Search results for: intervention program refreshers

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: M. H. Rajikin, S. M. M. Syairah, A. R. Sharaniza

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Effects of nicotine on pre-partum body weight and preimplantation embryonic development has been reported previously. Present study was conducted to determine the effects of annatto (Bixa orellana)-derived delta-tocotrienol (TCT) (with presence of 10% gamma-TCT isomer) on the nicotine-induced reduction in body weight and 8-cell embryonic growth in mice. Twenty four 6-8 weeks old (23-25g) female balb/c mice were randomly divided into four groups (G1-G4; n=6). Those groups were subjected to the following treatments for 7 consecutive days: G1 (control) were gavaged with 0.1 ml tocopherol stripped corn oil, G2 was subcutaneously (s.c.) injected with 3 mg/kg/day of nicotine, G3 received concurrent treatment of nicotine (3 mg/kg/day) and 60 mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma isomers) and G4 was given 60 mg/kg/day of δ-TCT mixture alone. Body weights were recorded daily during the treatment. On Day 8, females were superovulated with 5 IU Pregnant Mare’s Serum Gonadotropin (PMSG) for 48 hours followed with 5 IU human Chorionic Gonadotropin (hCG) before mated with males at the ratio of 1:1. Females were sacrificed by cervical dislocation for embryo collection 48 hours post-coitum. Collected embryos were cultured in vitro. Results showed that throughout Day 1 to Day 7, the body weight of nicotine treated group (G2) was significantly lower (p<0.05) than that of G1, G3 and G4. Intervention with δ-TCT mixture (G3) managed to increase the body weight close to the control group. This is also observed in the group treated with δ-TCT mixture alone (G4). The development of 8-cell embryos following in vitro culture (IVC) was totally inhibited in G2. Intervention with δ-TCT mixture (G3) resulted in the production of 8-cell embryos, although it was not up to that of the control group. Treatment with δ-TCT mixture alone (G4) caused significant increase in the average number of produced 8-cell embryo compared to G1. Present data indicated that δ-TCT mixture was able to reverse the body weight loss in nicotine treated mice and the development of 8-cell embryos was also improved.

Keywords: δ-tocotrienol, body weight, nicotine, preimplantation embryonic development

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Authors: Reham H. Diab, Amira A. A. Abdallah, Eman A. Embaby

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Background: The effectiveness of bracing on preventing spino-pelvic alignment deterioration in idiopathic scoliosis has been extensively studied especially in the frontal plane. Yet, there is lack of knowledge regarding the effect of soft braces on spino-pelvic alignment in the sagittal plane. Achieving harmonious sagittal plane spino-pelvic balance is critical for the preservation of physiologic posture and spinal health. Purpose: This study examined the kyphotic angle, lordotic angle and pelvic inclination in the sagittal plane and trunk imbalance in the frontal plane before and after a six-month rehabilitation period. Methods: Nineteen patients with idiopathic scoliosis participated in the study. They were divided into two groups; experimental and control. The experimental group (group I) used the SpineCor brace in addition to a rehabilitation exercise program while the control group (group II) had the exercise program only. The mean ±SD age, weight and height were 16.89±2.15 vs. 15.3±2.5 years; 59.78±6.85 vs. 62.5±8.33 Kg and 162.78±5.76 vs. 159±5.72 cm for group I vs. group II. Data were collected using for metric Π system. Results: Mixed design MANOVA showed that there were significant (p < 0.05) decreases in all the tested variables after the six-month period compared with “before” in both groups. Moreover, there was a significant decrease in the kyphotic angle in group I compared with group II after the six-month period. Interpretation and conclusion: SpineCor brace is beneficial in reducing spino-pelvic alignment deterioration in both sagittal and frontal planes.

Keywords: adolescent idiopathic scoliosis, SpineCor, spino-pelvic alignment, biomechanics

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Authors: Kristen Erekson, Sarah Spendlove Caswell

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Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

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Authors: Mauro Cristeche

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This work begins with a very simple question: How does the State spend? Argentina is witnessing a process of growing nationalization of social life, so it is necessary to find out the explanations of the phenomenon on the specific dynamic of the capitalist mode of production in Argentina and its transformations in the last decades. Then the new question is: what happened in Argentina that could explain this phenomenon? Since the seventies, the capital growth in Argentina faces deep competitive problems. Until that moment the agrarian wealth had worked as a compensation mechanism, but it began to find its limits. In the meantime, some important demographical and structural changes had happened. The strategy of the capitalist class had to become to seek in the cheapness of the labor force the main source of compensation of its weakness. As a result, a tendency to worsen the living conditions and fragmentation of the working class started to develop, manifested by unemployment, underemployment, and the fall of the purchasing power of the salary as a highlighted fact. As a consequence, it is suggested that the role of the State became stronger and public expenditure increased, as a historical trend, because it has to intervene to face the contradictions and constant growth problems posed by the development of capitalism in Argentina. On the one hand, the State has to guarantee the process of buying the cheapened workforce and at the same time the process of reproduction of the working class. On the other hand, it has to help to reproduce the individual capitals but needs to ‘attack’ them in different ways. This is why the role of the State is said to be the general political representative to the national portion of the total social capital. What will be studied is the dynamic of the intervention of the Argentine State in the context of the particular national process of capital growth, and its dynamics in the last decades. What this paper wants to show are the main general causes that could explain the phenomenon of nationalization of the social life and how it has impacted the life conditions of the working class and the system of rights.

Keywords: Argentina, nationalization, public policies, rights, state

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Authors: Vanita Singh

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In developing countries, there are conflicting political agendas; policy makers have to prioritize issues from a list of issues competing for the limited resources. Thus, it is imperative to understand how some issues gain attention, and others lose in the policy circles. Multiple-Streams Theory of Kingdon (1984) is among the influential theories that help to understand the public policy process and is utilitarian for health policy makers to understand how certain health issues emerge on the policy agendas. The issue of maternal mortality was long standing in India and was linked with high birth rate thus the focus of maternal health policy was on family planning since India’s independence. However, a paradigm shift was noted in the maternal health policy in the year 1992 with the launch of Safe Motherhood Programme and then in the year 2005, when the agenda of maternal health policy became universalizing institutional deliveries and phasing-out of Traditional Birth Attendants (TBAs) from the health system. There were many solutions proposed by policy communities other than universalizing of institutional deliveries, including training of TBAs and improving socio-economic conditions of pregnant women. However, Government of India favored medical community, which was advocating for the policy of universalizing institutional delivery, and neglected the solutions proposed by other policy communities. It took almost 15 years for the advocates of institutional delivery to transform their proposed solution into a program - the Janani Suraksha Yojana (JSY), a safe-motherhood program promoting institutional delivery through cash incentives to pregnant women. Thus, the case of safe motherhood policy in India is worth studying to understand how certain issues/problems gain political attention and how advocacy work in policy circles. This paper attempts to understand the factors that favored the agenda of safe-motherhood in the policy circle in India, using John Kingdon’s Multiple-Stream model of agenda-setting. Through document analysis and literature review, the paper traces the evolution of safe motherhood program and maternal health policy. The study has used open source documents available on the website of Ministry of Health and Family Welfare, media reports (Times of India Archive) and related research papers. The documents analyzed include National health policy-1983, National Health Policy-2002, written reports of Ministry of Health and Family Welfare Department, National Rural Health Mission (NRHM) document, documents related to Janani Suraksha Yojana and research articles related to maternal health programme in India. The study finds that focusing events and credible indicators coupled with media attention has the potential to recognize a problem. The political elites favor clearly defined and well-accepted solutions. The trans-national organizations affect the agenda-setting process in a country through conditional resource provision. The closely-knit policy communities and political entrepreneurship are required for advocating solutions high on agendas. The study has implications for health policy makers in identifying factors that have the potential to affect the agenda-setting process for a desired policy agenda and identify the challenges in generating political priorities.

Keywords: agenda-setting, focusing events, Kingdon’s model, safe motherhood program India

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Authors: Eleni Giouli

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Distance learning provides a flexible approach to education, enabling busy learners to complete their coursework at their own pace, on their own schedule, and from a convenient location. This flexibility combined with a series of other issues; make the benefits of lifelong distance learning numerous. The purpose of the paper is to investigate whether distance education can contribute to the improvement of adult skills in Greece, highlighting in this way the necessity of the lifelong distance learning. To investigate this goal, a questionnaire is constructed and analyzed based on responses from 3,016 attendees of lifelong distance learning programs in the e-learning of the National and Kapodistrian University of Athens in Greece. In order to do so, a series of relationships is examined including the effects of a) the gender, b) the previous educational level, c) the current employment status, and d) the method used in the distance learning program, on the development of new general, technical, administrative, social, cultural, entrepreneurial and green skills. The basic conclusions that emerge after using a binary logistic framework are that the following factors are critical in order to develop new skills: the gender, the education level and the educational method used in the lifelong distance learning program. The skills more significantly affected by those factors are the acquiring new skills in general, as well as acquiring general, language and cultural, entrepreneurial and green skills, while for technical and social skills only gender and educational method play a crucial role. Moreover, routine skills and social skills are not affected by the four factors included in the analysis.

Keywords: adult skills, distance learning, education, lifelong learning

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Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

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Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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Authors: Martina Maria Keitsch, Sangeeta Singh

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There has been a growing recognition that sustainable development needs to consider economic, social and environmental aspects including gender. In Nepal, the majority of the population lives in rural areas, and many households do not have access to electricity. In rural areas, the difficulty of accessing energy is becoming one of the greatest constraints for improving living conditions. This is particularly true for women and children, who spent much time for collecting firewood and cooking and thus are often deprived of time for education, political- and business activities. The poster introduces an education and research project financed by the Norwegian Government. The project runs from 2015-2020 and is a collaboration between the Norwegian University of Science (NTNU) and Technology Institute of Engineering (IOE), Tribhuvan University. It has the title Master program and Research in Energy for Sustainable Social Development Energy for Sustainable Social Development (MSESSD). The project addresses engineering and architecture students and comprises several integral activities towards gender mainstreaming. The following activities are conducted; 1. Creating academic opportunities, 2. Updating administrative personnel on strategies to effectively include gender issues, 3. Integrating female and male stakeholders in the design process, 4. Sensitizing female and male students for gender issues in energy systems. The project aims to enable students to design end-user-friendly solutions which can, for example, save time that can be used to generate and enhance income. Relating to gender mainstreaming, design concepts focus on smaller-scale technologies, which female stakeholders can take control of and manage themselves. Creating academic opportunities, we have a 30% female students’ rate in each master student batch in the program with the goal to educate qualified female personnel for academia and policy-making/government. This is a very ambitious target in a Nepalese context. The rate of female students, who completed the MSc program at IOE between 1998 and January 2015 is 10% out of 180 students in total. For recruiting, female students were contacted personally and encouraged to apply for the program. Further, we have established a Master course in gender mainstreaming and energy. On an administrative level, NTNU has hosted a training program for IOE on gender-mainstreaming information and -strategies for academic education. Integrating female and male stakeholders, local women groups such as, e.g., mothers group are actively included in research and education for example in planning, decision-making, and management to establish clean energy solutions. The project meets women’s needs not just practically by providing better technology, but also strategically by providing solutions that enhance their social and economic decision-making authority. Sensitizing the students for gender issues in energy systems, the project makes it mandatory to discuss gender mainstreaming based on the case studies in the Master thesis. All activities will be discussed in detail comprising an overview of MSESSD, the gender mainstreaming master course contents’, and case studies where energy solutions were co-designed with men and women as lead-users and/or entrepreneurs. The goal is to motivate educators to develop similar forms of transnational gender collaboration.

Keywords: knowledge generation on gender mainstreaming, sensitizing students, stakeholder inclusion, education strategies for design and architecture in gender mainstreaming, facilitation for cooperation

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Authors: Mariana Mangas, Yaroslava Martins, Ana Charraz, Ana Matos Pires

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Introduction: Health literacy empowers people of knowledge, motivation and skills to access, understand, evaluate and mobilize information relating to health. Although the benefits of public knowledge of physical disease are widely accepted, knowledge about mental disorder has been compatibly neglected. Nowadays there is considerably evidence that literacy is of great importance for the promotion of health and prevention of mental illness. Objective: Disclosure the concept and importance of mental health literacy and introduce the literacy program of Psychiatry Service of Hospital José Joaquim Fernandes. Methodology: A search was conducted on PubMed, using keywords “literacy” and “mental health”. A description of mental health literacy interventions implemented on Psychiatry Service of Hospital José Joaquim Fernandes was performed, namely, psychoeducation programs for depression and bipolar disorder. Results and discussion: Health literacy enables patient to be able to actively participate in his treatment. The improving of mental health literacy can promote early identification of mental disorders, improve treatment results, increase the use of health services and allow the community to take action to achieve better mental health. Psychoeducation is very useful in improving the course of disease and in reducing the number of episodes and hospitalizations. Bipolar patients who received psychoeducation and pharmacotherapy have no relapses during the program and last year. Conclusion: Mental health literacy is not simply a matter of having knowledge, rather, it is knowledge linked to action which can benefit mental health.

Keywords: mental health, literacy, psychoeducation, knowledge, empowerment

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Authors: Chien-Hung Liu, Yu-Fen Chen

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This study used triangular laser probe and three-axial direction mobile platform for surface measurement, programmed it and applied it to real-time analytic statistics of different measured data. This structure was used to design a system integration program: using triangular laser probe for scattering or reflection non-contact measurement, transferring the captured signals to the computer through RS-232, and using RS-485 to control the three-axis platform for a wide range of measurement. The data captured by the laser probe are formed into a 3D surface. This study constructed an optical measurement application program in the concept of visual programming language. First, the signals are transmitted to the computer through RS-232/RS-485, and then the signals are stored and recorded in graphic interface timely. This programming concept analyzes various messages, and makes proper presentation graphs and data processing to provide the users with friendly graphic interfaces and data processing state monitoring, and identifies whether the present data are normal in graphic concept. The major functions of the measurement system developed by this study are thickness measurement, SPC, surface smoothness analysis, and analytical calculation of trend line. A result report can be made and printed promptly. This study measured different heights and surfaces successfully, performed on-line data analysis and processing effectively, and developed a man-machine interface for users to operate.

Keywords: laser probe, non-contact measurement, triangulation measurement principle, statistical process control, labVIEW

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Authors: Giuliana Scuderi, Patrick Teuffel

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The proven vulnerability of the existing social housing building heritage to natural or induced earthquakes requires the development of new design concepts and conceptual method to preserve materials and object, at the same time providing new performances. An integrate intervention between civil engineering, building physics and architecture can convert the social housing districts from a critical part of the city to a strategic resource of revitalization. Referring to bio-mimicry principles the present research proposes a taxonomy with the exoskeleton of the insect, an external, light and resistant armour whose role is to protect the internal organs from external potentially dangerous inputs. In the same way, a “building exoskeleton”, acting from the outside of the building as an enclosing cage, can restore, protect and support the existing building, assuming a complex set of roles, from the structural to the thermal, from the aesthetical to the functional. This study evaluates the structural efficiency of shape memory alloys devices (SMADs) connecting the “building exoskeleton” with the existing structure to rehabilitate, in order to prevent the out-of-plane collapse of walls and for the passive dissipation of the seismic energy, with a calibrated operability in relation to the intensity of the horizontal loads. The two case studies of a masonry structure and of a masonry structure with concrete frame are considered, and for each case, a theoretical social housing building is exposed to earthquake forces, to evaluate its structural response with or without SMADs. The two typologies are modelled with the finite element program SAP2000, and they are respectively defined through a “frame model” and a “diagonal strut model”. In the same software two types of SMADs, called the 00-10 SMAD and the 05-10 SMAD are defined, and non-linear static and dynamic analyses, namely push over analysis and time history analysis, are performed to evaluate the seismic response of the building. The effectiveness of the devices in limiting the control joint displacements resulted higher in one direction, leading to the consideration of a possible calibrated use of the devices in the different walls of the building. The results show also a higher efficiency of the 00-10 SMADs in controlling the interstory drift, but at the same time the necessity to improve the hysteretic behaviour, to maximise the passive dissipation of the seismic energy.

Keywords: adaptive structure, biomimetic design, building exoskeleton, social housing, structural envelope, structural retrofitting

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Authors: Donna Erika E. De Jesus

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Introduction: Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7-10%. It is crucial that CPR be initiated within 4-6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes. Methods: This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Results: 43 were male patients, comprising the majority at 73.02%. Hypertension was identified as the top co-morbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival, which comprised only hands-only CPR. Twenty-three of which were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remains dismal, as a return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

Keywords: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, emergency medical services

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Authors: Deepak Nathiya1, Ramesh Roop Rai, Pratima Singh1, Preeti Raj1, Supriya Suman, Balvir Singh Tomar

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Background: Sarcopenia is a catabolic state in liver cirrhosis (LC), accelerated with a breakdown of skeletal muscle to release amino acids which adversely affects survival, health-related quality of life, and response to any underlying disease. The primary objective of the study was to investigate the long-term effect of branched-chain amino acids (BCAA) supplementations on parameters associated with improved prognosis in sarcopenic patients with LC, as well as to evaluate its impact on cirrhotic-related events. Methods: We carried out a 24 week, single-center, randomized, open-label, controlled, two cohort parallel-group intervention trial comparing the efficacy of BCAA against lactoalbumin (L-ALB) on 106 sarcopenic liver cirrhotics. The BCAA (intervention) group was treated with 7.2 g BCAA per whereas, the lactoalbumin group was also given 6.3 g of L-Albumin. The primary outcome was to assess the impact of BCAA on parameters of sarcopenia: muscle mass, muscle strength, and physical performance. The secondary outcomes were to study combined survival and maintenance of liver function changes in laboratory and clinical markers in the duration of six months. Results: Treatment with BCAA leads to significant improvement in sarcopenic parameters: muscle strength, muscle function, and muscle mass. The total cirrhotic-related complications and cumulative event-free survival occurred fewer in the BCAA group than in the L-ALB group. Prognostic markers also improved significantly in the study. Conclusion: The current clinical trial demonstrated that long-term BCAAs supplementation improved sarcopenia and prognostic markers in patients with advanced liver cirrhosis.

Keywords: sarcopenia, liver cirrhosis, BCAA, quality of life

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Authors: Saidia Houari

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The game of football is one of the global sports activities that have witnessed a remarkable development in recent years in the physical, technical, rhetorical and psychological aspects, so the modern play in different teams and international teams quickly and forcefully in the exact technical performance, and this is due to the interest of international coaches. The good training of the players during the youth stage at the level of various aspects to develop all the techniques that have a great effectiveness in competitions according to scientific methods studied. The muscle strength plays a very important role achieving the performance player during the game and it is clear the need for the player in many situations, especially when jumping to hit the ball head or the goal on the goal or long passes of different types and in the performance of various skills by force and speed appropriate to the possession of the ball or the control of the court of the court while overcoming the body weight during the game it is known that the stronger the muscles of the athlete and the reduced joints injuries, and the strength increases energy saving such as Latin phosphate and glycogen, and develop the player for a game football volitional qualities of the most important of courage, determination And self-confidence. There are also some skill movements that can not be performed without a certain level of strength, so the development of power may affect the effectiveness of the long-term training system.

Keywords: trainning program, maximum force and expolosive force, lowers limbs, under 17 years

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Authors: Marzieh Sayyad, Mohsen Salesi

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Metabolic syndrome (MetS), a collection of cardiometabolic risk factors, is linked to the development of cardiovascular disease (CVD) and diabetes. The prevalence of MetS is on the rise with more women affected than men. The goal of this study was to compare the effects of resistance and aerobic exercise training on metabolic syndrome components in non-athlete, middle-aged woman. 51 non-athlete overweight female participated voluntarily in this study. Participants were divided randomly into three groups including resistance, aerobic and control group (number of each group 17). 24 hours before the beginning of training program, the blood sample was taken in fasting state. The two training groups participated in sport activities for eight weeks, three times a week duration 60-90 minutes. Two days following the end of the 8th week, all the measurements were performed similar to the pretest phase. The data was analyzed using one-way analysis of variance. The results showed that aerobic exercise training significantly decreased weight (p=.05), triglyceride (p<0.01) and systolic blood pressure (p<0.02) and HDL-c (p<0.01) was significantly increased. Also in resistance exercise training group TG decreased significantly (p<0.01) and HDL-c (p<0.05) was significantly increased. This study demonstrated that a regular physical activity program improved several metabolic and physiological parameters in healthy, previously sedentary subjects with the metabolic syndrome. In conclusion, it seems that this type of training can be efficient, safe and inexpensive way in order to reduce and prevent metabolic syndrome.

Keywords: aerobic exercise, metabolic syndrome, overweight sedentary female, resistance exercise

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Authors: Chris Preston

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As we devise ever more sophisticated methods of on-line marketing, devising systems that are able to reach into the everyday lives of consumers, we are confronted by a generation of children who face unprecedented intervention by commercial organisations into young minds, via electronic devices, and whether by computer, tablet or phone, such children have been somehow reduced to the status of their devices, with little regard for their well being as individuals. This discussion paper seeks to draw attention to such practice and questions the ethics of digital marketing methods.

Keywords: online marketing to children, online research of children, online targeting of children, consumer rights, ethics

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Authors: Kamrun Nahar Koly, Saimul Islam

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Overweight and obesity is increasing at an alarming rate and a leading risk factor for morbidity throughout the world. In a country like Bangladesh where under nutrition and overweight both co-exist at the same time, but this issue has been underexplored as expected. The aim of the present study was to assess the knowledge, attitudes and identify the barriers of the physicians regarding overweight and obesity management on an urban hospital of Dhaka city in Bangladesh. A simple cross sectional study was conducted at two selected government and two private hospital to assess the knowledge, attitude and common barriers regarding overweight and obesity management among healthcare professionals. One hundred and fifty five physicians were surveyed. A standard questionnaire was constructed in local language and interview was administrated. Among the 155 physicians, majority 53 (34.20%) were working on SMC, 36 (23.20%) from DMC, 33 (21.30%) were based on SSMC and the rest 33 (21.30%) were from HFRCMH. Mean age of the study physicians were 31.88±5.92. Majority of the physicians 80 (51.60%) were not able to answer the correct prevalence of obesity but also a substantial number of them 75(48.40%) could mark the right answer. Among the physicians 150 (96.77%) reported BMI as a diagnostic index for overweight and obesity, where as 43 (27.74%) waist circumference, 30 (19.35%) waist hip ratio and 26 (16.77%) marked mid-arm circumference. A substantial proportion 71 (46.70%) of the physicians thought that they do not have much to do controlling weight problem in Bangladesh context though it has been opposed by 42 (27.60%) of the physicians and 39(25.70%) was neutral to comment. The majority of them 147 (96.1%) thought that a family based education program would be beneficial followed by 145 (94.8%) physicians mentioned about raising awareness among mothers as she is the primary caregiver. The idea of a school based education program will also help to early intervene referred by 142 (92.8%) of the physicians. Community based education program was also appreciated by 136 (89.5%) of the physicians. About 74 (47.7%) of them think that the patients still lack in motivation to maintain their weight properly at the same time too many patients to deal with can be a barrier as well assumed by 73 (47.1%) of them. Lack of national policy or management guideline can act as an obstacle told by 60 (38.7%) of the physicians. The relationship of practicing as a part of the general examination and chronic disease management was statistically significant (p<0.05) with physician occupational status. As besides, perceived barriers like lack of parents support, lack of a national policy was statistically significant (p<0.05) with physician occupational status. For the young physician, more training programme will be needed to transform their knowledge and attitude into practice. However, several important barriers interface for the physician treatment efforts and need to address.

Keywords: obesity management, physician, awareness, barriers, Bangladesh

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Authors: Parul Garg

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Bouveret Syndrome is a rare presentation described as Gastric Outlet Obstruction secondary to Gallstone Ileus. Here we describe the 3-year progression of disease from cholelithiasis to gallstone ileus with relevant imaging findings. The patient was treated under an Upper Gastrointestinal Surgery service with surgical intervention in the form of a laparoscopic assisted procedure with midline laparotomy. She recovered well and was discharged 1 week post operatively. No complications occurred.

Keywords: Cholelithiasis, Bouveret syndrome, Gallstone Ileus, gastric outlet obstruction

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of Covid-19 infection. Understanding novel treatment approaches are important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with virtual reality (VR) included. This game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with covid-19 related CVA. The safety of newly developed instruments for such cases provides new approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: covid-19, stroke, virtual reality, rehabilitation

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Authors: Belal Mohamadi Kalesar, Raouf Hasanpour

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Proper placement of Distributed Generation (DG) units such as wind turbine generators in distribution system are still very challenging issue for obtaining their maximum potential benefits because inappropriate placement may increase the system losses. This paper proposes Particle Swarm Optimization (PSO) technique for optimal placement of wind based DG (WDG) in the primary distribution system to reduce energy losses and voltage profile improvement with four different wind levels modeling in year duration. Also, wind turbine is modeled as a DFIG that will be operated at unity power factor and only one wind turbine tower will be considered to install at each bus of network. Finally, proposed method will be implemented on widely used 69 bus power distribution system in MATLAB software environment under four scenario (without, one, two and three WDG units) and for capability test of implemented program it is supposed that all buses of standard system can be candidate for WDG installing (large search space), though this program can consider predetermined number of candidate location in WDG placement to model financial limitation of project. Obtained results illustrate that wind speed increasing in some months will increase output power generated but this can increase / decrease power loss in some wind level, also results show that it is required about 3MW WDG capacity to install in different buses but when this is distributed in overall network (more number of WDG) it can cause better solution from point of view of power loss and voltage profile.

Keywords: wind turbine, DG placement, wind levels effect, PSO algorithm

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Authors: Jong H. Kim, Kathleen L. Chan, Luisa W. Cheng

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Control of fungal pathogens, such as foodborne mycotoxin producers, is problematic as effective antimycotic agents are often very limited. Mycotoxin contamination significantly interferes with the safe production of foods or crops worldwide. Moreover, expansion of fungal resistance to commercial drugs or fungicides is a global human health concern. Therefore, there is a persistent need to enhance the efficacy of commercial antimycotic agents or to develop new intervention strategies. Disruption of the cellular antioxidant system should be an effective method for pathogen control. Such disruption can be achieved with safe, redox-active compounds. Natural phenolic derivatives are potent redox cyclers that inhibit fungal growth through destabilization of the cellular antioxidant system. The goal of this study is to identify novel, redox-active compounds that disrupt the fungal antioxidant system. The identified compounds could also function as sensitizing agents to conventional antimycotics (i.e., chemosensitization) to improve antifungal efficacy. Various benzo derivatives were tested against fungal pathogens. Gene deletion mutants of the yeast Saccharomyces cerevisiae were used as model systems for identifying molecular targets of benzo analogs. The efficacy of identified compounds as potent antifungal agents or as chemosensitizing agents to commercial drugs or fungicides was examined with methods outlined by the Clinical Laboratory Standards Institute or the European Committee on Antimicrobial Susceptibility Testing. Selected benzo derivatives possessed potent antifungal or antimycotoxigenic activity. Molecular analyses by using S. cerevisiae mutants indicated antifungal activity of benzo derivatives was through disruption of cellular antioxidant or cell wall integrity system. Certain benzo analogs screened overcame tolerance of Aspergillus signaling mutants, namely mitogen-activated protein kinase mutants, to fludioxonil fungicide. Synergistic antifungal chemosensitization greatly lowered minimum inhibitory or fungicidal concentrations of test compounds, including inhibitors of mitochondrial respiration. Of note, salicylaldehyde is a potent antimycotic volatile that has some practical application as a fumigant. Altogether, benzo derivatives targeting cellular antioxidant system of fungi (along with cell wall integrity system) effectively suppress fungal growth. Candidate compounds possess the antifungal, antimycotoxigenic or chemosensitizing capacity to augment the efficacy of commercial antifungals. Therefore, chemogenetic approaches can lead to the development of novel antifungal intervention strategies, which enhance the efficacy of established microbe intervention practices and overcome drug/fungicide resistance. Chemosensitization further reduces costs and alleviates negative side effects associated with current antifungal treatments.

Keywords: antifungals, antioxidant system, benzo derivatives, chemosensitization

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Authors: Kristina Gordon

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One in three children in the United States is a victim of a maltreatment investigation, and about one in nine children has a substantiated investigation. Home visiting is one of several preventative strategies rooted in an early childhood approach that fosters maternal, infant, and early childhood health, protection, and growth. In the United States, 88% of states report administering home visiting programs or state-designed models. The purpose of this study was to conduct a systematic review on home visiting programs in the United States focused on the prevention of child abuse and neglect. This systematic review included 17 articles which found that most of the studies reported optimistic results. Common across studies was program content related to (1) typical child development, (2) parenting education, and (3) child physical health. Although several factors common to home visiting and parenting interventions have been identified, no research has examined the common components of manualized home visiting programs to prevent child maltreatment. Child maltreatment can be addressed with home visiting programs with evidence-based components and cultural adaptations that increase prevention by assisting families in tackling the risk factors they face. An innovative approach to child maltreatment prevention is bringing together at-risk families with the aging community. This innovative approach was prompted due to existing home visitation programs only focusing on improving skillsets and providing temporary relationships. This innovative approach can provide the opportunity for families to build a relationship with an aging individual who can share their wisdom, skills, compassion, love, and guidance, to support families in their well-being and decrease child maltreatment occurrence. Families would be identified if they experience any of the risk factors, including parental substance abuse, parental mental illness, domestic violence, and poverty. Families would also be identified as at risk if they lack supportive relationships such as grandparents or relatives. Families would be referred by local agencies such as medical clinics, hospitals, schools, etc., that have interactions with families regularly. The aging community would be recruited at local housing communities and community centers. An aging individual would be identified by the elderly community when there is a need or interest in a relationship by or for the individual. Cultural considerations would be made when assessing for compatibility between the families and aging individuals. The pilot program will consist of a small group of participants to allow manageable results to evaluate the efficacy of the program. The pilot will include pre-and post-surveys to evaluate the impact of the program. From the results, data would be created to determine the efficacy as well as the sufficiency of the details of the pilot. The pilot would also be evaluated on whether families were referred to Child Protective Services during the pilot as it relates to the goal of decreasing child maltreatment. The ideal findings will display a decrease in child maltreatment and an increase in family well-being for participants.

Keywords: child maltreatment, home visiting, neglect, preventative, abuse

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Authors: Ronaldo de Lima Cardoso, Thiago V. C. Marcos, Felipe J. da Costa, Antonio C. da Oliveira, Paulo G. P. Toro

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The 14-X is a strategic project of the Brazil Air Force Command to develop a technological demonstrator of a hypersonic air-breathing propulsion system based on supersonic combustion programmed to flight in the Earth's atmosphere at 30 km of altitude and Mach number 10. The 14-X is under development at the Laboratory of Aerothermodynamics and Hypersonic Prof. Henry T. Nagamatsu of the Institute of Advanced Studies. The program began in 2007 and was planned to have three stages: development of the wave rider configuration, development of the scramjet configuration and finally the ground tests in the hypersonic shock tunnel T3. The install configuration of the model based in the scramjet of the 14-X in the test section of the hypersonic shock tunnel was made to proportionate and test the flight conditions in the inlet of the combustion chamber. Experimental studies with hypersonic shock tunnel require special techniques to data acquisition. To measure the pressure along the experimental model geometry tested we used 30 pressure transducers model 122A22 of PCB®. The piezoeletronic crystals of a piezoelectric transducer pressure when to suffer pressure variation produces electric current (PCB® PIEZOTRONIC, 2016). The reading of the signal of the pressure transducers was made by oscilloscope. After the studies had begun we observed that the pressure inside in the combustion chamber was lower than expected. One solution to improve the pressure inside the combustion chamber was install an obstacle to providing high temperature and pressure. To confirm if the combustion occurs was selected the spectroscopy emission technique. The region analyzed for the spectroscopy emission system is the edge of the obstacle installed inside the combustion chamber. The emission spectroscopy technique was used to observe the emission of the OH*, confirming or not the combustion of the mixture between atmospheric air in supersonic speed and the hydrogen fuel inside of the combustion chamber of the model. This paper shows the results of experimental studies of the supersonic combustion induced by shock wave performed at the Hypersonic Shock Tunnel T3 using the scramjet 14-X model. Also, this paper provides important data about the combustion studies using the model based on the engine of 14-X (second stage of the 14-X Program). Informing the possibility of necessaries corrections to be made in the next stages of the program or in other models to experimental study.

Keywords: 14-X, experimental study, ground tests, scramjet, supersonic combustion

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Authors: Hui-Fang Lee, Meng-Chu Liu, Wen-Chi Lu, Hsuan-Jung Hsieh

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The purpose of the study was to examine the effect of health program on the fitness ability of abnormal BMI students of Ching-Yun University of Science and Technology. In order to achieve this purpose, self-regulation theory and dietary education were applied, and the effect of 10-week sports activities and three-day diet records on pre-test and post-test of fitness activities was analyzed. There were 40 original participants. Then, nine people who were with normal BMI, low attendance or unfinished fitness test were eliminated from this research. The valid samples were 31 (77.5%) participants. The fitness activities included sit-bending, one minute sit-up, standing long jump, and three-minute stage boarding. The averages of three-day diet records were compared, and differences of pre-test and post-test of the four fitness activities were analyzed with paired-samples t test. The results showed that there was a significant difference between pre-test and post of male students’ BMI and one minute sit-up. Females’ sit-bending and one minute sit-up had the same effect. Females had high fat intake in three-day diet records. The research showed that the use of self-regulation theory and dietary education, the implementation of sports activities and three-day diet records could significantly enhance the physical fitness indicators or effects. While in the course of sports, we should guide students to think about the gap between self-behavior and ideal behavior, then realize the main reasons and improving methods, and finally go towards the goal and improve the effect of physical fitness.

Keywords: self-regulation theory, dietary education, three-day diet records, physical fitness

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Authors: Paula Costa, Ana Picado, Filomena Pinto, Justina Catarino

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Environmental impact associated with large scale shale gas development is of major concern to the public, policy makers and other stakeholders. To assess this impact on the atmosphere, it is important to monitoring ambient air quality prior to and during all shale gas operation stages. Baseline observations can provide a standard of the pre-shale gas development state of the environment. The lack of baseline concentrations was identified as an important knowledge gap to assess the impact of emissions to the air due to shale gas operations. In fact baseline monitoring of air quality are missing in several regions, where there is a strong possibility of future shale gas exploration. This makes it difficult to properly identify, quantify and characterize environmental impacts that may be associated with shale gas development. The implementation of a baseline air monitoring program is imperative to be able to assess the total emissions related with shale gas operations. In fact, any monitoring programme should be designed to provide indicative information on background levels. A baseline air monitoring program should identify and characterize targeted air pollutants, most frequently described from monitoring and emission measurements, as well as those expected from hydraulic fracturing activities, and establish ambient air conditions prior to start-up of potential emission sources from shale gas operations. This program has to be planned for at least one year accounting for ambient variations. In the literature, in addition to GHG emissions of CH4, CO2 and nitrogen oxides (NOx), fugitive emissions from shale gas production can release volatile organic compounds (VOCs), aldehydes (formaldehyde, acetaldehyde) and hazardous air pollutants (HAPs). The VOCs include a.o., benzene, toluene, ethyl benzene, xylenes, hexanes, 2,2,4-trimethylpentane, styrene. The concentrations of six air pollutants (ozone, particulate matter (PM), carbon monoxide (CO), nitrogen oxides (NOx), sulphur oxides (SOx), and lead) whose regional ambient air levels are regulated by the Environmental Protection Agency (EPA), are often discussed. However, the main concern in the emissions to air associated to shale gas operations, seems to be the leakage of methane. Methane is identified as a compound of major concern due to its strong global warming potential. The identification of methane leakage from shale gas activities is complex due to the existence of several other CH4 sources (e.g. landfill, agricultural activity or gas pipeline/compressor station). An integrated monitoring study of methane emissions may be a suitable mean of distinguishing the contribution of different sources of methane to ambient levels. All data analysis needs to be carefully interpreted taking, also, into account the meteorological conditions of the site. This may require the implementation of a more intensive monitoring programme. So, it is essential the development of a low-cost sampling strategy, suitable for establishing pre-operations baseline data as well as an integrated monitoring program to assess the emissions from shale gas operation sites. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 640715.

Keywords: air emissions, baseline, green house gases, shale gas

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Authors: Andréanne Gagné, Jo Anni Joncas, Éric Tendon

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Teaching in vocational training requires an excellent mastery of the trade being taught, but also solid professional skills in pedagogy. Teachers are typically recruited on the basis of their trade expertise, and they do not necessarily have training or experience in pedagogy. In order to counter this lack, the Ministry of Education (Québec, Canada) requires them to complete a 120-credit university program to obtain their teaching certificate. They must complete this training in addition to their teaching duties. This training was rarely planned in the teacher’s life course, and each teacher approaches it differently: some are enthusiastic, but many feel reluctant discouragement and even frustration at the idea of committing to a training program lasting an average of 10 years to completion. However, Quebec is experiencing an unprecedented shortage of teachers, and the perseverance of vocational teachers in their careers requires special attention because of the conditions of their specific integration conditions. Our research examines the perceptions that vocational teachers in training have of their academic experience in pre-service teaching. It differs from previous research in that it focuses on the influence of the academic experience on the teaching employment experience. The goal is that by better understanding the university experience of teachers in vocational education, we can identify support strategies to support their school experience and their teaching. To do this, the research is based on the theoretical framework of the sociology of experience, which allows us to study the way in which these “teachers-students” give meaning to their university program in articulation with their jobs according to three logics of action. The logic of integration is based on the process of socialization, where the action is preceded by the internalization of values, norms, and cultural models associated with the training context. The logic of strategy refers to the usefulness of this experience where the individual constructs a form of rationality according to his objectives, resources, social position, and situational constraints. The logic of subjectivation refers to reflexivity activities aimed at solving problems and making choices. These logics served as a framework for the development of an online questionnaire. Three hundred respondents, newly enrolled in an undergraduate teaching program (bachelor's degree in vocational education), expressed themselves about their academic experience. This paper relates qualitative data (open-ended questions) subjected to an interpretive repertory analysis approach to descriptive data (closed-ended questions) that emerged. The results shed light on how the respondents perceive themselves as teachers and students, their perceptions of university training and the support offered, and the place that training occupies in their professional path. Indeed, their professional and academic paths are inextricably linked, and it seems essential to take them into account simultaneously to better meet their needs and foster the development of their expertise in pedagogy. The discussion focuses on the strengths and limitations of university training from the perspective of the logic of action. The results also suggest support strategies that can be implemented to better support the integration and retention of student teachers in professional education.

Keywords: teacher, vocational training, pre-service training, academic experience

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Authors: Tiantian Feng

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There is a dearth of research on the literary circle as a teaching strategy in English as a Foreign Language (EFL) classes in Chinese colleges and universities and even fewer empirical studies on its impacts. In this one-quarter, design-based project, the researcher aims to increase students’ engagement, cooperation, and, on top of that, reading comprehension performance by utilizing a researcher-developed, adapted reading circle model in an EFL reading course at a Chinese college. The model also integrated team-based learning and portfolio assessment, with an emphasis on the specialization of individual responsibilities, contributions, and outcomes in reading projects, with the goal of addressing current issues in EFL classes at Chinese colleges, such as passive learning, test orientation, ineffective and uncooperative teamwork, and lack of dynamics. In this quasi-experimental research, two groups of students enrolled in the course were invited to participate in four in-class team projects, with the intervention class following the adapted literature circle model and team members rotating as Leader, Coordinator, Brain trust, and Reporter. The researcher/instructor used a sequential explanatory mixed-methods approach to quantitatively analyze the final grades for the pre-and post-tests, as well as individual scores for team projects and will code students' artifacts in the next step, with the results to be reported in a subsequent paper(s). Initial analysis showed that both groups saw an increase in final grades, but the intervention group enjoyed a more significant boost, suggesting that the adapted reading circle model is effective in improving students’ reading comprehension performance. This research not only closes the empirical research gap of literature circles in college EFL classes in China but also adds to the pool of effective ways to optimize reading comprehension performance and class performance in college EFL classes.

Keywords: literature circle, EFL teaching, college english reading, reading comprehension

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Authors: Martabolette Stecher

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Introductory: How is knowledge and ability to act on employable opportunities constructed among students and graduates at higher educations? This question have been drawn much attention by researchers, governments and universities in Denmark, since there has been an increases in the rate of unemployment among graduates from higher education. The fact that more than ten thousand graduates from higher education without the opportunity to get a job in these years has a tremendous impact upon the social economy in Denmark. Every time a student graduate from higher education and become unemployed, it is possible to trace upon the person´s chances to get a job many years ahead. This means that the tremendous rate of graduate unemployment implies a decrease in employment and lost prosperity in Denmark within a billion Danish Kroner scale. Basic methodologies: The present study investigates the construction of knowledge and ability to act upon employable opportunities among students and graduates at higher educations in Denmark in a literature review as well as a preliminary study of students from Aarhus University. 15 students from the candidate of drama have been engaging in an introductory program at the beginning of their candidate study, which included three workshops focusing upon the more personal matters of their studies and life. They have reflected upon this process during the intervention and afterwards in a semi-structured interview. Concurrently a thorough literature review has delivered key concepts for the exploration of the research question. Major findings of the study: It is difficult to find one definition of what employability encompasses, hence the overall picture of how to incorporate the concept is difficult. The present theory of employability has been focusing upon the competencies, which students and graduates are going to develop in order to become employable. In recent years there has been an emphasis upon the mechanism which supports graduates to trust themselves and to develop their self-efficacy in terms of getting a sustainable job. However, there has been little or no focus in the literature upon the idea of how students and graduates from higher education construct knowledge about and ability to act upon employable opportunities involving network of actors both material and immaterial network and meaningful relations for students and graduates in developing their enterprising behavior to achieve employment. The Act-network-theory combined with theory of entrepreneurship education suggests an alternative strategy to focus upon when explaining sustainable ways of creating employability among graduates. The preliminary study also supports this theory suggesting that it is difficult to emphasize a single or several factors of importance rather highlighting the effect of a multitude network. Concluding statement: This study is the first step of a ph.d.-study investigating this problem in Denmark and the USA in the period 2015 – 2019.

Keywords: employablity, graduates, action, opportunities

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