Search results for: text presentation
Commenced in January 2007
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Edition: International
Paper Count: 2562

Search results for: text presentation

432 The Impact of Streptococcus pneumoniae Colonization on Viral Bronchiolitis

Authors: K. Genise, S. Murthy

Abstract:

Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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431 Engaging Medical Students in Research through Student Research Mentorship Programme

Authors: Qi En Han, Si En Wai, Eugene Quek

Abstract:

As one of the two Academic Medical Centres (AMCs) in Singapore, SingHealth Duke-NUS AMC strives to improve patients’ lives through excellent clinical care, research and education. These efforts are enhanced with the establishment of Academic Clinical Programmes (ACPs). Each ACP brings together specialists in a particular discipline from different institutions to maximize the power of shared knowledge and resources. Initiated by Surgery ACP, the student research mentorship programme is a programme designed to facilitate engagement between medical students and the surgical faculty. The programme offers mentors not only the opportunity to supervise research but also to nurture future clinician scientists. In turn, medical students acquire valuable research experience which may be useful in their future careers. The programme typically lasts one year, depending on the students’ commitment. Surgery ACP matches students’ research interests with the mentor's area of expertise whenever possible. Surgery ACP organizes informal tea sessions to bring students and prospective mentors together. Once a match is made, the pair is required to submit a project proposal which includes the title, proposed start and end dates, ethical and biosafety considerations and project details. The mentees either think of their own research question with guidance from the mentors or join an existing project. The mentees may participate in data collection, data analysis, manuscript writing and conference presentation. The progress of each research project is monitored through half-yearly progress report. The mentees report problems encountered or changes made to existing proposal on top of the progress made. A total of 18 mentors were successfully paired with 36 mentees since 2013. Currently, there are 23 on-going and 13 completed projects. The mentees are encouraged to present their projects at conferences and to publish in peer-reviewed journals. Six mentees have presented their completed projects at local or international conferences and one mentee has her work published. To further support student research, Surgery ACP organized a Research Day in 2015 to recognize their research efforts and to showcase their wide-range of research. Surgery ACP recognizes that early exposure of medical students to research is important in developing them into clinician scientists. As interest in research take time to develop and are usually realized during various research attachments, it is crucial that programmes such as the student research mentorship programme exist. Surgery ACP will continue to build on this programme.

Keywords: academic clinical programme, clinician scientist, medical student, mentoring

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430 Multilingualism in Medieval Romance: A French Case Study

Authors: Brindusa Grigoriu

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Inscribing itself in the field of the history of multilingual communities with a focus on the evolution of language didactics, our paper aims at providing a pragmatic-interactional approach on a corpus proposing to scholars of the international scientific community a relevant text of early modern European literature: the first romance in French, The Conte of Flore and Blanchefleur by Robert d’Orbigny (1150). The multicultural context described by the romance is one in which an Arab-speaking prince, Floire, and his Francophone protégée, Blanchefleur, learn Latin together at the court of Spain and become fluent enough to turn it into the language of their love. This learning process is made up of interactional patterns of affective relevance, in which the proficiency of the protagonists in the domain of emotive acts becomes a matter of linguistic and pragmatic emulation. From five to ten years old, the pupils are efficiently stimulated by their teacher of Latin, Gaidon – a Moorish scholar of the royal entourage – to cultivate their competencies of oral expression and reading comprehension (of Antiquity classics), while enjoying an ever greater freedom of written expression, including the composition of love poems in this second language of culture and emotional education. Another relevant parameter of the educational process at court is that Latin shares its prominent role as a language of culture with French, whose exemplary learner is the (Moorish) queen herself. Indeed, the adult 'First lady' strives to become a pupil benefitting from lifelong learning provided by a fortuitous slave-teacher with little training, her anonymous chambermaid and Blanchefleur’s mother, who, despite her status of a war trophy, enjoys her Majesty’s confidence as a cultural agent of change in linguistic and theological fields. Thus, the two foreign languages taught at Spains’s court, Latin and French – as opposed to Arabic -, suggest a spiritual authority allowing the mutual enrichment of intercultural pioneers of cross-linguistic communication, in the aftermath of religious wars. Durably, and significantly – if not everlastingly – the language of physical violence rooted in intra-cultural solipsism is replaced by two Romance languages which seem to embody, together and yet distinctly, the parlance of peace-making.

Keywords: multilingualism, history of European language learning, French and Latin learners, multicultural context of medieval romance

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429 The Reasons for Failure in Writing Essays: Teaching Writing as a Project-Based Enterprise

Authors: Ewa Toloczko

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Studies show that developing writing skills throughout years of formal foreign language instruction does not necessarily result in rewarding accomplishments among learners, nor an affirmative attitude they build towards written assignments. What causes this apparently wide-spread bias to writing might be a diminished relevance students attach to it, as opposed to the other productive skill — speaking, insufficient resources available for them to succeed, or the ways writing is approached by instructors, that is inapt teaching techniques that discourage rather that inflame learners’ engagement. The assumption underlying this presentation is that psychological and psycholinguistic factors constitute a key dimension of every writing process, and hence should be seriously considered in both material design and lesson planning. The author intends to demonstrate research in which writing tasks were conceived of as attitudinal rather than technical operations, and consequently turned into meaningful and socially-oriented incidents that students could relate to and have an active hand in. The instrument employed to achieve this purpose and to make writing even more interactive was the format of a project, a carefully devised series of tasks, which involved students as human beings, not only language learners. The projects rested upon the premise that the presence of peers and the teacher in class could be taken advantage of in a supportive rather than evaluative mode. In fact, the research showed that collaborative work and constant meaning negotiation reinforced not only bonds between learners, but also the language form and structure of the output. Accordingly, the role of the teacher shifted from the assessor to problem barometer, always ready to accept the slightest improvements in students’ language performance. This way, written verbal communication, which usually aims to merely manifest accuracy and coherent content for assessment, became part of the enterprise meant to emphasise its social aspect — the writer in real-life setting. The samples of projects show the spectrum of possibilities teachers have when exploring the domain of writing within school curriculum. The ideas are easy to modify and adjust to all proficiency levels and ages. Initially, however, they were meant to suit teenage and young adult learners of English as a foreign language in both European and Asian contexts.

Keywords: projects, psycholinguistic/ psychological dimension of writing, writing as a social enterprise, writing skills, written assignments

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428 Legal Initiatives for Afghan Humanitarian Crisis

Authors: Fereshteh Ganjavi, Rachel Schaffer, Varsha Jorawar

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Elena’s Light is a non-profit organization focused on building brighter futures for refugees, especially women and children. Our mission is to empower refugee women and children by addressing social, legal, and public health issues that predominantly concern them. Elena’s Light offers a range of services that support refugees from structural disadvantages, cultural and social stress, marginalization, and other stressors related to migration. Using a three-pronged approach, our programs focus on legal advocacy, English language acquisition, and health and wellness. Following the Afghan humanitarian crisis, Elena’s Light has developed and intensified advocacy efforts in the legal realm to address the influx of refugees who desperately need assistance. We developed and hosted a Know Your Rights presentation with local immigration lawyers and professionals in February 2022 on the Afghan Humanitarian Parole, which was very successful with over 100 attendees. Elena’s Light is hosting the second Know Your Rights session in early August 2022 on immigration options for Afghans, including Temporary Protected Status (TPS), asylum, Special Immigrant Visa (SIV), and humanitarian parole. Lastly, EL is also leading the local initiative to develop a pro-bono committee to respond to the overwhelming need for lawyers to work on legal cases for Afghan during this crisis. Furthermore, through our other services, we provide free, in-home customizable ESL tutoring sessions to refugee women with a focus on driver’s education, facilitating acculturation, and improving employment opportunities. We also provide in-home maternal, pediatric, and mental health education and wellness services that are aimed at addressing the explicit and implicit barriers to healthcare for refugee populations. Elena’s Light’s diverse community aims to counter the structural disadvantages and anxiety-inducing emotions and experiences related to being a refugee. We would like to join this International Conference on Refugee Law since protecting refugee rights is our mission. We would like to share what we have learned from our legal initiatives for refugee rights. We would also like to listen, learn from, and discuss with experts and researchers how to better understand and advocate for refugee rights. We hope to improve our understanding of how to provide better legal aid for our clients through this conference.

Keywords: legal, advocacy, Afghan humanitarian crisis, policy, pro-bono

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427 The Influence of Cognitive Load in the Acquisition of Words through Sentence or Essay Writing

Authors: Breno Barrreto Silva, Agnieszka Otwinowska, Katarzyna Kutylowska

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Research comparing lexical learning following the writing of sentences and longer texts with keywords is limited and contradictory. One possibility is that the recursivity of writing may enhance processing and increase lexical learning; another possibility is that the higher cognitive load of complex-text writing (e.g., essays), at least when timed, may hinder the learning of words. In our study, we selected 2 sets of 10 academic keywords matched for part of speech, length (number of characters), frequency (SUBTLEXus), and concreteness, and we asked 90 L1-Polish advanced-level English majors to use the keywords when writing sentences, timed (60 minutes) or untimed essays. First, all participants wrote a timed Control essay (60 minutes) without keywords. Then different groups produced Timed essays (60 minutes; n=33), Untimed essays (n=24), or Sentences (n=33) using the two sets of glossed keywords (counterbalanced). The comparability of the participants in the three groups was ensured by matching them for proficiency in English (LexTALE), and for few measures derived from the control essay: VocD (assessing productive lexical diversity), normed errors (assessing productive accuracy), words per minute (assessing productive written fluency), and holistic scores (assessing overall quality of production). We measured lexical learning (depth and breadth) via an adapted Vocabulary Knowledge Scale (VKS) and a free association test. Cognitive load was measured in the three essays (Control, Timed, Untimed) using normed number of errors and holistic scores (TOEFL criteria). The number of errors and essay scores were obtained from two raters (interrater reliability Pearson’s r=.78-91). Generalized linear mixed models showed no difference in the breadth and depth of keyword knowledge after writing Sentences, Timed essays, and Untimed essays. The task-based measurements found that Control and Timed essays had similar holistic scores, but that Untimed essay had better quality than Timed essay. Also, Untimed essay was the most accurate, and Timed essay the most error prone. Concluding, using keywords in Timed, but not Untimed, essays increased cognitive load, leading to more errors and lower quality. Still, writing sentences and essays yielded similar lexical learning, and differences in the cognitive load between Timed and Untimed essays did not affect lexical acquisition.

Keywords: learning academic words, writing essays, cognitive load, english as an L2

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426 Language in Court: Ideology, Power and Cognition

Authors: Mehdi Damaliamiri

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Undoubtedly, the power of language is hardly a new topic; indeed, the persuasive power of language accompanied by ideology has long been recognized in different aspects of life. The two and a half thousand-year-old Bisitun inscriptions in Iran, proclaiming the victories of the Persian King, Darius, are considered by some historians to have been an early example of the use of propaganda. Added to this, the modern age is the true cradle of fully-fledged ideologies and the ongoing process of centrifugal ideologization. The most visible work on ideology today within the field of linguistics is “Critical Discourse Analysis” (CDA). The focus of CDA is on “uncovering injustice, inequality, taking sides with the powerless and suppressed” and making “mechanisms of manipulation, discrimination, demagogy, and propaganda explicit and transparent.” possible way of relating language to ideology is to propose that ideology and language are inextricably intertwined. From this perspective, language is always ideological, and ideology depends on the language. All language use involves ideology, and so ideology is ubiquitous – in our everyday encounters, as much as in the business of the struggle for power within and between the nation-states and social statuses. At the same time, ideology requires language. Its key characteristics – its power and pervasiveness, its mechanisms for continuity and for change – all come out of the inner organization of language. The two phenomena are homologous: they share the same evolutionary trajectory. To get a more robust portrait of the power and ideology, we need to examine its potential place in the structure, and consider how such structures pattern in terms of the functional elements which organize meanings in the clause. This is based on the belief that all grammatical, including syntactic, knowledge is stored mentally as constructions have become immensely popular. When the structure of the clause is taken into account, the power and ideology have a preference for Complement over Subject and Adjunct. The subject is a central interpersonal element in discourse: it is one of two elements that form the central interactive nub of a proposition. Conceptually, there are countless ways of construing a given event and linguistically, a variety of grammatical devices that are usually available as alternate means of coding a given conception, such as political crime and corruption. In the theory of construal, then, which, like transitivity in Halliday, makes options available, Cognitive Linguistics can offer a cognitive account of ideology in language, where ideology is made possible by the choices a language allows for representing the same material situation in different ways. The possibility of promoting alternative construals of the same reality means that any particular choice in representation is always ideologically constrained or motivated and indicates the perspective and interests of the text-producer.

Keywords: power, ideology, court, discourse

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425 Variables, Annotation, and Metadata Schemas for Early Modern Greek

Authors: Eleni Karantzola, Athanasios Karasimos, Vasiliki Makri, Ioanna Skouvara

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Historical linguistics unveils the historical depth of languages and traces variation and change by analyzing linguistic variables over time. This field of linguistics usually deals with a closed data set that can only be expanded by the (re)discovery of previously unknown manuscripts or editions. In some cases, it is possible to use (almost) the entire closed corpus of a language for research, as is the case with the Thesaurus Linguae Graecae digital library for Ancient Greek, which contains most of the extant ancient Greek literature. However, concerning ‘dynamic’ periods when the production and circulation of texts in printed as well as manuscript form have not been fully mapped, representative samples and corpora of texts are needed. Such material and tools are utterly lacking for Early Modern Greek (16th-18th c.). In this study, the principles of the creation of EMoGReC, a pilot representative corpus of Early Modern Greek (16th-18th c.) are presented. Its design follows the fundamental principles of historical corpora. The selection of texts aims to create a representative and balanced corpus that gives insight into diachronic, diatopic and diaphasic variation. The pilot sample includes data derived from fully machine-readable vernacular texts, which belong to 4-5 different textual genres and come from different geographical areas. We develop a hierarchical linguistic annotation scheme, further customized to fit the characteristics of our text corpus. Regarding variables and their variants, we use as a point of departure the bundle of twenty-four features (or categories of features) for prose demotic texts of the 16th c. Tags are introduced bearing the variants [+old/archaic] or [+novel/vernacular]. On the other hand, further phenomena that are underway (cf. The Cambridge Grammar of Medieval and Early Modern Greek) are selected for tagging. The annotated texts are enriched with metalinguistic and sociolinguistic metadata to provide a testbed for the development of the first comprehensive set of tools for the Greek language of that period. Based on a relational management system with interconnection of data, annotations, and their metadata, the EMoGReC database aspires to join a state-of-the-art technological ecosystem for the research of observed language variation and change using advanced computational approaches.

Keywords: early modern Greek, variation and change, representative corpus, diachronic variables.

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424 Evaluating the Characteristics of Paediatric Accidental Poisonings

Authors: Grace Fangmin Tan, Elaine Yiling Tay, Elizabeth Huiwen Tham, Andrea Wei Ching Yeo

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Background: While accidental poisonings in children may seem unavoidable, knowledge of circumstances surrounding such incidents and identification of risk factors is important in the development of secondary prevention strategies. Some risk factors include age of the child, lack of adequate supervision and improper storage of substances. The aim of this study is to assess risk factors and circumstances influencing outcomes in these children. Methodology: A retrospective medical record review of all accidental poisoning cases presenting to the Children’s Emergency at National University Hospital (NUH), Singapore between January 2014 and December 2015 was conducted. Information on demographics, poisoning circumstances and clinical outcomes were collected. Results: Ninety-nine of a total of 186 poisoning cases were accidental ingestions, with a mean age of 4.7 (range 0.4 to 18.3 years). The gender distribution is rather equal with 52(52.5%) females and 47(47.5%) males. Seventy-nine (79.8%) were self-administered by the child and in 20 cases (20.2%), the substance was administered erroneously by caregivers 12/20 (60.0%) of whom were given the wrong drug dose while 8/20 (40.0%) were given the wrong substance. Self-administration was associated with presentation to the ED within 12 hours (p=0.027, OR 6.65, 95% CI 1.24-35.72). Notably, 94.9% of the cases involved substances kept within reach of the child. Sixty-nine (82.1%) had the substance kept in the original container, 3(3.6%) in food containers, 8(9.5%) in other containers and 4(4.8%) without a container. Of the 50 cases with information on labelling, 40/50(80.0%) were accurately labelled, 2/50 (4.0%) wrongly labelled, and 8/50 (16.0%) were unlabelled. Implicated substances included personal care products (11.1%), household cleaning products (3.0%), and different classes of drugs such as paracetamol (22.2%), antihistamines (17.2%) and sympathomimetics (8.1%). Children < 3 years of age were 4.8 times more likely to be poisoned by household substances than children >3 years of age (p=0.009, 95% CI 1.48-15.77). Prehospital interventions were more likely to have been done in poisoning with household substances (p=0.005, OR 6.12 95% CI 1.73-21.68). Fifty-nine (59.6%) were asymptomatic, 34 (34.3%) had a Poisoning Severity Score (PSS) grade of 1 (minor) and 6 (6.1%) grade 2 (moderate). Older children were 9.3 times more likely to be symptomatic (p<0.001, 95% CI 3.15-27.25). Thirty (32%) required admission. Conclusion: A significant proportion of accidental poisoning cases were due to medication administration errors by caregivers, which should be preventable. Risk factors for accidental poisoning included lack of adequate caregiver supervision, improper labelling and young age of the child. There is an urgent need to improve caregiver counselling during medication dispensing as well as to educate caregivers on basic child safety measures in the home to prevent future accidental poisonings.

Keywords: accidental, caregiver, paediatrics, poisoning

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423 Three Year Pedometer Based Physical Activity Intervention of the Adult Population in Qatar

Authors: Mercia I. Van Der Walt, Suzan Sayegh, Izzeldin E. L. J. Ibrahim, Mohamed G. Al-Kuwari, Manaf Kamil

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Background: Increased physical activity is associated with improvements in health conditions. Walking is recognized as an easy form of physical activity and a strategy used in health promotion. Step into Health (SIH), a national community program, was established in Qatar to support physical activity promotion through the monitoring of step counts. This study aims to assess the physical activity levels of the adult population in Qatar through a pedometer-based community program over a three-year-period. Methodology: This cross-sectional longitudinal study was conducted between from January 2013 and December 2015 based on daily step counts. A total of 15,947 adults (8,551 males and 7,396 females), from different nationalities enrolled in the program and aged 18 to 64, are included. The program involves free distribution of pedometers to members who voluntarily choose to register. It is also supported by a self-monitoring online account and linked to a web-database. All members are informed about the 10,000 steps/day target and automated emails as well as text messages are sent as reminders to upload data. Daily step counts were measured through the Omron HJ-324U pedometer (Omron Healthcare Co., Ltd., Japan). Analyses are done on the data extracted from the web-database. Results: Daily average step count for the overall community increased from 4,830 steps/day (2013) to 6,124 steps /day (2015). This increase was also observed within the three age categories (18–30), (31-45) and (>45) years. Average steps per day were found to be more among males compared with females in each of the aforementioned age groups. Moreover, males and females in the age group (>45 years) show the highest average step count with 7,010 steps/day and 5,564 steps/day respectively. The 21% increase in overall step count throughout the study period is associated with well-resourced program and ongoing impact in smaller communities such as workplaces and universities, a step in the right direction. However, the average step count of 6,124 steps/day in the third year is still classified as the low active category. Although the program showed an increase step count we found, 33% of the study population are low active, 35 % are sedentary with only 32% being active. Conclusion: This study indicates that the pedometer-based intervention was effective in increasing the daily physical activity of participants. However, alternative approaches need to be incorporated within the program to educate and encourage the community to meet the physical activity recommendations in relation to step count.

Keywords: pedometer, physical activity, Qatar, step count

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422 Preventing the Septic Shock in an Oncological Patient with Febrile Neutropenia Submitted to Chemotherapy: The Nurse's Responsibility

Authors: Hugo Reis, Isabel Rabiais

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The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

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421 Diversity and Distribution Ecology of Coprophilous Mushrooms of Family Psathyrellaceae from Punjab, India

Authors: Amandeep Kaur, Ns Atri, Munruchi Kaur

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Mushrooms have shaped our environment in ways that we are only beginning to understand. The weather patterns, topography, flora and fauna of Punjab state in India create favorable growing conditions for thousands of species of mushrooms, but the complete region was unexplored when it comes to coprophilous mushrooms growing on herbivorous dung. Coprophilous mushrooms are the most specialized fungi ecologically, which germinate and grow directly on different types of animal dung or on manured soil. In the present work, the diversity of coprophilous mushrooms' of Family Psathyrellaceae of the order Agaricales is explored, their relationship to the human world is sketched out, and their supreme significance to life on this planet is revealed. During the investigation, different dung localities from 16 districts of Punjab state have been explored for the collection of material. The macroscopic features of the collected mushrooms were documented on the Field key. The hand cut sections of the various parts of carpophore, such as pileus, gills, stipe and the basidiospores details, were studied microscopically under different magnification. Various authentic publications were consulted for the identification of the investigated taxa. The classification, authentic names and synonyms of the investigated taxa are as per the latest version of Dictionary of Fungi and the MycoBank. The present work deals with the taxonomy of 81 collections belonging to 39 species spread over 05 coprophilous genera, namely Psathyrella, Panaeolus, Parasola, Coprinopsis, and Coprinellus of family Psathyrellaceae. In the text, the investigated taxa have been arranged as they appear in the key to the genera and species investigated. In this work, have been thoroughly examined for their macroscopic, microscopic, ecological, and chemical reaction details. The authors dig deeper to give indication of their ecology and the dung type where they can be obtained. Each taxon is accompanied by a detailed listing of its prominent features and an illustration with habitat photographs and line drawings of morphological and anatomical features. Taxa are organized as per their status in the keys, which allow easy recognition. All the taxa are compared with similar taxa. The study has shown that dung is an important substrate which serves as a favorable niche for the growth of a variety of mushrooms. This paper shows an insight what short-lived coprophilous mushrooms can teach us about sustaining life on earth!

Keywords: abundance, basidiomycota, biodiversity, seasonal availability, systematics

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420 A Rare Case of Myometrial Ectopic

Authors: Madeleine Cox

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Objective: Discussion of diagnosis and management options for myometrial ectopic pregnancy Case: A 30 yo G1P0 presented to the emergency department with vaginal bleeding for the last 4 days. She had a positive home urine pregnancy test, confirmed with a serum HCG. When she presented for an ultrasound, there was no intrauterine pregnancy, no evidence of adnexal pregnancy, however, the anterior myometrium of the uterus was noted to be markedly abnormal. When she presented to the emergency department of a busy tertiary hospital in Queensland, she had a small amount of vaginal bleeding, was anxious but well, observations normal. Repeat blood testes demonstrated a serum HCG of 9246 IU/L, haemoglobin of 143g/L. The patient had an interesting history of a right oophorectomy and open myomectomy in another country. A repeat ultrasound again showed an abnormality within the myometrium of the uterus, which was initially reported as concerning for an AVM, or potentially invasive gestational trophoblastic disease. An MRI was organised 2 days later, which demonstrated a intramural/subserosal irregularity in the right lateral body measuring 35x38x42mm with peripheral enhancement and central cystic components, favouring a myometrial ectopic most likely at the site of previous myomectomy. Alternative diagnosis of AVM, GTD were considered less likely. After discussion with the patient, IV methotrexate was administered as an in patient 4 days after her initial presentation to emergency. After this, her HCG fell to 1236 IU/L on day 6 post treatment. Weekly reviews showed stable ultrasound appearances with a steadily dropping HCG level. A repeat MRI was performed 3 weeks after methotrexate administration which confirmed involution of the myometrial ectopic, however, showed ongoing progression of vascularity surrounding the site. Despite resolution of HCG, the patient persisted to have ongoing bleeding associated with this and went to have uterine artery embolisation. Follow up ultrasound showed resolution of abnormal vascularity and negative HCG levels. Conclusion: Myometrial ectopic pregnancies are a rare occurrence and require a multidisciplinary approach to achieve timely management for these patients. This patient was in a very well resourced setting with excellent access to Interventional Radiology and specialist Radiologists who could work together with the Obstetrics, Gynaecology, and Maternal Fetal Medicine team to provide multiple options of management which preserved her fertility. This case has a very good outcome, with the patient being referred back to our service 12 months later with an early intrauterine pregnancy.

Keywords: ectopic, pregnancy, miscarriage, gynaecology

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419 Insectivorous Medicinal Plant Drosera Ecologyand its Biodiversity Conservation through Tissue Culture and Sustainable Biotechnology

Authors: Sushil Pradhan

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Biotechnology contributes to sustainable development in several ways such as biofertilizer production, biopesticide production and management of environmental pollution, tissue culture and biodiversity conservation in vitro, in vivo and in situ, Insectivorous medicinal plant Drosera burmannii Vahl belongs to the Family-Droseraceae under Order-Caryophyllales, Dicotyledoneae, Angiospermeae which has 31 (thirty one) living genera and 194 species besides 7 (seven) extinct (fossil) genera. Locally it is known as “Patkanduri” in Odia. Its Hindi name is “Mukhajali” and its English name is “Sundew”. The earliest species of Drosera was first reported in 1753 by Carolous Linnaeus called Drosera indica L (Indian Sundew). The latest species of Drosera reported by Fleisch A, Robinson, AS, McPherson S, Heinrich V, Gironella E and Madulida D.A. (2011) is Drosera ultramafica from Malaysia. More than 50 % species of Drosera have been reported from Australia and next to Australia is South Africa. India harbours only 3 species such as D. indica L, Drosera burmannii Vahl and D. peltata L. From our Odisha only D. burmannii Vahl is being reported for the first time from the district of Subarnapur near Sonepur (Arjunpur Reserve Forest Area). Drosera plant is autotrophic but to supplement its Nitrogen (N2) requirement it adopts heterotrophic mode of nutrition (insectivorous/carnivorous) as well. The colour of plant in mostly red and about 20-30cm in height with beautiful pink or white pentamerous flowers. Plants grow luxuriantly during November to February in shady and moist places near small water bodies of running water stream. Medicinally it is a popular herb in the locality for the treatment of cold and cough in children in rainy season by the local Doctors (Kabiraj and Baidya). In the present field investigation an attempt has been made to understand the unique reproductive phase and life cycle of the plant thereby planning for its conservation and propagation through various techniques of tissue culture and biotechnology. More importantly besides morphological and anatomical studies, cytological investigation is being carried out to find out the number of chromosomes in the cell and its genomics as there is no such report as yet for Drosera burmannii Vahl. The ecological significance and biodiversity conservation of Drosera with special reference to energy, environmental and chemical engineering has been discussed in the research paper presentation.

Keywords: insectivorous, medicinal, drosera, biotechnology, chromosome, genome

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418 Measurements for Risk Analysis and Detecting Hazards by Active Wearables

Authors: Werner Grommes

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Intelligent wearables (illuminated vests or hand and foot-bands, smart watches with a laser diode, Bluetooth smart glasses) overflow the market today. They are integrated with complex electronics and are worn very close to the body. Optical measurements and limitation of the maximum light density are needed. Smart watches are equipped with a laser diode or control different body currents. Special glasses generate readable text information that is received via radio transmission. Small high-performance batteries (lithium-ion/polymer) supply the electronics. All these products have been tested and evaluated for risk. These products must, for example, meet the requirements for electromagnetic compatibility as well as the requirements for electromagnetic fields affecting humans or implant wearers. Extensive analyses and measurements were carried out for this purpose. Many users are not aware of these risks. The result of this study should serve as a suggestion to do it better in the future or simply to point out these risks. Commercial LED warning vests, LED hand and foot-bands, illuminated surfaces with inverter (high voltage), flashlights, smart watches, and Bluetooth smart glasses were checked for risks. The luminance, the electromagnetic emissions in the low-frequency as well as in the high-frequency range, audible noises, and nervous flashing frequencies were checked by measurements and analyzed. Rechargeable lithium-ion or lithium-polymer batteries can burn or explode under special conditions like overheating, overcharging, deep discharge or using out of the temperature specification. Some risk analysis becomes necessary. The result of this study is that many smart wearables are worn very close to the body, and an extensive risk analysis becomes necessary. Wearers of active implants like a pacemaker or implantable cardiac defibrillator must be considered. If the wearable electronics include switching regulators or inverter circuits, active medical implants in the near field can be disturbed. A risk analysis is necessary.

Keywords: safety and hazards, electrical safety, EMC, EMF, active medical implants, optical radiation, illuminated warning vest, electric luminescent, hand and head lamps, LED, e-light, safety batteries, light density, optical glare effects

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417 A Rare Case Report of Non-Langerhans Cell Cutaneous Histiocytosis in a 6-Month Old Infant

Authors: Apoorva D. R.

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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

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416 Clinical Outcomes and Symptom Management in Pediatric Patients Following Eczema Action Plans: A Quality Improvement Project

Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

Procedia PDF Downloads 133
415 National Branding through Education: South Korean Image in Romania through the Language Textbooks for Foreigners

Authors: Raluca-Ioana Antonescu

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The paper treats about the Korean public diplomacy and national branding strategies, and how the Korean language textbooks were used in order to construct the Korean national image. The field research of the paper stands at the intersection between Linguistics and Political Science, while the problem of the research is the role of language and culture in national branding process. The research goal is to contribute to the literature situated at the intersection between International Relations and Applied Linguistics, while the objective is to conceptualize the idea of national branding by emphasizing a dimension which is not much discussed, and that would be the education as an instrument of the national branding and public diplomacy strategies. In order to examine the importance of language upon the national branding strategies, the paper will answer one main question, How is the Korean language used in the construction of national branding?, and two secondary questions, How are explored in literature the relations between language and national branding construction? and What kind of image of South Korea the language textbooks for foreigners transmit? In order to answer the research questions, the paper starts from one main hypothesis, that the language is an essential component of the culture, which is used in the construction of the national branding influenced by traditional elements (like Confucianism) but also by modern elements (like Western influence), and from two secondary hypothesis, the first one is that in the International Relations literature there are little explored the connections between language and national branding, while the second hypothesis is that the South Korean image is constructed through the promotion of a traditional society, but also a modern one. In terms of methodology, the paper will analyze the textbooks used in Romania at the universities which provide Korean Language classes during the three years program B.A., following the dialogs, the descriptive texts and the additional text about the Korean culture. The analysis will focus on the rank status difference, the individual in relation to the collectivity, the respect for the harmony, and the image of the foreigner. The results of the research show that the South Korean image projected in the textbooks convey the Confucian values and it does not emphasize the changes suffered by the society due to the modernity and globalization. The Westernized aspect of the Korean society is conveyed more in an informative way about the Korean international companies, Korean internal development (like the transport or other services), but it does not show the cultural changed the society underwent. Even if the paper is using the textbooks which are used in Romania as a teaching material, it could be used and applied at least to other European countries, since the textbooks are the ones issued by the South Korean language schools, which other European countries are using also.

Keywords: confucianism, modernism, national branding, public diplomacy, traditionalism

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414 Articles, Delimitation of Speech and Perception

Authors: Nataliya L. Ogurechnikova

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The paper aims to clarify the function of articles in the English speech and specify their place and role in the English language, taking into account the use of articles for delimitation of speech. A focus of the paper is the use of the definite and the indefinite articles with different types of noun phrases which comprise either one noun with or without attributes, such as the King, the Queen, the Lion, the Unicorn, a dimple, a smile, a new language, an unknown dialect, or several nouns with or without attributes, such as the King and Queen of Hearts, the Lion and Unicorn, a dimple or smile, a completely isolated language or dialect. It is stated that the function of delimitation is related to perception: the number of speech units in a text correlates with the way the speaker perceives and segments the denotation. The two following combinations of words the house and garden and the house and the garden contain different numbers of speech units, one and two respectively, and reveal two different perception modes which correspond to the use of the definite article in the examples given. Thus, the function of delimitation is twofold, it is related to perception and cognition, on the one hand, and, on the other hand, to grammar, if the subject of grammar is the structure of speech. Analysis of speech units in the paper is not limited by noun phrases and is amplified by discussion of peripheral phenomena which are nevertheless important because they enable to qualify articles as a syntactic phenomenon whereas they are not infrequently described in terms of noun morphology. With this regard attention is given to the history of linguistic studies, specifically to the description of English articles by Niels Haislund, a disciple of Otto Jespersen. A discrepancy is noted between the initial plan of Jespersen who intended to describe articles as a syntactic phenomenon in ‘A Modern English Grammar on Historical Principles’ and the interpretation of articles in terms of noun morphology, finally given by Haislund. Another issue of the paper is correlation between description and denotation, being a traditional aspect of linguistic studies focused on articles. An overview of relevant studies, given in the paper, goes back to the works of G. Frege, which gave rise to a series of scientific works where the meaning of articles was described within the scope of logical semantics. Correlation between denotation and description is treated in the paper as the meaning of article, i.e. a component in its semantic structure, which differs from the function of delimitation and is similar to the meaning of other quantifiers. The paper further explains why the relation between description and denotation, i.e. the meaning of English article, is irrelevant for noun morphology and has nothing to do with nominal categories of the English language.

Keywords: delimitation of speech, denotation, description, perception, speech units, syntax

Procedia PDF Downloads 239
413 A webGIS Methodology to Support Sediments Management in Wallonia

Authors: Nathalie Stephenne, Mathieu Veschkens, Stéphane Palm, Christophe Charlemagne, Jacques Defoux

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According to Europe’s first River basin Management Plans (RBMPs), 56% of European rivers failed to achieve the good status targets of the Water Framework Directive WFD. In Central European countries such as Belgium, even more than 80% of rivers failed to achieve the WFD quality targets. Although the RBMP’s should reduce the stressors and improve water body status, their potential to address multiple stress situations is limited due to insufficient knowledge on combined effects, multi-stress, prioritization of measures, impact on ecology and implementation effects. This paper describes a webGis prototype developed for the Walloon administration to improve the communication and the management of sediment dredging actions carried out in rivers and lakes in the frame of RBMPs. A large number of stakeholders are involved in the management of rivers and lakes in Wallonia. They are in charge of technical aspects (client and dredging operators, organizations involved in the treatment of waste…), management (managers involved in WFD implementation at communal, provincial or regional level) or policy making (people responsible for policy compliance or legislation revision). These different kinds of stakeholders need different information and data to cover their duties but have to interact closely at different levels. Moreover, information has to be shared between them to improve the management quality of dredging operations within the ecological system. In the Walloon legislation, leveling dredged sediments on banks requires an official authorization from the administration. This request refers to spatial information such as the official land use map, the cadastral map, the distance to potential pollution sources. The production of a collective geodatabase can facilitate the management of these authorizations from both sides. The proposed internet system integrates documents, data input, integration of data from disparate sources, map representation, database queries, analysis of monitoring data, presentation of results and cartographic visualization. A prototype of web application using the API geoviewer chosen by the Geomatic department of the SPW has been developed and discussed with some potential users to facilitate the communication, the management and the quality of the data. The structure of the paper states the why, what, who and how of this communication tool.

Keywords: sediments, web application, GIS, rivers management

Procedia PDF Downloads 404
412 The Risk of Prioritizing Management over Education at Japanese Universities

Authors: Masanori Kimura

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Due to the decline of the 18-year-old population, Japanese universities have a tendency to convert their form of employment from tenured positions to fixed-term positions for newly hired teachers. The advantage of this is that universities can be more flexible in their employment plans in case they fail to fill the enrollment of quotas of prospective students or they need to supplement teachers who can engage in other academic fields or research areas where new demand is expected. The most serious disadvantage of this, however, is that if secure positions cannot be provided to faculty members, there is the possibility that coherence of education and continuity of research supported by the university cannot be achieved. Therefore, the question of this presentation is as follows: Are universities aiming to give first priority to management, or are they trying to prioritize educational and research rather than management? To answer this question, the author examined the number of job offerings for college foreign language teachers posted on the JREC-IN (Japan Research Career Information Network, which is run by Japan Science and Technology Agency) website from April 2012 to October 2015. The results show that there were 1,002 and 1,056 job offerings for tenured positions and fixed-term contracts respectively, suggesting that, overall, today’s Japanese universities show a tendency to give first priority to management. More detailed examinations of the data, however, show that the tendency slightly varies depending on the types of universities. National universities which are supported by the central government and state universities which are supported by local governments posted more job offerings for tenured positions than for fixed-term contracts: national universities posted 285 and 257 job offerings for tenured positions and fixed-term contracts respectively, and state universities posted 106 and 86 job offerings for tenured positions and fixed-term contracts respectively. Yet the difference in number between the two types of employment status at national and state universities is marginal. As for private universities, they posted 713 job offerings for fixed-term contracts and 616 offerings for tenured positions. Moreover, 73% of the fixed-term contracts were offered for low rank positions including associate professors, lectures, and so forth. Generally speaking, those positions are offered to younger teachers. Therefore, this result indicates that private universities attempt to cut their budgets yet expect the same educational effect by hiring younger teachers. Although the results have shown that there are some differences in personal strategies among the three types of universities, the author argues that all three types of universities may lose important human resources that will take a pivotal role at their universities in the future unless they urgently review their employment strategies.

Keywords: higher education, management, employment status, foreign language education

Procedia PDF Downloads 129
411 Evaluating Multiple Diagnostic Tests: An Application to Cervical Intraepithelial Neoplasia

Authors: Areti Angeliki Veroniki, Sofia Tsokani, Evangelos Paraskevaidis, Dimitris Mavridis

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The plethora of diagnostic test accuracy (DTA) studies has led to the increased use of systematic reviews and meta-analysis of DTA studies. Clinicians and healthcare professionals often consult DTA meta-analyses to make informed decisions regarding the optimum test to choose and use for a given setting. For example, the human papilloma virus (HPV) DNA, mRNA, and cytology can be used for the cervical intraepithelial neoplasia grade 2+ (CIN2+) diagnosis. But which test is the most accurate? Studies directly comparing test accuracy are not always available, and comparisons between multiple tests create a network of DTA studies that can be synthesized through a network meta-analysis of diagnostic tests (DTA-NMA). The aim is to summarize the DTA-NMA methods for at least three index tests presented in the methodological literature. We illustrate the application of the methods using a real data set for the comparative accuracy of HPV DNA, HPV mRNA, and cytology tests for cervical cancer. A search was conducted in PubMed, Web of Science, and Scopus from inception until the end of July 2019 to identify full-text research articles that describe a DTA-NMA method for three or more index tests. Since the joint classification of the results from one index against the results of another index test amongst those with the target condition and amongst those without the target condition are rarely reported in DTA studies, only methods requiring the 2x2 tables of the results of each index test against the reference standard were included. Studies of any design published in English were eligible for inclusion. Relevant unpublished material was also included. Ten relevant studies were finally included to evaluate their methodology. DTA-NMA methods that have been presented in the literature together with their advantages and disadvantages are described. In addition, using 37 studies for cervical cancer obtained from a published Cochrane review as a case study, an application of the identified DTA-NMA methods to determine the most promising test (in terms of sensitivity and specificity) for use as the best screening test to detect CIN2+ is presented. As a conclusion, different approaches for the comparative DTA meta-analysis of multiple tests may conclude to different results and hence may influence decision-making. Acknowledgment: This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014-2020» in the context of the project “Extension of Network Meta-Analysis for the Comparison of Diagnostic Tests ” (MIS 5047640).

Keywords: colposcopy, diagnostic test, HPV, network meta-analysis

Procedia PDF Downloads 136
410 A Framework of Virtualized Software Controller for Smart Manufacturing

Authors: Pin Xiu Chen, Shang Liang Chen

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A virtualized software controller is developed in this research to replace traditional hardware control units. This virtualized software controller transfers motion interpolation calculations from the motion control units of end devices to edge computing platforms, thereby reducing the end devices' computational load and hardware requirements and making maintenance and updates easier. The study also applies the concept of microservices, dividing the control system into several small functional modules and then deploy into a cloud data server. This reduces the interdependency among modules and enhances the overall system's flexibility and scalability. Finally, with containerization technology, the system can be deployed and started in a matter of seconds, which is more efficient than traditional virtual machine deployment methods. Furthermore, this virtualized software controller communicates with end control devices via wireless networks, making the placement of production equipment or the redesign of processes more flexible and no longer limited by physical wiring. To handle the large data flow and maintain low-latency transmission, this study integrates 5G technology, fully utilizing its high speed, wide bandwidth, and low latency features to achieve rapid and stable remote machine control. An experimental setup is designed to verify the feasibility and test the performance of this framework. This study designs a smart manufacturing site with a 5G communication architecture, serving as a field for experimental data collection and performance testing. The smart manufacturing site includes one robotic arm, three Computer Numerical Control machine tools, several Input/Output ports, and an edge computing architecture. All machinery information is uploaded to edge computing servers and cloud servers via 5G communication and the Internet of Things framework. After analysis and computation, this information is converted into motion control commands, which are transmitted back to the relevant machinery for motion control through 5G communication. The communication time intervals at each stage are calculated using the C++ chrono library to measure the time difference for each command transmission. The relevant test results will be organized and displayed in the full-text.

Keywords: 5G, MEC, microservices, virtualized software controller, smart manufacturing

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409 Endotracheal Intubation Self-Confidence: Report of a Realistic Simulation Training

Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Doris F. Rabelo

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Introduction: Endotracheal Intubation (ETI) is a procedure for clinical management of patients with severe clinical presentation of COVID-19 disease. Realistic simulation (RS) is an active learning methodology utilized for clinical skill's improvement. To improve ETI skills of public health network's physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was planned and carried out. Training scenario included the Nasco Lifeform realistic simulator, and three actions were simulated: ETI procedure, sedative drugs management, and bougie guide utilization. Training intervention occurred between May and June 2020, as an interinstitutional cooperation between the Health's Department of Bahia State and the Federal University from Recôncavo da Bahia. Objective: The main objective is to report the effects on participants' self-confidence perception for ETI procedure after RS based training. Methods: This is a descriptive study, with secondary data extracted from questionnaires applied throughout RS training. Priority workplace, time from last intubation, and knowledge about bougie were reported on a preparticipation questionnaire. Additionally, participants completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding self-confidence perception in performing each of simulated actions. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's Exact Test. Results: 36 physicians participated of training, 25 (69%) from primary care setting, 25 (69%) performed ETI over a year ago, and only 4 (11%) had previous knowledge about the bougie guide utilization. There was an increase in self-confidence medians for all three simulated actions. Medians (variation) for self-confidence before and after training, for each simulated action were as follows: ETI [5 (1-9) vs. 8 (6-10) (p < 0.0001)]; Sedative drug management [5 (1-9) vs. 8 (4-10) (p < 0.0001)]; Bougie guide utilization [2.5 (1-7) vs. 8 (4-10) (p < 0.0001)]. Among those who performed ETI over a year ago (n = 25), an increase in self-confidence greater than 3 points for ETI was reported by 23 vs. 2 physicians (p = 0.0002), and by 21 vs. 4 (p = 0.03) for sedative drugs management. Conclusions: RS training contributed to self-confidence increase in performing ETI. Among participants who performed ETI over a year, there was a significant association between RS training and increase of more than 3 points in self-confidence, both for ETI and sedative drug management. Training with RS methodology is suitable for ETI confidence enhancement during COVID-19 outbreak.

Keywords: confidence, COVID-19, endotracheal intubation, realistic simulation

Procedia PDF Downloads 138
408 The Problem of Suffering: Job, The Servant and Prophet of God

Authors: Barbara Pemberton

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Now that people of all faiths are experiencing suffering due to many global issues, shared narratives may provide common ground in which true understanding of each other may take root. This paper will consider the all too common problem of suffering and address how adherents of the three great monotheistic religions seek understanding and the appropriate believer’s response from the same story found within their respective sacred texts. Most scholars from each of these three traditions—Judaism, Christianity, and Islam— consider the writings of the Tanakh/Old Testament to at least contain divine revelation. While they may not agree on the extent of the revelation or the method of its delivery, they do share stories as well as a common desire to glean God’s message for God’s people from the pages of the text. One such shared story is that of Job, the servant of Yahweh--called Ayyub, the prophet of Allah, in the Qur’an. Job is described as a pious, righteous man who loses everything—family, possessions, and health—when his faith is tested. Three friends come to console him. Through it, all Job remains faithful to his God who rewards him by restoring all that was lost. All three hermeneutic communities consider Job to be an archetype of human response to suffering, regarding Job’s response to his situation as exemplary. The story of Job addresses more than the distribution of the evil problem. At stake in the story is Job’s very relationship to his God. Some exegetes believe that Job was adapted into the Jewish milieu by a gifted redactor who used the original ancient tale as the “frame” for the biblical account (chapters 1, 2, and 4:7-17) and then enlarged the story with the complex center section of poetic dialogues creating a complex work with numerous possible interpretations. Within the poetic center, Job goes so far as to question God, a response to which Jews relate, finding strength in dialogue—even in wrestling with God. Muslims only embrace the Job of the biblical narrative frame, as further identified through the Qur’an and the prophetic traditions, considering the center section an errant human addition not representative of a true prophet of Islam. The Qur’anic injunction against questioning God also renders the center theologically suspect. Christians also draw various responses from the story of Job. While many believers may agree with the Islamic perspective of God’s ultimate sovereignty, others would join their Jewish neighbors in questioning God, not anticipating answers but rather an awareness of his presence—peace and hope becoming a reality experienced through the indwelling presence of God’s Holy Spirit. Related questions are as endless as the possible responses. This paper will consider a few of the many Jewish, Christian, and Islamic insights from the ancient story, in hopes adherents within each tradition will use it to better understand the other faiths’ approach to suffering.

Keywords: suffering, Job, Qur'an, tanakh

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407 Comics as an Intermediary for Media Literacy Education

Authors: Ryan C. Zlomek

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The value of using comics in the literacy classroom has been explored since the 1930s. At that point in time researchers had begun to implement comics into daily lesson plans and, in some instances, had started the development process for comics-supported curriculum. In the mid-1950s, this type of research was cut short due to the work of psychiatrist Frederic Wertham whose research seemingly discovered a correlation between comic readership and juvenile delinquency. Since Wertham’s allegations the comics medium has had a hard time finding its way back to education. Now, over fifty years later, the definition of literacy is in mid-transition as the world has become more visually-oriented and students require the ability to interpret images as often as words. Through this transition, comics has found a place in the field of literacy education research as the shift focuses from traditional print to multimodal and media literacies. Comics are now believed to be an effective resource in bridging the gap between these different types of literacies. This paper seeks to better understand what students learn from the process of reading comics and how those skills line up with the core principles of media literacy education in the United States. In the first section, comics are defined to determine the exact medium that is being examined. The different conventions that the medium utilizes are also discussed. In the second section, the comics reading process is explored through a dissection of the ways a reader interacts with the page, panel, gutter, and different comic conventions found within a traditional graphic narrative. The concepts of intersubjective acts and visualization are attributed to the comics reading process as readers draw in real world knowledge to decode meaning. In the next section, the learning processes that comics encourage are explored parallel to the core principles of media literacy education. Each principle is explained and the extent to which comics can act as an intermediary for this type of education is theorized. In the final section, the author examines comics use in his computer science and technology classroom. He lays out different theories he utilizes from Scott McCloud’s text Understanding Comics and how he uses them to break down media literacy strategies with his students. The article concludes with examples of how comics has positively impacted classrooms around the United States. It is stated that integrating comics into the classroom will not solve all issues related to literacy education but, rather, that comics can be a powerful multimodal resource for educators looking for new mediums to explore with their students.

Keywords: comics, graphics novels, mass communication, media literacy, metacognition

Procedia PDF Downloads 295
406 The Impact of Autism on Children Behavior

Authors: Marina Wagdy Nageeb Eskander

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A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

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405 The Economic Burden of Mental Disorders: A Systematic Review

Authors: Maria Klitgaard Christensen, Carmen Lim, Sukanta Saha, Danielle Cannon, Finley Prentis, Oleguer Plana-Ripoll, Natalie Momen, Kim Moesgaard Iburg, John J. McGrath

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Introduction: About a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders. Methods: Systematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses, (2) diagnosis of at least one mental disorder, (3) samples based on the general population, and (4) outcome in monetary units. 13,640 publications were screened by their title/abstract and 439 articles were full-text screened by at least two independent reviewers. 112 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 143 included articles. Results: Information about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The vast majority of the included studies were from Western countries and only a few from Africa and South America. The disorder group most often investigated was mood disorders, followed by schizophrenia and neurotic disorders. The disorder group least examined was intellectual disabilities, followed by eating disorders. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies. An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality. Discussion: This is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policymaking.

Keywords: cost-of-illness, health economics, mental disorders, systematic review

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404 An Institutional Mapping and Stakeholder Analysis of ASEAN’s Preparedness for Nuclear Power Disaster

Authors: Nur Azha Putra Abdul Azim, Denise Cheong, S. Nivedita

Abstract:

Currently, there are no nuclear power reactors among the Association of Southeast Asian Nations (ASEAN) member states (AMS) but there are seven operational nuclear research reactors, and Indonesia is about to construct the region’s first experimental power reactor by the end of the decade. If successful, the experimental power reactor will lay the foundation for the country’s and region’s first nuclear power plant. Despite projecting confidence during the period of nuclear power renaissance in the region in the last decade, none of the AMS has committed to a political decision on the use of nuclear energy and this is largely due to the Fukushima nuclear power accident in 2011. Of the ten AMS, Vietnam, Indonesia and Malaysia have demonstrated the most progress in developing nuclear energy based on the nuclear power infrastructure development assessments made by the International Atomic Energy Agency. Of these three states, Vietnam came closest to building its first nuclear power plant but decided to delay construction further due to safety and security concerns. Meanwhile, Vietnam along with Indonesia and Malaysia continue with their nuclear power infrastructure development and the remaining SEA states, with the exception of Brunei and Singapore, continue to build their expertise and capacity for nuclear power energy. At the current rate of progress, Indonesia is expected to make a national decision on the use of nuclear power by 2023 while Malaysia, the Philippines, and Thailand have included the use of nuclear power in their mid to long-term power development plans. Vietnam remains open to nuclear power but has not placed a timeline. The medium to short-term power development projection in the region suggests that the use of nuclear energy in the region is a matter of 'when' rather than 'if'. In lieu of the prospects for nuclear energy in Southeast Asia (SEA), this presentation will review the literature on ASEAN radiological emergency and preparedness response (EPR) plans and examine ASEAN’s disaster management and emergency framework. Through a combination of institutional mapping and stakeholder analysis methods, which we examine in the context of the international EPR, and nuclear safety and security regimes, we will identify the issues and challenges in developing a regional radiological EPR framework in the SEA. We will conclude with the observation that ASEAN faces serious structural, institutional and governance challenges due to the AMS inherent political structures and history of interstate conflicts, and propose that ASEAN should either enlarge the existing scope of its disaster management and response framework or that its radiological EPR framework should exist as a separate entity.

Keywords: nuclear power, nuclear accident, ASEAN, Southeast Asia

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403 The Effect of Autism Attitudes and Laws and Restrictions

Authors: Eva Maged Hosni Sadek

Abstract:

A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.

Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills

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