Search results for: young woman

Authors: Young Nam Chun, Mun Sup Lim, Byeo Ri Jeong

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Sewage sludge is regarded as the residue produced by the waste water treatment process, during which liquids and solids are being separated. Thermal treatments are interesting techniques to stabilize the sewage sludge for disposal. Among the thermal treatments, pyrolysis and/or gasification has been being applied to the sewage sludge. The final goal of our NRF research is to develop a microwave In-line Drying-Pyrolysis-Gasification (IDPG) technology for the dewatered sewage sludge for the bio-waste to energy conversion. As a first step, the pyrolysis characteristics in a bench scale electric furnace was investigated at 800℃ for the dewatered sludge and dried sludge samples of which moisture contents are almost 80% and 0%, respectively. Main components of producer gas are hydrogen and carbon dioxide. Particularly, higher hydrogen for the dewatered sludge is shown as 75%. The hydrogen production for the dewatered sludge and dried sludge are 56% and 32%, respectively. However, the pyrolysis for the dried sludge produces higher carbon dioxide and other gases, while higher methane and carbon dioxide are given to 74% and 53%, respectively. Tar also generates during the pyrolysis process, showing lower value for case of the dewatered sludge. Gravimetric tar is 195 g/m3, and selected light tar like benzene, naphthalene, anthracene, pyrene are 9.4 g/m3, 2.1 g/m3, 0.5 g/m3, 0.3 g/m3, respectively. After the pyrolysis process, residual char for the dewatered sludge and dried sludge remain 1g and 1.3g, showing weight reduction rate of 93% and 57%, respectively. Through the results, this could be known that the dewatered sludge can be used to produce a clean hydrogen-rich gas fuel without the drying process. Therefore, the IDPG technology can be applied effectively to the energy conversion for dewater sludge waste without a drying pretreatment. Acknowledgment: This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIP) (No. 2015R1A2A2A03003044).

Keywords: pyrolysis, gasification, sewage sludge, tar generation, producer gas, sludge char, biomass energy

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Authors: Abduraheem K., Suboohi Nasrin

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Herbaria are specimens of preserved plants, which are very delicate and cellulosic in nature. While these collections are very useful for the enrichment of knowledge and are considered as natural heritage of our entire world, it is very important to preserve and conserve them. The significance is not only to prevent the herbaria from the deterioration of biological agencies but also to preserve its colours and retain natural colour. Colour is not only characteristic of a plant, but it can also help to identify closely related species or to distinguish a plant from a collection of herbaria. Keeping this in mind, a selective solution has been prepared for the conservation and preservation of herbarium in the present study. In this, the quantity of all the selected chemicals, i.e., formaldehyde and copper sulphate was kept constant, and the solution was prepared by dissolving it in distilled water by increasing the amount of picric acid (1, 2, 3, 4, and 5 ml). Fresh specimens of roses and bougainvillea were washed with distilled water and kept in the above solution for 10 to 15 minutes at room temperature. After 10 minutes, the specimen was removed from the solution, dried with the help of paper, and then pressed under the plant press. Blotting sheets were used to absorb the moisture content and were changed every 2 to 3 days to protect against fungal growth. The results revealed that all solutions had insecticidal properties and protected the herbarium specimen against pests. While in the case of colour retention, solution-1 and 2 were not satisfactory colour preservation, and solutions-3 and 5 maintained the colour of rose and bougainvillea leaves for 15 to 20 days and for a month, respectively. After that, the colour begins to fade, and the process is faster in rose leaves than in bougainvillea. And it was also observed that the colour of young leaves started to fade before that of older leaves. When the leaves of rose and bougainvillea are treated with Solution-4, then the colour of rose leaves is maintained for six months.

Keywords: solutions, colour retention, preservation and conservation, leaves of roses and bougainvillea

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Authors: Vânia Graça, Paula Quadros-Flores, Altina Ramos

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The use of Digital Technologies in teaching and learning processes is currently a reality, namely in initial teacher training. This study aims at knowing the digital reality of students in initial teacher training in order to improve training in the educational use of ICT and to promote digital technology integration strategies in an educational context. It is part of the IFITIC Project "Innovate with ICT in Initial Teacher Training to Promote Methodological Renewal in Pre-school Education and in the 1st and 2nd Basic Education Cycle" which involves the School of Education, Polytechnic of Porto and Institute of Education, University of Minho. The Project aims at rethinking educational practice with ICT in the initial training of future teachers in order to promote methodological innovation in Pre-school Education and in the 1st and 2nd Cycles of Basic Education. A qualitative methodology was used, in which a questionnaire survey was applied to teachers in initial training. For data analysis, the techniques of content analysis with the support of NVivo software were used. The results point to the following aspects: a) future teachers recognize that they have more technical knowledge about ICT than pedagogical knowledge. This result makes sense if we consider the objective of Basic Education, so that the gaps can be filled in the Master's Course by students who wish to follow the teaching; b) the respondents are aware that the integration of digital resources contributes positively to students' learning and to the life of children and young people, which also promotes preparation in life; c) to be a teacher in the digital age there is a need for the development of digital literacy, lifelong learning and the adoption of new ways of teaching how to learn. Thus, this study aims to contribute to a reflection on the teaching profession in the digital age.

Keywords: digital technologies, initial teacher training, pedagogical use of ICT, skills

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Authors: N. Tumenbayeva

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At the present time in Kazakhstan, the area for saxaul growing is strongly depopulateddue to anthropogenic and other factors. To prevent further reduction of natural haloxylon forest area their artificial crops are offered. Seed germination and survival of young plants in such haloxylon crops are very low. Insects, as one of the most important nutrient factors have appreciable effect on seed germination and saxaul productivity at the all stages of its formation. Insects, feeding on leaves, flowers, seeds and developing inside the trunk, branches, twigs, roots have a change in its formation and influence on the lifespan of saxaul. Representatives of Lepidoptera troop (Lepidopteraare the most harmful pests forsaxaul. As a result of our research we have identified 15 species of Lepidoptera living on haloxylon which display very different cycles and different types of food relations. It allows them to inhabit a variety of habitats, and feeding on various parts of saxaul. Some of them cause significant and sometimes very heavy damage for saxaul. There are 17identified species of Lepidoptera from the Coleophoridaefamily - 1, Gelechidae - 5, Pyralidae - 4, Noctuidae - 4, Lymantridae- 1, Cossidae - 2 species. At the same time we found 8 species for the first time, which have not been mentioned in the literature before. According to food specialization they are divided into monophages (2 types), oligophages (6 species) and polyphages (3 species). By affinity to plant parts, leaves and seeds are fed by 8 species, shoots by 1 specie, scions by 5 species, flowers, scions, seeds by 1, and 2species damage the roots and trunks. In whole installed seasonal groups of Lepidoptera - saxaul pests in the desert area, confined to the certain parts of the year, as well as certain parts of the plant for feeding. Harmfulness, depending on their activity appear during the growing season is also different.

Keywords: saxaul, Lepidoptera, insecta, haloxylon

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Authors: Umbreen Salim, Anila Noor

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This paper analyses the influences and faces of colonialism in women’s participation in economic activity in postcolonial Pakistan, through postcolonial feminist economic lens. It is an attempt to probe the shifts in gender inequalities that have existed in three stages; pre-colonial, colonial, and postcolonial times in the Indo-Pak subcontinent. It delves into an inquiry of pre-colonial as it is imperative to understand the situation and context before colonisation in order to assess the deviations associated with its onset. Hence, in order to trace gender inequalities this paper analyses from Mughal Era (1526-1757) that existed before British colonisation, then, the gender inequalities that existed during British colonisation (1857- 1947) and the associated dynamics and changes in women’s vulnerabilities to participate in the economy are examined. Followed by, the postcolonial (1947 onwards) scenario of discriminations and oppressions faced by women. As part of the research methodology, primary and secondary data analysis was done. Analysis of secondary data including literary works and photographs was carried out, followed by primary data collection using ethnographic approaches and participatory tools to understand the presence of coloniality and gender inequalities embedded in the social structure through participant’s real-life stories. The data is analysed using feminist postcolonial analysis. Intersectionality has been a key tool of analysis as the paper delved into the gender inequalities through the class and caste lens briefly touching at religion. It is imperative to mention the significance of the study and very importantly the practical challenges as historical analysis of 18th and 19th century is involved. Most of the available work on history is produced by a) men and b) foreigners and mostly white authors. Since the historical analysis is mostly by men the gender analysis presented misses on many aspects of women’s issues and since the authors have been mostly white European gives it as Mohanty says, ‘under western eyes’ perspective. Whereas the edge of this paper is the authors’ deep attachment, belongingness as lived reality and work with women in Pakistan as postcolonial subjects, a better position to relate with the social reality and understand the phenomenon. The study brought some key results as gender inequalities existed before colonisation when women were hidden wheel of stable economy which was completely invisible. During the British colonisation, the vulnerabilities of women only increased and as compared to men their inferiority status further strengthened. Today, the postcolonial woman lives in deep-rooted effects of coloniality where she is divided in class and position within the class, and she has to face gender inequalities within household and in the market for economic participation. Gender inequalities have existed in pre-colonial, during colonisation and postcolonial times in Pakistan with varying dynamics, degrees and intensities for women whereby social class, caste and religion have been key factors defining the extent of discrimination and oppression. Colonialism may have physically ended but the coloniality remains and has its deep, broad and wide effects in increasing gender inequalities in women’s participation in the economy in Pakistan.

Keywords: colonialism, economic participation, gender inequalities, women

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Authors: Nawaf A. Alqahtani, Ali M. Alqahtani, Khalid A. Alqahtani, Huda S. Abdullfattah, Ebtehal A. Alessa, Khalid S. Al Gelban, Ossama A. Mostafa

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Background: The internet is an exciting medium that is becoming an essential part of everyday life. Although the internet is fully observed in Saudi Arabia, young people may be vulnerable to problematic internet use, possibly leading to addiction. Aim of study: To explore the magnitude of internet addiction (IA) among medical students associated risk factors and its impact on students' academic achievement. Subjects and Methods: A cross sectional study was conducted in 2014 on 571 medical students (293 males and 278 females) at the College of Medicine, King Khalid University, Abha, Saudi Arabia. Data Collection was done through using the Arabic version of the Compulsive Internet Use Scale and a checklist of demographic characteristics. Results: Age of participants ranged from 19 to 26 years (Mean+SD: 21.9+1.5 years). Internet access was available to 97.4% of students at home and to 80.2% of students at their mobile phones. The most frequently accessed websites by medical students were the social media (90.7%), scientific website (50.4%) and the news websites (31.3%). IA was mild in 47.8% of medical students while 5.8% had moderate IA. None of the students had severe IA. Prevalence of IA was significantly higher among female medical students (p=0.002), availability of internet at home (p=0.022), and availability of internet at the students' mobile phone (p=0.041). The mean General Point Average (GPA) was highest among students with mild IA (4.0+0.6), compared with 3.6+0.6 among those with moderate addiction, and 3.9+0.6 among those who did not show IA. Differences in mean GPA according to grade of IA were statistically significant ((P=0.001). Conclusions: Prevalence of IA is high among medical students in Saudi Arabia. Risk factors for IA include female gender, availability of internet at home or at the mobile phone. IA has a significant impact on students' GPA. Periodic screening of medical students for IA and raising their awareness toward the possible risk of IA are recommended.

Keywords: internet addiction, medical students, risk factors, Saudi Arabia

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Authors: Belaynesh Tsegay Beyene, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

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Background: Hepatitis B and C viruses are of important health and socioeconomic problem of the globe with remarkable diseases and deaths in Sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigrai. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners of Tigrai, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigrai. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliter of blood was collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using enzyme-linked immunosorbent assay (ELISA) (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20 and p < 0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1(0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18-25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell [AOR =3.95, 95% CI= (1.15, 13.6, p =0.029)] and having history of alcohol consumption [AOR =3.01, 95% CI= (1.17, 7.74, p =0.022)] were significantly associated with HBV infections. Conclusions: The seroprevalence of HBV among prisoners was nearly high or borderline (7.9%) with a very low HCV prevalence (0.3%). HBV was most prevalent among young adults, large number of prisoners per cell and those who had history of alcohol consumption. This study recommends that there should be prison-focused intervention including regular health education by emphasis on the mode of transmission and introducing HBV screening policy for prisoners especially when they enter to the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, Tigrai

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Authors: Taek Hwan Lee, Moon Ho Do, Lalita Subedi, Young Un Park, Sun Yeou Kim

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Natural and artificial toxic substances namely neurotoxins induce the bitter effect in the nervous system termed as neurotoxicity. It can modulate the normal functioning of the nervous system either hyperactivate it or damage homeostasis of neuronal system. Neurotoxins induced toxicity ultimately kills the neuron. The present study investigated the neuroprotective effects of germinated Dolichos lablab on 6-hydroxydopamine (6-OHDA)-induced neurotoxicity using SH-SY5Y neuroblastoma cells. Germination is a process of plant growth from a seed. Sprouting of a seedling from a seed induced many molecular changes in the seed in order to prepare it for further growth. Because of these molecular and chemical changes, the neuroprotective effect of Dolichos lablab is higher in the germinated form than in the normal condition. SH-SY5Y cells were treated with Dolichos lablab extract (50, 100 g/ml) followed by 6-OHDA (25M) induced toxicity. Cell Viability was measured to check the cell survival against 6-OHDA induced toxicity using MTT assay. Dolichos lablab showed a neuroprotective effect against 6-OHDA induced neuronal cell death in neuroblastoma cell at a higher concentration of 100g/ml however the effect is much better even at the lower concentration after germination 50g/ml. Cell survival was increased dramatically after 15 h of germination and increased with time of germination in concentration dependent manner. Trigonelline as a representative compound was validated in germinated Dolichos lablab by HPLC analysis that might enhance the neuroprotective effect of Dolichos lablab. This result suggests that Dolichos lablab possess neuroprotective effect in neuroblastoma cells against 6-OHDA however its activity was more potent in the germinated form.

Keywords: dolichos lablab, germination, neuroprotection, trigonelline

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Authors: Erik Jon Byker

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Government leaders and education policymakers have increasingly focused on ways that teachers can better prepare children for life in a global society. Such preparation includes the development of global citizenship among young people. Yet, scholars point out that many elementary school educators and teacher candidates have limited awareness of being global citizens in an interdependent world. More and more teacher preparation programs aim to integrate global citizenship in their program plans and use educational technology to help develop global citizenship. Many non-governmental organizations (NGOs), like the Asia Society and Partnership for 21st Century Skills, have led the way in creating global citizenship frameworks that prepare teachers and students with global competencies. The development of global citizenship among teachers needs to begin even before teachers sign their first contract. Global citizenship development should start when teacher candidates are being prepared to teach. Using the Critical Cosmopolitan Theory as a conceptual lens, this paper examines the integration of global citizenship curricula in teacher education programs in North Carolina and Texas in the United States of America. Using a case study methodology, the paper describes and compares the teacher candidates’ (n=136) perceptions of the global citizenship curricula delivered with the aid of educational technology. The study found that after participating in the global citizenship curricula, participants: (1) made conceptual leaps in their global citizenship definitions; (2) developed a stronger commitment for their future role as educators in developing global citizens; and (3) were more willing to take action for social justice-related issues in education. In sum, this paper discusses empirical findings related to the ways to integrate educational technology in preparing globally competent teachers.

Keywords: educational technology, global education, intercultural awareness, teacher candidates

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Authors: Bataineh Abdallah, Alabdallah Ghaith, Alkharabshe Abdalhameed

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Social media is an umbrella term for different types of online communication channels. The most prominent forms can be divided into four categories: Collaborative projects (e.g. Wikipedia, comparison-shopping sites), blogs (e.g. Twitter), content communities (e.g. Youtube), social networking sites (e.g. Facebook) social media allow consumers to share their opinions, criticisms and suggestions in public. Facebook launched in 2004, initially targeted college students and later started including everyone has become the most popular sites amongst the young generation for connecting with friends and relatives and for the communication of ideas. In 2013 Facebook penetration rate reached 41.4% of the population making it the most popular social networking site in Jordan. Accordingly, the purpose of this research is to examine the impact of perceived usefulness, perceived ease of use, perceived trust, perceived enjoyment and subjective norms on users' satisfaction and continuance intention to use Facebook in Jordan. Using a structured questionnaire, the primary data was collected from 584 users who have an active Facebook accounts. Multiple regression analysis was employed to test the research model and hypotheses. The research findings indicate that perceived usefulness, perceived ease of use, perceived trust, perceived enjoyment, and subjective norms have a positive and significant effect on users' satisfaction and continuance intention to use Facebook. The findings also indicated that the strongest predictors, based on beta values, on both users' satisfaction and continuance intention to use Facebook is subjective norms and respectively, perceived enjoyment, perceived usefulness, perceived ease of us, and perceived trust. Research results, recommendations, and future research opportunities are also discussed.

Keywords: perceived usefulness, perceived ease of use, perceived trust, perceived enjoyment, perceived subjective norms, users' satisfaction, continuance intention, Facebook

Procedia PDF Downloads 440

Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim

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Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.

Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure

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Authors: Almutazballlah Qablan, Jihan M. Muhaidat, Bana Abu Rajab

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Background: Acne vulgaris is the most common skin condition that general practitioners and dermatologists encounter. It represents a chronic inflammatory disease affecting the pilosebaceous unit. Although acne vulgaris is not a life-threatening condition, it has a considerable psychological impact on the affected person. Acne patients have poor body image, low self-esteem, social isolation, and restricted activities. As part of the emotional impact, increased levels of anxiety, anger, depression, and frustration have also been observed in acne patients. (1) In this study, we want to assess the association between two modifiable risk factors; BMI and smoking, regarding acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Irbid, north Jordan in 2019/2020. A total number of 163 Acne cases were collected and interviewed by the author; on the other hand, there were 162 control cases. Anthropometric measures for Acne patients and control individuals were taken, and BMI was calculated. Both groups were asked about smoking habits. Data on subjects between 14 and 33 years of age were extracted. The characteristics of people who reported acne were compared with those with no acne using univariate and multivariate analysis. The Statistical Package for Social Sciences (SPSS) was relied on to analyze the collected data. The crosstabs methods (chi-square) and odd ratios were relied on to test the study hypothesis. Results: Cigarette smoking was highly associated with no-acne, with an odds ratio of 0.4 (95% CI: 0.2–0.9), P-value = 0.018. BMI and waterpipe smoking were not significantly associated with acne in the multivariate analysis. Conclusion: Cigarette smoking was found to be protective from Acne. No significant relation between BMI nor waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, BMI, smoking, case-control

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Authors: Maydariana Ayuningtyas, Bambang Riyanto, Akhiruddin Maddu

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Industrial waste of crustacean shells, such as shrimp and crab, has been considered as one of the major issues contributing to environmental pollution. The waste processing mechanisms to form new, practical substances with added value have been developed. Chitosan, a derived matter from chitin, which is obtained from crab and shrimp shells, performs prodigiously in broad range applications. A chitosan composite-based diaphragm is a new inspiration in fiber optic acoustic sensor advancement. Elastic modulus, dynamic response, and sensitivity to acoustic wave of chitosan-based composite film contribute great potentials of organic-based sound-detecting material. The objective of this research was to develop chitosan diaphragm application in fiber optic microphone system. The formulation was conducted by blending 5% polyvinyl alcohol (PVA) solution with dissolved chitosan at 0%, 1% and 2% in 1:1 ratio, respectively. Composite diaphragms were characterized for the morphological and mechanical properties to predict the desired acoustic sensor sensitivity. The composite with 2% chitosan indicated optimum performance with 242.55 µm thickness, 67.9% relative humidity, and 29-76% light transmittance. The Young’s modulus of 2%-chitosan composite material was 4.89×104 N/m2, which generated the voltage amplitude of 0.013V and performed sensitivity of 3.28 mV/Pa at 1 kHz. Based on the results above, chitosan from crustacean shell waste can be considered as a viable alternative material for fiber optic acoustic sensor sensing pad development. Further, the research in chitosan utilisation is proposed as novel optical microphone development in anthropogenic noise controlling effort for environmental and biodiversity conservation.

Keywords: acoustic sensor, chitosan, composite, crab shell, diaphragm, waste utilisation

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Authors: Kamal Ameis

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This study aims to further improve our understanding of the underlying mechanism of local injury that occurs after manual acupuncture needle manipulation, and that initiates the muscle regeneration process, which is essential for muscle maintenance and adaptation. Skeletal muscle is maintained by resident stem cells called muscle satellite cells. These cells are normally in quiescent state, but following muscle injury, they re-enter the cell cycle and execute a myogenic program resulting in muscle fiber regeneration. Our previous work in young rats demonstrated that acupuncture treatment induced injury that activated resident satellite (stem) cells, which leads to muscle regeneration. Skeletal muscle regeneration is an adaptive response to injury that requires a tightly orchestrated event between signaling pathways activated by growth factor and intrinsic regulatory program controlled by myogenic transcription factor. We identified several gene expressions uniquely important for muscle regeneration in response to acupuncture treatment at different time course using different biological techniques, including Immunocytochemistry, western blotting, and Real Time PCR. This study uses a novel but non-invasive model of injury induced by manual acupuncture to further our current understanding of regenerative mechanism of muscle stem cells. From a clinical perspective, this model of injury induced by manual acupuncture may be easily translatable into a clinical tool that can be used as an alternative to physical exercise for patients challenged by bed rest or forced inactivity. Finally, the knowledge gained from this research could be useful for studies of the local effects of various modalities of induced injury, such as the traditional method of healing by cupping (hijamah), which may enhanced muscle stem cells and muscle fiber regeneration.

Keywords: acupuncture, injury, regeneration, muscle stem cells

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Authors: Ruepert Jiel Cao

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This study explores the renegotiation of bakla culture in Philippine media in the context of Kalye Serye segment of the popular Filipino noontime variety show Eat Bulaga. Although the term “bakla” is usually translated to “gay” or “homosexual male” in English, they do not mean the same. The western notion of a gay refers to a male person attracted to another male person but still retains the masculine physical attributes. However, the bakla embodies loudness, femininity, and transvestitism. Hence, a bakla is a gay man aspiring to be a woman by assuming feminine actions and appearance, a definition much closer to a transgender. The Philippine media usually employs the bakla culture in comedy programs. The bakla nowadays is usually associated with the people of lower economic strata and carries a pathological connotation. The Filipino television program Eat Bulaga, which has been airing for more than 36 years, is fond of using bakla in comedy. However, the recently launched segment entitled Kalye Serye (literally “Street [Television] Series”), while still employing drag performance to incorporate bakla culture in comedy, renegotiates the bakla culture by deviating from the stereotypical notion of bakla. In this study, this researcher asks: (1) How does Kalye Serye renegotiate the Filipino concept of bakla in terms of economic aspirations and social norms? (2) How does Kalye Serye reappropriate the bakla culture to fit non-comedic performances? The study examines 15 purposively selected Kalye Serye episodes. Seven were selected from the Thursday episodes, seven from Saturday episodes, and the Lenten special episode. These were selected to cover as many characters and different character roles as possible. Data was constructed by identifying and coding the roles, physical appearance and gestures, and key dialogs of the characters. A total of six female characters played by three different male actors were examined. Semiotic analysis using semiotics of Roland Barthes was performed to produce a reading of the characters. Findings show that through physical appearance, the characters associate bakla with the economic affluence through the use of expensive-looking clothes, jewelries, cars, and elaborate gestures. This represents a new economic but old western aspiration of the bakla. In terms of social norms, the characters try to revive the traditional concepts of femininity, courtship, and respect, values which are touted to be lost in the current generation of Filipinos. This is quite ironic because while there is a seemingly tolerant attitude towards all forms of queerness, the bakla is considered immoral and yet, the bakla is used to teach about morality and values. Finally, the characters break the traditional association of the bakla with slapstick comedy and their roles are reappropriated to suit dramatic roles. By refraining from portraying the bakla in ridiculous manner (physically and in terms of roles), the bakla lends itself well in the performance of dramatic roles and their ridiculous and pathological associations removed. Future research may include other Filipino or Asian portrayals of queerness to get a better understanding of how queerness is incorporated in contemporary popular culture.

Keywords: bakla, drag performance, popular culture, queer representation

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Authors: Eunsong Lee, Gae Baik Kim, Young Pil Kim

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Bisphenol A (BPA) is one of the endocrine disruptors (EDCs), which have been suspected to be associated with reproductive dysfunction and physiological abnormality in human. Since the BPA has been widely used to make plastics and epoxy resins, the leach of BPA from the lining of plastic products has been of major concern, due to its environmental or human exposure issues. The simple detection of BPA based on the self-assembly of aptamer-mediated gold nanoparticles (AuNPs) has been reported elsewhere, yet the detection sensitivity still remains challenging. Here we demonstrate an improved AuNP-based sensor of BPA by using fluorescence-combined AuNP colorimetry in order to overcome the drawback of traditional AuNP sensors. While the anti-BPA aptamer (full length or truncated ssDNA) triggered the self-assembly of unmodified AuNP (citrate-stabilized AuNP) in the presence of BPA at high salt concentrations, no fluorescence signal was observed by the subsequent addition of SYBR Green, due to a small amount of free anti-BPA aptamer. In contrast, the absence of BPA did not cause the self-assembly of AuNPs (no color change by salt-bridged surface stabilization) and high fluorescence signal by SYBP Green, which was due to a large amount of free anti-BPA aptamer. As a result, the quantitative analysis of BPA was achieved using the combination of absorption of AuNP with fluorescence intensity of SYBR green as a function of BPA concentration, which represented more improved detection sensitivity (as low as 1 ppb) than did in the AuNP colorimetric analysis. This method also enabled to detect high BPA in water-soluble extracts from thermal papers with high specificity against BPS and BPF. We suggest that this approach will be alternative for traditional AuNP colorimetric assays in the field of aptamer-based molecular diagnosis.

Keywords: bisphenol A, colorimetric, fluoroscence, gold-aptamer nanobiosensor

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Authors: Maike Andresen, Georg Dochtmann

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Due to political, social, and societal changes in labor organization, top-sharing, defined as job-sharing in leading positions, becomes more important in HRM. German companies are looking for practical and economically meaningful solutions that allow to enduringly increase women’s ratio in management, not only because of a recently implemented quota. Furthermore, supporting employees in achieving work-life balance is perceived as an important goal for a sustainable HRM to gain competitive advantage. Top-sharing is seen as being suitable to reach both goals. To evaluate determinants leading to effective top-sharing, a case study of a newly implemented top-sharing tandem in a large German enterprise was conducted over a period of 15 months. In this company, a full leadership position was split into two 60%-part-time positions held by an experienced female leader in her late career and a female college who took over her first leadership position (mid-career). We assumed a person-person fit in terms of a match of the top sharing partners’ personality profiles (Big Five) and their leadership motivations to be important prerequisites for an effective collaboration between them. We evaluated the person-person fit variables once before the tandem started to work. Both leaders were expected to learn from each other (mentoring, competency development). On an operational level, they were supposed to lead together the same employees in an effective manner (leader-member exchange), presupposing an effective cooperation between both (handing over information). To see developments over time, these processes were evaluated three times over the span of the project. Top-Sharing and the underlined processes are expected to positively influence the tandem’s performance which has been evaluated twice, at the beginning and the end of the project, to assess its development over time as well. The evaluation of the personality and the basic motives suggests that both executives can be a successful top-sharing tandem. The competency evaluations (supervisor as well as self-assessment) increased over the time span. Although the top sharing tandem worked on equal terms, they implemented rather classical than peer-mentoring due to different career ambitions of the tandem partners. Thus, opportunities were not used completely. Team-member exchange scores proved the good cooperation between the top-sharers. Although the employees did not evaluate the leader-member-exchange between them and the two leaders of the tandem homogeneously, the top-sharing tandem itself did not have the impression that the employees’ task performance depended on whom of the tandem was responsible for the task. Furthermore, top-sharing did not negatively influence the performance of both leaders. During qualitative interviews with the top-sharers and their team, we found that the top-sharers could focus more easily on their tasks. The results suggest positive outcomes of top-sharing (e.g. competency improvement, learning from each other through mentoring). Top-Sharing does not hamper performance. Thus, further research and practical implementations are suggested. As part-time jobs are still more often a female solution to increase their work-life- and work-family-balance, top-sharing may be a suitable solution to increase the woman’s ratio in leadership positions as well as to sustainable increase work-life-balance of executives.

Keywords: mentoring, part-time leadership, top-sharing, work-life-balance

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Authors: Nikoletta G. Karytsioti

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The European Union’s function and effectiveness are still an issue that minds, bringing about division even in the member-states interior. Recently, more serious issues have been added in the Union’s malfunction, which affects not only the Union’s function but also their residents’ safety. One of these issues is the migration crisis, which frustrates the European Union’s balances and the stability. The present paper’s aim to frame and interpret the Greek public opinion in basic migration matters, throughout the political philosophy and specifically via John Rawls ‘Theory of Justice’. The theory is deployed to examine if it may be used in a practical way, on a tangible issue and in a specific area. In order to obtain a real frame of the public opinion about the matter of migration, a questionnaire was addressed to Greek people. The sample was chosen for three main reasons: a) Greeks are experienced in the migration as they had migrated in the past, b) many young people migrated the recent years after the debt crisis, c) Greece is a reception state. Being based in the Theory of Justice and specifically in the ‘veil of ignorance’, is tried to overcome the obstacles of human nature’s subjectivity, while examining the variations in the responses per social group. The questionnaire will have demographic questions and special interest questions, related with the crisis, before and after ‘the veil of ignorance’. The paper’s originality comes from the fact that it is the first time that a philosophical theory is used to examine the migration issue in a practical manner. The main goals of the paper are three: - To examine the differences/similarities in the responses before and after the veil of ignorance, - to reveal opinions on migration crisis from E.U. citizens and - to confirm or not the practical usefulness of the Political Philosophy as a highlighting tool

Keywords: European Union, immigrants, migration crisis, political philosophy, theory of justice, veil of ignorance

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Authors: Ayperi̇ Haspolat Özcan, Meltem Anafarta Şendağ

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This study aimed to establish a model in the light of current approaches for understanding the mediating role of early maladaptive schemas in the relationship between attachment and anger. Accordingly, the proposed mediation model was tested by mediation with bootstrapping technique, considering gender and attachment figure differences. The university students (N= 444) with ages ranging from 17 to 28 participated in the study. Participants filled out Parental and Peer Attachment Scale Short Form, Young Schema Questionnaire - Short Form 3, Trait Anger and Anger Expression Scales. The mediating role of early maladaptive schemas (impaired autonomy, disconnection and rejection, unrelenting standards, other-directedness, and impaired limits) in the relationship between attachment (mother and father) and anger aspects (trait anger, anger in, anger out and anger control) were found to be significant for both male and female participants. Separate mediation analyses for both genders and different attachment figures have also drawn attention to noticeable differences in the results. Specifically, for females, various paths were discovered in predicting various aspects of anger (anger in, anger out, anger control, and trait anger). On the other hand, for males only anger directed inwards was found to be predicted by any source of attachment through disconnection and rejection schema only. These obvious gender differences in understanding the mechanism of anger are discussed in the light of cultural gender roles and the social acceptance of anger in males. In the area of application, the study of various aspects of anger with particular attention to attachment and early maladaptive schemas as well as the importance of distinguishing the gender differences are emphasized as important points.

Keywords: anger expression, attachment, early maladaptive schemas, trait anger

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Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

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Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: bilingual, English, medicine, doctor

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Authors: Aanshika Puri, Sakshi Mehrotra

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Technology has always been a double edged sword. The constant rut of updating oneself to a better and newer version is the new norm. ‘Being Online’ is the latest addition to one’s everyday routine. Availability of various social online platforms being served on a platter topped with easy and cheap access to the internet makes it simple and doable for people of all social backgrounds. Interestingly, in India, a recent development is the line of demarcation between people from varied backgrounds, doing the vanishing act. One finds everybody on at least one, if not more, social platforms in a desire to stay connected. For instance, this ranges from sending a ‘WhatsApp’ message to a vegetable vendor for ordering your daily needs to vendors and small entrepreneurs. Even a rickshaw puller now has access to a mobile phone, an internet connection and apps/ platforms to stay connected. Recent observations show the extent to which everyone is hooked on to their mobile phones/ tabs/ laptops/ etc. Young mothers use them to distract their children and keep them busy while they finish the task at hand. Exposure to this part of the technology at such a tender age requires responsible and careful handling. Talking of adolescents, their self- image depends on their online social image to a large extent. There is a desire to be liked and accepted by the peer group at all times. Cyber-bullying is a by-product of the 24/7 availability of these resources. There is enough research-based evidence to prove the psychosocial and emotional impact on the development and well-being of the victim. The present paper attempts to understand the dynamics of cyber bullying vis-à-vis the developmental and mental health issues faced by the bully.

Keywords: Developmental Psychology, Empathy & Resilience Based Interventions, Mental Well-Being of Cyber Bully, Positive Psychology

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Jin Hwan Cheong, Mina Hwang, Myung Hoon Han, Je Il Ryu, Young ha Oh, Seong Ho Koh, Wu Duck Won, Byung Jin Ha

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Leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) has been reported to play critical roles in the proliferation of various cancer cells. However, the roles of LGR5 in brain tumors and the specific intracellular signaling proteins directly associated with it remain unknown. Expression of LGR5 was first measured in normal brain tissue, meningioma, and pituitary adenoma of humans. To identify the downstream signaling pathways of LGR5, siRNA-mediated knockdown of LGR5 was performed in SH-SY5Y neuroblastoma cells followed by proteomics analysis with 2-dimensional polyacrylamide gel electrophoresis (2D-PAGE). In addition, the expression of LGR5-associated proteins was evaluated in LGR5-inꠓhibited neuroblastoma cells and in human normal brain, meningioma, and pituitary adenoma tissue. Proteomics analysis showed 12 protein spots were significantly different in expression level (more than two-fold change) and subsequently identified by peptide mass fingerprinting. A protein association network was constructed from the 12 identified proteins altered by LGR5 knockdown. Direct and indirect interactions were identified among the 12 proteins. HSP 90-beta was one of the proteins whose expression was altered by LGR5 knockdown. Likewise, we observed decreased expression of proteins in the hnRNP subfamily following LGR5 knockdown. In addition, we have for the first time identified significantly higher hnRNP family expression in meningioma and pituitary adenoma compared to normal brain tissue. Taken together, LGR5 and its downstream sigꠓnaling play critical roles in neuroblastoma and brain tumors such as meningioma and pituitary adenoma.

Keywords: LGR5, neuroblastoma, meningioma, pituitary adenoma, hnRNP

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Authors: Yollande Sènan Djivoh, Dominique de Jaeger

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Background: Abdominal exercises are commonly practised nowadays. Specific techniques of abdominal muscles strengthening like hypopressive exercises have recently emerged and their practice is encouraged against the practice of Curl-up especially in postpartum. The acute and the training effects of these exercises did not allow to advise one exercise to the detriment of another. However, physiotherapists remain reluctant to perform Curl-up with postpartum women because of its potential harmful effect on the pelvic floor. Design: This study was a randomized control trial registered under the number PACTR202110679363984. Objective: to observe the training effect of two experimental protocols (Curl-up versus Drawing-in+Diaphragmatic aspiration) on the abdominal wall (interrecti distance, rectus and transversus abdominis thickness, abdominal strength) in Beninese postpartum women. Pelvic floor function (tone, endurance, urinary incontinence) will be assessed to evaluate potential side effects of exercises on the pelvic floor. Method: Postpartum women diagnosed with diastasis recti were randomly assigned to one of three groups (Curl-up, Drawingin+Diaphragmatic aspiration and control). Abdominal and pelvic floor parameters were assessed before and at the end of the 6-week protocol. The interrecti distance and the abdominal muscles thickness were assessed by ultrasound and abdominal strength by dynamometer. Pelvic floor tone and strength were assessed with Biofeedback and urinary incontinence was quantified by pad test. To compare the results between the three groups and the two measurements, a two-way Anova test with repeated measures was used (p<0.05). When interaction was significant, a posthoc using Student t test, with Bonferroni correction, was used to compare the three groups regarding the difference (end value minus initial value). To complete these results, a paired Student t test was used to compare in each group the initial and end values. Results: Fifty-eight women participated in this study, divided in three groups with similar characteristics regarding their age (29±5 years), parity (2±1 children), BMI (26±4 kg/m2 ), time since the last birth (10±2 weeks), weight of their baby at birth (330±50 grams). Time effect and interaction were significant (p<0.001) for all abdominal parameters. Experimental groups improved more than control group. Curl-up group improved more (p=0.001) than Drawing-in+Diaphragmatic aspiration group regarding the interrecti distance (9.3±4.2 mm versus 6.6±4.6 mm) and abdominal strength (20.4±16.4 Newton versus 11.4±12.8 Newton). Drawingin+Diaphragmatic aspiration group improved (0.8±0.7 mm) more than Curl-up group (0.5±0.7 mm) regarding the transversus abdominis thickness (p=0.001). Only Curl-up group improved (p<0.001) the rectus abdominis thickness (1.5±1.2 mm). For pelvic floor parameters, both experimental groups improved (p=0.01) except for tone which improved (p=0.03) only in Drawing-in+Diaphragmatic aspiration group from 19.9±4.1 cmH2O to 22.2±4.5 cmH2O. Conclusion: Curl-up was more efficient to improve abdominal function than Drawingin+Diaphragmatic aspiration. However, these exercises are complementary. None of them degraded the pelvic floor, but Drawing-in+Diaphragmatic aspiration improved further the pelvic floor function. Clinical implications: Curl-up, Drawing-in and Diaphragmatic aspiration can be used for the management of abdominal function in postpartum women. Exercises must be chosen considering the specific needs of each woman’s abdominal and pelvic floor function.

Keywords: curl-up, drawing-in, diaphragmatic aspiration, hypopressive exercise, postpartum women

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Authors: Amy Guidera, Steven Busby, Christian Williams, David Phillippi

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College students are a priority preventative healthcare population that can engage in high-risk behaviors which may concurrently increase the potential for unsafe sexual practices, including contracting sexually transmitted infections (STIs). Early education, screening, treatment, and partner notification are important interventions for breaking the chain of transmission and recurrence in relation to preventing poor health outcomes and mitigating college dropout rates. The aim of this quality improvement project was to determine if the reduction in STI screening costs for college students (aged 18-30 years old) would increase the amount of STI screenings conducted at a university health center over the course of an academic semester while evaluating our ability to achieve an improved quality of care at a reduced cost, along with improved STI reporting and documentation. This study was conducted through retrospective chart reviews of STI-related visits and utilized the RADAR matrix to provide a guiding, iterative mechanism to continuously reassess goals and outcomes defined in a memorandum of agreement (MOA) between a university health center and the state department of health (DOH) laboratory. The project failed to increase the amount of STI screenings, most likely due to the emergence of COVID-19, but resulted in improved quality of care for students, improved STI-related visit documentation and reporting, and significantly reduced costs for STI screening for collegiate students at a southeastern private university campus.

Keywords: college health, college students, preventive health, reproductive health, sexually transmitted infections, young adults

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Authors: Ladda Leungratanamart, Seree Chadcham

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Fluid intelligence declines along with age, but it can be developed. For this reason, increasing fluid intelligence in young adults can be possible. This study examined the effects of a two-month treadmill exercise program on fluid intelligence. The researcher designed a treadmill exercise program to promote cardiorespiratory fitness. Thirty-eight healthy voluntary students from the Boromarajonani College of Nursing, Chon Buri were assigned randomly to an exercise group (n=18) and a control group (n=20). The experiment consisted of three sessions: The baseline session consisted of measuring the VO₂max, electroencephalogram and behavioral response during performed the Raven Progressive Matrices (RPM) test, a measure of fluid intelligence. For the exercise session, an experimental group exercises using treadmill training at 60 % to 80 % maximum heart rate for 30 mins, three times per week, whereas the control group did not exercise. For the following two sessions, each participant was measured the same as baseline testing. The data were analyzed using the t-test to examine whether there is significant difference between the means of the two groups. The results showed that the mean VO₂ max in the experimental group were significantly more than the control group (p<.05), suggesting a two-month treadmill exercise program can improve fluid intelligence. When comparing the behavioral data, it was found that experimental group performed RPM test more accurately and faster than the control group. Neuroelectric data indicated a significant increase in percentages of alpha band ERD (%ERD) at P3 and Pz compared to the pre-exercise condition and the control group. These data suggest that a two-month treadmill exercise program can contribute to the development of cardiorespiratory fitness which influences an increase fluid intelligence. Exercise involved in cortical activation in difference brain areas.

Keywords: treadmill exercise, fluid intelligence, raven progressive matrices test, alpha band

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Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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Authors: Chee Wai Ku, Pui See Chin

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As an emerging alternative to hysterectomy, uterine artery embolization (UAE) has been widely used in the management of fibroids and in controlling postpartum hemorrhage (PPH) unresponsive to other therapies. Research has shown UAE to be a safe, minimally invasive procedure with few complications and minimal effects on future fertility. We present two cases highlighting the use of UAE in preventing PPH in a patient with a large fibroid at the time of cesarean section and in the treatment of secondary PPH refractory to other therapies in another patient. We present a 36-year primiparous woman who booked at 18+6 weeks gestation with a 13.7 cm subserosal fibroid at the lower anterior wall of the uterus near the cervix and a 10.8 cm subserosal fibroid in the left wall. Prophylactic internal iliac artery occlusion balloons were placed prior to the planned classical midline cesarean section. The balloons were inflated once the baby was delivered. Bilateral uterine arteries were embolized subsequently. The estimated blood loss (EBL) was 400 mls and hemoglobin (Hb) remained stable at 10 g/DL. Ultrasound scan 2 years postnatally showed stable uterine fibroids 10.4 and 7.1 cm, which was significantly smaller than before. We present the second case of a 40-year-old G2P1 with a previous cesarean section for failure to progress. There were no antenatal problems, and the placenta was not previa. She presented with term labour and underwent an emergency cesarean section for failed vaginal birth after cesarean. Intraoperatively extensive adhesions were noted with bladder drawn high, and EBL was 300 mls. Postpartum recovery was uneventful. She presented with secondary PPH 3 weeks later complicated by hypovolemic shock. She underwent an emergency examination under anesthesia and evacuation of the uterus, with EBL 2500mls. Histology showed decidua with chronic inflammation. She was discharged well with no further PPH. She subsequently returned one week later for secondary PPH. Bedside ultrasound showed that the endometrium was thin with no evidence of retained products of conception. Uterotonics were administered, and examination under anesthesia was performed, with uterine Bakri balloon and vaginal pack insertion after. EBL was 1000 mls. There was no definite cause of PPH with no uterine atony or products of conception. To evaluate a potential cause, pelvic angiogram and super selective left uterine arteriogram was performed which showed profuse contrast extravasation and acute bleeding from the left uterine artery. Superselective embolization of the left uterine artery was performed. No gross contrast extravasation from the right uterine artery was seen. These two cases demonstrated the superior efficacy of UAE. Firstly, the prophylactic use of intra-arterial balloon catheters in pregnant patients with large fibroids, and secondly, in the diagnosis and management of secondary PPH refractory to uterotonics and uterine tamponade. In both cases, the need for laparotomy hysterectomy was avoided, resulting in the preservation of future fertility. UAE should be a consideration for hemodynamically stable patients in centres with access to interventional radiology.

Keywords: fertility preservation, secondary postpartum hemorrhage, uterine embolization, uterine fibroids

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Authors: Paulson Young Ofenimu Okhawere

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Research suggests that the main trait differentiating social entrepreneurs from traditional entrepreneurs is empathy. And although prior research has established the relevance of empathy in predicting social entrepreneurial intentions in different contexts, its usefulness at predicting social entrepreneurial intentions in emerging economy like Nigeria is yet to be well established. Whereas, it is well known that students in tertiary institutions in Nigeria (e.g. Universities, Polytechnics, and Colleges of Education) are given entrepreneurial orientations by being made to offer compulsory courses in entrepreneurship, research focusing on the effect of such students’ entrepreneurial orientation on entrepreneurial intentions is scant. To address this gap in the entrepreneurship literature, this study attempts to enhance our understanding by focusing on students selected from one University of Technology, one Polytechnic, and one College of Education in Niger State of Nigeria. The purpose of this study, therefore, is to examine the mechanism through which students’ institutional level entrepreneurial orientations affect their social entrepreneurial intentions and the role empathy plays in this relationship. Building on complexity theory (Satish & Streufert, 2003, 2001), this study proposes empathy as a proximal antecedent of social entrepreneurial intentions and that it is the mechanism through which the students’ entrepreneurial orientations affect their social entrepreneurial intentions. Data collected from 598 respondents were analyzed using multilevel structural equation modelling with Mplus version 7.3. The findings reveal that (i) although students’ entrepreneurial orientation directly relates to their social entrepreneurial intentions, this relationship differs according to the kind of institution; and (ii) students’ entrepreneurial orientations positively relates to social entrepreneurial intentions indirectly through empathy. Finally, the paper discusses the theoretical and practical implications of the findings, highlights the study’s strengths and limitations, and then maps out some directions for future research.

Keywords: institutional level, entrepreneurial orientation, empathy, social entrepreneurial intentions

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