Search results for: aviation English
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2141

Search results for: aviation English

311 Speech Emotion Recognition: A DNN and LSTM Comparison in Single and Multiple Feature Application

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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310 Emotional State and Cognitive Workload during a Flight Simulation: Heart Rate Study

Authors: Damien Mouratille, Antonio R. Hidalgo-Muñoz, Nadine Matton, Yves Rouillard, Mickael Causse, Radouane El Yagoubi

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Background: The monitoring of the physiological activity related to mental workload (MW) on pilots will be useful to improve aviation safety by anticipating human performance degradation. The electrocardiogram (ECG) can reveal MW fluctuations due to either cognitive workload or/and emotional state since this measure exhibits autonomic nervous system modulations. Arguably, heart rate (HR) is one of its most intuitive and reliable parameters. It would be particularly interesting to analyze the interaction between cognitive requirements and emotion in ecologic sets such as a flight simulator. This study aims to explore by means of HR the relation between cognitive demands and emotional activation. Presumably, the effects of cognition and emotion overloads are not necessarily cumulative. Methodology: Eight healthy volunteers in possession of the Private Pilot License were recruited (male; 20.8±3.2 years). ECG signal was recorded along the whole experiment by placing two electrodes on the clavicle and left pectoral of the participants. The HR was computed within 4 minutes segments. NASA-TLX and Big Five inventories were used to assess subjective workload and to consider the influence of individual personality differences. The experiment consisted in completing two dual-tasks of approximately 30 minutes of duration into a flight simulator AL50. Each dual-task required the simultaneous accomplishment of both a pre-established flight plan and an additional task based on target stimulus discrimination inserted between Air Traffic Control instructions. This secondary task allowed us to vary the cognitive workload from low (LC) to high (HC) levels, by combining auditory and visual numerical stimuli to respond to meeting specific criteria. Regarding emotional condition, the two dual-tasks were designed to assure analogous difficulty in terms of solicited cognitive demands. The former was realized by the pilot alone, i.e. Low Arousal (LA) condition. In contrast, the latter generates a high arousal (HA), since the pilot was supervised by two evaluators, filmed and involved into a mock competition with the rest of the participants. Results: Performance for the secondary task showed significant faster reaction times (RT) for HA compared to LA condition (p=.003). Moreover, faster RT was found for LC compared to HC (p < .001) condition. No interaction was found. Concerning HR measure, despite the lack of main effects an interaction between emotion and cognition is evidenced (p=.028). Post hoc analysis showed smaller HR for HA compared to LA condition only for LC (p=.049). Conclusion. The control of an aircraft is a very complex task including strong cognitive demands and depends on the emotional state of pilots. According to the behavioral data, the experimental set has permitted to generate satisfactorily different emotional and cognitive levels. As suggested by the interaction found in HR measure, these two factors do not seem to have a cumulative impact on the sympathetic nervous system. Apparently, low cognitive workload makes pilots more sensitive to emotional variations. These results hint the independency between data processing and emotional regulation. Further physiological data are necessary to confirm and disentangle this relation. This procedure may be useful for monitoring objectively pilot’s mental workload.

Keywords: cognitive demands, emotion, flight simulator, heart rate, mental workload

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309 Libyan Residents in Britain and Identity of Place

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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308 The Views of Health Care Professionals outside of the General Practice Setting on the Provision of Oral Contraception in Comparison to Long-Acting Reversible Contraception

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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307 Collaborative Stylistic Group Project: A Drama Practical Analysis Application

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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306 The Effect of Psychosomatic Aspects of Endometriosis on Marital Relationships and Quality of Life: A Review Study

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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305 Immigration in British Southern Cameroons from 2016 to 2020

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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304 Translation and Adaptation of the Assessment Instrument “Kiddycat” for European Portuguese

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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303 Exploring Bidirectional Encoder Representations from the Transformers’ Capabilities to Detect English Preposition Errors

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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302 Communication Anxiety in Nigerian Students Studying English as a Foreign Language: Evidence from Colleges of Education Sector

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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301 Solar and Galactic Cosmic Ray Impacts on Ambient Dose Equivalent Considering a Flight Path Statistic Representative to World-Traffic

Authors: G. Hubert, S. Aubry

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The earth is constantly bombarded by cosmic rays that can be of either galactic or solar origin. Thus, humans are exposed to high levels of galactic radiation due to altitude aircraft. The typical total ambient dose equivalent for a transatlantic flight is about 50 μSv during quiet solar activity. On the contrary, estimations differ by one order of magnitude for the contribution induced by certain solar particle events. Indeed, during Ground Level Enhancements (GLE) event, the Sun can emit particles of sufficient energy and intensity to raise radiation levels on Earth's surface. Analyses of GLE characteristics occurring since 1942 showed that for the worst of them, the dose level is of the order of 1 mSv and more. The largest of these events was observed on February 1956 for which the ambient dose equivalent rate is in the orders of 10 mSv/hr. The extra dose at aircraft altitudes for a flight during this event might have been about 20 mSv, i.e. comparable with the annual limit for aircrew. The most recent GLE, occurred on September 2017 resulting from an X-class solar flare, and it was measured on the surface of both the Earth and Mars using the Radiation Assessment Detector on the Mars Science Laboratory's Curiosity Rover. Recently, Hubert et al. proposed a GLE model included in a particle transport platform (named ATMORAD) describing the extensive air shower characteristics and allowing to assess the ambient dose equivalent. In this approach, the GCR is based on the Force-Field approximation model. The physical description of the Solar Cosmic Ray (i.e. SCR) considers the primary differential rigidity spectrum and the distribution of primary particles at the top of the atmosphere. ATMORAD allows to determine the spectral fluence rate of secondary particles induced by extensive showers, considering altitude range from ground to 45 km. Ambient dose equivalent can be determined using fluence-to-ambient dose equivalent conversion coefficients. The objective of this paper is to analyze the GCR and SCR impacts on ambient dose equivalent considering a high number statistic of world-flight paths. Flight trajectories are based on the Eurocontrol Demand Data Repository (DDR) and consider realistic flight plan with and without regulations or updated with Radar Data from CFMU (Central Flow Management Unit). The final paper will present exhaustive analyses implying solar impacts on ambient dose equivalent level and will propose detailed analyses considering route and airplane characteristics (departure, arrival, continent, airplane type etc.), and the phasing of the solar event. Preliminary results show an important impact of the flight path, particularly the latitude which drives the cutoff rigidity variations. Moreover, dose values vary drastically during GLE events, on the one hand with the route path (latitude, longitude altitude), on the other hand with the phasing of the solar event. Considering the GLE occurred on 23 February 1956, the average ambient dose equivalent evaluated for a flight Paris - New York is around 1.6 mSv, which is relevant to previous works This point highlights the importance of monitoring these solar events and of developing semi-empirical and particle transport method to obtain a reliable calculation of dose levels.

Keywords: cosmic ray, human dose, solar flare, aviation

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300 Language Politics and Identity in Translation: From a Monolingual Text to Multilingual Text in Chinese Translations

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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299 Examining Statistical Monitoring Approach against Traditional Monitoring Techniques in Detecting Data Anomalies during Conduct of Clinical Trials

Authors: Sheikh Omar Sillah

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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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298 A Bayesian Approach for Analyzing Academic Article Structure

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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297 Disability Policy and Leaders in México

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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296 Associated Risks of Spontaneous Lung Collapse after Shoulder Surgery: A Literature Review

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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295 International E-Learning for Assuring Ergonomic Working Conditions of Orthopaedic Surgeons: First Research Outcomes from Train4OrthoMIS

Authors: J. Bartnicka, J. A. Piedrabuena, R. Portilla, L. Moyano - Cuevas, J. B. Pagador, P. Augat, J. Tokarczyk, F. M. Sánchez Margallo

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Orthopaedic surgeries are characterized by a high degree of complexity. This is reflected by four main groups of resources: 1) surgical team which is consisted of people with different competencies, educational backgrounds and positions; 2) information and knowledge about medical and technical aspects of surgery; 3) medical equipment including surgical tools and materials; 4) space infrastructure which is important from an operating room layout point of view. These all components must be integrated and build a homogeneous organism for achieving an efficient and ergonomically correct surgical workflow. Taking this as a background, there was formulated a concept of international project, called “Online Vocational Training course on ergonomics for orthopaedic Minimally Invasive” (Train4OrthoMIS), which aim is to develop an e-learning tool available in 4 languages (English, Spanish, Polish and German). In the article, there is presented the first project research outcomes focused on three aspects: 1) ergonomic needs of surgeons who work in hospitals around different European countries, 2) the concept of structure of e-learning course, 3) the definition of tools and methods for knowledge assessment adjusted to users’ expectation. The methodology was based on the expert panels and two types of surveys: 1) on training needs, 2) on evaluation and self-assessment preferences. The major findings of the study allowed describing the subjects of four training modules and learning sessions. According to peoples’ opinion there were defined most expected test methods which are single choice test and right after quizzes: “True or False” and “Link elements”. The first project outcomes confirmed the necessity of creating a universal training tool for orthopaedic surgeons regardless of the country in which they work. Because of limited time that surgeons have, the e-learning course should be strictly adjusted to their expectation in order to be useful.

Keywords: international e-learning, ergonomics, orthopaedic surgery, Train4OrthoMIS

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294 Local Governments Supporting Environmentally Sustainable Meals to Protect the Planet and People

Authors: Magdy Danial Riad

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Introduction: The ability of our world to support the expanding population after 2050 is at risk due to the food system's global role in poor health, climate change, and resource depletion. Healthy, equitable, and sustainable food systems must be achieved from the point of production through consumption in order to meet several of the sustainable development goals (SDG) targets. There is evidence that changing the local food environment can effectively change dietary habits in a community. The purpose of this article is to outline the policy initiatives taken by local governments to support environmentally friendly eating habits. Methods: Five databases were searched for peer-reviewed articles that described local government authorities' implementation of environmentally sustainable eating habits, were located in cities that had signed the Milan Urban Food Policy Pact, were published after 2015, were available in English, and described policy interventions. Data extraction was a two-step approach that started with extracting information from the included study and ended with locating information unique to policies in the grey literature. Results: 45 papers that described a variety of policy initiatives from low-, middle-, and high-income countries met the inclusion criteria. A variety of desired dietary behaviors were the focus of policy action, including reducing food waste, procuring food locally and in season, boosting breastfeeding, avoiding overconsumption, and consuming more plant-based meals and fewer items derived from animals. Conclusions: In order to achieve SDG targets, local governments are under pressure to implement evidence-based interventions. This study can help direct local governments toward evidence-based policy measures to improve regional food systems and support ecologically friendly eating habits.

Keywords: meals, planet, poor health, eating habits

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293 Teaching Audiovisual Translation (AVT):Linguistic and Technical Aspects of Different Modes of AVT

Authors: Juan-Pedro Rica-Peromingo

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Teachers constantly need to innovate and redefine materials for their lectures, especially in areas such as Language for Specific Purposes (LSP) and Translation Studies (TS). It is therefore essential for the lecturers to be technically skilled to handle the never-ending evolution in software and technology, which are necessary elements especially in certain courses at university level. This need becomes even more evident in Audiovisual Translation (AVT) Modules and Courses. AVT has undergone considerable growth in the area of teaching and learning of languages for academic purposes. We have witnessed the development of a considerable number of masters and postgraduate courses where AVT becomes a tool for L2 learning. The teaching and learning of different AVT modes are components of undergraduate and postgraduate courses. Universities, in which AVT is offered as part of their teaching programme or training, make use of professional or free software programs. This paper presents an approach in AVT withina specific university context, in which technology is used by means of professional and nonprofessional software. Students take an AVT subject as part of their English Linguistics Master’s Degree at the Complutense University (UCM) in which they are using professional (Spot) and nonprofessional (Subtitle Workshop, Aegisub, Windows Movie Maker) software packages. The students are encouraged to develop their tasks and projects simulating authentic professional experiences and contexts in the different AVT modes: subtitling for hearing and deaf and hard of hearing population, audio description and dubbing. Selected scenes from TV series such as X-Files, Gossip girl, IT Crowd; extracts from movies: Finding Nemo, Good Will Hunting, School of Rock, Harry Potter, Up; and short movies (Vincent) were used. Hence, the complexity of the audiovisual materials used in class as well as the activities for their projects were graded. The assessment of the diverse tasks carried out by all the students are expected to provide some insights into the best way to improve their linguistic accuracy and oral and written productions with the use of different AVT modes in a very specific ESP university context.

Keywords: ESP, audiovisual translation, technology, university teaching, teaching

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292 Using Wearable Technology to Monitor Perinatal Health: Perspectives of Community Health Workers and Potential Use by Underserved Perinatal Women in California

Authors: Tamara Jimah, Priscilla Kehoe, Pamela Pimentel, Amir Rahmani, Nikil Dutt, Yuqing Guo

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Ensuring equitable access to maternal health care is critical for public health. Particularly for underserved women, community health workers (CHWs) have been invaluable in providing support through health education and strategies for improved maternal self-care management. Our research aimed to assess the acceptance of technology by CHWs and perinatal women to promote healthy pregnancy and postpartum wellness. This pilot study was conducted at a local community organization in Orange County, California, where CHWs play an important role in supporting low-income women through home visitations. Questionnaires were administered to 14 CHWs and 114 pregnant and postpartum women, literate in English and/or Spanish. CHWs tested two wearable devices (Galaxy watch and Oura ring) and shared their user experience, including potential reception by the perinatal women they served. In addition, perinatal women provided information on access to a smart phone and the internet, as well as their interest in using wearable devices to self-monitor personal health with guidance from a CHW. Over 85% of CHWs agreed that it was useful to track pregnancy with the smart watch and ring. The majority of perinatal women owned a smartphone (97.4%), had access to the internet (80%) and unlimited data plans (78%), expressed interest in using the smart wearable devices to self-monitor health, and were open to receiving guidance from a CHW (87%). Community health workers and perinatal women embraced the use of wearable technology to monitor maternal health. These preliminary findings have formed the basis of an ongoing research study that integrates CHW guidance and technology (i.e., smart watch, smart ring, and a mobile phone app) to promote self-efficacy and self-management among underserved perinatal women.

Keywords: community health workers, health promotion and education, health equity, maternal and child health, technology

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291 Effects of School Facilities’ Mechanical and Plumbing Characteristics and Conditions on Student Attendance, Academic Performance and Health

Authors: Erica Cochran Hameen, Bobuchi Ken-Opurum, Shalini Priyadarshini, Berangere Lartigue, Sadhana Anath-Pisipati

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School districts throughout the United States are constantly seeking measures to improve test scores, reduce school absenteeism and improve indoor environmental quality. It is imperative to identify key building investments which will provide the largest benefits to schools in terms of improving the aforementioned factors. This study uses Analysis of Variance (ANOVA) tests to statistically evaluate the impact of a school building’s mechanical and plumbing characteristics on a child’s educational performance. The educational performance is measured via three indicators, i.e. test scores, suspensions, and absenteeism. The study investigated 125 New York City school facilities to determine the potential correlations between 50 mechanical and plumbing variables and the performance indicators. Key findings from the tests revealed that elementary schools with pneumatic systems in “good” condition have 48.8% lower percentages of students scoring at the minimum English Language Arts (ELA) competency level compared with those with no pneumatic system. Additionally, elementary schools with “unit heaters/cabinet heaters” in “good to fair” conditions have 1.1% higher attendance rates compared to schools with no “unit heaters/cabinet heaters” or those in inferior condition. Furthermore, elementary schools with air conditioning have 0.6% higher attendance rates compared to schools with no air conditioning, and those with interior floor drains in “good” condition have 1.8% higher attendance rates compared to schools with interior drains in inferior condition.

Keywords: academic attendance and performance, mechanical and plumbing systems, schools, student health

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290 Improving Subjective Bias Detection Using Bidirectional Encoder Representations from Transformers and Bidirectional Long Short-Term Memory

Authors: Ebipatei Victoria Tunyan, T. A. Cao, Cheol Young Ock

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Detecting subjectively biased statements is a vital task. This is because this kind of bias, when present in the text or other forms of information dissemination media such as news, social media, scientific texts, and encyclopedias, can weaken trust in the information and stir conflicts amongst consumers. Subjective bias detection is also critical for many Natural Language Processing (NLP) tasks like sentiment analysis, opinion identification, and bias neutralization. Having a system that can adequately detect subjectivity in text will boost research in the above-mentioned areas significantly. It can also come in handy for platforms like Wikipedia, where the use of neutral language is of importance. The goal of this work is to identify the subjectively biased language in text on a sentence level. With machine learning, we can solve complex AI problems, making it a good fit for the problem of subjective bias detection. A key step in this approach is to train a classifier based on BERT (Bidirectional Encoder Representations from Transformers) as upstream model. BERT by itself can be used as a classifier; however, in this study, we use BERT as data preprocessor as well as an embedding generator for a Bi-LSTM (Bidirectional Long Short-Term Memory) network incorporated with attention mechanism. This approach produces a deeper and better classifier. We evaluate the effectiveness of our model using the Wiki Neutrality Corpus (WNC), which was compiled from Wikipedia edits that removed various biased instances from sentences as a benchmark dataset, with which we also compare our model to existing approaches. Experimental analysis indicates an improved performance, as our model achieved state-of-the-art accuracy in detecting subjective bias. This study focuses on the English language, but the model can be fine-tuned to accommodate other languages.

Keywords: subjective bias detection, machine learning, BERT–BiLSTM–Attention, text classification, natural language processing

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289 Al-Azhar’s Ideological Capacity to Counter Extremism

Authors: Dina Tawfic, Robert Hassan

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The current chapter addresses Al-Azhar's strategy to counter extremism in tandem with reflecting on the ideology of the Islamic establishment itself. The topic is motivated by the fact that some of the Western governments have been relying on Al-Azhar to counter the ideology of Islamist radicalism and violent extremism, in particular during the rise of the Islamic State in Syria and Iraq (known as ISIS/ ISIL/ Daesh) in 2014/2015. In his visit to Egypt in June 2016, Brett McGurk, the then U.S. envoy for the global coalition to counter ISIS, commended Al-Azhar’s “intellectual and reforming role” in refuting the ideology of extremism. On the other hand, Egyptian liberal intellectuals, such as Farag Fouda (1945- 1992) and Nasr Hamed Abu Zeid (1943-2010), had always questioned the ideological capability of Al-Azhar to counter extremism, citing the rigidity and resistance of the Islamic establishment to carry out genuine reformation. This chapter aims to discuss the following research questions: what is the strategy of Al-Azhar to counter extremism? Does Al-Azhar have a solid strategy to combat online propaganda produced by violent extremist groups? Is it applicable to identify Al-Azhar ideological identity? and is it capable of countering extremism? To answer these questions, I conducted intensive interviews with seven senior scholars and officials at Al-Azhar and the Endowments ministry from September to December 2020. Using a qualitative approach as a backdrop, this project uses semi-structured interviews to collect data. Participants were briefed on the purpose of the study and consented to be interviewed and to record their interviews. Some of the participants chose to conceal their names. All the interviews were conducted in Arabic via Zoom. The researcher then transcribed and translated the interviews into English. A purposive sample is used to select the seven interviewees, based on their prominence and experience in the field of counter-extremism and Al-Azhar affairs. The researcher uses a snowball sample to select the sample, in which a personal contact recommends other officials within the establishment.

Keywords: Al-Azhar, Egypt, Counter-Extremism, Political Islam, Ideology

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288 Contributions of Women to the Development of Hausa Literature as an Effective Means of Public Enlightenment: The Case of a 19th Century Female Scholar Maryam Bint Uthman Ibn Foduye

Authors: Balbasatu Ibrahim

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In the 19th century, Hausaland an Islamic revolution known as the Sokoto Jihad took place that led to the establishment of the Sokoto Caliphate in 1804 under the leadership of the famous Sheik Uthman Bn Fodiye. Before the Jihad movement in Hausaland (now Northern Nigeria), women were left in ignorance and were used and dumped like old kitchen utensils. The sheik and his followers did their best to actualising women’s right to education by using their female family members as role models who were highly educated and renowned scholars. After the Jihad with the establishment of an Islamic state, the women scholars initiated different strategies to teach the generality of the women. The most efficient strategy was the ‘Yantaru Movement founded by Nana Asma’u the daughter of Sheikh Uthman Bn Fodiye in collaboration with her sisters around 1840. The ‘Yantaru movement is a women’s educational movement aimed at enlightening women in rural and urban areas. The move helped in massively mobilizing women for education. In addition to town pupils, women from villages and throughout the nooks and crannies of metropolitan Sokoto participated in the movement in the search for knowledge. Thus, the birth of the ‘Yantaru system of women’s education. The ‘Yantaru operates the three-tier system at village, town and the metropolitan capital of Sokoto. ‘Yantaru functions include imparting knowledge to elderly women and young girls. Step down enlightenment program on returning home. The most effective medium of communication in the ‘Yantaru movement was through poetry where scholars composed educational poems which were memorized by the ‘Yantaru, who on return recite it to fellow women at home. Through this system, many women were educated. This paper translated and examines one of such educative poems written by the second leader of the ‘Yantaru Movement Maryam Bn Uthman Bn Fodiye in 1855.

Keywords: English, Hausa language, public enlightenment, Maryam Bint Uthman Ibn Foduye

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287 Barriers to Access among Indigenous Women Seeking Prenatal Care: A Literature Review

Authors: Zarish Jawad, Nikita Chugh, Karina Dadar

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Introduction: This paper aims to identify barriers indigenous women face in accessing prenatal care in Canada. It explores the differences in prenatal care received between indigenous and non-indigenous women. The objective is to look at changes or programs in Canada's healthcare system to reduce barriers to accessing safe prenatal care for indigenous women. Methods: A literature search of 12 papers was conducted using the following databases: PubMed, Medline, OVID, Google Scholar, and ScienceDirect. The studies included were written in English only, including indigenous females between the age of 19-35, and review articles were excluded. Participants in the studies examined did not have any severe underlying medical conditions for the duration of the study, and study designs included in the review are prospective cohort, cross-sectional, case report, and case-control studies. Results: Among all the barriers Indigenous women face in accessing prenatal care, the three most significant barriers Indigenous women face include a lack of culturally safe prenatal care, lack of services in the Indigenous community, proximity of prenatal facilities to Indigenous communities and costs of transportation. Discussion: The study found three significant barriers indigenous women face in accessing prenatal care in Canada; the geographical distribution of healthcare facilities, distrust between patients and healthcare professionals, and cultural sensitivity. Some of the suggested solutions include building more birthing and prenatal care facilities in rural areas for indigenous women, educating healthcare professionals on culturally sensitive healthcare, and involving indigenous people in the decision-making process to reduce distrust and power imbalances. Conclusion: The involvement of indigenous women and community leaders is important in making decisions regarding the implementation of effective healthcare and prenatal programs for indigenous women. However, further research is required to understand the effectiveness of the solutions and the barriers that make prenatal care less accessible for indigenous women in Canada.

Keywords: indigenous, maternal health, prenatal care, barriers

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286 Prevalence of Risk Factors of the Female Athlete Triad Among Young Elite Athletes of the World

Authors: Muhammad Saleem

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Background: Inattentive food choices and engagement in excessive physical activities by male athletes can potentially lead to adverse health consequences. Objective: The aim was to ascertain the occurrence of risk factors associated with the Male Athlete Triad among young elite athletes in Pakistan. Methodology: In 2018, a cross-sectional study based on questionnaires was conducted at the Pakistan Sports Board. The study aimed to explore the risk factors related to the Male Athlete Triad in young elite athletes who were part of national training camps in major metropolitan areas. The study included proficient male elite athletes aged 18 to 25 years, capable of understanding the English questionnaire. The athletes completed a survey encompassing aspects like demographic information, educational background, Body Mass Index (BMI), sports involvement, and hours of participation. Additionally, they filled out the Eating Attitude Test-26 (EAT-26) and questionnaires assessing risks of amenorrhea and low bone mineral density. The prevalence of risk factors for each of the three components was individually evaluated. The collected data underwent analysis using SPSS-20, with descriptive statistics being applied. Results: The study comprised a sample of 90 elite athletes (mean age: 23.57 ± 2.37 years, mean BMI: 21.97 ± 1.90) engaged in various sports. The EAT-26 results indicated that 50% of athletes were at risk of developing an eating disorder. Moreover, 83.3% exhibited disordered eating behaviors that necessitated referral. Risks for amenorrhea were observed in 15% of the participants, and regarding low bone mineral density, notable risks were absent except for the consumption of caffeinated beverages, which was noted in 51.7% of participants. Conclusion: The study identified a significant prevalence of disordered eating risk among male elite athletes in Pakistan. However, the risks associated with amenorrhea and low bone mineral density were not a major concern in this particular group.

Keywords: Pakistan, osteoporosis, female athlete triad, bone mineral density, athlete, amenorrhea, eating disorders

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285 The State of Oral Health after COVID-19 Lockdown: A Systematic Review

Authors: Faeze omid, Morteza Banakar

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Background: The COVID-19 pandemic has had a significant impact on global health and healthcare systems, including oral health. The lockdown measures implemented in many countries have led to changes in oral health behaviors, access to dental care, and the delivery of dental services. However, the extent of these changes and their effects on oral health outcomes remains unclear. This systematic review aims to synthesize the available evidence on the state of oral health after the COVID-19 lockdown. Methods: We conducted a systematic search of electronic databases (PubMed, Embase, Scopus, and Web of Science) and grey literature sources for studies reporting on oral health outcomes after the COVID-19 lockdown. We included studies published in English between January 2020 and March 2023. Two reviewers independently screened the titles, abstracts, and full texts of potentially relevant articles and extracted data from included studies. We used a narrative synthesis approach to summarize the findings. Results: Our search identified 23 studies from 12 countries, including cross-sectional surveys, cohort studies, and case reports. The studies reported on changes in oral health behaviors, access to dental care, and the prevalence and severity of dental conditions after the COVID-19 lockdown. Overall, the evidence suggests that the lockdown measures had a negative impact on oral health outcomes, particularly among vulnerable populations. There were decreases in dental attendance, increases in dental anxiety and fear, and changes in oral hygiene practices. Furthermore, there were increases in the incidence and severity of dental conditions, such as dental caries and periodontal disease, and delays in the diagnosis and treatment of oral cancers. Conclusion: The COVID-19 pandemic and associated lockdown measures have had significant effects on oral health outcomes, with negative impacts on oral health behaviors, access to care, and the prevalence and severity of dental conditions. These findings highlight the need for continued monitoring and interventions to address the long-term effects of the pandemic on oral health.

Keywords: COVID-19, oral health, systematic review, dental public health

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284 The Attitude of Parents and Teachers towards Multilingual Medium of Instruction in Lower Primary School Classrooms: The Case of Kapiri District Schools of Zambia

Authors: E. Machinyise

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The main purpose of this study was to investigate the attitudes of parents and teachers towards multilingual medium of instruction in lower primary schools of Zambia. In 2013, the Government of Zambia formulated a language policy which stipulates that regional familiar languages should be used as the medium of instruction (MOI) from grade one to four in all public primary schools, while English is introduced as a subject in the second grade. This study investigated the views of parents and teachers on the use of multilingual medium of instruction in lower primary schools in order to accommodate learners who are not native speakers of regional familiar languages as well as the second languages which are official languages used in class. The study revealed that most parents suggested that teachers who teach lower primary school classes should be conversant with at least the four major local languages of Zambia (Bemba, Nyanja, Tonga and Lozi). In the same vain other parents felt that teachers teaching lower grades should not only be familiar with the regional official language but should be able to speak other dialects found in the region. Teachers teaching in lower primary grade felt that although it is difficult to speak all languages of learners in class, it is important for a teacher of lower grade class to try to accommodate children who are not speakers of the familiar languages by addressing them in the language they understand. Both teachers and parents highlighted a number of advantages of teaching children in their mother tongues. Both qualitative and quantitative methods were used for the collection of data for this study. 30 teachers from selected public primary schools and 20 parents of Kapiri district and five lecturers of teacher training colleges in Central province were selected for this study. The researcher also observed class lessons in lower primary schools of Kapiri district. This study revealed that both parents and teachers are of the views that teachers teaching lower primary classes should use multilingual medium of instruction in lower primary classes so as to accommodated children of different linguistic backgrounds.

Keywords: familiar languages, medium of instruction, multilingual medium of instruction, native speakers

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283 Effectiveness of Educational and Supportive Interventions for Primiparous Women on Breastfeeding Outcomes: A Systematic Review and Meta-Analysis

Authors: Mei Sze Wong, Huanyu Mou, Wai-Tong Chien

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Background: Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Therefore, breastfeeding promotion is an important topic for infant health; whereas, different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal, or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches of educational and supportive interventions to improve breastfeeding. Outcome measures were exclusive breastfeeding, partial breastfeeding, and breastfeeding self-efficacy, being analyzed in terms of ≤ 2 months, 3-5 months, and ≥ 6 months postpartum. Method: Eleven electronic databases and the reference lists of eligible articles were searched. English or Chinese articles of randomized controlled trials on educational and supportive intervention with the above breastfeeding outcomes over recent 20 years were searched. Quality appraisal and risk of bias of the studies were checked by Effective Public Health Practice Project tool and Revised Cochrane risk-of-bias tool, respectively. Results: 13 articles that met the inclusion criteria were included; and they had acceptable quality and risk of bias. The optimal structure, format, and delivery of the interventions significantly increased exclusive breastfeeding rate at ≤ 2 months and ≥ 6 months and breastfeeding self-efficacy at ≤ 2 months included: (a) delivering from antenatal to postnatal period, (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups, (c) both individual and group basis, (d) being guided by self-efficacy theory, and (e) having ≥ 3 sessions. Conclusion: The findings showed multicomponent theory-based interventions with ≥ 3 sessions that delivered across antenatal and postnatal period; using both face-to-face teaching and telephone follow-ups can be useful to enhance exclusive breastfeeding rate for more than 6 months and breastfeeding self-efficacy over the first two months of postpartum.

Keywords: breastfeeding self-efficacy, education, exclusive breastfeeding, primiparous, support

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282 Study on the Contributions and Social Validity of an Online Autism Training for School Staff

Authors: Myriam Rousseau, Suzie McKinnon, Mathieu Mireault, Anaïs V. Berthiaume, Marie-Hélène Poulin, Jacinthe Bourassa, Louis-Simon Maltais

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The increasing presence of young people with autism is forcing schools to adapt to this new situation and to offer services that meet the needs of this clientele. However, school staff often feels unqualified to support these students, lacking the preparation, skills and training to meet their needs. Continuing education for these staff is therefore essential to ensure that they can meet the needs of these students. As a result, the Government of Quebec has developed a bilingual (French and English) online training on autism specific to the needs of school staff. Therefore, adequate training for all school staff is likely to provide quality learning opportunities for these students. The research project focuses on the participants' appreciation, contributions, and social validity of the training. More specifically, it aims to: 1) evaluate the knowledge and self-efficacy of the participants, 2) evaluate the social validity and 3) document the evaluation of the ergonomics of the platform hosting the training. The evaluation carried out as part of this descriptive study uses a quantitative method. Data are collected using questionnaires completed online. The analysis of preliminary data reveals that participants' knowledge of autism and their sense of self-efficacy increased significantly. They value the training positively and consider it to be acceptable, appropriate, and suitable. The participants find it important for school staff to take this training. Almost all the items measuring the ergonomics of the platform have averages above 4.57/5. In general, the study shows that the training allows participating of the trainee school staff to improve their knowledge of autism and their sense of self-efficacy with young people with autism. In addition, participants recognize that the training has good social validity and appreciate the online modality. However, these results should be interpreted with caution given the limited number of participants who completed the research project. It is therefore important to continue the research with a larger number of participants to allow an adequate and general representativeness of the social validity, the feeling of competence and the appreciation of the platform.

Keywords: autism, online training, school staff, social validity

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