growth management, land use externalities, land value, spatial panel dynamic

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4601 Microthermometry of Carbonated Rocks of the Hondita-Lomagorda Formations, the Tiger Cave Sector, Municipality of Yaguara, Colombia

Authors: Camila Lozano-Vivas, Camila Quevedo-Villamil, Ingrid Munoz-Quijano, Diego Loaiza

Abstract:

Colombia's limited oil reserves make the finding of new fields of extraction or the potentiate of the existing ones a more important task to do every day; the exploration projects that allow to have a better knowledge of the oil basins are essential. The upper Magdalena Valley basin - VSM, whose reserves are limited, has been one of the first basins for the exploration and production of hydrocarbons in Colombia. The Hondita and Lomagorda formations were deposited in the Late Cretaceous Middle Albian to the Coniacian and are characterized by being the hydrocarbon-generating rocks in the VSM basin oil system along with the Shale de Bambucá; therefore multiple studies have been made. In the oil industry, geochemical properties are used to understand the origin, migration, accumulation, and alteration of hydrocarbons and, in general, the evolution of the basin containing them. One of the most important parameters to understand this evolution is the formation temperature of the oil system. For this reason, a microthermometric study of fluid inclusions was carried out to recognize formation temperatures and to determine certain basic physicochemical variables, homogenization temperature, pressure, density and salinity of the fluid at the time of entrapment, providing evidence on the history of different events in different geological environments in the evolution of a sedimentary basin. Prior to this study, macroscopic and microscopic petrographic analyses of the samples collected in the field were performed. The results of the mentioned properties of the fluid inclusions in the different samples analyzed have salinities ranging from 20.22% to 26.37% eq. by weight NaCl, similar densities found in the ranges of 1.05 to 1.16 g/cc and an average homogenization temperature at 142.92°C, indicating that, at the time of their entanglement, the rock was in the window of generation of medium hydrocarbons –light with fragile characteristics of the rock that would make it useful to treat them as naturally fractured reservoirs.

Keywords: homogenization temperature, fluid inclusions, microthermometry, salinity

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4600 Specific Language Impairment: Assessing Bilingual Children for Identifying Children with Specific Language Impairment (SLI)

Authors: Manish Madappa, Madhavi Gayathri Raman

Abstract:

The primary vehicle of human communication is language. A breakdown occurring in any aspect of communication may lead to frustration and isolation among the learners and the teachers. Over seven percent of the population in the world currently experience limitations and those children who exhibit a deviant/deficient language acquisition curve even when being in a language rich environment as their peers may be at risk of having a language disorder or language impairment. The difficulty may be in the word level [vocabulary/word knowledge] and/or the sentence level [syntax/morphology) Children with SLI appear to be developing normally in all aspects except for their receptive and/or expressive language skills. Thus, it is utmost importance to identify children with or at risk of SLI so that an early intervention can foster language and social growth, provide the best possible learning environment with special support for language to be explicitly taught and a step in providing continuous and ongoing support. The present study looks at Kannada English bilingual children and works towards identifying children at risk of “specific language impairment”. The study was conducted through an exploratory study which systematically enquired into the narratives of young Kannada-English bilinguals and to investigate the data for story structure in their narrative formulations. Oral narrative offers a rich source of data about a child’s language use in a relatively natural context. The fundamental objective is to ensure comparability and to be more universal and thus allows for the evaluation narrative text competence. The data was collected from 10 class three students at a primary school in Mysore, Karnataka and analyzed for macrostructure component reflecting the goal directed behavior of a protagonist who is motivated to carry out some kind of action with the intention of attaining a goal. The results show that the children exhibiting a deviation of -1.25 SD are at risk of SLI. Two learners were identified to be at risk of Specific Language Impairment with a standard deviation of more the 1.25 below the mean score.

Keywords: bilingual, oral narratives, SLI, macrostructure

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4599 Consolidation Behavior of Lebanese Soil and Its Correlation with the Soil Parameters

Authors: Robert G. Nini

Abstract:

Soil consolidation is one of the biggest problem facing engineers. The consolidation process has an important role in settlement analysis for the embankments and footings resting on clayey soils. The settlement amount is related to the compression and the swelling indexes of the soil. Because the predominant upper soil layer in Lebanon is consisting mainly of clay, this layer is a real challenge for structural and highway engineering. To determine the effect of load and drainage on the engineering consolidation characteristics of Lebanese soil, a full experimental and synthesis study was conducted on different soil samples collected from many locations. This study consists of two parts. During the first part which is an experimental one, the Proctor test and the consolidation test were performed on the collected soil samples. After it, the identifications soil tests as hydrometer, specific gravity and Atterberg limits are done. The consolidation test which is the main test in this research is done by loading the soil for some days then an unloading cycle was applied. It takes two weeks to complete a typical consolidation test. Because of these reasons, during the second part of our research which is based on the analysis of the experiments results, some correlations were found between the main consolidation parameters as compression and swelling indexes with the other soil parameters easy to calculate. The results show that the compression and swelling indexes of Lebanese clays may be roughly estimated using a model involving one or two variables in the form of the natural void ratio and the Atterberg limits. These correlations have increasing importance for site engineers, and the proposed model also seems to be applicable to a wide range of clays worldwide.

Keywords: atterberg limits, clay, compression and swelling indexes, settlement, soil consolidation

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4598 Bilateral Thalamic Hypodense Lesions in Computing Tomography

Authors: Angelis P. Barlampas

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Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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4597 Comparative Study of Analgesic Efficacy of Ultrasound Guided Femoral Nerve Block Versus Intravenous Fentanyl Injection in Fracture Femur Patients at Emergency Department

Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly

Abstract:

Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.

Keywords: femur fracture, nerve block, fentanyl, ultrasound guided

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4596 Genetic Polymorphism in the Vitamin D Receptor Gene and 25-Hydroxyvitamin D Serum Levels in East Indian Women with Polycystic Ovary Syndrome

Authors: Dipanshu Sur, Ratnabali Chakravorty

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Background: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in women with PCOS. Variants on vitamin D receptor (VDR) gene have also been related to metabolic comorbidities in general population. Aim: The aim of this case-control study was to investigate whether the VDR gene polymorphisms are associated with susceptibility to PCOS. Methods: Women with PCOS and a control group, all aged 16-40 years, were enrolled. Genotyping of VDR Fok-I (rs2228570), VDR Apa-I (rs7975232) as well as GC (rs2282679), DHCR7 (rs12785878) SNPs between groups were determined by using direct sequencing. Serum 25-hydroxyvitamin D [25(OH)] levels were measured by ELISA. Results: Mean serum 25(OH)D in the PCOS and control samples were 19.08±7 and 23.27±6.03 (p=0.048) which were significantly lower in PCOS patients compared with controls. CC genotype of the VDR Apa-I SNP was same frequent in PCOS (25.6%) and controls (25.6%) (OR: 0.9995; 95%CI: 0.528 to 1.8921; p= 0.9987). The CC genotype was also significantly associated with both lower E2 (p=0.031) and Androstenedione levels (p=0.062). We observed a significant association of GC polymorphism with 25(OH)D levels. PCOS women carrying the GG genotype (in GC genes) had significantly higher risk for vitamin D deficiency than women carrying the TT genotype. Conclusions: In conclusion, data from this study indicate that vitamin D levels are lower, and vitamin D deficiency more frequent, in PCOS than in controls. The present findings suggest that the Apa-I, Fok-I polymorphism of the VDR gene is associated with PCOS and seems to modulate ovarian steroid secretion. Further studies are needed to better clarify the biological mechanisms by which the polymorphism influences PCOS risk.

Keywords: vitamin D receptor, polymorphism, vitamin D, polycystic ovary syndrome

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4595 The Performance of Natural Light by Roof Systems in Cultural Buildings

Authors: Ana Paula Esteves, Diego S. Caetano, Louise L. B. Lomardo

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This paper presents an approach to the performance of the natural lighting, when the use of appropriated solar lighting systems on the roof is applied in cultural buildings such as museums and foundations. The roofs, as a part of contact between the building and the external environment, require special attention in projects that aim at energy efficiency, being an important element for the capture of natural light in greater quantity, but also for being the most important point of generation of photovoltaic solar energy, even semitransparent, allowing the partial passage of light. Transparent elements in roofs, as well as superior protection of the building, can also play other roles, such as: meeting the needs of natural light for the accomplishment of the internal tasks, attending to the visual comfort; to bring benefits to the human perception and about the interior experience in a building. When these resources are well dimensioned, they also contribute to the energy efficiency and consequent character of sustainability of the building. Therefore, when properly designed and executed, a roof light system can bring higher quality natural light to the interior of the building, which is related to the human health and well-being dimension. Furthermore, it can meet the technologic, economic and environmental yearnings, making possible the more efficient use of that primordial resource, which is the light of the Sun. The article presents the analysis of buildings that used zenith light systems in search of better lighting performance in museums and foundations: the Solomon R. Guggenheim Museum in the United States, the Iberê Camargo Foundation in Brazil, the Museum of Fine Arts in Castellón in Spain and the Pinacoteca of São Paulo.

Keywords: natural lighting, roof lighting systems, natural lighting in museums, comfort lighting

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4594 Exploring the Effectiveness and Challenges of Implementing Self-Regulated Learning to Improve Spoken English

Authors: Md. Shaiful Islam, Mahani Bt. Stapa

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To help learners overcome their struggle in developing proficiency in spoken English, self-regulated learning strategies seem to be promising. Students in the private universities in Bangladesh are expected to communicate with the teachers, peers, and staff members in English, but most of them suffer from their inadequate oral communicative competence in English. To address this problem, the researchers adopted a qualitative research approach to answer the research questions. They employed the learner diary method to collect data from the first-semester undergraduate students of a reputed private university in Bangladesh who were involved in writing weekly diaries about their use of self-regulated learning strategies to improve speaking in an English speaking course. The learners were provided with prompts for writing the diaries. The thematic analysis method was applied to analyze the entries of the diaries for the identification of themes. Seven strategies related to the effectiveness of SRL for the improvement of spoken English were identified from the data, and they include goal-setting, strategic planning, identifying the sources of self-motivation, help-seeking, environmental restructuring, self-monitoring, and self-evaluation. However, the students reported in their diaries that they faced challenges that impeded their SRL strategy use. Five challenges were identified, and they entail the complex nature of SRL, lack of literacy on SRL, teachers’ preference for controlling the class, learners’ past habit of learning, and students’ addiction to gadgets. The implications the study addresses include revising the syllabus and curriculum, facilitating SRL training for students and teachers, and integrating SRL in the lessons.

Keywords: private university in Bangladesh, proficiency, self-regulated learning, spoken English

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4593 Parametric Study on the Development of Earth Pressures Behind Integral Bridge Abutments Under Cyclic Translational Movements

Authors: Lila D. Sigdel, Chin J. Leo, Samanthika Liyanapathirana, Pan Hu, Minghao Lu

Abstract:

Integral bridges are a class of bridges with integral or semi-integral abutments, designed without expansion joints in the bridge deck of the superstructure. Integral bridges are economical alternatives to conventional jointed bridges with lower maintenance costs and greater durability, thereby improving social and economic stability for the community. Integral bridges have also been proven to be effective in lowering the overall construction cost compared to the conventional type of bridges. However, there is significant uncertainty related to the design and analysis of integral bridges in response to cyclic thermal movements induced due to deck expansion and contraction. The cyclic thermal movements of the abutments increase the lateral earth pressures on the abutment and its foundation, leading to soil settlement and heaving of the backfill soil. Thus, the primary objective of this paper is to investigate the soil-abutment interaction under the cyclic translational movement of the abutment. Results from five experiments conducted to simulate different magnitudes of cyclic translational movements of abutments induced by thermal changes are presented, focusing on lateral earth pressure development at the abutment-soil interface. Test results show that the cycle number and magnitude of cyclic translational movements have significant effects on the escalation of lateral earth pressures. Experimentally observed earth pressure distributions behind the integral abutment were compared with the current design approaches, which shows that the most of the practices has under predicted the lateral earth pressure.

Keywords: integral bridge, cyclic thermal movement, lateral earth pressure, soil-structure interaction

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4592 Simulating the Dynamics of E-waste Production from Mobile Phone: Model Development and Case Study of Rwanda

Authors: Rutebuka Evariste, Zhang Lixiao

Abstract:

Mobile phone sales and stocks showed an exponential growth in the past years globally and the number of mobile phones produced each year was surpassing one billion in 2007, this soaring growth of related e-waste deserves sufficient attentions paid to it regionally and globally as long as 40% of its total weight is made from metallic which 12 elements are identified to be highly hazardous and 12 are less harmful. Different research and methods have been used to estimate the obsolete mobile phones but none has developed a dynamic model and handle the discrepancy resulting from improper approach and error in the input data. The study aim was to develop a comprehensive dynamic system model for simulating the dynamism of e-waste production from mobile phone regardless the country or region and prevail over the previous errors. The logistic model method combined with STELLA program has been used to carry out this study. Then the simulation for Rwanda has been conducted and compared with others countries’ results as model testing and validation. Rwanda is about 1.5 million obsoletes mobile phone with 125 tons of waste in 2014 with e-waste production peak in 2017. It is expected to be 4.17 million obsoletes with 351.97 tons by 2020 along with environmental impact intensity of 21times to 2005. Thus, it is concluded through the model testing and validation that the present dynamic model is competent and able deal with mobile phone e-waste production the fact that it has responded to the previous studies questions from Czech Republic, Iran, and China.

Keywords: carrying capacity, dematerialization, logistic model, mobile phone, obsolescence, similarity, Stella, system dynamics

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4591 Uncovering Geometrical Ideas in Weaving: An Ethnomathematical Approaches to School Pedagogy

Authors: Jaya Bishnu Pradhan

Abstract:

Weaving mat is one of the common activities performed in different community generally in the rural part of Nepal. Mat weavers’ practice mathematical ideas and concepts implicitly in order to perform their job. This study is intended to uncover the mathematical ideas embedded in mat weaving that can help teachers and students for the teaching and learning of school geometry. The ethnographic methodology was used to uncover and describe the beliefs, values, understanding, perceptions, and attitudes of the mat weavers towards mathematical ideas and concepts in the process of mat weaving. A total of 4 mat weavers, two mathematics teachers and 12 students from grade level 6-8, who are used to participate in weaving, were selected for the study. The whole process of the mat weaving was observed in a natural setting. The classroom observation and in-depth interview were taken with the participants with the help of interview guidelines and observation checklist. The data obtained from the field were categorized according to the themes regarding mathematical ideas embedded in the weaving activities, and its possibilities in teaching learning of school geometry. In this study, the mathematical activities in different sectors of their lives, their ways of understanding the natural phenomena, and their ethnomathematical knowledge were analyzed with the notions of pluralism. From the field data, it was found that the mat weaver exhibited sophisticated geometrical ideas in the process of construction of frame of mat. They used x-test method for confirming if the mat is rectangular. Mat also provides a good opportunity to understand the space geometry. A rectangular form of mat may be rolled up when it is not in use and can be converted to a cylindrical form, which usually can be used as larder so as to reserve food grains. From the observation of the situations, this cultural experience enables students to calculate volume, curved surface area and total surface area of the cylinder. The possibilities of incorporation of these cultural activities and its pedagogical use were observed in mathematics classroom. It is argued that it is possible to use mat weaving activities in the teaching and learning of school geometry.

Keywords: ethnography, ethnomathematics, geometry, mat weaving, school pedagogy

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4590 Classification of Regional Innovation Types and Region-Based Innovation Policies

Authors: Seongho Han, Dongkwan Kim

Abstract:

The focus of regional innovation policies is shifting from a central government to local governments. The central government demands that regions enforce autonomous and responsible regional innovation policies and that regional governments seek for innovation policies fit for regional characteristics. However, the central government and local governments have not arrived yet at a conclusion on what innovation policies are appropriate for regional circumstances. In particular, even if each local government is trying to find regional innovation strategies that are based on the needs of a region, its innovation strategies turn out to be similar with those of other regions. This leads to a consequence that is inefficient not only at a national level, but also at a regional level. Existing researches on regional innovation types point out that there are remarkable differences in the types or characteristics of innovation among the regions of a nation. In addition they imply that there would be no expected innovation output in cases in which policies are enforced with ignoring such differences. This means that it is undesirable to enforce regional innovation policies under a single standard. This research, given this problem, aims to find out the characteristics and differences in innovation types among the regions in Korea and suggests appropriate policy implications by classifying such characteristics and differences. This research, given these objectives, classified regions in consideration of the various indicators that comprise the innovation suggested by existing related researches and illustrated policies based on such characteristics and differences. This research used recent data, mainly from 2012, and as a methodology, clustering analysis based on multiple factor analysis was applied. Supplementary researches on dynamically analyzing stability in regional innovation types, establishing systematic indicators based on the regional innovation theory, and developing additional indicators are necessary in the future.

Keywords: regional innovation policy, regional innovation type, region-based innovation, multiple factor analysis, clustering analysis

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4589 Deprivation of Visual Information Affects Differently the Gait Cycle in Children with Different Level of Motor Competence

Authors: Miriam Palomo-Nieto, Adrian Agricola, Rudolf Psotta, Reza Abdollahipour, Ludvik Valtr

Abstract:

The importance of vision and the visual control of movement have been labeled in the literature related to motor control and many studies have demonstrated that children with low motor competence may rely more heavily on vision to perform movements than their typically developing peers. The aim of the study was to highlight the effects of different visual conditions on motor performance during walking in children with different levels of motor coordination. Participants (n = 32, mean age = 8.5 years sd. ± 0.5) were divided into two groups: typical development (TD) and low motor coordination (LMC) based on the scores of the Movement Assessment Battery for Children (MABC-2). They were asked to walk along a 10 meters walkway where the Optojump-Next instrument was installed in a portable laboratory (15 x 3 m), which allows that all participants had the same visual information. They walked in self-selected speed under four visual conditions: full vision (FV), limited vision 100 ms (LV-100), limited vision 150 ms (LV-150) and non-vision (NV). For visual occlusion participants were equipped with Plato Goggles that shut for 100 and 150 ms, respectively, within each 2 sec. Data were analyzed in a two-way mixed-effect ANOVA including 2 (TD vs. LMC) x 4 (FV, LV-100, LV-150 & NV) with repeated-measures on the last factor (p ≤.05). Results indicated that TD children walked faster and with longer normalized steps length and strides than LMC children. For TD children the percentage of the single support and swing time were higher than for low motor competence children. However, the percentage of load response and pre swing was higher in the low motor competence children rather than the TD children. These findings indicated that through walking we could be able to identify different levels of motor coordination in children. Likewise, LMC children showed shorter percentages in those parameters regarding only one leg support, supporting the idea of balance problems.

Keywords: visual information, motor performance, walking pattern, optojump

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4588 Transient Electrical Resistivity and Elastic Wave Velocity of Sand-Cement-Inorganic Binder Mixture

Authors: Kiza Rusati Pacifique, Ki-il Song

Abstract:

The cement milk grout has been used for ground improvement. Due to the environmental issues related to cement, the reduction of cement usage is requesting. In this study, inorganic binder is introduced to reduce the use of cement contents for ground improvement. To evaluate transient electrical and mechanical properties of sand-cement-inorganic binder mixture, two non-destructive testing (NDT) methods, Electrical Resistivity (ER) and Free Free Resonant Column (FFRC) tests were adopted in addition to unconfined compressive strength test. Electrical resistivity, longitudinal wave velocity and damping ratio of sand-cement admixture samples improved with addition of inorganic binders were measured. Experimental tests were performed considering four different mixing ratios and three different cement contents depending on the curing time. Results show that mixing ratio and curing time have considerable effects on electrical and mechanical properties of mixture. Unconfined compressive strength (UCS) decreases as the cement content decreases. However, sufficient grout strength can be obtained with increase of content of inorganic binder. From the results, it is found that the inorganic binder can be used to enhance the mechanical properties of mixture and reduce the cement content. It is expected that data and trends proposed in this study can be used as reference in predicting grouting quality in the field.

Keywords: damping ratio, electrical resistivity, ground improvement, inorganic binder, longitudinal wave velocity, unconfined compression strength

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4587 Effectiveness of Myofascial Release Technique in Treatment of Sacroiliac Joint Hypo-Mobility in Postnatal Women

Authors: Ahmed A. Abd El Rahim, Mohamed M. M. Essa, Magdy M. A. Shabana, Said A. Mohamed, Mohamed Ibrahim Mabrouk

Abstract:

Background: Sacroiliac joint (SIJ) dysfunction is considered the main cause of pregnancy-related back pain, which may continue to persist postnatally. Myofascial release technique (MFR) is an application of low-intensity, prolonged stretch to myofascial structures to improve function by increasing the sliding properties of restricted myofascial tissues. Purpose: This study was designed to investigate the effect of MFR on postnatal SIJ hypo-mobility. Materials and Methods: Fifty postnatal women complaining of SIJ hypo-mobility participated in this study. Their ages ranged from 26 to 35 yrs., and their body mass index (BMI) didn`t exceed 30 kg/m2. They were randomly assigned to two equal groups, group A (Gr. A) and group B (Gr. B). Both groups received three sessions per week for eight successive weeks. Gr. A received a traditional physical therapy program, while Gr. B received a traditional physical therapy program in addition to MFR. Doppler imaging of vibration was utilized to measure SIJ mobility pre- and post-intervention, and an electronic digital goniometer was used to measure back flexion and extension Range of motion. Results: Findings revealed a statistical improvement in post-intervention values of SIJ mobility in addition to trunk flexion and extension ROM in Gr. B compared to Gr. A (P<0.001). Conclusion: Adding MFR to traditional physical therapy programs is highly recommended in the treatment of SIJ hypo-mobility in postnatal women.

Keywords: sacroiliac hypo-mobility, sacroiliac dysfunction, myofascial release technique, traditional physical therapy, postnatal

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4586 A Linguistic Product of K-Pop: A Corpus-Based Study on the Korean-Originated Chinese Neologism Simida

Authors: Hui Shi

Abstract:

This article examines the online popularity of Chinese neologism simida, which is a loanword derived from Korean declarative sentence-final suffix seumnida. Facilitated by corpus data obtained from Weibo, the Chinese counterpart of Twitter, this study analyzes the morphological and syntactical processes behind simida’s coinage, as well as the causes of its prevalence on Chinese social media. The findings show that simida is used by Weibo bloggers in two manners: (1) as an alternative word of 'Korea' and 'Korean'; (2) as a redundant sentence-final particle which adds a Korean-like speech style to a statement. Additionally, Weibo user profile analysis further reveals demographical distribution patterns concerning this neologism and highlights young Weibo users in the third-tier cities as the leading adopters of simida. These results are accounted for under the theoretical framework of social indexicality, especially how variations generate style in the indexical field. This article argues that the creation of such an ethnically-targeted neologism is a linguistic demonstration of Chinese netizen’s two-sided attitudes toward the previously heated Korean-wave. The exotic suffix seumnida is borrowed to Chinese as simida due to its high-frequency in Korean cultural exports. Therefore, it gradually becomes a replacement of Korea-related lexical items due to markedness, regardless of semantic prosody. Its innovative implantation to Chinese syntax, on the other hand, reflects Chinese netizens’ active manipulation of language for their online identity building. This study has implications for research on the linguistic construction of identity and style and lays the groundwork for linguistic creativity in the Chinese new media.

Keywords: Chinese neologism, loanword, humor, new media

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4585 Development of Transgenic Tomato Immunity to Pepino Mosaic Virus and Tomato Yellow Leaf Curl Virus by Gene Silencing Approach

Authors: D. Leibman, D. Wolf, A. Gal-On

Abstract:

Viral diseases of tomato crops result in heavy yield losses and may even jeopardize the production of these crops. Classical tomato breeding for disease resistance against Tomato yellow leaf curl virus (TYLCV), leads to partial resistance associated with a number of recessive genes. To author’s best knowledge Pepino mosaic virus (PepMV) genetic resistance is not yet available. The generation of viral resistance by means of genetic engineering was reported and implemented for many crops, including tomato. Transgenic resistance against viruses is based, in most cases, on Post Transcriptional Gene Silencing (PTGS), an endogenous mechanism which destroys the virus genome. In this work, we developed immunity against PepMV and TYLCV in a tomato based on a PTGS mechanism. Tomato plants were transformed with a hairpin-construct-expressed transgene-derived double-strand-RNA (tr-dsRNA). In the case of PepMV, the binary construct harbored three consecutive fragments of the replicase gene from three different PepMV strains (Italian, Spanish and American), to provide resistance against a range of virus strains. In the case of TYLCV, the binary vector included three consecutive fragments of the IR, V2 and C2 viral genes constructed in a hairpin configuration. Selected transgenic lines (T0) showed a high accumulation of transgene siRNA of 21-24 bases, and T1 transgenic lines showed complete immunity to PepMV and TYLCV. Graft inoculation displayed immunity of the transgenic scion against PepMV and TYLCV. The study presents the engineering of resistance in tomato against two serious diseases, which will help in the production of high-quality tomato. However, unfortunately, these resistant plants have not been implemented due to public ignorance and opposition against breeding by genetic engineering.

Keywords: PepMV, PTGS, TYLCV, tr-dsRNA

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4584 Increasing Sustainability Using the Potential of Urban Rivers in Developing Countries with a Biophilic Design Approach

Authors: Mohammad Reza Mohammadian, Dariush Sattarzadeh, Mir Mohammad Javad Poor Hadi Hosseini

Abstract:

Population growth, urban development and urban buildup have disturbed the balance between the nature and the city, and so leading to the loss of quality of sustainability of proximity to rivers. While in the past, the sides of urban rivers were considered as urban green space. Urban rivers and their sides that have environmental, social and economic values are important to achieve sustainable development. So far, efforts have been made at various scales in various cities around the world to revitalize these areas. On the other hand, biophilic design is an innovative design approach in which attention to natural details and relation to nature is a fundamental concept. The purpose of this study is to provide an integrated framework of urban design using the potential of urban rivers (in order to increase sustainability) with a biophilic design approach to be used in cities in developing countries. The methodology of the research is based on the collection of data and information from research and projects including a study on biophilic design, investigations and projects related to the urban rivers, and a review of the literature on sustainable urban development. Then studying the boundary of urban rivers is completed by examining case samples. Eventually, integrated framework of urban design, to design the boundaries of urban rivers in the cities of developing countries is presented regarding the factors affecting the design of these areas. The result shows that according to this framework, the potential of the river banks is utilized to increase not only the environmental sustainability but also social, economic and physical stability with regard to water, light, and the usage of indigenous materials, etc.

Keywords: urban rivers, biophilic design, urban sustainability, nature

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4583 Risk of Disrupted Eating Attitudes in Disabled Athletes

Authors: Zehra Buyuktuncer, Aylin H. Büyükkaragöz, Tuğçe N. Balcı, Nevin Ergun

Abstract:

Background: Undergoing rigid dietary habits for enhancing athletic performance could lead to eating disorders. High prevalence of eating disorders among female athletes has been already reported. However, the risk of disordered eating among disabled athletes is not known. A better knowledge of the different eating behaviors and their prevalence in disabled athletes would be helpful to understand interactions between eating and health. This study aimed to examine the cognitive restraint, uncontrolled eating and emotional eating behaviors in a disabled athlete population. Method: A total of 70 disabled Turkish national athletes (33 female, 37 male) from 5 sport branches (soccer, weight lifting, shooting, table tennis and basketball) were involved in the study. The cognitive restraint, uncontrolled eating and emotional eating behaviors were assessed using the revised version of Three Factor Eating Questionnaire-R18 (TFEQ-R18). The questionnaires were conducted by dietitian during the preparation camps of athletes. Body weight, height and waist circumference (WC) were measured; and body composition was analyzed by bioelectrical impedance analysis method. Results: The TFEQ scales showed a cognitive dietary restraint score of 13.9±4.2, uncontrolled eating score of 17.7±5.8 and emotional eating score of 4.9±2.5. The mean score of total TFEQ-R18 was 36.5±8.62. Neither total TFEQ-R18 score nor subscale scores differed significantly by gender or sport branches (p>0.05, for each). The scores were also similar in BMI groups (n=63; p>0.05). Total TFEQ, uncontrolled eating and emotional eating scores were significantly higher among the athletes with congenital disabilities compared to the scores of the athletes with acquired disabilities (p<0.05, for each). Moreover, the cognitive dietary restraint score was significantly high in athletes who would like to lose weight (p=0.009). Conclusion: Disabled athletes might have a risk of disordered eating. The different eating behaviors among disabled athletes should be assessed using validated tools to develop personalized nutritional strategies for those athletes.

Keywords: disabled athletes, eating behaviour, three-factor eating questionnaire-r18, body composition

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4582 Oral Fluency: A Case Study of L2 Learners in Canada

Authors: Maaly Jarrah

Abstract:

Oral fluency in the target language is what many second language learners hope to achieve by living abroad. Research in the past has demonstrated the role informal environments play in improving L2 learners' oral fluency. However, living in the target country and being part of its community does not ensure the development of oral fluency skills. L2 learners' desire to communicate and access to speaking opportunities in the host community are key in achieving oral fluency in the target language. This study attempts to identify differences in oral fluency, specifically speech rate, between learners who communicate in the L2 outside the classroom and those who do not. In addition, as the desire to communicate is a crucial factor in developing oral fluency, this study investigates whether or not learners' desire to speak the L2 outside the classroom plays a role in their frequency of L2 use outside the classroom. Finally, given the importance of the availability of speaking opportunities for L2 learners in order to practice their speaking skills, this study reports on the participants' perceptions of the speaking opportunities accessible to them in the target community while probing whether or not their perceptions differed based on their oral fluency level and their desire to communicate. The results suggest that exposure to the target language and daily communication with the native speakers is strongly related to the development of learners' oral fluency. Moreover, the findings suggest that learners' desire to communicate affects their frequency of communication in their L2 outside the classroom. At the same time, all participants, regardless of their oral fluency level and their desire to communicate, asserted that speaking opportunities beyond the classroom are very limited. Finally, the study finds there are marked differences in the perceptions learners have regarding opportunities for learning offered by the same language program. After reporting these results, the study concludes with recommendations for ESL programs that serve international students.

Keywords: ESL programs, L2 Learners, oral fluency, second language

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