Search results for: American english
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2680

Search results for: American english

520 Effects of the Affordable Care Act On Preventive Care Disparities

Authors: Cagdas Agirdas

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Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.

Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities

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519 The Impact of Task-Based Language Teaching on Iranian Female Intermediate EFL Learners’ Writing Performance

Authors: Gholam Reza Parvizi, Hossein Azad, Ali Reza Kargar

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This article investigated the impact of task-based language teaching (TBLT) on writing performance of the Iranian intermediate EFL learners. There were two groups of forty students of the intermediate female learners studying English in Jahad-e-Daneshgahi language institute, ranging in age from thirteen to nineteen. They participated in their regular classes in the institute and were assigned to two groups including an experimental group of task-based language teaching and a control group for the purpose of homogeneity, all students in two groups took an achievement test before the treatment. As a pre-test; students were assigned to write a task at the beginning of the course. One of the classes was conducted through talking a TBLT approach on their writing, while the other class followed regular patterns of teaching, namely traditional approach for TBLT group. There were some tasks chosen from learners’ textbook. The task selection was in accordance with learning standards for ESL and TOFEL writing sections. At the end of the treatment, a post-test was administered to both experimental group and the control group. Scoring was done on the basis of scoring scale of “expository writing quality scale”. The researcher used paired samples t-test to analyze the effect of TBLT teaching approach on the writing performance of the learners. The data analysis revealed that the subjects in TBLT group performed better on the writing performance post-test than the subjects in control group. The findings of the study also demonstrated that TBLT would enhance writing performance in the group of learners. Moreover, it was indicated that TBLT has been effective in teaching writing performance to Iranian EFL learners

Keywords: task-based language teaching, task, language teaching approach, writing proficiency, EFL learners

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518 Role of Speech Articulation in English Language Learning

Authors: Khadija Rafi, Neha Jamil, Laiba Khalid, Meerub Nawaz, Mahwish Farooq

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Speech articulation is a complex process to produce intelligible sounds with the help of precise movements of various structures within the vocal tract. All these structures in the vocal tract are named as articulators, which comprise lips, teeth, tongue, and palate. These articulators work together to produce a range of distinct phonemes, which happen to be the basis of language. It starts with the airstream from the lungs passing through the trachea and into oral and nasal cavities. When the air passes through the mouth, the tongue and the muscles around it form such coordination it creates certain sounds. It can be seen when the tongue is placed in different positions- sometimes near the alveolar ridge, soft palate, roof of the mouth or the back of the teeth which end up creating unique qualities of each phoneme. We can articulate vowels with open vocal tracts, but the height and position of the tongue is different every time depending upon each vowel, while consonants can be pronounced when we create obstructions in the airflow. For instance, the alphabet ‘b’ is a plosive and can be produced only by briefly closing the lips. Articulation disorders can not only affect communication but can also be a hurdle in speech production. To improve articulation skills for such individuals, doctors often recommend speech therapy, which involves various kinds of exercises like jaw exercises and tongue twisters. However, this disorder is more common in children who are going through developmental articulation issues right after birth, but in adults, it can be caused by injury, neurological conditions, or other speech-related disorders. In short, speech articulation is an essential aspect of productive communication, which also includes coordination of the specific articulators to produce different intelligible sounds, which are a vital part of spoken language.

Keywords: linguistics, speech articulation, speech therapy, language learning

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517 Revisiting Domestication and Foreignisation Methods: Translating the Quran by the Hybrid Approach

Authors: Aladdin Al-Tarawneh

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The Quran, as it is the sacred book of Islam and considered the literal word of God (Allah) in Arabic, is highly translated into many languages; however, the foreignising or the literal approach excessively stains the quality and discredits the final product in the eyes of its receptors. Such an approach fails to capture the intended meaning of the Quran and to communicate it in any language. Therefore, this study is conducted to propose a different approach that seeks involving other ones according to a hybrid model. Indeed, this study challenges the binary adherence that is highly used in Translation Studies (TS) in general and in the translation of the Quran in particular. Drawing on the genuine fact that the Quran can be communicated in any language in terms of meaning, and the translation is not sacred; this paper approaches the translation of the Quran by blending different methods like domestication or foreignisation in a systematic way, avoiding the binary choice made by many translators. To reach this aim, the paper has a conceptual part that seeks to elucidate and clarify the main methods employed in TS, and criticise and modify them to propose the new hybrid approach (the hybrid model) for translating the Quran – that is, the deductive method. To support and validate the outcome of the previous part, a comparative model is employed in order to highlight the differences between the suggested translation and other widely used ones – that is, the inductive method. By applying this methodology, the paper proves that there is a deficiency of communicating the original meaning of the Quran in light of the foreignising approach. In conclusion, the paper suggests producing a Quran translation has to take into account the adoption of many techniques to express the meaning of the Quran as understood in the original, and to offer this understanding in English in the most native-like manner to serve the intended target readers.

Keywords: Quran translation, hybrid approach, domestication, foreignization, hybrid model

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516 A Qualitative Evidence of the Markedness of Code Switching during Commercial Bank Service Encounters in Ìbàdàn Metropolis

Authors: A. Robbin

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In a multilingual setting like Nigeria, the success of service encounters is enhanced by the use of a language that ensures the linguistic and persuasive demands of the interlocutors. This study examined motivations for code switching as a negotiation strategy in bank-hall desk service encounters in Ìbàdàn metropolis using Myers-Scotton’s exploration on markedness in language use. The data consisted of transcribed audio recording of bank-hall service encounters, and direct observation of bank interactions in two purposively sampled commercial banks in Ìbàdàn metropolis. The data was subjected to descriptive linguistic analysis using Myers Scotton’s Markedness Model.  Findings reveal that code switching is frequently employed during different stages of service encounter: greeting, transaction and closing to fulfil relational, bargaining and referential functions. Bank staff and customers code switch to make unmarked, marked and explanatory choices. A strategy used to identify with customer’s cultural affiliation, close status gap, and appeal to begrudged customer; or as an explanatory choice with non-literate customers for ease of communication. Bankers select English to maintain customers’ perceptions of prestige which is retained or diverged from depending on their linguistic preference or ability.  Yoruba is seen as an efficient negotiation strategy with both bankers and their customers, making choices within conversation to achieve desired conversational and functional aims.

Keywords: banking, bilingualism, code-switching, markedness, service encounter

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515 Data Collection in Protected Agriculture for Subsequent Big Data Analysis: Methodological Evaluation in Venezuela

Authors: Maria Antonieta Erna Castillo Holly

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During the last decade, data analysis, strategic decision making, and the use of artificial intelligence (AI) tools in Latin American agriculture have been a challenge. In some countries, the availability, quality, and reliability of historical data, in addition to the current data recording methodology in the field, makes it difficult to use information systems, complete data analysis, and their support for making the right strategic decisions. This is something essential in Agriculture 4.0. where the increase in the global demand for fresh agricultural products of tropical origin, during all the seasons of the year requires a change in the production model and greater agility in the responses to the consumer market demands of quality, quantity, traceability, and sustainability –that means extensive data-. Having quality information available and updated in real-time on what, how much, how, when, where, at what cost, and the compliance with production quality standards represents the greatest challenge for sustainable and profitable agriculture in the region. The objective of this work is to present a methodological proposal for the collection of georeferenced data from the protected agriculture sector, specifically in production units (UP) with tall structures (Greenhouses), initially for Venezuela, taking the state of Mérida as the geographical framework, and horticultural products as target crops. The document presents some background information and explains the methodology and tools used in the 3 phases of the work: diagnosis, data collection, and analysis. As a result, an evaluation of the process is carried out, relevant data and dashboards are displayed, and the first satellite maps integrated with layers of information in a geographic information system are presented. Finally, some improvement proposals and tentatively recommended applications are added to the process, understanding that their objective is to provide better qualified and traceable georeferenced data for subsequent analysis of the information and more agile and accurate strategic decision making. One of the main points of this study is the lack of quality data treatment in the Latin America area and especially in the Caribbean basin, being one of the most important points how to manage the lack of complete official data. The methodology has been tested with horticultural products, but it can be extended to other tropical crops.

Keywords: greenhouses, protected agriculture, data analysis, geographic information systems, Venezuela

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514 Patients' Understanding of Their Treatment Plans and Diagnosis during Discharge in Emergency Ward at B. P. Koirala Institute of Health Sciences

Authors: Ajay Kumar Yadav, Masum Paudel, Ritesh Chaudhary

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Background: Understanding the diagnosis and the treatment plan is very important for the patient which reflects the effectiveness of the patient care as well as counseling. Large groups of patients do not understand their emergency care plan or their discharge instructions. With only a little more than 2/3ʳᵈ of the adult population is literate and poorly distributed health service institutions in Nepal, exploring the current status of patient understanding of their diagnosis and treatment would help identify interventions to improve patient compliance with the provided care and the treatment outcomes. Objectives: This study was conducted to identify and describe the areas of patients’ understanding and confusion regarding emergency care and discharge instructions at the Emergency ward of B. P. Koirala Institute of Health Sciences teaching hospital, Dharan, Nepal. Methods: A cross-sectional study was conducted among 426 patients discharged from the emergency unit of BPKIHS. Cases who are leaving against medical advice absconded cases and those patients who came just for vaccination are excluded from the study. Patients’ understanding of the treatment plan and diagnosis was measured. Results: There were 60% men in this study. More than half of the participants reported not being able to read English. More than 90% of the respondents reported they could not read their prescription at all. While patient could point out their understanding of their diagnosis at discharge, most of them could not tell the names and the dosage of all the drugs prescribed to them at discharge. More than 95% of the patients could not tell the most common side effects of the drugs that they are prescribed. Conclusions: There is a need to further explore the factors influencing the understanding of the patients regarding their treatment plan. Interventions to understand the health literacy needs and ways to improve the health literacy of the patients are needed.

Keywords: discharge instruction, emergency ward, health literacy, treatment plan

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513 Revealing Celtic and Norse Mythological Depths through Dragon Age’s Tattoos and Narratives

Authors: Charles W. MacQuarrie, Rachel R. Tatro Duarte

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This paper explores the representation of medieval identity within the world of games such as Dragon Age, Elden Ring, Hellblade: Senua’s sacrifice, fantasy role-playing games that draw effectively and problematically on Celtic and Norse mythologies. Focusing on tattoos, onomastics, and accent as visual and oral markers of status and ethnicity, this study analyzes how the game's interplay between mythology, character narratives, and visual storytelling enriches the themes and offers players an immersive, but sometimes baldly ahistorical, connection to ancient mythologies and contemporary digital storytelling. Dragon Age is a triple a game series, Hellblade Senua’s Sacrifice, and Elden Ring of gamers worldwide with its presentation of an idealized medieval world, inspired by the lore of Celtic and Norse mythologies. This paper sets out to explore the intricate relationships between tattoos, accent, and character narratives in the game, drawing parallels to themes,heroic figures and gods from Celtic and Norse mythologies. Tattoos as Mythic and Ethnic Markers: This study analyzes how tattoos in Dragon Age visually represent mythological elements from both Celtic and Norse cultures, serving as conduits of cultural identity and narratives. The nature of these tattoos reflects the slave, criminal, warrior associations made in classical and medieval literature, and some of the episodes concerning tattoos in the games have either close analogs or sources in literature. For example the elvish character Solas, in Dragon Age Inquisition, removes a slave tattoo from the face of a lower status elf in an episode that is reminiscent of Bridget removing the stigmata from Connallus in the Vita Prima of Saint Bridget Character Narratives: The paper examines how characters' personal narratives in the game parallel the archetypal journeys of Celtic heroes and Norse gods, with a focus on their relationships to mythic themes. In these games the Elves usually have Welsh or Irish accents, are close to nature, magically powerful, oppressed by apparently Anglo-Saxon humans and Norse dwarves, and these elves wear facial tattoos. The Welsh voices of fairies and demons is older than the reference in Shakespeare’s Merry Wives of Windsor or even the Anglo-Saxon Life of Saint Guthlac. The English speaking world, and the fantasy genre of literature and gaming, undoubtedly driven by Tolkien, see Elves as Welsh speakers, and as having Welsh accents when speaking English Comparative Analysis: A comparative approach is employed to reveal connections, adaptations, and unique interpretations of the motifs of tattoos and narrative themes in Dragon Age, compared to those found in Celtic and Norse mythologies. Methodology: The study uses a comparative approach to examine the similarities and distinctions between Celtic and Norse mythologies and their counterparts in video games. The analysis encompasses character studies, narrative exploration, visual symbolism, and the historical context of Celtic and Norse cultures. Mythic Visuals: This study showcases how tattoos, as visual symbols, encapsulate mythic narratives, beliefs, and cultural identity, echoing Celtic and Norse visual motifs. Archetypal Journeys: The paper analyzes how character arcs mirror the heroic journeys of Celtic and Norse mythological figures, allowing players to engage with mythic narratives on a personal level. Cultural Interplay: The study discusses how the game's portrayal of tattoos and narratives both preserves and reinterprets elements from Celtic and Norse mythologies, fostering a connection between ancient cultures and modern digital storytelling. Conclusion: By exploring the interconnectedness of tattoos and character narratives in Dragon Age, this paper reveals the game series' ability to act as a bridge between ancient mythologies and contemporary gaming. By drawing inspiration from Celtic heroes and Norse gods and translating them into digital narratives and visual motifs, Dragon Age offers players a multi-dimensional engagement with mythic themes and a unique lens through which to appreciate the enduring allure of these cultures.

Keywords: comparative analysis, character narratives, video games and literature, tattoos, immersive storytelling, character development, mythological influences, Celtic mythology, Norset mythology

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512 Early Modern Controversies of Mobility within the Spanish Empire: Francisco De Vitoria and the Peaceful Right to Travel

Authors: Beatriz Salamanca

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In his public lecture ‘On the American Indians’ given at the University of Salamanca in 1538-39, Francisco de Vitoria presented an unsettling defense of freedom of movement, arguing that the Spanish had the right to travel and dwell in the New World, since it was considered part of the law of nations [ius gentium] that men enjoyed free mutual intercourse anywhere they went. The principle of freedom of movement brought hopeful expectations, promising to bring mankind together and strengthen the ties of fraternity. However, it led to polemical situations when those whose mobility was in question represented a harmful threat or was for some reason undesired. In this context, Vitoria’s argument has been seen on multiple occasions as a justification of the expansion of the Spanish empire. In order to examine the meaning of Vitoria’s defense of free mobility, a more detailed look at Vitoria’s text is required, together with the study of some of his earliest works, among them, his commentaries on Thomas Aquinas’s Summa Theologiae, where he presented relevant insights on the idea of the law of nations. In addition, it is necessary to place Vitoria’s work in the context of the intellectual tradition he belonged to and the responses he obtained from some of his contemporaries who were concerned with similar issues. The claim of this research is that the Spanish right to travel advocated by Vitoria was not intended to be interpreted in absolute terms, for it had to serve the purpose of bringing peace and unity among men, and could not contradict natural law. In addition, Vitoria explicitly observed that the right to travel was only valid if the Spaniards caused no harm, a condition that has been underestimated by his critics. Therefore, Vitoria’s legacy is of enormous value as it initiated a long lasting discussion regarding the question of the grounds under which human mobility could be restricted. Again, under Vitoria’s argument it was clear that this freedom was not absolute, but the controversial nature of his defense of Spanish mobility demonstrates how difficult it was and still is to address the issue of the circulation of peoples across frontiers, and shows the significance of this discussion in today’s globalized world, where the rights and wrongs of notions like immigration, international trade or foreign intervention still lack sufficient consensus. This inquiry about Vitoria’s defense of the principle of freedom of movement is being placed here against the background of the history of political thought, political theory, international law, and international relations, following the methodological framework of contextual history of the ‘Cambridge School’.

Keywords: Francisco de Vitoria, freedom of movement, law of nations, ius gentium, Spanish empire

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511 The Use of Mobile Phone as Enhancement to Mark Multiple Choice Objectives English Grammar and Literature Examination: An Exploratory Case Study of Preliminary National Diploma Students, Abdu Gusau Polytechnic, Talata Mafara, Zamfara State, Nigeria

Authors: T. Abdulkadir

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Most often, marking and assessment of multiple choice kinds of examinations have been opined by many as a cumbersome and herculean task to accomplished manually in Nigeria. Usually this may be in obvious nexus to the fact that mass numbers of candidates were known to take the same examination simultaneously. Eventually, marking such a mammoth number of booklets dared and dread even the fastest paid examiners who often undertake the job with the resulting consequences of stress and boredom. This paper explores the evolution, as well as the set aim to envision and transcend marking the Multiple Choice Objectives- type examination into a thing of creative recreation, or perhaps a more relaxing activity via the use of the mobile phone. A more “pragmatic” dimension method was employed to achieve this work, rather than the formal “in-depth research” based approach due to the “novelty” of the mobile-smartphone e-Marking Scheme discovery. Moreover, being an evolutionary scheme, no recent academic work shares a direct same topic concept with the ‘use of cell phone as an e-marking technique’ was found online; thus, the dearth of even miscellaneous citations in this work. Additional future advancements are what steered the anticipatory motive of this paper which laid the fundamental proposition. However, the paper introduces for the first time the concept of mobile-smart phone e-marking, the steps to achieve it, as well as the merits and demerits of the technique all spelt out in the subsequent pages.

Keywords: cell phone, e-marking scheme (eMS), mobile phone, mobile-smart phone, multiple choice objectives (MCO), smartphone

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510 Place and Situational Management in Crime Prevention

Authors: Mehdi Moghimi

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Doctrines associated with situational prevention considers 'place of committing crime' as one of the fundamental elements of a crime. Meanwhile, with regard to causing or having effect on a crime situation, 'place' can be one of the pivotal indices in situational prevention analyses. This study aims at examining the role of place in construction of a crime situation and explaining the relationship between 'place' and situational preventive measures and procedures. Also, how to identify high-crime places, types of high-crime places and the factors influencing their creation are among the most important secondary objectives of this article. Concerning the purpose, it is a practical study whose material has been written through a documentary method using original sources (English), books and written and translated articles etc. This article is written in two main parts. In the first section, cognitive-conceptual issues about 'place' as one of the main causes of crime situation, and its effective interaction with situational preventive measures will be reviewed. The second part of this paper will focus on criminological examination of places and critical locations of crime and provide situational preventive measures to deal with the situation. 'Crime displacement' and 'geographical distribution of benefits'are also considered as the possible consequences of implementing preventive strategies. The results of the study suggest that the inventory of offenses is distributed according to the spatial characteristics. Moreover, according to the criminological characteristics governing region or location, offenders choose the place of crime based on a logical calculation. Therefore, some locations, regions or neighborhoods are permanent places of occurring lots of crimes. As a result, considering "place", preventive measures and procedures can be systematically directed, and using the most effective ways, limited preventive resources are utilized in the most critical places. Finally, some suggestions for further research and application are provided in line with more favorable promotion of situational preventive measures.

Keywords: crime prevention, place, police crime, situational crime prevention

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509 Reader Reception of Cultural Context for Chinese Translation of Scientific and Technical Discourse: An Empirical Study

Authors: Caiwen Wang, Yuling Liu

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Scientific and technical discourse is non-literary, and so it is often regarded as merely informative, free of the cultural context of both the source and the target language. Thus it is supposed that translators of sci-tech texts do not need to consider cultural factors in the translation process as readers only care for the information conveyed. This paper takes a different standpoint and shows that cultural context plays an important part in scientific and technical texts and thereafter in bridging the gap between different cultural communities of readers. The paper argues that the common cultural context for members of the same cultural community, such as morals, customs, and values, also underpins the sci-tech discourse of various text types, and therefore may pose difficulties for readers of a different cultural community if this is re-presented or translated literally. The research hypothesises that depending on how it is re-presented or translated; cultural context can either encourage or discourage readers’ reading experience and subsequently their interest to read and use translation texts. Drawing upon the Reception Theory by Hans Robert Jauss, the research investigates the relationship between cultural context and scientific and technical translation from English to Chinese. Citing 55 examples of sci-tech translations from magazines, newspapers and the website of Shell, a major international oil and gas company, the research shows that the source texts for these 55 cases all have bearing on the source cultural context, and translators will need to address this in the translation process instead of doing literal translation to be merely correct. The research then interviews 15 research subjects for their views of the translations. By assessing readers’ reception and perception of translated Chinese sci-tech discourse, the research concludes that cultural context contributes to the quality of scientific and technical translation in an important way and then discusses the implications of the findings for training scientific and technical translators.

Keywords: Chinese translation, cultural context, reception theory, scientific and technical texts

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508 Anthropometric Indices of Obesity and Coronary Artery Atherosclerosis: An Autopsy Study in South Indian population

Authors: Francis Nanda Prakash Monteiro, Shyna Quadras, Tanush Shetty

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The association between human physique and morbidity and mortality resulting from coronary artery disease has been studied extensively over several decades. Multiple studies have also been done on the correlation between grade of atherosclerosis, coronary artery diseases and anthropometrical measurements. However, the number of autopsy-based studies drastically reduces this number. It has been suggested that while in living subjects, it would be expensive, difficult, and even harmful to subject them to imaging modalities like CT scans and procedures involving contrast media to study mild atherosclerosis, no such harm is encountered in study of autopsy cases. This autopsy-based study was aimed to correlate the anthropometric measurements and indices of obesity, such as waist circumference (WC), hip circumference (HC), body mass index (BMI) and waist hip ratio (WHR) with the degree of atherosclerosis in the right coronary artery (RCA), main branch of the left coronary artery (LCA) and the left anterior descending artery (LADA) in 95 South Indian origin victims of both the genders between the age of 18 years and 75 years. The grading of atherosclerosis was done according to criteria suggested by the American Heart Association. The study also analysed the correlation of the anthropometric measurements and indices of obesity with the number of coronaries affected with atherosclerosis in an individual. All the anthropometric measurements and the derived indices were found to be significantly correlated to each other in both the genders except for the age, which is found to have a significant correlation only with the WHR. In both the genders severe degree of atherosclerosis was commonly observed in LADA, followed by LCA and RCA. Grade of atherosclerosis in RCA is significantly related to the WHR in males. Grade of atherosclerosis in LCA and LADA is significantly related to the WHR in females. Significant relation was observed between grade of atherosclerosis in RCA and WC, and WHR, and between grade of atherosclerosis in LADA and HC in males. Significant relation was observed between grade of atherosclerosis in RCA and WC, and WHR, and between grade of atherosclerosis in LADA and HC in females. Anthropometric measurements/indices of obesity can be an effective means to identify high risk cases of atherosclerosis at an early stage that can be effective in reducing the associated cardiac morbidity and mortality. A person with anthropometric measurements suggestive of mild atherosclerosis can be advised to modify his lifestyle, along with decreasing his exposure to the other risk factors. Those with measurements suggestive of higher degree of atherosclerosis can be subjected to confirmatory procedures to start effective treatment.

Keywords: atherosclerosis, coronary artery disease, indices, obesity

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507 Community Observatory for Territorial Information Control and Management

Authors: A. Olivi, P. Reyes Cabrera

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Ageing and urbanization are two of the main trends that characterize the twenty-first century. Its trending is especially accelerated in the emerging countries of Asia and Latin America. Chile is one of the countries in the Latin American region, where the demographic transition to ageing is becoming increasingly visible. The challenges that the new demographic scenario poses to urban administrators call for searching innovative solutions to maximize the functional and psycho-social benefits derived from the relationship between older people and the environment in which they live. Although mobility is central to people's everyday practices and social relationships, it is not distributed equitably. On the contrary, it can be considered another factor of inequality in our cities. Older people are a particularly sensitive and vulnerable group to mobility. In this context, based on the ageing in place strategy and following the social innovation approach within a spatial context, the "Community Observatory of Territorial Information Control and Management" project aims at the collective search and validation of solutions for the satisfaction of mobility and accessibility specific needs of urban aged people. Specifically, the Observatory intends to: i) promote the direct participation of the aged population in order to generate relevant information on the territorial situation and the satisfaction of the mobility needs of this group; ii) co-create dynamic and efficient mechanisms for the reporting and updating of territorial information; iii) increase the capacity of the local administration to plan and manage solutions to environmental problems at the neighborhood scale. Based on a participatory mapping methodology and on the application of digital technology, the Observatory designed and developed, together with aged people, a crowdsourcing platform for smartphones, called DIMEapp, for reporting environmental problems affecting mobility and accessibility. DIMEapp has been tested at a prototype level in two neighborhoods of the city of Valparaiso. The results achieved in the testing phase have shown high potential in order to i) contribute to establishing coordination mechanisms with the local government and the local community; ii) improve a local governance system that guides and regulates the allocation of goods and services destined to solve those problems.

Keywords: accessibility, ageing, city, digital technology, local governance

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506 The Relevance of Shared Cultural Leadership in the Survival of the Language and of the Francophone Culture in a Minority Language Environment

Authors: Lyne Chantal Boudreau, Claudine Auger, Arline Laforest

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As an English-speaking country, Canada faces challenges in French-language education. During both editions of a provincial congress on education planned and conducted under shared cultural leadership, three organizers created a Francophone space where, for the first time in the province of New Brunswick (the only officially bilingual province in Canada), a group of stakeholders from the school, post-secondary and community sectors have succeeded in contributing to reflections on specific topics by sharing winning practices to meet the challenges of learning in a minority Francophone environment. Shared cultural leadership is a hybrid between theories of leadership styles in minority communities and theories of shared leadership. Through shared cultural leadership, the goal is simply to guide leadership and to set up all minority leaderships in minority context through shared leadership. This leadership style requires leaders to transition from a hierarchical to a horizontal approach, that is, to an approach where each individual is at the same level. In this exploratory research, it has been demonstrated that shared leadership exercised under the T-learning model best fosters the mobilization of all partners in advancing in-depth knowledge in a particular field while simultaneously allowing learning of the elements related to the domain in question. This session will present how it is possible to mobilize the whole community through leaders who continually develop their knowledge and skills in their specific field but also in related fields. Leaders in this style of management associated to shared cultural leadership acquire the ability to consider solutions to problems from a holistic perspective and to develop a collective power derived from the leadership of each and everyone in a space where all are rallied to promote the ultimate advancement of society.

Keywords: education, minority context, shared leadership, t-leaning

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505 Window Seat: Examining Public Space, Politics, and Social Identity through Urban Public Transportation

Authors: Sabrina Howard

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'Window Seat' uses public transportation as an entry point for understanding the relationship between public space, politics, and social identity construction. This project argues that by bringing people of different races, classes, and genders in 'contact' with one another, public transit operates as a site of exposure, as people consciously and unconsciously perform social identity within these spaces. These performances offer a form of freedom that we associate with being in urban spaces while simultaneously rendering certain racialized, gendered, and classed bodies vulnerable to violence. Furthermore, due to its exposing function, public transit operates as a site through which we, as urbanites and scholars, can read social injustice and reflect on the work that is necessary to become a truly democratic society. The major questions guiding this research are: How does using public transit as the entry point provide unique insights into the relationship between social identity, politics, and public space? What ideas do Americans hold about public space and how might these ideas reflect a liberal yearning for a more democratic society? To address these research questions, 'Window Seat' critically examines ethnographic data collected on public buses and trains in Los Angeles, California, and online news media. It analyzes these sources through literature in socio-cultural psychology, sociology, and political science. It investigates the 'everyday urban hero' narrative or popular news stories that feature an individual or group of people acting against discriminatory or 'Anti-American' behavior on public buses and trains. 'Window Seat' studies these narratives to assert that by circulating stories of civility in news media, United Statsians construct and maintain ideas of the 'liberal city,' which is characterized by ideals of freedom and democracy. Furthermore, for those involved, these moments create an opportunity to perform the role of the Good Samaritan, an identity that is wrapped up in liberal beliefs in diversity and inclusion. This research expands conversations in urban studies by making a case for the political significance of urban public space. It demonstrates how these sites serve as spaces through which liberal beliefs are circulated and upheld through identity performance.

Keywords: social identity, public space, public transportation, liberalism

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504 725 Arcadia Street in Pretoria: A Pretoria Case Study Focusing on Urban Acupuncture

Authors: Konrad Steyn, Jacques Laubscher

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South African urban design solutions are mostly aligned with European and North American models that are often not appropriate in addressing some of this country’s challenges such as multiculturalism and decaying urban areas. Sustainable urban redevelopment in South Africa should be comprehensive in nature, sensitive in its manifestation, and should be robust and inclusive in order to achieve social relevance. This paper argues that the success of an urban design intervention is largely dependent on the public’s perceptions and expectations, and the way people participate in shaping their environments. The concept of sustainable urbanism is thus more comprehensive than – yet should undoubtedly include – methods of construction, material usage and climate control principles. The case study is a central element of this research paper. 725 Arcadia Street in Pretoria, was originally commissioned as a food market structure. A starkly contrasting existing modernist adjacent building forms the morphological background. Built in 1969, it is a valuable part of Pretoria’s modernist fabric. It was realised early on that the project should not be a mere localised architectural intervention, but rather an occasion to revitalise the neighbourhood through urban regeneration. Because of the complex and comprehensive nature of the site and rich cultural diversity of the area, a multi-faceted approach seemed the most appropriate response. The methodology for collating data consisted of a combination of literature reviews (regarding the historic original fauna and flora and current plants, observation (frequent site visits) and physical surveying on the neighbourhood level (physical location, connectivity to surrounding landmarks as well as movement systems and pedestrian flows). This was followed by an exploratory design phase, culminating in the present redevelopment proposal. Since built environment interventions are increasingly based on generalised normative guidelines, an approach focusing of urban acupuncture could serve as an alternative. Celebrating the specific urban condition, urban acupuncture offers an opportunity to influence the surrounding urban fabric and achieve urban renewal through physical, social and cultural mediation.

Keywords: neighbourhood, urban renewal, South African urban design solutions, sustainable urban redevelopment

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503 Brokerage and Value-Creation: Trading Practices in the English Market of 20th-Century Maps

Authors: Shaun Lim

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This paper presents a 9-month ethnographic case study of the value creating strategies employed by an Oxford market-trader of 20th-century maps. Maps are usually valued and sold as either antique objets d’art or useful navigational tools, with 20th-century maps precariously lying between the boundary of the aesthetic and utilitarian value-regimes. Here, the brokerage practices involved in the framing of outdated, lowly valued maps into vintage commodities will be examined. Ethnographic material of the unstudied market of old maps is introduced and situated in the second-hand, antique and collectible spheres of exchange. The map-trader as a broker is the ethnographic and methodological starting point of this paper. Brokerage is understood through the activity of framing that defines and brackets the value-regimes of commodities with the aid of market and framing devices. The trader’s activities will be examined in three parts. (1) The post-sourcing industry: the altering, mounting and tagging of maps before putting them into market circulation. Mounts, frames and tags are seen as market devices that authenticates and frames maps with aesthetic and symbolic values along with the disentanglement of its use value. (2) The market-display: the constitution of space that encourages the relations of looking at maps as aesthetic objects, while the categorical arrangement of the display contributes to legitimising of the collectability of maps. (3) The salesmanship strategies of the trader: the match-making of customers with maps of meaningful value, and the mediating of knowledge through the verbal articulation of the map’s symbolic values. Ultimately, value is not created in an accumulative sense, but is layered and superimposed to cater to a wide spectrum of patrons. The trader creates demand for his goods by mediating and articulating value-regimes already coherent to potential patrons.

Keywords: art and material culture, brokerage, commodification, framing, markets, value

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502 Efficacy of Learning: Digital Sources versus Print

Authors: Rahimah Akbar, Abdullah Al-Hashemi, Hanan Taqi, Taiba Sadeq

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As technology continues to develop, teaching curriculums in both schools and universities have begun adopting a more computer/digital based approach to the transmission of knowledge and information, as opposed to the more old-fashioned use of textbooks. This gives rise to the question: Are there any differences in learning from a digital source over learning from a printed source, as in from a textbook? More specifically, which medium of information results in better long-term retention? A review of the confounding factors implicated in understanding the relationship between learning from the two different mediums was done. Alongside this, a 4-week cohort study involving 76 1st year English Language female students was performed, whereby the participants were divided into 2 groups. Group A studied material from a paper source (referred to as the Print Medium), and Group B studied material from a digital source (Digital Medium). The dependent variables were grading of memory recall indexed by a 4 point grading system, and total frequency of item repetition. The study was facilitated by advanced computer software called Super Memo. Results showed that, contrary to prevailing evidence, the Digital Medium group showed no statistically significant differences in terms of the shift from Remember (Episodic) to Know (Semantic) when all confounding factors were accounted for. The shift from Random Guess and Familiar to Remember occurred faster in the Digital Medium than it did in the Print Medium.

Keywords: digital medium, print medium, long-term memory recall, episodic memory, semantic memory, super memo, forgetting index, frequency of repetitions, total time spent

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501 Effect of Distance Education Students Motivation with the Turkish Language and Literature Course

Authors: Meva Apaydin, Fatih Apaydin

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Role of education in the development of society is great. Teaching and training started with the beginning of the history and different methods and techniques which have been applied as the time passed and changed everything with the aim of raising the level of learning. In addition to the traditional teaching methods, technology has been used in recent years. With the beginning of the use of internet in education, some problems which could not be soluted till that time has been dealt and it is inferred that it is possible to educate the learners by using contemporary methods as well as traditional methods. As an advantage of technological developments, distance education is a system which paves the way for the students to be educated individually wherever and whenever they like without the needs of physical school environment. Distance education has become prevalent because of the physical inadequacies in education institutions, as a result; disadvantageous circumstances such as social complexities, individual differences and especially geographical distance disappear. What’s more, the high-speed of the feedbacks between teachers and learners, improvement in student motivation because there is no limitation of time, low-cost, the objective measuring and evaluation are on foreground. In spite of the fact that there is teaching beneficences in distance education, there are also limitations. Some of the most important problems are that : Some problems which are highly possible to come across may not be solved in time, lack of eye-contact between the teacher and the learner, so trust-worthy feedback cannot be got or the problems stemming from the inadequate technological background are merely some of them. Courses are conducted via distance education in many departments of the universities in our country. In recent years, giving lectures such as Turkish Language, English, and History in the first grades of the academic departments in the universities is an application which is constantly becoming prevalent. In this study, the application of Turkish Language course via distance education system by analyzing advantages and disadvantages of the distance education system which is based on internet.

Keywords: distance education, Turkish language, motivation, benefits

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500 Managing Pseudoangiomatous Stromal Hyperplasia Appropriately and Safely: A Retrospective Case Series Review

Authors: C. M. Williams, R. English, P. King, I. M. Brown

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Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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499 The Short-Term Stress Indicators in Home and Experimental Dogs

Authors: Madara Nikolajenko, Jevgenija Kondratjeva

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Stress is a response of the body to physical or psychological environmental stressors. Cortisol level in blood serum is determined as the main indicator of stress, but the blood collection, the animal preparation and other activities can cause unpleasant conditions and induce increase of these hormones. Therefore, less invasive methods are searched to determine stress hormone levels, for example, by measuring the cortisol level saliva. The aim of the study is to find out the changes of stress hormones in blood and saliva in home and experimental dogs in simulated short-term stress conditions. The study included clinically healthy experimental beagle dogs (n=6) and clinically healthy home American Staffordshire terriers (n=6). The animals were let into a fenced area to adapt. Loud drum sounds (in cooperation with 'Andžeja Grauda drum school') were used as a stressor. Blood serum samples were taken for sodium, potassium, glucose and cortisol level determination and saliva samples for cortisol determination only. Control parameters were taken immediately before the start of the stressor, and next samples were taken immediately after the stress. The last measurements were taken two hours after the stress. Electrolyte levels in blood serum were determined using direction selective electrode method (ILab Aries analyzer) and cortisol in blood serum and saliva using electrochemical luminescence method (Roche Diagnostics). Blood glucose level was measured with glucometer (ACCU-CHECK Active test strips). Cortisol level in the blood increased immediately after the stress in all home dogs (P < 0,05), but only in 33% (P < 0,05) of the experimental dogs. After two hours the measurement decreased in 83% (P < 0,05) of home dogs (in 50% returning to the control point) and in 83% (P < 0,05) of the experimental dogs. Cortisol in saliva immediately after the stress increased in 50% (P > 0,05) of home dogs and in 33% (P > 0,05) of the experimental dogs. After two hours in 83% (P > 0,05) of the home animals, the measurements decreased, only in 17% of the experimental dogs it decreased as well, while in 49% measurement was undetectable due to the lack of material. Blood sodium, potassium, and glucose measurements did not show any significant changes. The combination of short-term stress indicators, when, after the stressor, all indicators should immediately increase and decrease after two hours, confirmed in none of the animals. Therefore the authors can conclude that each animal responds to a stressful situation with different physiological mechanisms and hormonal activity. Cortisol level in saliva and blood is released with the different speed and is not an objective indicator of acute stress.

Keywords: animal behaivor, cortisol, short-term stress, stress indicators

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498 The Phenomena of False Cognates and Deceptive Cognates: Issues to Foreign Language Learning and Teaching Methodology Based on Set Theory

Authors: Marilei Amadeu Sabino

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The aim of this study is to establish differences between the terms ‘false cognates’, ‘false friends’ and ‘deceptive cognates’, usually considered to be synonyms. It will be shown they are not synonyms, since they do not designate the same linguistic process or phenomenon. Despite their differences in meaning, many pairs of formally similar words in two (or more) different languages are true cognates, although they are usually known as ‘false’ cognates – such as, for instance, the English and Italian lexical items ‘assist x assistere’; ‘attend x attendere’; ‘argument x argomento’; ‘apology x apologia’; ‘camera x camera’; ‘cucumber x cocomero’; ‘fabric x fabbrica’; ‘factory x fattoria’; ‘firm x firma’; ‘journal x giornale’; ‘library x libreria’; ‘magazine x magazzino’; ‘parent x parente’; ‘preservative x preservativo’; ‘pretend x pretendere’; ‘vacancy x vacanza’, to name but a few examples. Thus, one of the theoretical objectives of this paper is firstly to elaborate definitions establishing a distinction between the words that are definitely ‘false cognates’ (derived from different etyma) and those that are just ‘deceptive cognates’ (derived from the same etymon). Secondly, based on Set Theory and on the concepts of equal sets, subsets, intersection of sets and disjoint sets, this study is intended to elaborate some theoretical and practical questions that will be useful in identifying more precisely similarities and differences between cognate words of different languages, and according to graphic interpretation of sets it will be possible to classify them and provide discernment about the processes of semantic changes. Therefore, these issues might be helpful not only to the Learning of Second and Foreign Languages, but they could also give insights into Foreign and Second Language Teaching Methodology. Acknowledgements: FAPESP – São Paulo State Research Support Foundation – the financial support offered (proc. n° 2017/02064-7).

Keywords: deceptive cognates, false cognates, foreign language learning, teaching methodology

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497 Understanding Algerian International Student Mental Health Experiences in UK (United Kingdom) Universities: Difficulties of Disclosure, Help-Seeking and Coping Strategies

Authors: Nesrine Boussaoui

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Background: International students often encounter challenges while studying in the UK, including communication and language barriers, lack of social networks, and socio-cultural differences that adversely impact on their mental health. For Algerian international students (AISs), these challenges may be heightened as English is not their first language and the culture of their homeland is substantially different from British culture, yet research has to incorporate their experiences and perspectives. Aim: The current study aimed to explore AISs’ 1) understandings of mental health; 2) issues of disclosure for mental health difficulties; and 3) mental health help-seeking and coping strategies. Method: In-depth, audio recorded semi-structured interviews (n = 20) with AISs in UK universities were conducted. An inductive, reflective thematic approach analysis was used. Finding: The following themes and associated sub-themes were developed: (1) Algerian cultural influences on mental health understanding(socio-cultural comparisons); (2) the paradox of the family (pressure vs. support); (3) stigma and fear of disclosure; (4) Barriers to formal help-seeking (informal disclosure as first step to seeking help); (5) Communication barriers (resort to mother tongue to disclose); (6) Self-reliance and religious coping. Conclusion: Recognising and understanding the challenges faced by AISs in terms of disclosure and mental health help-seeking is essential to reduce barriers to formal help-seeking. Informal disclosure among peers is often the first step to seeking help. Enhancing practitioners’ cultural competences and awareness of diverse understandings of mental health and the role of religious coping among AISs’ may have transferable benefits to a wider international student population.

Keywords: mental health, stegma, coping, disclosure

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496 Real Fictions: Converging Landscapes and Imagination in an English Village

Authors: Edoardo Lomi

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A problem of central interest in anthropology concerns the ethnographic displacement of modernity’s conceptual sovereignty over that of native collectives worldwide. Part of this critical project has been the association of Western modernity with a dualist, naturalist ontology. Despite its demonstrated value for comparative work, this association often comes at the cost of reproducing ideas that lack an empirical ethnographic basis. This paper proposes a way forward by bringing to bear some of the results produced by an ethnographic study of a village in Wiltshire, South England. Due to its picturesque qualities, this village has served for decades as a ready-made set for fantasy movies and a backdrop to fictional stories. These forms of mediation have in turn generated some apparent paradoxes, such as fictitious characters that affect actual material changes, films that become more real than history, and animated stories that, while requiring material grounds to unfold, inhabit a time and space in other respects distinct from that of material processes. Drawing on ongoing fieldwork and interviews with locals and tourists, this paper considers the ways villagers engage with fiction as part of their everyday lives. The resulting image is one of convergence, in the same landscape, of people and things having different ontological status. This study invites reflection on the implications of this image for diversifying our imagery of Western lifeworlds. To this end, the notion of ‘real fictions’ is put forth, connecting the ethnographic blurring of modernist distinctions–such as sign and signified, mind and matter, materiality and immateriality–with discussions on anthropology’s own reliance on fictions for critical comparative work.

Keywords: England, ethnography, landscape, modernity, mediation, ontology, post-structural theory

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495 Influence of Pretreatment Magnetic Resonance Imaging on Local Therapy Decisions in Intermediate-Risk Prostate Cancer Patients

Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

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Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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494 The Decline of National Sovereignty in Light of the International Transformations

Authors: Djehich Mohamed Yousri

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The national sovereignty of states is now facing a dangerous situation that has witnessed a clear exacerbation of the restrictions that this sovereignty has known for quite some time, if not since the establishment of the sovereign national state in the first place, and things have reached this way to the extent that a group of analysts and commentators are talking about the demise or disappearance of the phenomenon of sovereignty Patriotism, a judgment that some consider exaggerated, although there is agreement on the seriousness of what has afflicted the national sovereignty of medium and small states in particular. In fact, the phenomenon of national sovereignty has not completely ended, as there is still a category of countries that are able to disagree with the American will without disappearing from the world map, as happened with the Soviet Union. China, some European countries, and some countries with leading regional roles are still able to deal with This administration, with rational and complex calculations, makes the restrictions on its sovereignty minimal, or at least draws a red line in front of the vital interests of those countries that the restrictions on sovereignty cannot cross, and it is certain that strengthening internal democratic development in countries will increase their ability to challenge external restrictions. On its sovereignty to the extent that this development creates a cohesive society in the face of external hegemony attempts, as well as to the extent that it eliminates some pretexts for interference in the internal affairs of states, including the claim of a lack of democracy or lack of respect for human rights in it. What led to transformations in the international arena in the wake of globalization and its effects on international aspects, including national sovereignty and the principle of state independence. Which was marred by several currents, which led to affecting it in a negative way, and this is what poor countries suffer from at the expense of rich countries, which led us to research the extent of the presence of national sovereignty on the international arena, and the extent to which the principle of non-interference in affairs is applied or existed. The internal affairs of states, which are stipulated in the Charter of the United Nations in the modern era, the theory of sovereignty has been subjected to substantial criticism and abandonment by many on the grounds that it is inconsistent with the current conditions of the international community. In fact, the theory of sovereignty has been misused to justify internal tyranny and international chaos. This theory has hindered the development of international law, the work of international organizations and the dominance of strong states over weak ones. At the present time, the concept of sovereignty has moved towards direction, as the transformations of the international system in the economic, political and military fields have led to the decline and erosion of the idea of the sovereignty of the national state.

Keywords: sovereignty, intervention, non-interference, globalization, humanitarian intervention

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493 A Comparative Analysis on Survival in Patients with Node Positive Cutaneous Head and Neck Squamous Cell Carcinoma as per TNM 7th and Tnm 8th Editions

Authors: Petr Daniel Edward Kovarik, Malcolm Jackson, Charles Kelly, Rahul Patil, Shahid Iqbal

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Introduction: Recognition of the presence of extra capsular spread (ECS) has been a major change in the TNM 8th edition published by the American Joint Committee on Cancer in 2018. Irrespective of the size or number of lymph nodes, the presence of ECS makes N3b disease a stage IV disease. The objective of this retrospective observational study was to conduct a comparative analysis of survival outcomes in patients with lymph node-positive cutaneous head and neck squamous cell carcinoma (CHNSCC) based on their TNM 7th and TNM 8th editions classification. Materials and Methods: From January 2010 to December 2020, 71 patients with CHNSCC were identified from our centre’s database who were treated with radical surgery and adjuvant radiotherapy. All histopathological reports were reviewed, and comprehensive nodal mapping was performed. The data were collected retrospectively and survival outcomes were compared using TNM 7th and 8th editions. Results: The median age of the whole group of 71 patients was 78 years, range 54 – 94 years, 63 were male and 8 female. In total, 2246 lymph nodes were analysed; 195 were positive for cancer. ECS was present in 130 lymph nodes, which led to a change in TNM staging. The details on N-stage as per TNM 7th edition was as follows; pN1 = 23, pN2a = 14, pN2b = 32, pN2c = 0, pN3 = 2. After incorporating the TNM 8th edition criterion (presence of ECS), the details on N-stage were as follows; pN1 = 6, pN2a = 5, pN2b = 3, pN2c = 0, pN3a = 0, pN3b = 57. This showed an increase in overall stage. According to TNM 7th edition, there were 23 patients were with stage III and remaining 48 patients, stage IV. As per TNM 8th edition, there were only 6 patients with stage III as compared to 65 patients with stage IV. For all patients, 2-year disease specific survival (DSS) and overall survival (OS) were 70% and 46%. 5-year DSS and OS rates were 66% and 20% respectively. Comparing the survival between stage III and stage IV of the two cohorts using both TNM 7th and 8th editions, there is an obvious greater survival difference between the stages if TNM 8th staging is used. However, meaningful statistics were not possible as the majority of patients (n = 65) were with stage IV and only 6 patients were stage III in the TNM 8th cohort. Conclusion: Our study provides a comprehensive analysis on lymph node data mapping in this specific patient population. It shows a better differentiation between stage III and stage IV in the TNM 8th edition as compared to TNM 7th however meaningful statistics were not possible due to the imbalance of patients in the sub-cohorts of the groups.

Keywords: cutaneous head and neck squamous cell carcinoma, extra capsular spread, neck lymphadenopathy, TNM 7th and 8th editions

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492 Geotechnical Education in the USA: A Comparative Analysis of Academic Schooling vs. Industry Needs in the Area of Earth Retaining Structures

Authors: Anne Lemnitzer, Eric Tavarez

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The academic rigor of the geotechnical engineering curriculum indicates strong institutional and geographical variations. Geotechnical engineering deals with the most challenging civil engineering material, as opposed to structural engineering, environmental studies, transportation engineering, and water resources. Yet, technical expectations posed by the practicing professional community do not necessarily consider the challenges inherent to the disparity in academic rigor and disciplinary differences. To recognize the skill shortages among current graduates as well as identify opportunities to better equip graduate students in specific fields of geotechnical engineering, a two-part survey was developed in collaboration with the Earth Retaining Structures (ERS) Committee of the American Society of Civil Engineers. Earth Retaining Structures are critical components of infrastructure systems and integral components to many major engineering projects. Within the geotechnical curriculum, Earth Retaining Structures is either taught as a separate course or major subject within a foundation design class. Part 1 of the survey investigated the breadth and depth of the curriculum with respect to ERS by requesting faculty across the United States to provide data on their curricular content, integration of practice-oriented course content, student preparation for professional licensing, and level of technical competency expected upon student graduation. Part 2 of the survey enables a comparison of training provided versus training needed. This second survey addressed practicing geotechnical engineers in all sectors of the profession (e.g., private engineering consulting, governmental agencies, contractors, suppliers/manufacturers) and collected data on the expectations with respect to technical and non-technical skills of engineering graduates entering the professional workforce. Results identified skill shortages in soft skills, critical thinking, analytical and language skills, familiarity with design codes and standards, and communication with various stakeholders. The data will be used to develop educational tools to advance the proficiency and expertise of geotechnical engineering students to meet and exceed the expectations of the profession and to stimulate a lifelong interest in advancing the field of geotechnical engineering.

Keywords: geotechnical engineering, academic training, industry requirements, earth retaining structures

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491 Making Waves: Preparing the Next Generation of Bilingual Medical Doctors

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

Procedia PDF Downloads 124