Search results for: R. English

Authors: Atsebaha Gebrekidan Kahsay, Tsehaye Asmelash, Enquebaher Kassaye

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Background: Salmonella remains a global public health problem with a significant burden in sub-Saharan African countries. Human restricted cause of typhoid and paratyphoid fever are S. Typhi and S. Paratyphi, whereas S. Enteritidis and S. Typhimurium is the causative agent of invasive nontyphoidal diseases among humans and animals are their reservoir. The antibiotic resistance of Salmonella is another public health threat around the globe. To come up with full information about human and animal salmonellosis, we made a systematic review of the prevalence, serotypes, and antibiotic resistance of Salmonella in Ethiopia. Methods: This systematic review used Google Scholar and PubMed search engines to search articles from Ethiopia that were published in English in peer-reviewed international journals from 2010 to 2022. We used keywords to identify the intended research articles and used a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the inclusion and exclusion criteria. Frequencies and percentages were analyzed using Microsoft Excel. Results: Two hundred seven published articles were searched, and 43 were selected for a systematic review, human (28) and animals (15). The prevalence of Salmonella in humans and animals was 434 (5.2%) and 641(10.1%), respectively. Fourteen serotypes were identified from animals, and S. Typhimurium was among the top five. Among the ciprofloxacin-resistant isolates in human studies, 16.7% was the highest, whereas, for ceftriaxone, 100% resistance was reported. Conclusions: The prevalence of Salmonella among diarrheic patients and food handlers (5.2%) was lower than the prevalence in food animals (10.1%). We did not find serotypes of Salmonella in human studies, although fourteen serotypes were included in food-animal studies, and S. Typhimurium was among the top five. Salmonella species from some human studies revealed a non-susceptibility to ceftriaxone. We recommend further study about invasive nontyphoidal Salmonella and predisposing factors among humans and animals in Ethiopia.

Keywords: antibiotic resistance, prevalence, systematic review, serotypes, Salmonella, Ethiopia

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Authors: Wen Hsin Hsu, Pin Lin

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Objective: Thirst discomfort is the most common yet often overlooked symptom in patients in the intensive care unit (ICU), with an incidence rate of 69.8%. If not properly cared for, it can easily lead to irritability, affect sleep quality, and increase the incidence of delirium, thereby extending the length of hospital stay. Research points out that the sensation of coldness is an effective strategy to alleviate thirst. Using a combined care approach for thirst can prolong the sensation of coldness in the mouth and reduce thirst discomfort. Therefore, it needs to be further analyzed and its effectiveness reviewed. Methods: This study uses systematic literature review and meta-analysis methodologies and searched databases including PubMed, MEDLINE, EMBASE, Cochrane, CINAHL, and two Chinese databases (CEPS and CJTD) based on keywords. JBI was used to appraise the quality of the literature. RevMen 5.4 software package was used, and Fix Effect Model was applied for data analysis. We selected experimental articles, including those in English and Chinese, that met the inclusion and exclusion criteria. Three research articles were included in total, with a sample size of 416 people. Two were randomized controlled trials, and one was a quasi-experimental design. Results: The results show that the combined care for thirst, which includes ice water spray or oral swab wipes, menthol mouthwash, and lip balm, can significantly relieve thirst intensity MD=-1.36 (3 studies, 95% CI (-1.77, -0.95), p <0.001) and thirst distress MD=-0.71 (2 studies, 95% CI (-1.32, -0.10), p =0.02). Therefore, it is recommended that medical staff identify high-risk groups for thirst early on. Implications for Practice: For patients who cannot eat orally, providing combined care for thirst can increase oral comfort and improve the quality of care.

Keywords: thirst bundle care, intensive care units, meta-analysis, ice water spray, menthol

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Authors: L. Sun, C. Hardacre, A. Garforth, N. Zhang

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Higher Education (HE) degrees in the UK are attractive for international students. The recognized reputation of the HE and the world-leading researchers in some areas in the UK imply that the HE degree from the UK might be a passport to a successful career for abroad students. However, it is a challenge to inspire outstanding students applying for the universities in the UK. The incentives should be country-specific for undergraduates and postgraduates. The potential obstacles to stop students applying for the study in the UK mainly lie in these aspects: different HE systems between the UK and other countries, such as China; less information for the application procedures; worries for the study in English for those non-native speakers; and expensive international tuition fees. The hybrid incentives have been proposed by the efforts from the institutions, stuffs, and students themselves. For example, excellent students from top universities would join us based on the abroad exchange programs or ‘2+2 programme’ with discount tuition. They are potential PhD candidates in the further study in the UK. Diversity promotions are implemented to share information and answer queries for potential students and their guardians. Face to face presentations, workshops, and seminars deliver chances for students to admire teaching and learning in the UK, and give students direct answers for their confusions. WeChat official account and Twitter as the online information platform are set up to post messages of recruitment, the guidance for the application procedures, and international collaboration in teaching and research as well. Students who are studying in the UK and the alumni would share their experiences in the study and lives in the UK and their careers after obtaining the HE degree would play as a positive stimulus to our potential students. Short term modules in the UK with exchangeable credits in summer holidays would give abroad students firsthand experiences of the study in the reputable schools with excellent academics, different cultures and the network with international students. Successful cases at the University of Manchester illustrated the effectiveness of these presented methodologies.

Keywords: abroad students, degree study, high education, hybrid incentives

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Authors: Esraa Elaraby, Dania Abu Zahra, Ghidaa Maswadah, Osama Amira, Mohamed Alshoura, Nihar Dash

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Background: Human being uses salon for a variety of purposes, from trimming of hair and shaving to a range of beauty treatments such as manicure and pedicure. Salon activities involve use of several instruments including scissors, scalpels and razors, materials such as soaps, solutions, creams and gels on human skin and body. Besides, salon customers also use chair, bed and many other common shared utensils and appliances. These salons related activities create a suitable environment for the transmission of several diseases and pathogens including hepatitis B and C, scabies, tuberculosis, staphylococcus and MRSA etc. The transmission of these pathogens can be prevented by maintenance of adequate hygiene and standard preventive measures. Aim: To assess the customer’s level of knowledge about salon-acquired infections and practices taken to prevent their transmission. Methods: A cross-sectional study was conducted among 500 participants across the Emirates. Moreover, self-administered questionnaires (in English and Arabic) were distributed through convenience sampling methods between February and April 2017. Results: The study included 500 participants of which 250 were females. The mean age of the study population was 33 years (SD=4.77). The participants were from several nationalities including 325 Arabs (Non-GCC) (66.2%), 108 Non-Arabs (22%), and 59 Arabs (GCC) (11.8%). The majority of the participants 421 (84.4%) had required knowledge about salon-associated infections with a mean knowledge score of 6/10 (60%). However, when it comes down to preventive practices, only 73 of the 500 participants (14.6%) did carry their own equipment. Thus, there was insufficient correlation between the level of knowledge and preventive practices (p=0.139) of salon-associated infections. Conclusion: People’s knowledge about the salon-associated infections among UAE residents was good, but only a small number practically took the required preventative measures towards this issue. Therefore, a public awareness program is recommended to enhance the deficiencies in knowledge and practices to prevent salon-acquired infections among the users. Up to our knowledge, this is the first study of this kind in the UAE targeting the salon customers about this important issue.

Keywords: awareness, knowledge, practices, salon-associated infections

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Authors: Mukhtar Raban

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Nelson Mandela University subscribes to a humanizing pedagogy (HP), as housed under broader critical pedagogy, that underpins and informs learning and teaching activities at the institution. The investigation sought to explore the implications of humanizing and critical pedagogical considerations for a technology-enhanced language learning (TELL) environment in a university course. The paper inquires into the design of a learning resource in an online learning environment of an English communication module, that applied HP principles. With an objective of creating agentive spaces for foregrounding identity, student voice, critical self-reflection, and recognition of others’ humanity; a flexible and open 'My Presence' feature was added to the TELL environment that allowed students and lecturers to share elements of their backgrounds in a ‘mutually vulnerable’ manner as a way of establishing digital identity and a more ‘human’ presence in the online language learning encounter, serving as a catalyst for the recognition of the ‘other’. Following a qualitative research design, the study adopted an auto-ethnographic approach, complementing the critical inquiry nature embedded into the activity’s practices. The study’s findings provide critical reflections and deductions on the possibilities of leveraging digital human expression within a humanizing pedagogical framework to advance the realization of HP-adoption in language learning and teaching encounters. It was found that the consideration of humanizing pedagogical principles in the design of online learning was more effective when the critical outcomes were explicated to students and lecturers prior to the completion of the activities. The integration of humanizing pedagogy also led to a contextual advancement of ‘affective’ language learning. Upon critical reflection and analysis, student identity and agency can flourish in a technology-enhanced learning environment when humanizing, and critical pedagogy influences the learning design.

Keywords: critical reflection, humanizing pedagogy, student identity, technology-enhanced language learning

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Authors: Paul Lam, Kevin Wong, Chi Him Chan

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Constant practicing and accurate, immediate feedback are the keys to improving students’ speaking skills. However, traditional oral examination often fails to provide such opportunities to students. The traditional, face-to-face oral assessment is often time consuming – attending the oral needs of one student often leads to the negligence of others. Hence, teachers can only provide limited opportunities and feedback to students. Moreover, students’ incentive to practice is also reduced by their anxiety and shyness in speaking the new language. A mobile app was developed to use artificial intelligence (AI) to provide immediate feedback to students’ speaking performance as an attempt to solve the above-mentioned problems. Firstly, it was thought that online exercises would greatly increase the learning opportunities of students as they can now practice more without the needs of teachers’ presence. Secondly, the automatic feedback provided by the AI would enhance students’ motivation to practice as there is an instant evaluation of their performance. Lastly, students should feel less anxious and shy compared to directly practicing oral in front of teachers. Technically, the program made use of speech-to-text functions to generate feedback to students. To be specific, the software analyzes students’ oral input through certain speech-to-text AI engine and then cleans up the results further to the point that can be compared with the targeted text. The mobile app has invited English teachers for the pilot use and asked for their feedback. Preliminary trials indicated that the approach has limitations. Many of the users’ pronunciation were automatically corrected by the speech recognition function as wise guessing is already integrated into many of such systems. Nevertheless, teachers have confidence that the app can be further improved for accuracy. It has the potential to significantly improve oral drilling by giving students more chances to practice. Moreover, they believe that the success of this mobile app confirms the potential to extend the AI-assisted assessment to other language skills, such as writing, reading, and listening.

Keywords: artificial Intelligence, mobile learning, oral assessment, oral practice, speech-to-text function

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Authors: Catherine Harrison

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Faced with arrest, imprisonment and the denazification process in 1945, Tübingen University’s Professor of Theology, Gerhard Kittel, refused to abandon the “Christian” antisemitism which he had first expounded in his Die Judenfrage [The Jewish Question] (1933 and 1934). At the heart of this paper is a critical engagement with Die Judenfrage, the first in English. Putting Die Judenfrage into dialogue with Kittel’s 1946, Meine Verteidigung [My Defence] (1945-6) exposes the remarkable consistency of Kittel’s idiosyncratic but closely argued Christian theology of antisemitism. Girdling his career as a foremost theologian, antisemite and enthusiastic supporter of Hitler and the NSDAP, the consistency between Die Judenfrage and Meine Verteidigung attests Kittel’s consistent and authentic, intellectual position. In both texts, he claims to be advancing Christian, as opposed to “vulgar” or racial, antisemitism. Yet, in the thirteen years which divide them, Kittel had mediated contact with Nazi illuminati Rudolph Hess, Alfred Rosenberg, Winnifred Wagner, Josef Goebbels and Baldur von Schirach, through his publications in various antisemitic journals. The paper argues: Die Judenfrage, as both a text and as a theme, is axiomatic to Kittel’s defence statement; and that Die Judenfrage constitutes the template of Kittel’s arcane, personal “Christian” antisemitism of which Meine Verteidigung is a faithful impression. Both are constructed on the same theologically chimeric and abstruse hypotheses regarding Volk, Spätjudentum [late Judaism] and Heilgeschichte [salvation history]. Problematising these and other definitional vagaries that make up Kittel’s “Christian” antisemitism highlight the remarkable theoretical consistency between Die Judenfrage and Meine Verteidigung. It is concluded that a deadly synergy of Nazi racial antisemitism and the New Testament antisemitism shaped Kittel’s judgement to the degree that, despite the slipstream of concentration camp footage which was shaking the foundations of post-war German academia, Meine Verteidigung is a simple restatement of the antisemitsm conveyed in Die Judenfrage.

Keywords: Gerhard Kittel, Third Reich theology, the Jewish Question, Nazi antisemitism

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Authors: Shaista Maseeh

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English Literature from the beginning itself has had psychological, social and environment concerns. Virgil, Shakespeare, John Milton, William Wordsworth to the most current Robert Hass have shown and proved their environmental and ecological interests as well as distress related to its loss. Pastoral literature is also one such genre that links literature with environment. Thanks to the contemporary literary theories that they successfully are relating Literature formally to the subjects other than written text. One of such literary theory is 'Ecocriticism.' It stands under the umbrella of the Economics term, Sustainable Development,' or it can also be understood as an ecological extension of it. Ecocriticism helps the reader to study the dynamic relation between literature and our degrading environment. It draws attention towards the ravaged condition of nature and animals, that how nature is exploited by human beings for their own benefit leaving nature at a repairable loss. For instance, deforestation is reducing the size of forest every year, injuring permanently flora, fauna and also the habitat of animals. This paper will study the ecological and environmental concerns in the latest novel by Pakistani British writer Kamila Shamsie, A God in every Stone (2014). The book is not only a literary masterpiece in elegant prose, but also a novel posing a lot of questions about 'nature and environment' in general and 'animals' in particular. It gives the glimpses of the interesting history of Temple of Zeus in Greece and Ancient Caria, and covers many episodes of history the Indian freedom struggle. In course of novel's narrative Kamila Shamsie poses disturbing question about environmental abuse, about how human beings are more 'beasts' than so call beasts, poor animals. She also glorifies the simplicity of past. The novel has enough instances to prove Shamsie's positive stand on saving the earth that is being more abused than used by human beings. This paper will provide an ecocritical approach to study A God in Every Stone (2014).

Keywords: animals, ecocriticism, environment, nature

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Authors: Sriranjani Srinivasan

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To appreciate Indian art and architecture by studying it in India alone will only lead to partial understanding of the whole story and the variety of the statement has been amply proved by subsequent decades of patient research. The results of the work of the Archaeological Survey of India forms only one half of the picture, the other half emerges with the studies of the archaeology and art of the Far East that progressed almost simultaneously under the Archaeological Survey of the Dutch East Indies, the École française d'Extrême-Orient (EFEO), or French School of Asian Studies, and allied institutions. The conclusions arrived at have only rendered the assertion that India produced her ultimate master pieces only through foreign influences and in foreign lands (the South-Eastern peninsular and archipelagic regions) almost axiomatic. Angkor in Cambodia and Borobudur in Java, undoubtedly the two greatest architectural marvels of Indian genius, for in content and spirit these (and other monuments of varying magnitudes), are purely Indian, would well illustrate the statement mentioned earlier. Stimulated research followed the discoveries and among the many studies and publications of such pioneers like Coedes, Parmentier, Coomaraswamy and many others in Dutch, French and English made growing contributions to the subject. This paper will discuss in detail the impact of India on the architecture of South East Asia by detailed comparison of architectural styles, elements, and construction materials of a few specific architectural master pieces, in both India and South East Asian countries. It will also analyze the reasoning behind the influence of India on South East Asian countries in spite of them being exposed to the equally culturally rich and civilized kingdoms of China. The intention of this paper is to understand that, conquest by war is not always the only reason for architectural influences and impacts.

Keywords: architectural influence, Buddhist architecture, Indian architecture, Southeast Asian architecture

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Authors: Archana Rao R., Deepak P., Chayashree P. D., Darshan H. S.

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Cognitive abilities in bilinguals have been widely studied over the last few decades. Bilingualism has been found to extensively facilitate the ability to store and manipulate information in Working Memory (WM). The mechanism of WM includes primary memory, attentional control, and secondary memory, each of which makes a contribution to WM. Many researches have been done in an attempt to measure WM capabilities through both verbal (phonological) and nonverbal tasks (visuospatial). Since there is a lot of speculations regarding the relationship between WM and bilingualism, further investigation is required to understand the nature of WM in bilinguals, i.e., with respect to sequential and simultaneous bilinguals. Hence the present study aimed to highlight the verbal working memory abilities in sequential and simultaneous bilinguals with respect to the processing and recall abilities of nouns and verbs. Two groups of bilinguals aged between 18-30 years were considered for the study. Group 1 consisted of 20 (10 males and 10 females) sequential bilinguals who had acquired L1 (Kannada) before the age of 3 and had exposure to L2 (English) for a period of 8-10 years. Group 2 consisted of 20 (10 males and 10 females) simultaneous bilinguals who have acquired both L1 and L2 before the age of 3. Working memory abilities were assessed using two tasks, and a set of stimuli which was presented in gradation of complexity and the stimuli was inclusive of frequent and infrequent nouns and verbs. The tasks involved the participants to judge the correctness of the sentence and simultaneously remember the last word of each sentence and the participants are instructed to recall the words at the end of each set. The results indicated no significant difference between sequential and simultaneous bilinguals in processing the nouns and verbs, and this could be attributed to the proficiency level of the participants in L1 and the alike cognitive abilities between the groups. And recall of nouns was better compared to verbs, maybe because of the complex argument structure involved in verbs. Similarly, authors found a frequency of occurrence of nouns and verbs also had an effect on WM abilities. The difference was also found across gradation due to the load imposed on the central executive function and phonological loop.

Keywords: bilinguals, nouns, verbs, working memory

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Authors: Anne Klimesch, Alejandra Martinez, Martin HäRter, Isabelle Scholl, Paulina Bravo

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Patient-centered care (PCC) is a key principle of high-quality healthcare. In Latin America, research on and promotion of PCC have taken place in the past. However, thorough implementation of PCC in practice is still missing. In Germany, an integrative model of patient-centeredness has been developed by synthesis of diverse concepts of PCC. The model could serve as a point of reference for further research on the implementation of PCC. However, it is predominantly based on research from Europe and North America. This scoping review, therefore, aims to accumulate research on PCC in Latin America in the past 15 years and analyse how PCC has been conceptualized. The resulting overview of PCC in Latin America will be a foundation for a subsequent study aiming at the adaptation of the integrative model of patient-centeredness to the Latin American health care context. Scientific databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Web of Science, SCIELO, Redalyc.) will be searched, and reference and citation tracking will be performed. Studies will be included if they were carried out in Latin America, investigated PCC in any clinical and community setting (public and private), and were published in English, Spanish, French, or Portuguese since 2006. Furthermore, any theoretical framework or conceptual model to guide how PCC is conceptualized in Latin America will be included. Two reviewers will be responsible for the identification of articles, screening of records, and full-text assessment. The results of the scoping review will be used in the development of a mixed-methods study with the aim to understand the needs for PCC, as well as barriers and facilitators in Latin America. Based on the outcomes, the integrative model of PCC will be translated to Spanish and adapted to the Latin American context. The integrative model will enable the dissemination of the concept of PCC in Latin America and will provide a common ground for further research on the topic. The project will thereby make an important contribution to an evidence-based implementation of PCC in Latin America.

Keywords: conceptual framework, integrative model of PCC, Latin America, patient-centered care

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Authors: Jou-An Chung

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The purpose of this study is to investigate the verb bias of the Mandarin verbs in children’s reading materials and provide the criteria for categorization. Verb bias varies cross-linguistically. As Mandarin and English are typological different, this study hopes to shed light on Mandarin verb bias with the use of corpus and provide thorough and detailed criteria for analysis. Moreover, this study focuses on children’s reading materials since it is a significant issue in understanding children’s sentence processing. Therefore, investigating verb bias of Mandarin verbs in children’s reading materials is also an important issue and can provide further insights into children’s sentence processing. The small corpus is built up for this study. The corpus consists of the collection of school textbooks and Mandarin Daily News for children. The files are then segmented and POS tagged by JiebaR (Chinese segmentation with R). For the ease of analysis, the one-word character verbs and intransitive verbs are excluded beforehand. The total of 20 high frequency verbs are hand-coded and are further categorized into one of the three types, namely DO type, SC type and other category. If the frequency of taking Other Type exceeds the threshold of 25%, the verb is excluded from the study. The results show that 10 verbs are direct object bias verbs, and six verbs are sentential complement bias verbs. The paired T-test was done to assure the statistical significance (p = 0.0001062 for DO bias verb, p=0.001149 for SC bias verb). The result has shown that in children’s reading materials, the DO biased verbs are used more than the SC bias verbs since the simplest structure of sentences is easier for children’s sentence comprehension or processing. In sum, this study not only discussed verb bias in child's reading materials but also provided basic coding criteria for verb bias analysis in Mandarin and underscored the role of context. Sentences are easier for children’s sentence comprehension or processing. In sum, this study not only discussed verb bias in child corpus, but also provided basic coding criteria for verb bias analysis in Mandarin and underscored the role of context.

Keywords: corpus linguistics, verb bias, child language, psycholinguistics

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Authors: Hushyar Azari

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Aim and background: Deep brain stimulation (DBS) is regarded as an important therapeutic choice for Parkinson's disease (PD). The two most common targets for DBS are the subthalamic nucleus (STN) and globus pallidus (GPi). This review was conducted to compare the clinical effectiveness of these two targets. Methods: A systematic literature search in electronic databases: Embase, Cochrane Library and PubMed were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies which evaluated the Unified Parkinson's Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) compared both GPi and STN DBS; (2) had at least three months follow-up period; (3)at least five participants in each group; (4)conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale. Results: 3577 potentially relevant articles were identified, of these, 3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). According to Modified Jadad Scale, the majority of included studies had low evidence quality which was a limitation of this review. 5 studies reported no statistically significant between-group difference for improvements in UPDRS ш scores. At the same time, there were some results in terms of pain, action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice. Regarding the adverse effects, GPi was superior. Conclusion: It is clear that other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for deep brain stimulation in Parkinson’s disease and imposes fewer adverse effects on the patients. Meanwhile, STN seems more reasonable according to the results of this systematic review.

Keywords: brain stimulation, globus pallidus, Parkinson's disease, subthalamic nucleus

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Authors: Dike Ibegbulem

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This paper interrogates the chances of Nigeria achieving its target of making the list of the first 70 countries in World Bank’s Ease of Doing Business (EoDB) rankings by the year 2023. That is, in light of existing conflicts in policies relating to the door-to-door carriage of goods and multimodal transport operations (MTOs) in the country. Drawing on the famed Legal Origins theory plus data from World Bank; and using Singapore as a touchstone, the paper unveils how amongst the top-ranked Commonwealth jurisdictions, positive correlations have been recorded over the past years between certainty in their policies on MTOs on the one hand; and their Enforcing Contracts (EC) and Doing Business (DB) indices on the other. The paper postulates that to increase Nigeria’s chances of achieving her DB2023 objective, legislative and curial policies on MTOs and door-to-door carriage of goods have to be realigned in line with prevailing policies in highly-ranked Commonwealth jurisdictions of the Global North. Her appellate courts, in particular, will need some unshackling from English pedigrees which still delimit admiralty jurisdiction to port-to-port shipping, to the exclusion of door-to-door carriage of goods beyond navigable waters. The paper identifies continental and domestic instruments, plus judicial precedents, which provide bases for expanding admiralty jurisdiction to adjudication of claims derived from door-to-door or multimodal transport contracts and other allied maritime-plus contracts. It prescribes synergy between legislative and curial policies on MTOs and door-to-door carriage of goods as species of admiralty – an emerging trend in top-ranked Commonwealth jurisdictions of the Global North.

Keywords: admiralty jurisdiction, legal origins, world bank, ease of doing business, enforcing contracts, multimodal transport operation, door-to-door, carriage of goods by sea, combined transport shipping

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Authors: Gülcan Taşkıran, Ayla Bayık Temel

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Background: Florence Nightingale, the modern founder of the nursing, is most famous for her role as a nurse. But not so much known about her contributions as a mathematician and statistician. Aim: In this conceptual article it is aimed to examine Florence Nightingale's statistics education, how she used her passion for statistics and applied statistical data in nursing care and her scientific contributions to statistical science. Design: Literature review method was used in the study. The databases of Istanbul University Library Search Engine, Turkish Medical Directory, Thesis Scanning Center of Higher Education Council, PubMed, Google Scholar, EBSCO Host, Web of Science were scanned to reach the studies. The keywords 'statistics' and 'Florence Nightingale' have been used in Turkish and English while being screened. As a result of the screening, totally 41 studies were examined from the national and international literature. Results: Florence Nightingale has interested in mathematics and statistics at her early ages and has received various training in these subjects. Lessons learned by Nightingale in a cultured family environment, her talent in mathematics and numbers, and her religious beliefs played a crucial role in the direction of the statistics. She was influenced by Quetelet's ideas in the formation of the statistical philosophy and received support from William Farr in her statistical studies. During the Crimean War, she applied statistical knowledge to nursing care, developed many statistical methods and graphics, so that she made revolutionary reforms in the health field. Conclusions: Nightingale's interest in statistics, her broad vision, the statistical ideas fused with religious beliefs, the innovative graphics she has developed and the extraordinary statistical projects that she carried out has been influential on the basis of her professional achievements. Florence Nightingale has also become a model for women in statistics. Today, using and teaching of statistics and research in nursing care practices and education programs continues with the light she gave.

Keywords: Crimean war, Florence Nightingale, nursing, statistics

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Authors: Fabiha Tanzeem

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BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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Authors: Thiago Spilborghs Bueno Meyer, Plinio Thomaz Aquino Junior

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Through speech, which privileges the functional and interactive nature of the text, it is possible to ascertain the spatiotemporal circumstances, the conditions of production and reception of the discourse, the explicit purposes such as informing, explaining, convincing, etc. These conditions allow bringing the interaction between humans closer to the human-robot interaction, making it natural and sensitive to information. However, it is not enough to understand what is said; it is necessary to recognize emotions for the desired interaction. The validity of the use of neural networks for feature selection and emotion recognition was verified. For this purpose, it is proposed the use of neural networks and comparison of models, such as recurrent neural networks and deep neural networks, in order to carry out the classification of emotions through speech signals to verify the quality of recognition. It is expected to enable the implementation of robots in a domestic environment, such as the HERA robot from the RoboFEI@Home team, which focuses on autonomous service robots for the domestic environment. Tests were performed using only the Mel-Frequency Cepstral Coefficients, as well as tests with several characteristics of Delta-MFCC, spectral contrast, and the Mel spectrogram. To carry out the training, validation and testing of the neural networks, the eNTERFACE’05 database was used, which has 42 speakers from 14 different nationalities speaking the English language. The data from the chosen database are videos that, for use in neural networks, were converted into audios. It was found as a result, a classification of 51,969% of correct answers when using the deep neural network, when the use of the recurrent neural network was verified, with the classification with accuracy equal to 44.09%. The results are more accurate when only the Mel-Frequency Cepstral Coefficients are used for the classification, using the classifier with the deep neural network, and in only one case, it is possible to observe a greater accuracy by the recurrent neural network, which occurs in the use of various features and setting 73 for batch size and 100 training epochs.

Keywords: emotion recognition, speech, deep learning, human-robot interaction, neural networks

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Authors: Intesar Ibrahim

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Large-scale Libyan emigration is a relatively new phenomenon. Most of the Libyan families in the UK are new immigrants, unlike the other neighbouring countries of Egypt, Tunisia, Algeria and even Sudan. Libyans have no particular history of large-scale migration. On the other hand, many Libyan families live in modest homes located in large Muslim communities of Pakistanis and Yemenis. In the UK as a whole, there are currently 16 Libyan schools most of which are run during the weekend for children of school age. There are three such weekend schools in Sheffield that teach a Libyan school curriculum, and Libyan women and men run these schools. Further, there is also a Masjid (mosque) that is operated by Libyans, beside the other Masjids in the city, which most of the Libyan community attend for prayer and for other activities such as writing marriage contracts. The presence of this Masjid increases the attraction for Libyans to reside in the Sheffield area. This paper studies how Libyan immigrants in the UK make their decisions on their housing and living environment in the UK. Libyan residents in the UK come from different Libyan regions, social classes and lifestyles; this may have an impact on their choices in the interior designs of their houses in the UK. A number of case studies were chosen from Libyan immigrants who came from different types of dwellings in Libya, in order to compare with their homes and their community lifestyle in the UK and those in Libya. This study explores the meaning and the ways of using living rooms in Libyan emigrants’ houses in the UK and compares those with those in their houses back in their home country. For example, the way they set up furniture in rooms acts as an indicator of the hierarchical structure of society. The design of furniture for Libyan sitting rooms for floor-seating is different from that of the traditional English sitting room. The paper explores the identity and cultural differences that affected the style and design of the living rooms for Libyan immigrants in the UK. The study is carried out based on the "production of space" theory that any culture has its needs, style of living and way of thinking. I argue that the study found more than 70% of Libyan immigrants in the UK still furnish the living room in their traditional way (flooring seating).

Keywords: place, identity, culture, immigrants

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Authors: Carri Welsby, Jessie Gunson, Pen Roe

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Currently, there is limited research examining health care professionals (HCPs) views on long-acting reversible contraception (LARC) advice and prescription, particularly outside of the general practice (GP) setting. The aim of this study is to systematically review existing evidence around the barriers and enablers of oral contraception (OC) in comparison to LARC, as perceived by HCPs in non-GP settings. Five electronic databases were searched in April 2018 using terms related to LARC, OC, HCPs, and views, but not terms related to GPs. Studies were excluded if they concerned emergency oral contraception, male contraceptives, contraceptive use in conjunction with a health condition(s), developing countries, GPs and GP settings, were non-English or was not published before 2013. A total of six studies were included for systematic reviewing. Five key areas emerged, under which themes were categorised, including (1) understanding HCP attitudes and counselling practices towards contraceptive methods; (2) assessment of HCP attitudes and beliefs about contraceptive methods; (3) misconceptions and concerns towards contraceptive methods; and (4) influences on views, attitudes, and beliefs of contraceptive methods. Limited education and training of HCPs exists around LARC provision, particularly compared to OC. The most common misconception inhibiting HCPs contraceptive information delivery to women was the belief that LARC was inappropriate for nulliparous women. In turn, by not providing the correct information on a variety of contraceptive methods, HCP counselling practices were disempowering for women and restricted them from accessing reproductive justice. Educating HCPs to be able to provide accurate and factual information to women on all contraception is vital to encourage a woman-centered approach during contraceptive counselling and promote informed choices by women.

Keywords: advice, contraceptives, health care professionals, long acting reversible contraception, oral contraception, reproductive justice

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Authors: Omnia F. Elkommos

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In the course of teaching stylistics to undergraduate students of the Department of English Language and Literature, Faculty of Arts and Humanities, the linguistic tool kit of theories comes in handy and useful for the better understanding of the different literary genres: Poetry, drama, and short stories. In the present paper, a model of teaching of stylistics is compiled and suggested. It is a collaborative group project technique for use in the undergraduate diverse specialisms (Literature, Linguistics and Translation tracks) class. Students initially are introduced to the different linguistic tools and theories suitable for each literary genre. The second step is to apply these linguistic tools to texts. Students are required to watch videos performing the poems or play, for example, and search the net for interpretations of the texts by other authorities. They should be using a template (prepared by the researcher) that has guided questions leading students along in their analysis. Finally, a practical analysis would be written up using the practical analysis essay template (also prepared by the researcher). As per collaborative learning, all the steps include activities that are student-centered addressing differentiation and considering their three different specialisms. In the process of selecting the proper tools, the actual application and analysis discussion, students are given tasks that request their collaboration. They also work in small groups and the groups collaborate in seminars and group discussions. At the end of the course/module, students present their work also collaboratively and reflect and comment on their learning experience. The module/course uses a drama play that lends itself to the task: ‘The Bond’ by Amy Lowell and Robert Frost. The project results in an interpretation of its theme, characterization and plot. The linguistic tools are drawn from pragmatics, and discourse analysis among others.

Keywords: applied linguistic theories, collaborative learning, cooperative principle, discourse analysis, drama analysis, group project, online acting performance, pragmatics, speech act theory, stylistics, technology enhanced learning

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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Authors: Geraldine Ambe

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Cameroon is a country in a country in Central Africa. Before the first World War, Germany colonized Cameroon, including some parts of Gabon, Chad, Nigeria, and the Central African Republic. After the war, the United Nations divided most of the colony into Britain and France. In 1960, Eastern Cameroon (‘La Republique du Cameroon’) gained its independence from France while British Southern Cameroons obtained its independence from Britain. The two entities agreed to live together as a federal state officially called the Federal Republic of Cameroon. In 1962, the name of the name of the country was changed from the Federal Republic of Cameroon to the United Republic of Cameroon, while the Prime Minister of Western Cameroon was moved to Yaounde. In 1984, President Paul Biya singlehandedly changed the name to the Republic of Cameroon, implying that Southern Cameroon is not recognized in the union again. From the words of Am Cohen, the two territories came together to form a federal government with one currency, one army, and one foreign policy like states in the United States of America. However, the name Republic of Cameroon (‘La Republique du Cameroun’) does not recognize BSC, and this is exactly what has been practiced: politics of exclusion and excessive centralization in Yaounde. In 2016, teachers and Lawyers started strikes to call the attention of the government on the inhalation of the English culture/people. They were greeted with guns, causing the radicalization of the youths. The civil society came together to form a union to address the issues facing the people, and the government took their leaders and sentenced them to live imprisonment. The consequence was a civil war with nobody to dialogue with. Out of Cameroon, more than half a million people from BSC have been taking dangerous trips through the air, land, and sea. In the jungles and the deserts, the snow of Europe, these people have been seen for the last 4 years. This paper will present some personalities, political fractions, and their stands of decentralization, federalism, and independence as the war continues. The paper will further look at the consequence of this crisis on migration in Central and Eastern Europe.

Keywords: British Southern Cameroons, decolonization, Second World War, dialogue, civil war, immigration

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Authors: Elsa Marta Soares, Ana Rita Valente, Cristiana Rodrigues, Filipa Gonçalves

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Background: The assessment of feelings and attitudes of preschool children in relation to stuttering is crucial. Negative experiences can lead to anxiety, worry or frustration. To avoid the worsening of attitudes and feelings related to stuttering, it is important the early detection in order to intervene as soon as possible through an individualized intervention plan. Then it is important to have Portuguese instruments that allow this assessment. Aims: The aim of the present study is to realize the translation and adaptation of the Communication Attitude Test for Children in Preschool Age and Kindergarten (KiddyCat) for EP. Methodology: For the translation and adaptation process, a methodological study was carried out with the following steps: translation, back translation, assessment by a committee of experts and pre-test. This abstract describes the results of the first two phases of this process. The translation was accomplished by two bilingual individuals without experience in health and any knowledge about the instrument. One of them was an English teacher and the other one a Translator. The back-translation was conducted by two Senior Class Teachers that live in United Kingdom without any knowledge in health and about the instrument. Results and Discussion: In translation there were differences in semantic equivalences of various expressions and concepts. A discussion between the two translators, mediated by the researchers, allowed to achieve the consensus version of the translated instrument. Taking into account the original version of KiddyCAT the results demonstrated that back-translation versions were similar to the original version of this assessment instrument. Although the back-translators used different words, they were synonymous, maintaining semantic and idiomatic equivalences of the instrument’s items. Conclusion: This project contributes with an important resource that can be used in the assessment of feelings and attitudes of preschool children who stutter. This was the first phase of the research; expert panel and pretest are being developed. Therefore, it is expected that this instrument contributes to an holistic therapeutic intervention, taking into account the individual characteristics of each child.

Keywords: assessment, feelings and attitudes, preschool children, stuttering

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Authors: Dylan Elliott, Katya Pertsova

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Preposition errors are some of the most common errors created by L2 speakers. In addition, improving error correction and detection methods remains an open issue in the realm of Natural Language Processing (NLP). This research investigates whether the bidirectional encoder representations from the transformers model (BERT) have the potential to correct preposition errors accurately enough to be useful in error correction software. This research finds that BERT performs strongly when the scope of its error correction is limited to preposition choice. The researchers used an open-source BERT model and over three hundred thousand edited sentences from Wikipedia, tagged for part of speech, where only a preposition edit had occurred. To test BERT’s ability to detect errors, a technique known as multi-level masking was used to generate suggestions based on sentence context for every prepositional environment in the test data. These suggestions were compared with the original errors in the data and their known corrections to evaluate BERT’s performance. The suggestions were further analyzed to determine if BERT more often agreed with the judgements of the Wikipedia editors. Both the untrained and fined-tuned models were compared. Finetuning led to a greater rate of error-detection which significantly improved recall, but lowered precision due to an increase in false positives or falsely flagged errors. However, in most cases, these false positives were not errors in preposition usage but merely cases where more than one preposition was possible. Furthermore, when BERT correctly identified an error, the model largely agreed with the Wikipedia editors, suggesting that BERT’s ability to detect misused prepositions is better than previously believed. To evaluate to what extent BERT’s false positives were grammatical suggestions, we plan to do a further crowd-sourcing study to test the grammaticality of BERT’s suggested sentence corrections against native speakers’ judgments.

Keywords: BERT, grammatical error correction, preposition error detection, prepositions

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Authors: Yasàlu Haruna

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In every transaction, the use of language is central regardless of form or complexity if any meaning is expected to be harvested therefrom. Students constituting a population group in the learning landscape of Nigeria occupy a central position with a propensity to excel or otherwise in the context of communication, especially in the learning process and social interaction. The nature or quantum of anxiety or confidence in speaking a second language is not only peculiar to societies where the second language is not an official language but to a degree, the linguistic gap created by adoption and adaptation syndrome manifests in created anxiety or lack of confidence especially where mastery of a spoken language becomes a major challenge. This paper explores the manner in which linguistic complexity and cultural barriers combine to widen the adaptation and adoption gap. In much the same way, typical issues of pronouncement, intonation and accent difficulties are vital variables that explain the root cause of anxiety. Using a combination of primary and secondary sources of data expressed in questionnaires, key informant interviews and other available data, the paper concludes that the non-integration of anxiety possibility into the education delivery framework has left a lot to be needed in cultivating second language speakers among students of Nigerian Colleges of Education. In addition, cultural barriers and the absence of integration interfaces in the course of learning within and outside the classroom contribute to further widening the gap. Again, colleagues/mates/conversation partners' mastery of a second language remains a contributory factor largely due to the quality of the preparatory school system in many parts of the country. The paper recommends that national policies and frameworks must be reviewed to consider integration windows where culture and conversation partner deficiencies can be remedied through educational events such as debates, quizzes and symposia; improvements can be attained while commercial advertisements are tailored towards seeking for adoption of second language in commerce and major cultural activities.

Keywords: cultural barriers, integration, college of education and adaptation, second language

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Authors: Chu-Ching Hsu

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This paper focuses on how the government-led language policies and the political changes in Taiwan manipulate the languages choice in translations and what translation strategies are employed by the translator to show his or her language ideology behind the power struggles and decision-making. Therefore, framed by Lefevere’s theoretical concept of translating as rewriting, and carried out a diachronic and chronological study, this paper specifically sets out to investigate the language ideology and translator’s idiolect of Chinese language translations of Anglo-American novels. The examples drawn to explore these issues were taken from different versions of Chinese renditions of Mark Twain’s English-language novel The Adventures of Huckleberry Finn in which there are several different dialogues originally written in the colloquial language and dialect used in the American state of Mississippi and reproduced in Mark Twain’s works. Also, adapted corpus methodology, many examples are extracted as instances from the translated texts and source text, to illuminate how the translators in Taiwan deal with the dialectal features encoded in Twain’s works, and how different versions of Chinese translations are employed by Taiwanese translators to confirm the language polices and to express their language identity textually in different periods of the past five decades, from the 1960s onward. The finding of this study suggests that the use of Taiwanese dialect and language patterns in translations does relate to the movement of the mother-tongue language and language ideology of the translator as well as to the issue of language identity raised in the island of Taiwan. Furthermore, this study confirms that the change of political power in Taiwan does bring significantly impact in language policy-- assimilationism, pluralism or multiculturalism, which also makes Taiwan from a monolingual to multilingual society, where the language ideology and identity can be revealed not only in people’s daily communication but also in written translations.

Keywords: language politics and policies, literary translation, mother-tongue, multiculturalism, translator’s ideology

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Authors: Sheikh Omar Sillah

Abstract:

Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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Authors: Jia-Lien Hsu, Chiung-Wen Chang

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Research articles may follow a simple and succinct structure of organizational patterns, called move. For example, considering extended abstracts, we observe that an extended abstract usually consists of five moves, including Background, Aim, Method, Results, and Conclusion. As another example, when publishing articles in PubMed, authors are encouraged to provide a structured abstract, which is an abstract with distinct and labeled sections (e.g., Introduction, Methods, Results, Discussions) for rapid comprehension. This paper introduces a method for computational analysis of move structures (i.e., Background-Purpose-Method-Result-Conclusion) in abstracts and introductions of research documents, instead of manually time-consuming and labor-intensive analysis process. In our approach, sentences in a given abstract and introduction are automatically analyzed and labeled with a specific move (i.e., B-P-M-R-C in this paper) to reveal various rhetorical status. As a result, it is expected that the automatic analytical tool for move structures will facilitate non-native speakers or novice writers to be aware of appropriate move structures and internalize relevant knowledge to improve their writing. In this paper, we propose a Bayesian approach to determine move tags for research articles. The approach consists of two phases, training phase and testing phase. In the training phase, we build a Bayesian model based on a couple of given initial patterns and the corpus, a subset of CiteSeerX. In the beginning, the priori probability of Bayesian model solely relies on initial patterns. Subsequently, with respect to the corpus, we process each document one by one: extract features, determine tags, and update the Bayesian model iteratively. In the testing phase, we compare our results with tags which are manually assigned by the experts. In our experiments, the promising accuracy of the proposed approach reaches 56%.

Keywords: academic English writing, assisted writing, move tag analysis, Bayesian approach

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Authors: Jennifer Isabelle Rios Rendón, Ursula Sanchez, Dana Lee Baker

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Disability Policy in México has witnessed numerous changed throughout the years. Physical disabilities are more often recognized in Mexican culture. However, with an emerging focus on neurological disabilities or differences in individuals’ new policies are needed to serve better and understand the needs of these populations. The need to understand and communicate with local leaders is imperative, as the lens used to analyze autism has historically been from a Western school of thought. We are looking to comprehend the disability policy subsystem in México - specifically how autism is perceived, the language used to describe it, and how it ties to the cultural stigma of disabilities that exist in México. Therefore, to understand this, we seek to interview multiple policy leaders on their experience in autism and disability policy. The goal is to conduct qualitative research through interviews with local autism and disability leaders in México. This methodology aims to answer the questions of what language commonly and culturally is utilized in disability policy, the context of how autism is perceived in México, and in general, the lived experience of the disability policy leaders that take part in this effort in México. Local activists and policy leaders were initially found through an online search then collected using snowball sampling. The interviews were conducted through a series of pre-formulated questions that the policy leader answered via email or a phone conversation with the researchers. Acknowledging the importance of language and accessibility, the need for the content to be in both English and Spanish as well as auditory and visual is essential to take steps in the inclusion of a Neurodiverse group of leaders. This work is a demonstration of the framework of the investigation which hopes to create a more complete understanding of the policy and political culture around autism in México. Results of the project include new insight into the developing relationship between the President Andrés Manuel López Obrador’s administration, disability activists, and neurodiverse communities. The project contributes to denormalizing the legacy of white supremacy in autism related, historically rooted in the assumption that autism occurs predominantly in white communities.

Keywords: autism, disability leaders, disability policy, México, Neurodiversity

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Authors: Fiona Bei Na Tan, Glen Wen Kiat Ho, Ee Leen Liow, Li Yin Tan, Sean Wei Loong Ho

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Background: Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Objectives: Our aim is to highlight a case report of pneumothorax post shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors associated with developing a pneumothorax during or after shoulder arthroscopy. Case Report: We report the case of a 75-year-old male non-smoker who underwent left shoulder arthroscopy without regional anaesthesia and in the left lateral position. The general anaesthesia and surgery were uncomplicated. The patient was desaturated postoperatively and was found to have a pneumothorax on examination and chest X-ray. A chest tube drain was inserted promptly into the right chest. He had an uncomplicated postoperative course. Methods: PubMed Medline and Cochrane database search was carried out using the terms shoulder arthroplasty, pneumothorax, pneumomediastinum, and subcutaneous emphysema. We selected full-text articles written in English. Results: Thirty-two articles were identified and thoroughly reviewed. Based on our inclusion and exclusion criteria, 14 articles, which included 20 cases of pneumothorax during or after shoulder arthroscopy, were included. Eighty percent (16/20) of pneumothoraxes occurred postoperatively. In the articles that specify the side of pneumothorax, 91% (10/11) occur on the ipsilateral side of the arthroscopy. Eighty-eight percent (7/8) of pneumothoraxes occurred when subacromial decompression was performed. Fifty-six percent (9/16) occurred in patients placed in the lateral decubitus position. Only 30% (6/20) occurred in current or ex-smokers, and only 25% (5/20) had a pre-existing lung condition. Overall, of the articles that posit a mechanism, 75% (9/12) deem the pathogenesis to be multifactorial. Conclusion: The exact mechanism of pneumothorax is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should have a low threshold to obtain diagnostic plain radiographs in the event of clinical suspicion.

Keywords: rotator cuff repair, decompression, pressure, complication

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