Search results for: Anne Greenfield

Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

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Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

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Authors: Md Monir Hossain, Anne Staples, Kuya Takami, Tomonari Furukawa

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Tire noise has a significant impact on ride quality and vehicle interior comfort, even at low frequency. Reduction of tire noise is especially important due to strict state and federal environmental regulations. The primary sources of tire noise are the low frequency structure-borne noise and the noise that originates from the release of trapped air between the tire tread and road surface during each revolution of the tire. The frequency response of the tire changes at low and high frequency. At low frequency, the tension and bending moment become dominant, while the internal structure and local deformation become dominant at higher frequencies. Here, we analyze tire response in terms of deformation and rolling velocity at low revolution frequency. An Abaqus FEA finite element model is used to calculate the static and dynamic response of a rolling tire under different rolling conditions. The natural frequencies and mode shapes of a deformed tire are calculated with the FEA package where the subspace-based steady state dynamic analysis calculates dynamic response of tire subjected to harmonic excitation. The analysis was conducted on the dynamic response at the road (contact point of tire and road surface) and side nodes of a static and rolling tire when the tire was excited with 200 N vertical load for a frequency ranging from 20 to 200 Hz. The results show that frequency has little effect on tire deformation up to 80 Hz. But between 80 and 200 Hz, the radial and lateral components of displacement of the road and side nodes exhibited significant oscillation. For the static analysis, the fluctuation was sharp and frequent and decreased with frequency. In contrast, the fluctuation was periodic in nature for the dynamic response of the rolling tire. In addition to the dynamic analysis, a steady state rolling analysis was also performed on the tire traveling at ground velocity with a constant angular motion. The purpose of the computation was to demonstrate the effect of rotating motion on deformation and rolling velocity with respect to a fixed Newtonian reference point. The analysis showed a significant variation in deformation and rolling velocity due to centrifugal and Coriolis acceleration with respect to a fixed Newtonian point on ground.

Keywords: natural frequency, rotational motion, steady state rolling, subspace-based steady state dynamic analysis

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Authors: Andrée-Anne Parent, Alain-Steve Comtois

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The Antarctica environment can be a great challenge for human exploration. Explorers need to be focused on the task and require the physical abilities to succeed and survive in complete autonomy in this hostile environment. The aim of this study was to observe cognitive performance and physiological stress with a biomarker (cortisol) and hand grip strength during an expedition in Antarctica. A total of 6 explorers were in complete autonomous exploration on the Forbidden Plateau in Antarctica to reach unknown summits during a 30 day period. The Stroop Test, a simple reaction time, and mood scale (PANAS) tests were performed every week during the expedition. Saliva samples were taken before sailing to Antarctica, the first day on the continent, after the mission on the continent and on the boat return trip. Furthermore, hair samples were taken before and after the expedition. The results were analyzed with SPSS using ANOVA repeated measures. The Stroop and mood scale results are presented in the following order: 1) before sailing to Antarctica, 2) the first day on the continent, 3) after the mission on the continent and 4) on the boat return trip. No significant difference was observed with the Stroop (759±166 ms, 850±114 ms, 772±179 ms and 833±105 ms, respectively) and the PANAS (39.5 ±5.7, 40.5±5, 41.8±6.9, 37.3±5.8 positive emotions, and 17.5±2.3, 18.2±5, 18.3±8.6, 15.8±5.4 negative emotions, respectively) (p>0.05). However, there appears to be an improvement at the end of the second week. Furthermore, the simple reaction time was significantly lower at the end of the second week, a moment where important decisions were taken about the mission, vs the week before (416±39 ms vs 459.8±39 ms respectively; p=0.030). Furthermore, the saliva cortisol was not significantly different (p>0.05) possibly due to important variations and seemed to reach a peak on the first day on the continent. However, the cortisol from the hair pre and post expedition increased significantly (2.4±0.5 pg/mg pre-expedition and 16.7±9.2 pg/mg post-expedition, p=0.013) showing important stress during the expedition. Moreover, no significant difference was observed on the grip strength except between after the mission on the continent and after the boat return trip (91.5±21 kg vs 85±19 kg, p=0.20). In conclusion, the cognitive performance does not seem to be affected during the expedition. Furthermore, it seems to increase for specific important events where the crew seemed to focus on the present task. The physiological stress does not seem to change significantly at specific moments, however, a global pre-post mission measure can be important and for this reason, for long-term missions, a pre-expedition baseline measure is important for crewmembers.

Keywords: Antarctica, cognitive performance, expedition, physiological adaptation, reaction time

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Authors: Solene Masloh, Anne Chevrel, Maxime Culot, Leonardo Scapozza, Magali Zeisser-Labouebe

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The limited stability of clinically proven therapeutic antibodies limits their administration by the parenteral route. However, oral administration remains the best alternative as it is the most convenient and less invasive one. Obtaining a targeted treatment based on biologics, which can be orally administered, would, therefore, be an ideal situation to improve patient adherence and compliance. Nevertheless, the delivery of macromolecules through the intestine remains challenging because of their sensitivity to the harsh conditions of the gastrointestinal tract and their low permeability across the intestinal mucosa. To address this challenge, this project aims to demonstrate that targeting receptor-mediated endocytosis followed by transcytosis could maximize the intestinal uptake and transport of large molecules, such as Nanofitins. These affinity proteins of 7 kDa with binding properties similar to antibodies have already demonstrated retained stability in the digestive tract and local efficiency. However, their size does not allow passive diffusion through the intestinal barrier. Nanofitins having a controlled affinity for membrane receptors involved in the transcytosis mechanism used naturally for the transport of large molecules in humans were generated. Proteins were expressed using ribosome display and selected based on affinity to the targeted receptor and other characteristics. Their uptake and transport ex vivo across viable porcine intestines were investigated using an Ussing chambers system. In this paper, we will report the results achieved while addressing the different challenges linked to this study. To validate the ex vivo model, first, we proved the presence of the receptors targeted in humans on the porcine intestine. Then, after the identification of an optimal way of detection of Nanofitins, transport experiments were performed on porcine intestines with viability followed during the time of the experiment. The results, showing that the physiological process of transcytosis is capable of being triggered by the binding of Nanofitins on their target, will be reported here. In conclusion, the results show that Nanofitins can be transported across the intestinal barrier by triggering the receptor-mediated transcytosis and that the ex vivo model is an interesting technique to assess biologics absorption through the intestine.

Keywords: ex-vivo, Nanofitins, oral administration, transcytosis

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Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

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Authors: Anne Waithira Dormal

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Climate change is threatening pastoral livelihoods in Kajiado County, Kenya, through water shortages, livestock deaths, and increasing poverty. This study examines how these impacts differ for men and women within these communities. Limited access to resources, limited land and livestock rights, and limited decision-making power increase women's vulnerability, which is further burdened by traditional gender roles in water procurement. The research recognizes the complexity of climate change and emphasizes that factors such as wealth, family dynamics, and socioeconomic status also influence resilience. Effective adaptation strategies must address all genders. While livestock farming provides a safety net, socioeconomic empowerment through access to credit, healthcare, and education strengthens entire communities. An intersectional perspective that takes ethnicity, social status, and other factors into account is also crucial. This research, therefore, aims to examine how gender-specific adaptation strategies interact with gender and socioeconomic factors to determine the resilience of these Kenyan pastoralist communities. Such strategies, which address the specific needs and vulnerabilities of men and women, are expected to lead to increased resilience to climate change. The aim of the study is to identify effective, gender-specific adaptation strategies that can be integrated into climate change planning and implementation. Additionally, research awaits a deeper understanding of how socioeconomic factors interact with gender to influence vulnerability and resilience within these communities. The study uses a gender-sensitive qualitative approach with focus group discussions in four different pastoral and agropastoral communities. Both qualitative and demographic data are used to capture sources of income, education level, and household size of focus group respondents to increase the power of the analysis. While the research acknowledges the limitations of specific focus sites and potential biases in self-reporting, it offers valuable insights into gender and climate change in pastoral contexts. This study contributes to understanding gender-based vulnerabilities and building resilience in these communities.

Keywords: climate adaptation strategies, climate change, climate resilience, gendered vulnerability, pastoralism

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Authors: Beryl Rene R. Lopez, Lesley Anne M. Lipat, Rhogene Barbette C. Lirio, Laurice Joy H. Llanes, Karl Philippe M. Llapitan, Einstein James R. Lopez, Socorro S. GuanHing

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Background: Measles remain as one of the most common childhood diseases despite the availability of the vaccine that is safe and cost-effective. Because of morbidity and mortality associated with the recent measles outbreak in the Philippines, there is an increasing concern from the health care professionals. Objective: The purpose of this study is to determine the relationship between the compliance of Filipino mothers to measles vaccination and their health beliefs when grouped according to the given socio-demographic factors using a researcher-made questionnaire. Research Methodology: This research utilized the descriptive-correlational research design. With the use of purposive sampling technique, the study involved 200 Filipino mothers aged 18 years old and above excluding those who are healthcare professionals with children aged 2-3 years old with either urban or rural as their settlements. Pre-testing was done prior to the actual data gathering. A questionnaire composed of 26 items involving socio-demographic, compliance, and health beliefs was distributed to the sample population. Statistical analysis was done with the use of Exploratory Factor Analysis (EFA) for the first research question and Structural Equation Model (SEM) for the second research question. Results: Four dimensions were generated with the use of EFA namely: Vulnerability-Oriented Beliefs (VOB), Knowledge-Oriented Beliefs (KOB), Accessibility-Oriented Beliefs (AOB), and Outcomes-Oriented Beliefs (OOB). These were then correlated with the mothers’ socio-demographic factors (age, educational attainment, the area of residence, the number of children, and family income) and their compliance to the measles vaccination schedule. Results showed significant and direct relationships between area of residence and compliance, family income and compliance, KOB and compliance, education and KOB, KOB and VOB, KOB and OOB, AOB and KOB, AOB and OOB, AOB and VOB, and lastly, OOB and VOB. Conclusion: The Knowledge – Oriented Belief dimension greatly influence compliance to measles vaccination. Other determinants of compliance like the area of residence, educational attainment, and family income significantly increase the Filipino mothers’ likelihood of compliance to measles vaccination, which have implications to health education.

Keywords: socio-demographic, health beliefs, compliance, measles vaccination

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Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

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Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

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Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

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Authors: Anne Mastamet-Mason

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Crimes against women is a global concern, and South Africa, in particular, is in a dilemma of dealing with constant criminal acts that face the country. Debates on violence against women in South Africa cannot be overemphasised any longer as crimes continue to rise year by year. The recent death of a university student at the University of Cape Town, as well as many other cases, continues to strengthen the need to find solutions from all the spheres of South African society. The advanced textiles market contains a high number and variety of technologies, many of which have protected status and constitute a relatively small portion of the textiles used for the consumer market. Examples of advanced textiles include nanomaterials, such as silver, titanium dioxide and zinc oxide, designed to create an anti-microbial and self-cleaning layer on top of the fibers, thereby reducing body smell and soiling. Smart textiles propose materials and fabrics versatile and adaptive to different situations and functions. Integrating textiles and computing technologies offer an opportunity to come up with differentiated characteristics and functionality. This paper presents a proposal to design a smart camisole/Yoga sports brazier and a smart Yoga sports pant garment to be worn by women while alone and while in purported danger zones. The smart garments are to be worn under normal clothing and cannot be detected or seen, or suspected by perpetrators. The garments are imbued with devices to sense any physical aggression and any abnormal or accelerated heartbeat that may be exhibited by the victim of violence. The signals created during the attack can be transmitted to the police and family members who own a mobile application system that accepts signals emitted. The signals direct the receiver to the exact location of the offence, and the victim can be rescued before major violations are committed. The design of the Yoga sports garments will be done by Professor Mason, who is a fashion designer by profession, while the mobile phone application system will be developed by Mr. Amos Yegon, who is an independent software developer.

Keywords: smart clothing, wearable technology, south africa, 4th industrial revolution

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Authors: Anne Joseph, Yinusa Asiwaju-Bello, Oluwaseun Olabode

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Sustainable administration of groundwater resources tapped in Coastal Plain Sands aquifer in Abesan area, Eastern Dahomey Basin, Southwestern Nigeria necessitates the knowledge of the pattern of groundwater flow in meeting a suitable environmental need for habitation. Thirty hand-dug wells were identified and evaluated to study the groundwater flow dynamics and anionic species distribution in the study area. Topography and water table levels method with the aid of Surfer were adopted in the identification of recharge and discharge zones where six recharge and discharge zones were delineated correspondingly. Dissolved anionic species of HCO3-, Cl-, SO42-and NO3- were determined using titrimetric and spectrophotometric method. The trend of significant anionic concentrations of groundwater samples are in the order Cl- > HCO3-> SO42- > NO3-. The prominent anions in the discharge and recharge area are Cl- and HCO3- ranging from 0.22ppm to 3.67ppm and 2.59ppm to 0.72ppm respectively. Analysis of groundwater head distribution and the groundwater flow vector in Abesan area confirmed that Cl- concentration is higher than HCO3- concentration in recharge zones. Conversely, there is a high concentration of HCO3- than Cl- inland towards the continent; therefore, HCO3-concentration in the discharge zones is higher than the Cl- concentration. The anions were to be closely related to the recharge and discharge areas which were confirmed by comparison of activities such as rainfall regime and anthropogenic activities in Abesan area. A large percentage of the samples showed that HCO3-, Cl-, SO42-and NO3- falls within the permissible limit of the W.H.O standard. Most of the samples revealed Cl- / (CO3- + HCO3-) ratio higher than 0.5 indicating that there is saltwater intrusion imprints in the groundwater of the study area. Gibbs plot shown that most of the samples is from rock dominance, some from evaporation dominance and few from precipitation dominance. Potential salinity and SO42/ Cl- ratios signifies that most of the groundwater in Abesan is saline and falls in a water class found to be insuitable for irrigation. Continuous dissolution of these anionic species may pose a significant threat to the inhabitants of Abesan area in the nearest future.

Keywords: Abessan, Anionic species, Discharge, Groundwater flow, Recharge

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Authors: Steven M. Graham, Anne V. Magee

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Most world religions have sacred texts and traditions that provide instruction about and definitions of marriage, family, and family duties and responsibilities. Given that religious fundamentalism (RF) is defined as the belief that these sacred texts and traditions are literally and completely true to the exclusion of other teachings, RF should be predictive of the attitudes one holds about these topics. The goals of the present research were to: (1) explore the extent to which people think that men and women can be happy without marriage, a significant sexual relationship, a long-term romantic relationship, and having children; (2) determine the extent to which RF is associated with these beliefs; and, (3) to determine how RF is associated with considering certain elements of a relationship to be necessary for thinking of that relationship as a marriage. In Study 1, participants completed a reliable and valid measure of RF and answered questions about the necessity of various elements for a happy life. Higher RF scores were associated with the belief that both men and women require marriage, a sexual relationship, a long-term romantic relationship, and children in order to have a happy life. In Study 2, participants completed these same measures and the pattern of results replicated when controlling for overall religiosity. That is, RF predicted these beliefs over and above religiosity. Additionally, participants indicated the extent to which a variety of characteristics were necessary to consider a particular relationship to be a marriage. Controlling for overall religiosity, higher RF scores were associated with the belief that the following were required to consider a relationship a marriage: religious sanctification, a sexual component, sexual monogamy, emotional monogamy, family approval, children (or the intent to have them), cohabitation, and shared finances. Interestingly, and unexpectedly, higher RF scores were correlated with less importance placed on mutual consent in order to consider a relationship a marriage. RF scores were uncorrelated with the importance placed on legal recognition or lifelong commitment and these null findings do not appear to be attributable to ceiling effects or lack of variability. These results suggest that RF constrains views about both the importance of marriage and family in one’s life and also the characteristics required to consider a relationship a proper marriage. This could have implications for the mental and physical health of believers high in RF, either positive or negative, depending upon the extent to which their lives correspond to these templates prescribed by RF. Additionally, some of these correlations with RF were substantial enough (> .70) that the relevant items could serve as a brief, unobtrusive measure of RF. Future research will investigate these possibilities.

Keywords: attitudes about marriage, fertility intentions, measurement, religious fundamentalism

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Authors: Torben Hansen, Lars Gronholdt, Alexander Josiassen, Anne Martensen

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Consumers often exhibit a bias in their knowledge; they often think that they know more or less than they do. The concept of 'knowledge over/underconfidence' (O/U) has in previous studies been used to investigate such knowledge bias. O/U appears as a combination of subjective and objective knowledge. Subjective knowledge relates to consumers’ perception of their knowledge, while objective knowledge relates to consumers’ absolute knowledge measured by objective standards. This separation leads to three scenarios: The consumer can either be knowledge calibrated (subjective and objective knowledge are similar), overconfident (subjective knowledge exceeds objective knowledge) or underconfident (objective knowledge exceeds subjective knowledge). Knowledge O/U is a highly useful concept in understanding consumer choice behavior. For example, knowledge overconfident individuals are likely to exaggerate their ability to make right choices, are more likely to opt out of necessary information search, spend less time to carry out a specific task than less knowledge confident consumers, and are more likely to show high financial trading volumes. Through the use of financial services as a case study, this study contributes to previous research by examining how consumer knowledge O/U affects two types of trust (broad-scope trust and narrow-scope trust) and consumer relationship satisfaction. Trust does not only concern consumer trust in individual companies (i.e., narrow.-scope confidence NST), but also concerns consumer confidence in the broader business context in which consumers plan and implement their behavior (i.e., broad scope trust, BST). NST is defined as "the expectation that the service provider can be relied on to deliver on its promises’, while BST is defined as ‘the expectation that companies within a particular business type can generally be relied on to deliver on their promises.’ This study expands our understanding of the interplay between consumer knowledge bias, consumer trust, and relationship marketing in two main ways: First, it is demonstrated that the more knowledge O/U a consumer becomes, the higher/lower NST and levels of relationship satisfaction will be. Second, it is demonstrated that BST has a negative moderating effect on the relationship between knowledge O/U and satisfaction, such that knowledge O/U has a higher positive/negative effect on relationship satisfaction when BST is low vs. high. The data for this study comprises 756 mutual fund investors. Trust is particularly important in consumers’ mutual fund behavior because mutual funds have important responsibilities in providing financial advice and in managing consumers’ funds.

Keywords: knowledge, cognitive bias, trust, customer-seller relationships, financial services

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Authors: Anne Öman

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Today in Sweden and in other countries, a variety of digital artefacts, such as laptops, tablets, interactive whiteboards, are being used at all school levels. From an educational perspective, digital artefacts challenge traditional teaching because they provide a range of modes for expression and communication and are not limited to the traditional medium of paper. Digital technologies offer new opportunities for representations and physical interactions with objects, which put forward the role of the body in interaction and learning. From a multimodal perspective the emphasis is on the use of multiple semiotic resources for meaning- making and the study presented here has examined the differential use of semiotic resources by pupils interacting in a digitally designed task in a primary school context. The instances analyzed in this paper come from a case study where the learning task was to create an advertising film in a film-software. The study in focus involves the analysis of a single case with the emphasis on the examination of the classroom setting. The research design used in this paper was based on a micro ethnographic perspective and the empirical material was collected through video recordings of small-group work in order to explore pupils’ communication within the group activity. The designed task described here allowed students to build, share, collaborate upon and publish the redesigned products. The analysis illustrates the variety of communicative modes such as body position, gestures, visualizations, speech and the interaction between these modes and the representations made by the pupils. The findings pointed out the importance of embodied communication during the small- group processes from a learning perspective as well as a pedagogical understanding of pupils’ representations, which were similar from a cultural literacy perspective. These findings open up for discussions with further implications for the school practice concerning the small- group processes as well as the redesigned products. Wider, the findings could point out how multimodal interactions shape the learning experience in the meaning-making processes taking into account that language in a globalized society is more than reading and writing skills.

Keywords: communicative learning, interactive learning environments, pedagogical issues, primary school education

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Authors: Lucie Matricon, Anne Roubaud, Geert Haarlemmer, Christophe Geantet

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Introduction: This case discusses the management of two floor of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. Case Report: A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Discussion: Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk, and second primary cancer development.

Keywords: microalgae, biofuels, hydrothermal liquefaction, biomass

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Authors: Vrinda Hari Ankolekar, Anne D. Souza, Mamatha Hosapatna

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Introduction: Precise anatomical assessment of femoral neck anteversion (FNA) and the neck shaft angles (NSA) would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. FNA of greater than 20 degrees is considered excessive femoral anteversion, whereas a torsion angle of fewer than 10 degrees is considered femoral retroversion. Excessive femoral torsion is not uncommon and has been associated with certain neurologic and orthopedic conditions. The enlargement and maturation of the hip joint increases at the 20th week of gestation and the NSA ranges from 135- 140◦ at birth. Material and methods: 48 femurs were tagged according to the GA and two photographs for each femur were taken using Nikon digital camera. Each femur was kept on a horizontal hard desk and end on an image of the upper end was taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. The images were transferred to the computer and were stored in TIFF format. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. 1. Calculation of FNA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. The angle made by this line with the horizontal plane was measured as FNA. 2. Calculation of NSA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. A vertical line was drawn passing through the tip of the greater trochanter to the inter-condylar notch. The angle formed by these lines was calculated as NSA. Results: The paired t-test for the inter-observer variability showed no significant difference between the values of two observers. (FNA: t=-1.06 and p=0.31; NSA: t=-0.09 and p=0.9). The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t-test was applied to compare the mean angles between the second and third trimesters which did not show any statistical significance. This shows that the FNA and NSA of femur did not vary significantly during the third trimester. The FNA and NSA were correlated with the GA using Pearson’s correlation. FNA appeared to increase with the GA (r=0.5) but the increase was not statistically significant. A decrease in the NSA was also noted with the GA (r=-0.3) which was also statistically not significant. Conclusion: The present study evaluates the FNA and NSA of the femur in fetuses and correlates their development with the GA during second and third trimesters. The FNA and NSA did not vary significantly during the third trimester.

Keywords: anteversion, coxa antetorsa, femoral torsion, femur neck shaft angle

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Authors: Sarah Holdren, Laura Crook, Anne Drapkin Lyerly

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Objective: The COVID-19 Pandemic has drawn new attention to long-existing bioethical questions around pregnancy, childbirth, and parenthood. Due to the increased risk of severe COVID-19, pregnant individuals may experience anxiety regarding medical decision-making. Especially in the case of hospital births, questions around the ethics of bringing healthy pregnant individuals into a high-risk environment for viral transmission illuminate gaps in the American maternal and child healthcare system. Limited research has sought to understand the experiences of those who gave birth outside hospitals during this time. This study aims to understand pregnant individuals’ conceptualization of risk during the COVID-19 pandemic. Methods: Individuals who gave birth after March 2020 were recruited through advertisements on social media. Participants completed a 1-hour semi-structured interview and a demographic questionnaire. Interviews were transcribed and coded by members of the research team using thematic narrative analysis. Results: A total of 18 participants were interviewed and completed the demographic questionnaire. The language of risk was utilized in birth narratives in three different ways, which highlighted the multileveled and nuanced ways in which risk is understood and mitigated by pregnant and birthing individuals. These included: 1. The risk of contracting COVID-19 before, during, and after birth, 2. The risk of birth complications requiring medical interventions dependent on selected birthing space (home, birthing center, hospital), and 3. The overall risk of creating life in the middle of a pandemic. The risk of contracting COVID-19 and risk of birth complications were often weighed in paradoxical ways throughout each individual’s pregnancy, while phrases such as “pandemic baby” and “apocalypse” appeared throughout narratives and highlighted the broader implications of pregnancy and childbirth during this momentous time. Conclusions: Healthcare professionals should consider the variety of ways that pregnant and birthing individuals understand the risk when counseling patients on healthcare decisions, especially during times of healthcare crisis such as COVID-19. Future work should look to understand how the language of risk fits into a broader understanding of the human experience of growing life in times of crisis.

Keywords: maternal and child health, thematic narrative analysis, COVID-19, risk mitigation

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Authors: Pernille K. Christiansen, Mette Maria Skjøth, Line Lorenzen, Eva Draborg, Christina Anne Vinter, Trine Kjær, Mette Juel Rothmann

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Background and aims: Overweight and obesity are an increasing challenge on a global level. In Denmark, more than one-third of all pregnant women are overweight or obese, and many women exceed the gestational weight gain recommendations from the Institute of Medicine. Being overweight or obese, is associated with a higher risk of adverse maternal and fetal outcomes, including gestational diabetes and childhood obesity. Thus, it is important to focus on the women’s lifestyles between their pregnancies to lower the risk of gestational weight retention in the long run. The objective of this study was to explorer what barriers and challenges postpartum women experience with respect to healthy lifestyles during the postpartum period and to access whether an Information Technology based intervention might be a supportive tool to assist and motivate postpartum women to a healthy lifestyle. Materials and methods: The method is inspired by participatory design. A systematic text condensation was applied to semi-structured focus groups. Five focus group interviews were carried out with a total of 17 postpartum women and two interviews with a total of six health professionals. Participants were recruited through the municipality in Svendborg, Denmark, and at Odense University Hospital in Odense, Denmark, during a four-month period in early 2018. Results: From the women’s perspective, better assistance is needed from the health professionals to obtain or maintain a healthy lifestyle. The women need tools that inform and help them understand and prioritise their own health-related risks, and to motivate them to plan and take care of their own health. As the women use Information Technology on a daily basis, the solution could be delivered through Information Technology. Finally, there is room for engaging the partner more in the communication related to the baby and family’s lifestyle. Conclusion: Postpartum women need tools that inform and motivate a healthy lifestyle postpartum. The tools should allow access to high-quality information from health care professionals, when the information is needed, and also allow engagement from the partner. Finally, Information Technology is a potential tool for delivering tools.

Keywords: information technology, lifestyle, overweight, postpartum

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Authors: Chantell Gouws, Lourens Millard, Anne Naude, Jan-Wessel Meyer, Brandon Stuwart Shaw, Ina Shaw

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Background: Millions of South African youths participate in team sports, with netball and rugby being two of the largest worldwide. This increased participation and professionalism have resulted in an increase in the number of musculoskeletal injuries. Objective: This study examined the extent to which sport coaching knowledge translates to the injuries and prevention of injuries in adolescents participating in netball and rugby. Methods: Thirty-four South African sports coaches participated in the study. Eighteen netball coaches and 16 rugby coaches with varying levels of coaching experience were selected to participate. An adapted version of Nash and Sproule’s questionnaire was used to investigate the coaches’ knowledge with regards to sport-specific common injuries, injury prevention, fitness/conditioning, individual technique development, training programs, mental training, and preparation of players. The analysis of data was carried out using a number of different techniques outlined by Nash and Sproule (2012). These techniques were determined by the type of data. Descriptive data was used to provide statistical analysis. Quantitative data was used to determine the educational framework and knowledge of sports coaches on injury prevention. Numerical data was obtained through questions on sports injuries, as well as coaches’ sports knowledge levels. Participants’ knowledge was measured using a standardized scoring system. Results: For the 0-4 years of netball coaching experience, 76.4% of the coaches had knowledge and experience and 33.3% appropriate first aid knowledge, while for the 9-12 years and 13-16 years, 100% of the coaches had knowledge and experience and first aid knowledge. For the 0-4 years in rugby coaching experience, 59.1% had knowledge and experience and 71% the appropriate first aid knowledge; for the 17-20 years, 100% had knowledge and experience and first aid, while for higher or equal to 25 years, 45.5% had knowledge and experience. In netball, 90% of injuries consisted of ankle injuries, followed by 70% for knee, 50% for shoulder, 20% for lower leg, and 15% for finger injuries. In rugby, 81% of the injuries occurred at the knee, followed by 50% for the shoulder, 40% for the ankle, 31% for the head and neck, and 25% for hamstring injuries. Six hours of training resulted in a 13% chance of injuries in netball and a 32% chance in rugby. For 10 hours of training, the injury prevalence was 10% in netball and 17% in rugby, while 15 hours resulted in an injury incidence of 58% in netball players and a 25% chance in rugby players. Conclusion: This study highlights the need for coaches to improve their knowledge in relation to injuries and injury prevention, along with factors that act as a preventative measure and promotes players’ well-being.

Keywords: musculoskeletal injury, sport coaching, sport trauma

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Authors: Anne Marie Morrin

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This paper will focus on the design, delivery and assessment of a transdisciplinary STEAM (Science, Technology, Engineering, Arts, and Mathematics) education initiative in a college of education in Ireland. The project explores a transdisciplinary approach to supporting STEAM education where the concepts, methodologies and assessments employed derive from visual art sessions within initial teacher education. The research will demonstrate that the STEAM Education approach is effective when visual art concepts and methods are placed at the core of the teaching and learning experience. Within this study, emphasis is placed on authentic collaboration and transdisciplinary pedagogical approaches with the STEAM subjects. The partners included a combination of teaching expertise in STEM and Visual Arts education, artists, in-service and pre-service teachers and children. The inclusion of all stakeholders mentioned moves towards a more authentic approach where transdisciplinary practice is at the core of the teaching and learning. Qualitative data was collected using a combination of questionnaires (focused and open-ended questions) and focus groups. In addition, the data was collected through video diaries where students reflected on their visual journals and transdisciplinary practice, which gave rich insight into participants' experiences and opinions on their learning. It was found that an effective program of STEAM education integration was informed by co-teaching (continuous professional development), which involved a commitment to adaptable and flexible approaches to teaching, learning, and assessment, as well as the importance of continuous reflection-in-action by all participants. The delivery of a transdisciplinary model of STEAM education was devised to reconceptualizatise how individual subject areas can develop essential skills and tackle critical issues (such as self-care and climate change) through data visualisation and technology. The success of the project can be attributed to the collaboration, which was inclusive, flexible and a willingness between various stakeholders to be involved in the design and implementation of the project from conception to completion. The case study approach taken is particularistic (focusing on the STEAM-ED project), descriptive (providing in-depth descriptions from varied and multiple perspectives), and heuristic (interpreting the participants’ experiences and what meaning they attributed to their experiences).

Keywords: collaboration, transdisciplinary, STEAM, visual arts education

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Authors: Anne Lemnitzer, Eric Tavarez

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The academic rigor of the geotechnical engineering curriculum indicates strong institutional and geographical variations. Geotechnical engineering deals with the most challenging civil engineering material, as opposed to structural engineering, environmental studies, transportation engineering, and water resources. Yet, technical expectations posed by the practicing professional community do not necessarily consider the challenges inherent to the disparity in academic rigor and disciplinary differences. To recognize the skill shortages among current graduates as well as identify opportunities to better equip graduate students in specific fields of geotechnical engineering, a two-part survey was developed in collaboration with the Earth Retaining Structures (ERS) Committee of the American Society of Civil Engineers. Earth Retaining Structures are critical components of infrastructure systems and integral components to many major engineering projects. Within the geotechnical curriculum, Earth Retaining Structures is either taught as a separate course or major subject within a foundation design class. Part 1 of the survey investigated the breadth and depth of the curriculum with respect to ERS by requesting faculty across the United States to provide data on their curricular content, integration of practice-oriented course content, student preparation for professional licensing, and level of technical competency expected upon student graduation. Part 2 of the survey enables a comparison of training provided versus training needed. This second survey addressed practicing geotechnical engineers in all sectors of the profession (e.g., private engineering consulting, governmental agencies, contractors, suppliers/manufacturers) and collected data on the expectations with respect to technical and non-technical skills of engineering graduates entering the professional workforce. Results identified skill shortages in soft skills, critical thinking, analytical and language skills, familiarity with design codes and standards, and communication with various stakeholders. The data will be used to develop educational tools to advance the proficiency and expertise of geotechnical engineering students to meet and exceed the expectations of the profession and to stimulate a lifelong interest in advancing the field of geotechnical engineering.

Keywords: geotechnical engineering, academic training, industry requirements, earth retaining structures

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Authors: Florent Cerdan, Anne-Gaëlle Denay, Annette Roy, Jean-Claude Grandidier, Éric Laine

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The insulation of MarkIII membrane of the Liquid Natural Gas Carriers (LNGC) consists of a load- bearing system made of panels in reinforced polyurethane foam (R-PUF). During the shipping, the cargo containment shall be potentially subject to risk events which can be water leakage through the wall ballast tank. The aim of these present works is to further develop understanding of water transfer mechanisms and water effect on properties of R-PUF. This multi-scale approach contributes to improve the durability. Macroscale / Mesoscale Firstly, the use of the gravimetric technique has allowed to define, at room temperature, the water transfer mechanisms and kinetic diffusion, in the R-PUF. The solubility follows a first kinetic fast growing connected to the water absorption by the micro-porosity, and then evolves linearly slowly, this second stage is connected to molecular diffusion and dissolution of water in the dense membranes polyurethane. Secondly, in the purpose of improving the understanding of the transfer mechanism, the study of the evolution of the buoyant force has been established. It allowed to identify the effect of the balance of total and partial pressure of mixture gas contained in pores surface. Mesoscale / Microscale The differential scanning calorimetry (DSC) and Dynamical Mechanical Analysis (DMA), have been used to investigate the hydration of the hard and soft segments of the polyurethane matrix. The purpose was to identify the sensitivity of these two phases. It been shown that the glass transition temperatures shifts towards the low temperatures when the solubility of the water increases. These observations permit to conclude to a plasticization of the polymer matrix. Microscale The Fourier Transform Infrared (FTIR) study has been used to investigate the characterization of functional groups on the edge, the center and mid-way of the sample according the duration of submersion. More water there is in the material, more the water fix themselves on the urethanes groups and more specifically on amide groups. The pic of C=O urethane shifts at lower frequencies quickly before 24 hours of submersion then grows slowly. The intensity of the pic decreases more flatly after that.

Keywords: porous materials, water sorption, glass transition temperature, DSC, DMA, FTIR, transfer mechanisms

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Authors: Alvarez Barrantes, Robert Dorrell, Christopher Hackney, Anne Baar, Roberto Fernandez, Daniel Parsons

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Microplastic particles entering fluvial environments are deposited with natural sediments. Their settling properties can change by the absorption or adsorption of contaminants, organic matter, and organisms. These deposits include positively, neutrally, and negatively buoyant particles. This study aims to understand how plastic particles of different densities interact with natural sediments as they settle and how they are stored within the sediment deposit. The results of this study contribute to a better understanding of the deposition of microplastic particles and associated pollution in rivers. A set of 48 experiments was designed to investigate the settling process of microplastic particles in freshwater. The experimental work describes the vertical variation of cohesive and/or non-cohesive sediment versus microplastic densities in deposited sediment. The experiment consisted of adding microplastic particles, sediment, and water in a waterproof carton tube of a height of 24 cm and a diameter of 5 cm. The plastic selected is positively, neutrally, and negatively buoyant. The sediments consist of sand and clay with four different concentrations. The mixture of materials was shaken until is thoroughly mixed and left to settle for 24 hours. After the settlement, the tubes were frozen at -20 °C to be able to cut them and measure the thickness of the deposits and analyze the sediment and plastic distribution. The most representative experiments were repeated in a glass tube of the same size; to analyse the influences of current flows and depositional process. Finally, the glass tube experiments were used to study organic materials adsorption in plastic, settling the sample for four months. Defined microplastic layers were identified as the density of the plastic change. Preliminary results show that most of the positive buoyancy particles floated, neutral buoyancy particles form a layer above the sediment and negative buoyancy particles mixed with the sediment. The vertical grain size distribution of the deposits was analysed to determine deposition variation with and without plastic. It is expected that the positively buoyant particles are trapped in the sediment by the currents flows and sink due to organic material adsorption. Finally, the experiments will explain how microplastic particles, including positively buoyant ones, are stored in natural sediment deposits.

Keywords: microplastic adsorption process, microplastic deposition in natural sediment, microplastic pollution in rivers, storages of positive buoyancy microplastic particles

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Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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Authors: Anne Allmrodt

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Regions of South-East Europe are characterised by high out-migration for decades. The reasons for leaving range from the hope of a better work situation to a better health care system and beyond. In Serbia, this high out-migration hits the rural areas in particular so that the population number is in the red repeatedly. It might not be hard to guess that this negative population growth has the potential to create different challenges for those who stay in rural areas. So how are they coping with the – statistically proven – high out-migration? Having this in mind, the study is investigating the people‘s individual awareness of the social phenomenon high out-migration and their daily life strategies in rural areas. Furthermore, the study seeks to find out the people’s resilient skills in that context. Is the condition of high out-migration conducive for resilience? The methodology combines a quantitative and a qualitative approach (mixed methods). For the quantitative part, a standardised questionnaire has been developed, including a multiple choice section and a choice experiment. The questionnaire was handed out to people living in rural areas of Serbia only (n = 100). The sheet included questions about people’s awareness of high out-migration, their own daily life strategies or challenges and their social network situation (data about the social network was necessary here since it is supposed to be an influencing variable for resilience). Furthermore, test persons were asked to make different choices of coping with high out-migration in a self-designed choice experiment. Additionally, the study included qualitative interviews asking citizens from rural areas of Serbia. The topics asked during the interview focused on their awareness of high out-migration, their daily life strategies, and challenges as well as their social network situation. Results have shown the following major findings. The awareness of high out-migration is not the same with all test persons. Some declare it as something positive for their own life, others as negative or not effecting at all. The way of coping generally depended – maybe not surprising – on the people’s social network. However – and this might be the most important finding - not everybody with a certain number of contacts had better coping strategies and was, therefore, more resilient. Here the results show that especially people with high affiliation and proximity inside their network were able to cope better and shew higher resilience skills. The study took one step forward in terms of knowledge about societal resilience as well as coping strategies of societies in rural areas. It has shown part of the other side of nowadays migration‘s coin and gives a hint for a more sustainable rural development and community empowerment.

Keywords: coping, out-migration, resilience, rural development, social networks, south-east Europe

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Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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Authors: Anne-Marie Dionne

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Teacher reading aloud to students is a practice that is well established in preschool and primary classrooms. Many benefits of this pedagogical activity have been highlighted in multiple studies. However, it has also been shown that teachers are not keen on choosing informational texts for their read aloud, as their selections for this venue are mainly fictional stories, mostly written in a unique narrative story-like structure. Considering that students soon have to read complex informational texts by themselves as they go from one grade to another, there is cause for concern because those who do not benefit from an early exposure to informational texts could be lacking knowledge of informational text structures that they will encounter regularly in their reading. Exposing students to informational texts could be done in different ways in classrooms. However, since read aloud appears to be such a common and efficient practice in preschool and primary grades, it is important to examine more deeply the factors taken into account by teachers when they are selecting their readings for this important teaching activity. Moreover, it seems critical to know why teachers are not inclined to choose more often informational texts when they are reading aloud to their pupils. A group of 22 preschool or primary grade teachers participated in this study. The data collection was done by a survey and an individual semi-structured interview. The survey was conducted in order to get quantitative data on the read-aloud practices of teachers. As for the interviews, they were organized around three categories of questions (exploratory, analytical, opinion) regarding the process of selecting the texts for the read-aloud sessions. A statistical analysis was conducted on the data obtained by the survey. As for the interviews, they were subjected to a content analysis aiming to classify the information collected in predetermined categories such as the reasons given to favor fictional texts over informative texts, the reasons given for avoiding informative texts for reading aloud, the perceptions of the challenges that the informative texts could bring when they are read aloud to students, and the perceived advantages that they would present if they were chosen more often for this activity. Results are showing variable factors that are guiding the teachers when they are making their selection of the texts to be read aloud. As for example, some of them are choosing solely fictional texts because of their convictions that these are more interesting for their students. They also perceive that the informational texts are not good choices because they are not suitable for pleasure reading. In that matter, results are pointing to some interesting elements. Many teachers perceive that read aloud of fictional or informational texts have different goals: fictional texts are read for pleasure and informational texts are read mostly for academic purposes. These results bring out the urgency for teachers to become aware of the numerous benefits that the reading aloud of each type of texts could bring to their students, especially the informational texts. The possible consequences of teachers’ perceptions will be discussed further in our presentation.

Keywords: fictional texts, informational texts, preschool or primary grade teachers, reading aloud

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Authors: Homyr L. Garcia, Jr., Anne Margaret A. Rendon, Carla Michaela B. Taguinod

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Nothing is constant in this world but change. This is the reality wherein a lot of people fail to recognize and maybe, it is because of the fact that some see things that are happening with little value or no value at all until it’s gone. For the past years, Egypt was known for its stable government. It was able to withstand a lot of problems and crisis which challenged their country in ways which can never be imagined. In the present time, it seems like in just a snap of a finger, the said stability vanished and it was immediately replaced by a crisis which resulted to a failure in some parts of their government. In addition, this problem continued to worsen and the current situation of Egypt is just a reflection or a result of it. On the other hand, as the researchers continued to study the reasons why the government of Egypt is unstable, they concluded that there might be a possibility that they will be able to produce ways in which their country could be helped or improved. The instability of the government of Egypt is the product of combining all the problems which affects the lives of the people. Some of the reasons that the researchers found are the following: 1) unending doubts of the people regarding the ruling capacity of elected presidents, 2) removal of President Mohamed Morsi in position, 3) economic crisis, 4) a lot of protests and revolution happened, 5) resignation of the long term President Hosni Mubarak and 6) the office of the President is most likely available only to the chosen successor. Also, according to previous researches, there are two plausible scenarios for the instability of Egypt: 1) a military intervention specifically the Supreme Council of the Armed Forces or SCAF, resulting from a contested succession and 2) an Islamist push for political power which highlights the claim that religion is a hindrance towards the development of their country and government. From the eight possible reasons, the researchers decided that they will be focusing on economic crisis since the instability is more clearly seen in the country’s economy which directly affects the people and the government itself. In addition, they made a hypothesis which states that stable economy is a prerequisite towards a stable government. If they will be able to show how this claim is true by using the Social Autopsy Research Design for the qualitative method and Pearson’s correlation coefficient for the quantitative method, the researchers might be able to produce a proposal on how Egypt can stabilize their government and avoid such problems. Also, the hypothesis will be based from the Rational Action Theory which is a theory for understanding and modeling social and economy as well as individual behavior.

Keywords: Pearson’s correlation coefficient, rational action theory, social autopsy research design, supreme council of the armed forces (SCAF)

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Authors: Jihane Saad, Thomas Lendormi, Caroline Le Marechal, Anne-marie Pourcher, Céline Druilhe, Jean-louis Lanoiselle

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Agricultural anaerobic digestion consists in the conversion of animal slurry and manure into biogas and digestate. They need, however, to be treated at 70 ºC during 60 min before anaerobic digestion according to the European regulation (EC n°1069/2009 & EU n°142/2011). The impact of such heat treatment on the outcome of bacteria has been poorly studied up to now. Moreover, a recent study¹ has shown that enterococci and clostridia are still detected despite the application of such thermal treatment, questioning the relevance of this approach for the hygienisation of digestate. The aim of this study is to establish the heat inactivation kinetics of two species of enterococci (Enterococcus faecalis and Enterococcus faecium) and two species of clostridia (Clostridioides difficile and Clostridium novyi as a non-toxic model for Clostridium botulinum of group III). A pure culture of each strain was prepared in a specific sterile medium at concentration of 10⁴ – 10⁷ MPN / mL (Most Probable number), depending on the bacterial species. Bacterial suspensions were then filled in sterilized capillary tubes and placed in a water or oil bath at desired temperature for a specific period of time. Each bacterial suspension was enumerated using a MPN approach, and tests were repeated three times for each temperature/time couple. The inactivation kinetics of the four indicator bacteria is described using the Weibull model and the classical Bigelow model of first-order kinetics. The Weibull model takes biological variation, with respect to thermal inactivation, into account and is basically a statistical model of distribution of inactivation times as the classical first-order approach is a special case of the Weibull model. The heat treatment at 70 ºC / 60 min contributes to a reduction greater than 5 log10 for E. faecium and E. faecalis. However, it results only in a reduction of about 0.7 log10 for C. difficile and an increase of 0.5 log10 for C. novyi. Application of treatments at higher temperatures is required to reach a reduction greater or equal to 3 log10 for C. novyi (such as 30 min / 100 ºC, 13 min / 105 ºC, 3 min / 110 ºC, and 1 min / 115 ºC), raising the question of the relevance of the application of heat treatment at 70 ºC / 60 min for these spore-forming bacteria. To conclude, the heat treatment (70 ºC / 60 min) defined by the European regulation is sufficient to inactivate non-sporulating bacteria. Higher temperatures (> 100 ºC) are required as far as spore-forming bacteria concerns to reach a 3 log10 reduction (sporicidal activity).

Keywords: heat treatment, enterococci, clostridia, inactivation kinetics

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Authors: Anne Hovgaard Jorgensen

Abstract:

This study investigates how Muslim fathers in Denmark are struggling to overcome notions of mistrust from teachers and educators. Starting from school-home-cooperation (parent conferences, school-home communication, etc.), the study finds that many Muslim fathers do not feel acknowledged as a resource in the upbringing of their children. To explain these experiences further, the study suggest the notion of ‘mistrusted masculinity’ to grasp the controlling image these fathers meet in various schools and child-care-institutions in the Danish Welfare state. The paper is based on 9 months of fieldwork in a Danish school, a social housing area and in various ‘father groups’ in Denmark. Additional, 50 interviews were conducted with fathers, children, mothers, schoolteachers, and educators. By using Connell's concepts 'hegemonic' and 'marginalized' masculinity as steppingstones, the paper argues that these concepts might entail a too static and dualistic picture of gender. By applying the concepts of 'emergent masculinity' and 'emergent fatherhood' the paper brings along a long needed discussion of how Muslim men in Denmark are struggling to overcome and change the controlling images of them as patriarchal and/or ignorant fathers regarding the upbringing of their children. As such, the paper shows how Muslim fathers are taking action to change this controlling image, e.g. through various ‘father groups’. The paper is inspired by the phenomenological notions of ‘experience´ and in the light of this notion, the paper tells the fathers’ stories about their upbringing of their children and aspirations for fatherhood. These stories share light on how these fathers take care of their children in everyday life. The study also shows that the controlling image of these fathers have affected how some Muslim fathers are actually being fathers. The study shows that fear of family-interventions from teachers or social workers e.g. have left some Muslim fathers in a limbo, being afraid of scolding their children, and being confused of ‘what good parenting in Denmark is’. This seems to have led to a more lassie fair upbringing than these fathers actually wanted. This study is important since anthropologists generally have underexposed the notion of fatherhood, and how fathers engage in the upbringing of their children. Over more, the vast majority of qualitative studies of fatherhood have been on white middleclass fathers, living in nuclear families. In addition, this study is crucial at this very moment due to the major refugee crisis in Denmark and in the Western world in general. A crisis, which has resulted in a vast number of scare campaigns against Islam from different nationalistic political parties, which enforces the negative controlling image of Muslim fathers.

Keywords: fatherhood, Muslim fathers, mistrust, education

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