Search results for: sensory interventions

Authors: Yannay Casas-Ledon, Cinthya A. Andrade, Camila E. Salazar, Mauricio Aguayo

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The sustainable management of available natural resources is a crucial question for policy-makers, economists, and the research community. Among several, land constitutes one of the most critical resources, which is being intensively appropriated by human activities producing ecological stresses and reducing ecosystem services. In this context, net primary production (NPP) has been considered as a feasible proxy indicator for estimating the impacts of human interventions on land-uses intensity. Accordingly, the human appropriation of NPP (HANPP) was calculated for the south-central regions of Chile between 2007 and 2014. The HANPP was defined as the difference between the potential NPP of the naturally produced vegetation (NPP0, i.e., the vegetation that would exist without any human interferences) and the NPP remaining in the field after harvest (NPPeco), expressed in gC/m² yr. Other NPP flows taken into account in HANPP estimation were the harvested (NPPh) and the losses of NPP through land conversion (NPPluc). The ArcGIS 10.4 software was used for assessing the spatial and temporal HANPP changes. The differentiation of HANPP as % of NPP0 was estimated by each landcover type taken in 2007 and 2014 as the reference years. The spatial results depicted a negative impact on land use efficiency during 2007 and 2014, showing negative HANPP changes for the whole region. The harvest and biomass losses through land conversion components are the leading causes of loss of land-use efficiency. Furthermore, the study depicted higher HANPP in 2014 than in 2007, representing 50% of NPP0 for all landcover classes concerning 2007. This performance was mainly related to the higher volume of harvested biomass for agriculture. In consequence, the cropland depicted the high HANPP followed by plantation. This performance highlights the strong positive correlation between the economic activities developed into the region. This finding constitutes the base for a better understanding of the main driving force influencing biomass productivity and a powerful metric for supporting the sustainable management of land use.

Keywords: human appropriation, land-use changes, land-use impact, net primary productivity

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Authors: Myriam Roy

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The perspectives of the Togolese public towards mental illness were assessed, looking at religious affiliation, personal knowledge of someone with a mental illness, and education level as influencers. The goal was to observe which factors influenced most strongly the general public’s attitudes towards mental illness. The Togolese population was surveyed within the context of mental health awareness workshops and involved college and university students, rural community members, and company employees. Taylor and Dear’s Community Attitudes towards the Mentally Ill (CAMI) questionnaire was used to assess these influencers and includes four dimensions of community attitudes towards mental illness: authoritarianism, benevolence, social restrictiveness, and community mental health ideology (CMHI). Demographic questions were also included, tailored to the various realities of the Togolese population. These questions looked, among others, at religious, ethnical (region of origin within Togo), and educational background. It was found that religious affiliation and personal knowledge did not correlate significantly with changes in the four dimensions of the CAMI scale. It suggests that public perspectives towards mental illness might not be as associated with these variables as was previously thought. The dimensions, however, did correlate with themselves as was expected. Authoritarianism was associated positively with social restrictiveness, benevolence was associated negatively with social restrictiveness and positively with CMHI, and CMHI was associated negatively with social restrictiveness, indicating the CAMI did not suffer from reliability and validity issues when used with this population. Interestingly, level of education significantly impacted authoritarianism level, with higher education associated with a decrease in authoritarianism. This finding would support the notion that education is likely to provide access to a wide array of information as well as interaction with people from various backgrounds and situations. Providing increased awareness regarding mental health and illness in schools could be beneficial to favor the impact that education appears to have on public perspectives towards mental illness in Togo. Future studies could assess which mental health interventions in schools would be the most useful in Togo.

Keywords: CAMI questionnaire, cross-cultural psychology, stigma towards mental illness, West African psychology

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Authors: Thomas P. Carroll

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The phenomenon of mindfulness has become ever more popular in an increasingly pluralist Western society. Mindfulness practice has penetrated secular contexts that would otherwise be closed to religious influence, including state schools, hospitals, and commerce. The contemporary understanding of mindfulness has its origins in Buddhist meditation. However, since Jon Kabat-Zinn’s pioneering work in Mindfulness-Based Interventions, the concept has developed and sometimes mutated into various forms of practice which are disembedded from their original spiritual philosophy. This project will explore the spiritual climate within which mindfulness is currently flourishing through dialogue with three interlocutors. The first interlocutor is the Canadian philosopher Charles Taylor whose seminal work, ‘A Secular Age’, outlines three distinct modes of secularity. Taylor examines how the conditions of belief have changed and how the self seeks meaning in an age where belief in the divine is no longer axiomatic. The next interlocutor is Czech theologian and psychotherapist Tomáš Halík who offers a unique perspective of a Catholic who belongs to a section of society outnumbered by secular counterparts, with a theological hermeneutic best described as 'Den Fremden verstehen- understanding the stranger'. Finally, Irish theologian Michael Paul Gallagher offers a theological perspective on how the Christian faith can be translated into dialogue with Irish secular culture, as well as addressing the crisis of imagination and culture rather than the crisis of faith in Ireland. These interlocutors will illustrate that there are sometimes striking differences in how to interpret the religious signs of the times. However, these approaches also reveal significant similarities in how they address and explore the meaning of religious belief and experience today. In this way, themes will emerge that will help to frame the conversation about mindfulness in the West. These themes will include; the failure of the secularization thesis to pass, the growth of a diverse marketplace of religions and beliefs and the growth of a demographic who identify as spiritual but not religious. Such research is paramount in enabling a richer dialogue between Christian faith and mindfulness in a fragmented, postmodern Western context.

Keywords: culture, mindfulness, secularism, spirituality

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Authors: Barbara Vojvodikova, Katerina Jupova, Iva Ticha

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Cities in their historical evolution have always adapted their internal structure to the needs of society (for example protective city walls during classicism era lost their defense function, became unnecessary, were demolished and gave space for new features such as roads, museums or parks). Today it is necessary to modify the internal structure of the city in order to minimize the impact of climate changes on the environment of the population. This article discusses the results of the Urban Climate model owned by VITO, which was carried out as part of a project from the European Union's Horizon grant agreement No 730004 Pan-European Urban Climate Services Climate-Fit city. The use of the model was aimed at changes in land use and land cover in cities related to urban heat islands (UHI). The task of the application was to evaluate possible land use change scenarios in connection with city requirements and ideas. Two pilot areas in the Czech Republic were selected. One is Ostrava and the other Hodonín. The paper provides a demonstration of the application of the model for various possible future development scenarios. It contains an assessment of the suitability or inappropriateness of scenarios of future development depending on the temperature increase. Cities that are preparing to reconstruct the public space are interested in eliminating proposals that would lead to an increase in temperature stress as early as in the assignment phase. If they have evaluation on the unsuitability of some type of design, they can limit it into the proposal phases. Therefore, especially in the application of models on Local level - in 1 m spatial resolution, it was necessary to show which type of proposals would create a significant temperature island in its implementation. Such a type of proposal is considered unsuitable. The model shows that the building itself can create a shady place and thus contribute to the reduction of the UHI. If it sensitively approaches the protection of existing greenery, this new construction may not pose a significant problem. More massive interventions leading to the reduction of existing greenery create a new heat island space.

Keywords: climate model, heat islands, Hodonin, land use changes, Ostrava

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Authors: Yiqi Sun, Zhiyuan Zhang, Chenkun Ma

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Regeneration of outmoded urban forms and restorative environments are now recognized as major assets towards achieving sustainable development. Shanghai, like many Chinese cities, is now shifting from an agitated industrial past to more livable development schemes. Therefore, a sustainable approach to Shanghai development consists in turning industrial heritage into places with high potential for improving citizen’s daily life as regard to the three pillars of sustainability, namely: environment, economy, and society. As such, this study focuses on the Corniche in Xuhui West Bund district; a former industrial area converted into recreational public spaces in Xuhui West Bund. This area was the birthplace of the aviation industry of China, and many of the industrial features were preserved. Unused areas have been transformed into exhibition halls and green spaces, integrating some of the original industrial, architectural forms. Our case study investigates the effects of this approach associating urban regeneration with restorative design, as well as its impact on the surrounding neighborhood. Information extracted from visitors’ answers to a questionnaire survey; on-site systematic observation, counts, and measurements allowed us to assess the sustainability of this intervention in terms of accessibility, functionality, cultural and restorative qualities. In general, we found that cycling is not highly encouraged by the current design and level of connectivity, while visitors widely acknowledge the enhancement of cultural heritage resulting from the intervention. Moreover, recreational and restorative areas were found to have a very positive effect on local communities. Indeed, such an approach can provide valuable insights on how future interventions in Chinese major cities could take full advantage of existing assets in creating a more environmental, more livable, and culturally richer city.

Keywords: architectural heritage conservation, cultural urban identity, sustainability assessment, restorative environment, urban regeneration

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Authors: Tajudin Ahmed

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Malnutrition is a significant problem in developing countries, particularly among children, due to inadequate diets, lack of proper care, and unequal distribution of food within households. High rates of malnutrition have been shown in Ethiopia, including stunting, underweight, and wasting. This study aims to assess the prevalence and associated factors of Protein-Energy Malnutrition (PEM) among children aged 6-59 months in Babile Town. The study utilized a community-based cross-sectional design conducted in Babile Town, Eastern Ethiopia. Two kebeles were randomly selected, and a census was conducted to identify eligible households. A total of 391 households with children aged 6-59 months were included in the study. Data was collected using structured questionnaires, and anthropometric measurements were taken to assess the weight and height of the children. The study found that a majority of the mothers (72.34%) and fathers (43%) had no formal education. Among the mothers who could read and write, a small percentage had completed primary (14%) or secondary (14%) education, and even fewer had higher education (2.7%). Similarly, among the fathers who could read and write, a majority had completed primary (46.15%) or secondary (27.22%) education, with smaller percentages completing preparatory (8.4%) or higher education (6.29%). The prevalence of malnutrition in the study area was high, with 38.85% of children experiencing stunting (8.2% severely stunted), 50.13% wasting (9% severely wasted), and 41.43% underweight (6.65% severely underweight). These findings indicate a significant burden of malnutrition in Babile Town, likely exacerbated by the high prevalence of infectious diseases such as diarrhea. The study concludes that the prevalence of malnutrition, particularly stunting, wasting, and underweight, is high in Babile Town. The findings indicate the urgent need for interventions to address malnutrition and improve nutrition and healthcare practices in the study area. These results can serve as a baseline for future studies and inform policymakers and healthcare providers in their efforts to combat childhood malnutrition.

Keywords: protein-energy malnutrition, children 6-59 month age babble town, Marasmus

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Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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Authors: Simon Shibru, Karen Vancampenhout, Jozef Deckers, Herwig Leirs

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We investigated the population size of the endemic and endangered Swayne’s Hartebeest (Alcelaphus buselaphus swaynei) in Nech Sar National Park from 2012 to 2014 and document the major threats why the species is on the verge of local extinction. The park was once known for its abundant density of Swayne’s Hartebeest. We used direct total count methods for a census. We administered semi-structured interviews and open-ended questionnaires with senior scouts who are the member of the local communities. Historical records were obtained to evaluate the population trends of the animals since 1974. The density of the animal decreased from 65 in 1974 to 1 individual per 100 km2 in 2014 with a decline of 98.5% in the past 40 years. The respondents agreed that the conservation status of the park was in its worst condition ever now with only 2 Swayne’s Hartebeest left, with a rapid decline from 4 individuals in 2012 and 12 individuals in 2009. Mainly hunting and habitat loss, but also the unsuitable season of reproduction and shortage of forage as minor factors were identified as threats for a local extinction of the Swayne’s Hartebeests. On the other hand, predation, fire, disease, and ticks were not considered a cause for the declining trend. Hunting happens mostly out of some kind of revenge since the local community thought that they were pushed out from the land because of the presence of Swayne's Hartebeest in the area. Respondents agreed that the revenge action of the local communities was in response to their unwillingness to be displaced from the park in 1982/3. This conflict situation is resulting from the exclusionary wildlife management policy of the country. We conclude that the human interventions in general and illegal hunting, in particular, pushed the Swayne’s Hartebeest to a point of local extinction. Therefore, we recommend inclusive wildlife management approach for continuing existence of the park together with its natural resources so that sustainable use of the resources is in place.

Keywords: hunting, habitat destruction, local extinction, Nech Sar National Park, Swayne’s Hartebeest

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Authors: Anesha Atul Shende

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When we are aiming at high goals for economic development, such as sustainable growth and development of the economy, poverty reduction, reduction in inequality, etc., we must not forget to include each and everyone in the society in the process of achieving these goals. This study particularly talks about women participation in economic activities. The analysis is primarily done with a special focus on Indian states. The study analyses the female labour force participation rate in all many states in India. It makes a comparison between the states having low female Labour force participation with the states that have comparatively high female Labour population. In the beginning, data has been provided to know the current state of gender biases in employment. It has been found that the male workforce is dominant all across India. Further, the study highlights the major reasons for low women participation in economic activities in some of the backward states in India like Bihar, etc. These reasons basically talk about economic, cultural, and social factors that are responsible for women unemployment. Afterward, it analyses the reasons behind comparatively higher women participation in all other states in India. The case of the north-eastern state of Telangana and Tamil Nadu have been analysed in brief. These states show the improvements in female Labour participation over a few decades. This is because of government policies that have been adopted, women-friendly workplaces, availability of quality jobs for women, etc. Organization like women UN has recognized the social and economic benefits of having active women Labour force in the country. If women unemployment declines, it will improve the growth rate of the nation as well as the welfare of the society. The study discusses the reasons why an economy must try to increase women workforce participation. It further provides suggestions to improve the conditions in backward states in India, where the female unemployment rate is high. One must understand that policy interventions and government schemes are a few of the ways to recognize this issue and work on it. However, the conditions will improve only when the changes would happen from the ground level with social and moral support to the women.

Keywords: women unemployment, labour force participation, women empowerment, economic growth and development, gender disparity

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Authors: G. Cunningham, E. Cantor, X. Wu, F. Shen, G. Jiang, S. Philips, C. Bales, Y. Xiao, T. R. Cummins, J. C. Fehrenbacher, B. P. Schneider

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Background: Taxane-induced peripheral neuropathy (TIPN) is the most devastating survivorship issue for patients receiving therapy. Dose reductions due to TIPN in the curative setting lead to inferior outcomes for African American patients, as prior research has shown that this group is more susceptible to developing severe neuropathy. The mechanistic underpinnings of TIPN, however, have not been entirely elucidated. While it would be appealing to use primary tissue to study the development of TIPN, procuring nerves from patients is not realistically feasible, as nerve biopsies are painful and may result in permanent damage. Therefore, our laboratory has investigated paclitaxel-induced neuronal morphological and molecular changes using an ex vivo model of human-induced pluripotent stem cell (iPSC)-derived neurons. Methods: iPSCs are undifferentiated and endlessly dividing cells that can be generated from a patient’s somatic cells, such as peripheral blood mononuclear cells (PBMCs). We successfully reprogrammed PBMCs into iPSCs using the Erythroid Progenitor Reprograming Kit (STEMCell Technologiesᵀᴹ); pluripotency was verified by flow cytometry analysis. iPSCs were then induced into neurons using a differentiation protocol that bypasses the neural progenitor stage and uses selected small-molecule modulators of key signaling pathways (SMAD, Notch, FGFR1 inhibition, and Wnt activation). Results: Flow cytometry analysis revealed expression of core pluripotency transcription factors Nanog, Oct3/4 and Sox2 in iPSCs overlaps with commercially purchased pluripotent cell line UCSD064i-20-2. Trilineage differentiation of iPSCs was confirmed with immunofluorescent imaging with germ-layer-specific markers; Sox17 and ExoA2 for ectoderm, Nestin, and Pax6 for mesoderm, and Ncam and Brachyury for endoderm. Sensory neuron markers, β-III tubulin, and Peripherin were applied to stain the cells for the maturity of iPSC-derived neurons. Patch-clamp electrophysiology and calcitonin gene-related peptide (CGRP) release data supported the functionality of the induced neurons and provided insight into the timing for which downstream assays could be performed (week 4 post-induction). We have also performed a cell viability assay and fluorescence-activated cell sorting (FACS) using four cell-surface markers (CD184, CD44, CD15, and CD24) to select a neuronal population. At least 70% of the cells were viable in the isolated neuron population. Conclusion: We have found that these iPSC-derived neurons recapitulate mature neuronal phenotypes and demonstrate functionality. Thus, this represents a patient-derived ex vivo neuronal model to investigate the molecular mechanisms of clinical TIPN.

Keywords: chemotherapy, iPSC-derived neurons, peripheral neuropathy, taxane, paclitaxel

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Authors: Abdirahim Mohamed, Sarita Rana Chhetri, Michael Sleath, Nadia Saleem

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Rationale: Internet usage has been very much integrated into our daily lives. Internet usage within a neurodevelopmental disorder population is also on the increase. Nevertheless, there is very little empirical research on how this population virtually protect themselves; along with how their parents can keep them safe online. This topic was an ever-growing concern to the parents within our services and in many cases would add to the stresses and mental health of parents. This ignited an idea within our team to conduct research to explore the perceived online risks within this population and how they keep themselves safe. In conjunction, we also explored how parents and caregivers monitor and safeguard their young people to the potential threats online. Our hypothesis was that the perceived risks will heavily outnumber the safeguarding measures implemented by this population. Method: Within the Coventry and Warwickshire NHS Partnership Trust Child and Adolescent Mental Health Service (CAMHS), we distributed qualitative questionnaires to all the clinical bases (N=80). Questions explored topics such as daily internet usage, safeguarding measures, and perceived threats. The researchers requested for all CAMHS clinicians to identify participants. Participants in this study were accessing CAMHS for neurodevelopmental specific interventions. Results: The data were analysed using both Excel and SPSS. Within SPSS, a MANOVA was conducted and found a significant difference between safeguarding measures and perceived online risks within responses (p ≤ 0.5). This supports our hypothesis that participants in this population are well versed in the safeguarding issues of the internet; however, struggle to implement appropriate preventative measures. Data were also screened using Excel and found that all parents and carers stated they 'monitored their child’s internet use'. Conclusion: Data suggest that parents/carers may require more specific intervention to equip them with preventative measures due to the clear discrepancy between perceived risks and safeguarding measures. More research may also need to be conducted around this area to determine appropriate methodology to explore this topic further.

Keywords: Internet, health , how safe are we , internet health check

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Authors: Mahdi Taheri Asl

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Using a variety of strategies to read text plays an important role to make students strategic independent, strategic, and metacognitive readers. Given the importance of comprehension instruction (CI), it is essential to support the fostering comprehension skills at elementary age students, particularly those who struggle with or dislike reading. One of the main components of CI is activating metacognitive skills, which double function of elementary students. Thus, it’s important to evaluate the implemented comprehension interventions to inform reading specialist and teachers. There has been limited review research in the area of CI, so the conduction review research is required. The purpose of this review is to examine the effectiveness of metacognitive reading strategies in a regular classroom environment with elementary aged students. We develop five inclusion criteria to identify researches relevant to our research. First, the article had to be published in a peer-reviewed journal from 2000 to 2023. second, the study had to include participants in elementary school it could include of special education students. Third, the intervention needed to be involved with metacognitive strategies. Fourth, the articles had to use experimental or quasi experimental design. The last one needed to include measurement of reading performance in pre and post intervention. We used computer data-based site like Eric, PsychoINFO, and google scholar to search for articles that met these criteria. we used the following search terms: comprehension instruction, meta cognitive strategies, and elementary school. The next step was to do an ancestral search that get in reviewing the relevant studies cited in the articles that were found in the database search. We identified 30studies in the initial searches. After coding agreement, we synthesized 13 with respect to the participant, setting, research design, dependent variables, measures, the intervention used by instructors, and general outcomes. The finding show metacognitive strategies were effective to empower student’s comprehension skills. It also showed that linguistic instruction will be effective if got mixed with metacognitive strategies. The research provides a useful view into reading intervention. Despite the positive effect of metacognitive instruction on students’ comprehension skills, it is not widely used in classroom.

Keywords: comprehension instruction, metacogntion, metacognitive skills, reading intervention

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Authors: Sheriff Muhammad Ibrahim

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The contemporary world has seen many agents of market liberalization, globalization, and expansion in agribusiness, which pose a big threat to the existence of smallholder farmers in the farming business or, at most, being marginalized against government interventions, investors' partnerships and further stretched by government policies in an effort to promote subsistent farming that can generate profits and speedy growth through attracting foreign businesses. The consequence of these modern shifts ends basically at the expense of smallholder farmers. Many scholars believed that this shift was among the major causes of urban-rural drift facing almost all communities in the World. In an effort to address these glaring economic crises, various governments at different levels and development agencies have created different programs trying to identify other sources of income generation for rural farmers. However, despite the different approaches adopted by many communities and states, the mass rural exodus continues to increase as the rural farmers continue to lose due to a lack of reliable sources for cost-efficient inputs such as agricultural extension services, mechanization supports, quality, and improved seeds, soil matching fertilizers and access to credit facilities and profitable markets for rural farmers output. Unfortunately for them, they see these agricultural requirements provided by large-scale farmers making their farming activities cheaper and yields higher. These have further created other social problems between the smallholder farmers and the large-scale farmers in many areas. This study aims to suggest the Islamic mode of agricultural financing named Muzara’ah for smallholder farmers as a microfinance banking product adopted and practiced by Yobe Microfinance Bank as a model to promote agricultural financing to be adopted in other communities. The study adopts a comparative research method to conclude that the Muzara’ah model of financing can be adopted as a valid means of financing smallholder farmers and reducing food insecurity.

Keywords: Muzara'ah, Islamic finance, agricultural financing, microfinance, smallholder farmers

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Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: Ricardo Godoy, Herbert Venthur, Hector Jimenez, Andres Quiroz, Ana Mutis

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In agriculture, grape production has great economic importance at global level, considering that in 2013 it reached 7.4 million hectares (ha) covered by plantations of this fruit worldwide. Chile is the number one exporter in the world with 800,000 tons. However, these values have been threatened by the attack of the grapevine moth, Lobesia botrana (Denis & Schiffermuller) (Lepidoptera: Tortricidae), since its detection in 2008. Nowadays, the use of semiochemicals, in particular the major component of the sex pheromone, (E,Z)-7.9-dodecadienil acetate, are part of mating disruption methods to control L. botrana. How insect pests can recognize these molecules, is being part of huge efforts to deorphanize their olfactory mechanism at molecular level. Thus, an interesting group of proteins has been identified in the antennae of insects, where odorant-binding proteins (OBPs) are known by transporting molecules to odorant receptors (ORs) and a co-receptor (ORCO) causing a behavioral change in the insect. Other proteins such as chemosensory proteins (CSPs), ionotropic receptors (IRs), odorant degrading enzymes (ODEs) and sensory neuron membrane proteins (SNMPs) seem to be involved, but few studies have been performed so far. The above has led to an increasing interest in insect communication at a molecular level, which has contributed to both a better understanding of the olfaction process and the design of new pest management strategies. To date, it has been reported that the ORs can detect one or a small group of odorants in a specific way. Therefore, the objective of this study is the identification of genes that encode these ORs using the antennal transcriptome of L. botrana. Total RNA was extracted for females and males of L. botrana, and the antennal transcriptome sequenced by Next Generation Sequencing service using an Illumina HiSeq2500 platform with 50 million reads per sample. Unigenes were assembled using Trinity v2.4.0 package and transcript abundance was obtained using edgeR. Genes were identified using BLASTN and BLASTX locally installed in a Unix system and based on our own Tortricidae database. Those Unigenes related to ORs were characterized using ORFfinder and protein Blastp server. Finally, a phylogenetic analysis was performed with the candidate amino acid sequences for LbotORs including amino acid sequences of other moths ORs, such as Bombyx mori, Cydia pomonella, among others. Our findings suggest 61 genes encoding ORs and one gene encoding an ORCO in both sexes, where the greatest difference was found in the OR6 because of the transcript abundance according to the value of FPKM in females and males was 1.48 versus 324.00. In addition, according to phylogenetic analysis OR6 is closely related to OR1 in Cydia pomonella and OR6, OR7 in Epiphyas postvittana, which have been described as pheromonal receptors (PRs). These results represent the first evidence of ORs present in the antennae of L. botrana and a suitable starting point for further functional studies with selected ORs, such as OR6, which is potentially related to pheromonal recognition.

Keywords: antennal transcriptome, lobesia botrana, odorant receptors (ORs), phylogenetic analysis

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Authors: Pulari C. Milu Maria Anto

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Background: Cognitive Rehabilitation/Retraining has been variously used in the research literature to represent non-pharmacological interventions that target the cognitive impairments with the goal of ameliorating cognitive function and functional behaviors to optimize the quality of life. Along with adult’s cognitive impairments, the need to address acquired cognitive impairments (due to any chronic illnesses like CHD - congenital heart diseases or ALL - Acute Lymphoblastic Leukemia) among child populations is inevitable. Also, it has to be emphasized as same we consider the cognitive impairments seen in the children having neurodevelopmental disorders. Methods: All published brain image studies (Hermann, B. et al,2002, Khalil, A. et al., 2004, Follin, C. et al, 2016, etc.) and studies emphasizing cognitive impairments in attention, memory, and/or executive function and behavioral aspects (Henkin, Y. et al,2007, Bellinger, D. C., & Newburger, J. W. (2010), Cheung, Y. T., et al,2016, that could be identified were reviewed. Based on a systematic review of the literature from (2000 -2021) different brain imaging studies, increased risk of neuropsychological and psychosocial impairments are briefly described. Clinical and research gap in the area is discussed. Results:30 papers, both Indian studies and foreign publications (Sage journals, Delhi psychiatry journal, Wiley Online Library, APA PsyNet, Springer, Elsevier, Developmental medicine, and child neurology), were identified. Conclusions: In India, a very limited number of brain imaging studies and neuropsychological studies have done by indicating the cognitive deficits of a child having or undergone chronic illness. None of the studies have emphasized the relevance nor the need of implementingCR among such children, even though its high time to address but still not established yet. The review of the current evidence is to bring out an insight among rehabilitation professionals in establishing a child specific CR and to publish new findings regarding the implementation of CR among such children. Also, this study will be an awareness on considering cognitive aspects of a child having acquired cognitive deficit (due to chronic illness), especially during their critical developmental period.

Keywords: cognitive rehabilitation, neuropsychological impairments, congenital heart diseases, acute lymphoblastic leukemia, epilepsy, and neuroplasticity

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Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

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Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

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Authors: A. Afrashi

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Introduction: Synaesthesia is a term denoting the perception or description of the perception of one sense modality in terms of another. In literature, synaesthesia refers to a technique adopted by writers to present ideas, characters or places in such a manner that they appeal to more than one sense like hearing, seeing, smell etc. at a given time. In everyday language too we find many examples of synaesthesia. We commonly hear phrases like ‘loud colors’, ‘frozen silence’ and ‘warm colors’, ‘bitter cold’ etc. Empirical cognitive studies have proved that synaesthetic representations both in literature and everyday languages are constrained ie. they do not map randomly among sensory domains. From the beginning of the 20th century Synaesthesia has been a research domain both in literature and structural linguistics. However the exploration of cognitive mechanisms motivating synaesthesia, have made it an important topic in 21st century cognitive linguistics and literary studies. Synaesthetic metaphors are linguistic representations of those mental mechanisms, the study of which reveals invaluable facts about perception, cognition and conceptualization. According to the main tenets of cognitive approach to language and literature, unified and similar cognitive mechanisms are active both in everyday language and literature, and synaesthesia is one of those cognitive mechanisms. Main objective of the present research is to answer the following questions: What types of sense transfers are accessible in Persian synaesthetic metaphors. How are these types of sense transfers cognitively explained. What are the results of cross-linguistic comparative study of synaestetic metaphors based on the existing observations? Methodology: The present research employs a cognitive - corpus based method, and the theoretical framework adopted to analyze linguistic synaesthesia is the contemporary theory of metaphor, where conceptual metaphor is the result of systemic mappings across cognitive domains. Persian Language Data- base (PLDB) in the Institute for Humanities and Cultural Studies which consists mainly of Persian modern prose, is searched for synaesthetic metaphors. Then for each metaphorical structure, the source and target domains are determined. Then sense transfers are identified and the types of synaesthetic metaphors recognized. Findings: Persian synaesthetic metaphors conform to the hierarchical distribution principle, according to which transfers tend to go from touch to taste to smell to sound and to sight, not vice versa. In other words mapping from more accessible or basic concepts onto less accessible or less basic ones seems more natural. Furthermore the most frequent target domain in Persian synaesthetic metaphors is sound. Certain characteristics of Persian synaesthetic metaphors are comparable with existing related researches carried on English, French, Hungarian and Chinese synaesthetic metaphors. Conclusion: Cognitive corpus based approaches to linguistic synaesthesia, are applicable to stylistics and literary criticism and this recent research domain is an efficient approach to study cross linguistic variations to find out which of the five senses is dominant cross linguistically and cross culturally as the target domain in metaphorical mappings , and so forth receiving dominance in conceptualizations.

Keywords: cognitive semantics, conceptual metaphor, synaesthesia, corpus based approach

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Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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Authors: Safee Chaudhary, Mahnoor Naseer Gondal, Hira Anees Awan, Abdul Rehman, Ammar Arif, Risham Hussain, Huma Khawar, Zainab Arshad, Muhammad Faizyab Ali Chaudhary, Waleed Ahmed, Muhammad Umer Sultan, Bibi Amina, Salaar Khan, Muhammad Moaz Ahmad, Osama Shiraz Shah, Hadia Hameed, Muhammad Farooq Ahmad Butt, Muhammad Ahmad, Sameer Ahmed, Fayyaz Ahmed, Omer Ishaq, Waqar Nabi, Wim Vanderbauwhede, Bilal Wajid, Huma Shehwana, Muhammad Tariq, Amir Faisal

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Cancer is a manifestation of multifactorial deregulations in biomolecular pathways. These deregulations arise from the complex multi-scale interplay between cellular and extracellular factors. Such multifactorial aberrations at gene, protein, and extracellular scales need to be investigated systematically towards decoding the underlying mechanisms and orchestrating therapeutic interventions for patient treatment. In this work, we propose ‘TISON’, a next-generation web-based multiscale modeling platform for clinical systems oncology. TISON’s unique modeling abstraction allows a seamless coupling of information from biomolecular networks, cell decision circuits, extra-cellular environments, and tissue geometries. The platform can undertake multiscale sensitivity analysis towards in silico biomarker identification and drug evaluation on cellular phenotypes in user-defined tissue geometries. Furthermore, integration of cancer expression databases such as The Cancer Genome Atlas (TCGA) and Human Proteome Atlas (HPA) facilitates in the development of personalized therapeutics. TISON is the next-evolution of multiscale cancer modeling and simulation platforms and provides a ‘zero-code’ model development, simulation, and analysis environment for application in clinical settings.

Keywords: systems oncology, cancer systems biology, cancer therapeutics, personalized therapeutics, cancer modelling

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.

Keywords: depression, men, postpartum, risk factors, women

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Authors: Andy S.K. Cheng, Samuel Leung, Cindy Kwok, Hector Tsang

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Background: Telephone counselling is one of the essential interventions that can be found in most of the Employee Assistance Programs (EAP). The purposes of this study were to (1) explore the trend of the telephone counselling from 2003-2016 in Hong Kong; (2) explore which EAP issue requires more follow-up; and 3) examine the relationship between the EAP issues and demographic data such as gender and job ranking. Method: Date of EAP services usage was collected from EAP providers in Hong Kong during 2003-2016. EAP issues were categorized into two domains, namely workplace issues and personal issues. Each domain has 12 sub-categories. Two hypotheses were formulated in this study (1) there was a gender difference in EAP issues and the follow-up hours; and (2) there was a significant difference between job ranking, EAP issues and follow-up hours. Results: A total of eight hundred and ninety-three valid cases were identified for analysis. Of them, three hundred and forty-three cases sought for follow-up. The duration of follow-up by hours was calculated for each of the follow-up cases. The results of the study shows that the top three workplace issues that required the longest duration of follow-up were (1) workload, (2) supervisor-subordinate relationship; and (3) team member’s relationship. On the other hand, the top three personal issues that required the longest duration of follow-up were (1) parenting/parent-child relationship, (2) family care, and (3) marital relationship. Two-way ANOVA was performed to compare the total follow-up hours (excluding first intake) between gender and EAP issues. There was no statistical significance for gender (p =.891), but a statistically significant main effect for EAP issues (p <.001) was found. Post-hoc analysis (Tukey’s test) showed that total follow-up hour in personal issues was statistically significant higher than that in handling workplace issues (p <.001). However, there was no statistically significant interaction effect between gender and EAP issues (p=.879) and between job ranking and EAP issues (p=.843). Conclusion: Telephone counselling is a very common intervention in addressing EAP issues arising from workplace and personal level in Hong Kong. It was frequently used to handle interpersonal relationships and the service usage was independent of gender and job ranking.

Keywords: employee assistance program, follow-up time, interpersonal relationships, telephone counselling

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Authors: Michael Lousis

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Mathematical competence is the great aim of every mathematical teaching and learning endeavour. This can be defined as an idealised conceptualisation of the quality of cognition and the ability of implementation in practice of the mathematical subject matter, which is included in the curriculum, and is displayed only through performance of doing mathematics. The present study gives a clear definition of mathematical competence in the domains of Arithmetic and Algebra that stems from the explanation of the learners’ errors in these domains. The learners, whose errors are explained, were Greek and English participants of a large, international, longitudinal, comparative research program entitled the Kassel Project. The participants’ errors emerged as results of their work in dealing with mathematical questions and problems of the tests, which were presented to them. The construction of the tests was such as only the outcomes of the participants’ work was to be encompassed and not their course of thinking, which resulted in these outcomes. The intention was that the tests had to provide undeviating comparable results and simultaneously avoid any probable bias. Any bias could stem from obtaining results by involving so many markers from different countries and cultures, with so many different belief systems concerning the assessment of learners’ course of thinking. In this way the validity of the research was protected. This fact forced the implementation of specific research methods and theoretical prospects to take place in order the participants’ erroneous way of thinking to be disclosed. These were Methodological Pragmatism, Symbolic Interactionism, Philosophy of Mind and the ideas of Computationalism, which were used for deciding and establishing the grounds of the adequacy and legitimacy of the obtained kinds of knowledge through the explanations given by the error analysis. The employment of this methodology and of these theoretical prospects resulted in the definition of the learners’ mathematical competence, which is the thesis of the present study. Thus, learners’ mathematical competence is depending upon three key elements that should be developed in their minds: appropriate representations, appropriate meaning, and appropriate developed schemata. This definition then determined the development of appropriate teaching practices and interventions conducive to the achievement and finally the entailment of mathematical competence.

Keywords: representations, meaning, appropriate developed schemata, computationalism, error analysis, explanations for the probable causes of the errors, Kassel Project, mathematical competence

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Authors: Lucy Lugo Mawang

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Educational Psychologists have highlighted the significance of creativity in education. Likewise, a fundamental objective of music education concern the development of students’ musical creativity potential. The purpose of this study was to determine the relationship between motivation strategies and musical creativity, and establish the prediction equation of musical creativity. The study used purposive sampling and census to select 201 fourth-form music students (139 females/ 62 males), mainly from public secondary schools in Kenya. The mean age of participants was 17.24 years (SD = .78). Framed upon self- determination theory and the dichotomous model of achievement motivation, the study adopted an ex post facto research design. A self-report measure, the Achievement Goal Questionnaire-Revised (AGQ-R) was used in data collection for the independent variable. Musical creativity was based on a creative music composition task and measured by the Consensual Musical Creativity Assessment Scale (CMCAS). Data collected in two separate sessions within an interval of one month. The questionnaire was administered in the first session, lasting approximately 20 minutes. The second session was for notation of participants’ creative composition. The results indicated a positive correlation r(199) = .39, p ˂ .01 between musical creativity and intrinsic music motivation. Conversely, negative correlation r(199) = -.19, p < .01 was observed between musical creativity and extrinsic music motivation. The equation for predicting musical creativity from music motivation strategies was significant F(2, 198) = 20.8, p < .01, with R2 = .17. Motivation strategies accounted for approximately (17%) of the variance in participants’ musical creativity. Intrinsic music motivation had the highest significant predictive value (β = .38, p ˂ .01) on musical creativity. In the exploratory analysis, a significant mean difference t(118) = 4.59, p ˂ .01 in musical creativity for intrinsic and extrinsic music motivation was observed in favour of intrinsically motivated participants. Further, a significant gender difference t(93.47) = 4.31, p ˂ .01 in musical creativity was observed, with male participants scoring higher than females. However, there was no significant difference in participants’ musical creativity based on age. The study recommended that music educators should strive to enhance intrinsic music motivation among students. Specifically, schools should create conducive environments and have interventions for the development of intrinsic music motivation since it is the most facilitative motivation strategy in predicting musical creativity.

Keywords: extrinsic music motivation, intrinsic music motivation, musical creativity, music composition

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Authors: Nchanji Yvonne Kiki, Mala William Armand, Nchanji Eileen Bogweh, Ramcilovik-Suominen Sabaheta, Kotilainen Juha

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The Campo Ma'an National Park was created as part of an environmental and biodiversity compensation for the Chad-Cameroon Oil Pipeline Project, which was meant to help alleviate poverty and boost the livelihood of rural communities around the area. This paper examines different strategies and coping mechanisms employed by the indigenous people and local communities to deal with the national and internationally driven conservation policies and initiatives in the case of the Campo Ma'an National Park. While most literature on park management/co-management/nature conservation has focused on the negative implications for local peoples’ livelihoods, fewer studies have investigated the strategies of local people to respond to these policies and renegotiate their position in a way that enables them to continue their traditional livelihoods using the existing local knowledge systems. This study contributes to the current literature by zooming into not only the impacts of nature conservation policies but also the local individual and collective strategies and responses to such policies and initiatives. We employ a qualitative research approach using ethnomethodology and a convivial lens to analyze data collected from October to November 2018. We find that conservation policies have worsened some existing livelihoods on the one hand and constrained livelihood improvement of indigenous people and local communities (IPLC) on the other hand. Nonetheless, the IPLC has devised individual and collective coping mechanisms to deal with these conservation interventions and the negative effects they have caused. Upon exploring these mechanisms and their effectiveness, this study proposes a management approach to conservation centered on both people and nature, based on indigenous and local people's knowledge and practices, promoting nature for and by humans and strengthening both livelihood and conservation. We take inspiration from the convivial conservation approach and thinking by Bucher and Fletcher.

Keywords: conservation policies, national park management, indigenous and local people’s experiences, livelihoods, local knowledge, coping strategies, conviviality

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Authors: Njoroge Margaret W., Johnson Deborah

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Gender-specific risk factors for common mental disorders that disproportionately affect women include but are not limited to gender-based violence, socioeconomic disadvantage, sociocultural factors and unrelenting responsibility for the care of others. The overall objective of this study was to assess mental health conditions and their risk factors among women in Garissa County, Kenya. The study adopted both quantitative and qualitative research designs. The study participants were 100 adult women and 20 key informants from different sectors in the region. Data was collected using DSM-5 (PCL-5) and Kessler Psychological Distress, interviews schedule and focus group discussions. Analysis of quantitative data was done using univariate analysis, while qualitative data was analyzed using thematic analysis. The results revealed that about 60% of women presented with moderate to severe psychological distress (PD), while 53% presented with PTSD. Additionally, women who have undergone female genital mutilation had higher PTSD and PD scores. They also presented with low self-esteem, depressive symptoms, sex anxiety, avoidance of reminders and intrusive memories of the event, especially those who developed fistula. The risk factors for poor mental health outcomes include lack of awareness/knowledge of mental health, retrogressive cultural practices (child marriage and female genital mutilation), as well as beliefs about the causes of mental disorders. The study also established that people with mental illness are neglected, abused and stigmatized. Preferred treatment approaches include prayers and the use of witch doctors and traditional healers. The study recommends gendered and culturally responsive interventions geared towards increasing community awareness and knowledge on mental health, reducing stigma and improving mental-health-seeking behaviors for women and girls in the region. Supported by the Ministry of Health, the approach should be spearheaded by trained community lay counselors.

Keywords: women, mental health conditions, cultural beliefs/practices, stigma, poverty, psychological distress, PTSD

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Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

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Background: Our study assesses the impact of the COVID-19 pandemic on early pregnancy assessment clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ± 4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID-19 compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID-19, but ectopic pregnancy operative management remained unchanged.

Keywords: early pregnancy, ultrasound, COVID-19, obstetrics

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Authors: Rachel Talbot, Nasuh Malas

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Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care. Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service. Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry. This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry. Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame. There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating ‘real problems’ and personality blunting. Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare. For this study, families are given a survey highlighting these concerns, prior to and after watching the video. Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care. Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.

Keywords: child and adolescent psychiatry, consult-liaison psychiatry, media, stigma

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Authors: Luiz Nolasco Jr. Rezende, Antonio Villar M. Sá, Claudia Marcia L. Pato

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The increasing urban violence in Brazil involves more and more infractions committed by children and youths. The challenges faced by the institutional environments responsible for the education and resocialization of adolescents in conflict with the law are enormous, especially of those deprived of their liberty. These institutions have an inadequate educational structure. They are characterized by a dirty and unhealthy environment without the minimum basic conditions for their activities, by frequent practices of degradation, humiliation, and the physical and psychological punishment of inmates. This mixed-method study investigated the personal values of adolescents with restriction of freedom in a socio-educational institutional environment aiming to contribute to the development of their morality through an educational process. For that, we used a survey and transdisciplinary play workshops involving thirty-two boys aged between 15 and 19 years old and at least two years out of school. To evaluate the survey the reduced version of the Portrait Questionnaire—PQ21—was used. The workshops happened once a week, lasting 80 minutes each, totaling twelve meetings. By using the game of chess and its metaphors, participants produced texts and engaged in critical brainstorming about their lives. The survey results pointed out that these young people showed a predominance of values of openness to change and self-transcendence, dissatisfaction with one's own reality and surroundings, not considering the consequences of their actions on themselves and others, difficulties in speaking and writing, and desire for changes in their lives. After the pedagogical interventions, these adolescents demonstrated an understanding of the implications of their actions for themselves, for their families, especially for the mothers, with whom they demonstrated stronger bonds. It was possible to observe evidence of improvement in the capacity of linguistic expression, more autonomy and critical vision, including about themselves and their respective contexts. These results demonstrated the educational potential of lively, symbolic, dynamic and playful activities that favor the mediation and identification of these adolescents with their lives, and contribute to the projection of dreams.

Keywords: adolescents arrested, human values, moral development, playful workshops

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Authors: Shilpa Sharma, Lakshmi Ganesh, Mantra Gurumurthy, Shweta Sharma

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Board games provide affordances of 21st-century skills like collaboration, critical thinking, and strategy. Board games such as chess, Catan, Battleship, Scrabble, and Taboo can enhance learning in these areas. While board games are popular in informal child settings, their use in formal K-12 education is limited. To encourage teachers to incorporate board games, it's essential to grasp their perceptions and tailor professional development programs accordingly. This paper aims to explore teacher attitudes toward board games and propose interventions to motivate teachers to integrate and create board games in the classroom. A user study was conceived, designed, and administered with teachers (n=38) to understand their experience in playing board games and using board games in the classroom. Purposive sampling was employed as the questionnaire was floated to teacher groups that the authors were aware of. The teachers taught in K-12 affordable private schools. The majority of them had experience ranging from 2-5 years. The questionnaire consisted of questions on teacher perceptions and beliefs of board game usage in the classroom. From the responses, it was observed that ~90% of teachers, though they had experience of playing board games, rarely did it translate to using board games in the classroom. Additionally, it was observed that translating learning objectives to board game objectives is the key factor that teachers consider while using board games in the classroom. Based on the results from the questionnaire, a professional development workshop was co-designed with the objective of motivating teachers to design, create and use board games in the classroom. The workshop is based on the principles of gamification. This is to ensure that the teachers experience a board game in a learning context. Additionally, the workshop is based on the principles of andragogy, such as agency, pertinence, and relevance. The workshop will begin by modifying and reusing known board games in the learning context so that the teachers do not find it difficult and daunting. The intention is to verify the face validity and content validity of the workshop design, orchestration and content with experienced teacher development professionals and education researchers. The results from this study will be published in the full paper.

Keywords: board games, professional development, teacher motivation, teacher perception

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