Search results for: maternal and child healthcare
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3337

Search results for: maternal and child healthcare

697 Waist Circumference-Related Performance of Tense Indices during Varying Pediatric Obesity States and Metabolic Syndrome

Authors: Mustafa Metin Donma

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Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. One hundred and ninety-four children, aged 06-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight+obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements, as well as blood pressure values were taken. Tense indices were computed. The formula for the first tense index was (SP+DP)/2. The second index was Advanced Donma Tense Index (ADTI). The formula for this index was [(SP+DP)/2] * Height. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and advanced Donma tense index (ADTI), which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: blood pressure, child, height, metabolic syndrome, waist circumference

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696 Investigating the Impact of Factors Associated with Student Academic Achievement and Expectations through the Ecosystemic Perspective in the Greek Context: The Role of the Individual, Family, School and of the Community

Authors: Olga Giovani

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In this research, Bronfenbrenner's theory will be used to investigate the individual, microsystemic, and exosystemic factors that may affect adolescents' academic achievement as well as their expectations in Greece. First, the topic of academic achievement in an adolescent developmental context will be set as the target of the proposed study while focusing on the aspects of community influences on adolescents. More specifically, the effect of available resources and the perceived sense of safety and support will be further investigated. Then the issue of family factors will be analyzed, as they are subjectively perceived by the adolescents, focusing on the perceived parental style, parental monitor, and involvement as a mesosystemic factor. In turn, the school will also be discussed with emphasis on the perceived school climate and support as well as the academic aspects of student achievement. Finally, the adolescent's individual perspective will be taken into consideration in developmental terms, examining their perceptions regarding their community/neighborhood, their family, their school, as well as their sense of self-concept and self-esteem as these are expressed through their academic performance and prosocial behavior. The aim of the proposed research is to study these associations through the prism of the systemic perspective, the relationship between aspects of educational achievement and socioeconomic background, with an emphasis on the role of the community, which has not been adequately researched in the Greek context. Community will be defined by the available community resources (recreational activities, public library, local orchestras, free entrance museums, etc.), adolescents' own perception of social support, safety, and support inside that community. These perceptions need to be investigated since they may serve as possible predictors of a child's current cognitive, developmental, and psycho-social outcomes, such as their perceived self-concept and self-esteem, as well as on their future expectations related to the entrance to university and job expectations.

Keywords: bioecological model, developmental psychology, ecosystemic approach, student achievement, microsystemic factors, mesosystemic factors, individual perceptions

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695 Long-Term Outcomes of Dysphagia in Children with Severe Cerebral Palsy Using Videofluoroscopic Evaluation

Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Oropharyngeal dysphagia is prevalent in children with cerebral palsy (CP). There are many studies concerning this problem, however, studies examining long term outcomes of dysphagia using videofluoroscopic study (VFSS) are very rare. The Aim of this study is to investigate long-term outcomes of dysphagia in children with severe CP using initial VFSS. It was a retrospective study and chart review was done from January 2000 to December 2013. Thirty one patients under 18 years who have been diagnosed as CP in outpatient clinic of Rehabilitation Medicine, and who did VFSS were included. Long-term outcomes such as feeding method, height percentile, weight percentile, and body mass index (BMI) were tracked up for at least 3 years by medical records. Significant differences between initial and follow-up datas were investigated. The patients consisted of 18 males and 13 females, and the mean age was 31.0±18.0 months old. 64.5% of patients were doing oral diet, and 25.8% of patients were doing non-oral diet. When comparing VFSS findings among oral feeding patients, oral and non-oral feeding patients, and non-oral feeding patients at initial period, dysphagia severity, supraglottic penetration, and subglottic aspiration showed significant differences. Most of the patients who could feed orally at initial period were found to have the same feeding method at follow-up. But among eight patients who required non-oral feeding initially, three patients became possible to feed orally, and one patient was doing oral and non-oral feeding method together at follow-up. Follow up feeding method showed correlation with dysphagia severity by initial VFSS. Weight percentile was decreased in patients with GMFCS level V at follow up, which may represent poor nutritional status due to severe dysphagia compared to other patients. Initial VFSS severity would play a significant role in making an assumption about future diet in children with severe CP. Patients with GMFCS level V seem to have serious dysphagia at follow up and have nutritional deficiency over time, therefore, more careful nutritional support is needed in children with severe CP are suggested.

Keywords: cerebral palsy, child, dysphagia, videofluoroscopic study

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694 Connecting Life and Learning: Transformative Learning to Increase Student Engagement

Authors: Kashi Raj Pandey

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Transformative learning is a form of learning rooted in learners' life experiences and their inherent love for learning. It emphasizes the importance of incorporating students' everyday work through the use of learning diaries and reflective journals. It encourages learners to take a proactive role in their own improvement, fostering creativity and promoting informed discussions about the learning process. Reflecting on the personal experience with English language learning in a rural village in Nepal where rote memorization was the prevailing teaching method, this traditional approach hindered a deeper understanding of the language, prompting the author to recognize the need for more effective pedagogy. In this study, the author delved into the cultural contextualization of English language learning, taking into account learners' backgrounds. The study’s findings highlighted the importance of equity, inclusion, mutuality, and social justice in the classroom, emphasizing the significance of integrating students' lived experiences into the pedagogical approach. This, in turn, can encourage students to engage in profound and collaborative learning practices within the realm of English language education. Upon successfully implementing the research findings, including the eight key conditions of transformative learning, in multiple classrooms, the author collaborated with international educationists and government stakeholders in Nepal. The purpose was to disseminate the research findings, conduct teacher training workshops, and systematically enhance Nepali students’ English language learning. These methods have already demonstrated a significant improvement in student engagement within the same school where the author once learned English as a child. This study aims to explore teachers’ decision-making process regarding the transition from traditional teaching methods to interactive ones, which have gained national recognition within the ESL/EFL teaching community in Nepal. By sharing these experiences, it is expected that other teachers will also contemplate adopting transformative learning pedagogy in their own classrooms.

Keywords: reflection, student engagement, pedagogy, transformative learning

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693 How to Motivate Child to Loose Weight When He Is Not Aware That the Overweight Is a Real Problem: «KeepHealthyKids», Study Perspectives

Authors: Daria Druzhinenko- Silhan, Patrick Schmoll

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Childhood obesity is one of the important problem in domain of health care. During two recent decades we are observing a real epidemic of this noninfectious illness. Its consequences are hard: cardio-vascular disease; diabetes; arthrosis etc. (OMS, 2012) Keep Healthy Kids  » study aims to create a new system of accompanying of childhood obesity based on new technologies as mobile applications or serious video-games. We realize a support-study which aims to understand motivations, psychological dynamite and family's impact on weight-loss process in childhood. Sample: 65 children from 7 to 10 years old accompanied by special Care Center in France. Methodology: we proceed by an innovative approach that bases on quantitative and qualitative methods of data collection. We focus our proposal on data collected from medical files. We are also realizing individual assessment (still ongoing) that aims to understand psychological profiles of obese children and their family dynamic. Results: Only 16,9% of children asked for medical accompanying of obesity. We noted that the most important reason to come to the care Center was the fact of mates' scoffs (46,2%°), the second one was the appearance or look (40 %). We found out that the self-image of these children in self-evaluation questionnaire was described mostly as rather good (46,2) or good (28,2%); the most part of children evaluated their well-being as rather good (29,7%) or good (51,4%). In interviews children had tendency to not recall why they came to the Care Center. Discussion : These results permit us to make a hypothesis that children suffering of overweight or obesity are not clearly aware why they must loose weight. It was rather the peer environment that pointed out the problem of overweight for them. So the motivation to loose weight is mostly supported by environment. We suppose that it is a « weak-point » of their motivation and it can be over-come using serious video-games supporting physical activity that can make deviate the motivation from « to loose weight for be looked better by the others » into « have fun and feeling me better ».

Keywords: childhood obesity, motivation, weight-loss, serious video-game

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692 DNA Methylation Score Development for In utero Exposure to Paternal Smoking Using a Supervised Machine Learning Approach

Authors: Cristy Stagnar, Nina Hubig, Diana Ivankovic

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The epigenome is a compelling candidate for mediating long-term responses to environmental effects modifying disease risk. The main goal of this research is to develop a machine learning-based DNA methylation score, which will be valuable in delineating the unique contribution of paternal epigenetic modifications to the germline impacting childhood health outcomes. It will also be a useful tool in validating self-reports of nonsmoking and in adjusting epigenome-wide DNA methylation association studies for this early-life exposure. Using secondary data from two population-based methylation profiling studies, our DNA methylation score is based on CpG DNA methylation measurements from cord blood gathered from children whose fathers smoked pre- and peri-conceptually. Each child’s mother and father fell into one of three class labels in the accompanying questionnaires -never smoker, former smoker, or current smoker. By applying different machine learning algorithms to the accessible resource for integrated epigenomic studies (ARIES) sub-study of the Avon longitudinal study of parents and children (ALSPAC) data set, which we used for training and testing of our model, the best-performing algorithm for classifying the father smoker and mother never smoker was selected based on Cohen’s κ. Error in the model was identified and optimized. The final DNA methylation score was further tested and validated in an independent data set. This resulted in a linear combination of methylation values of selected probes via a logistic link function that accurately classified each group and contributed the most towards classification. The result is a unique, robust DNA methylation score which combines information on DNA methylation and early life exposure of offspring to paternal smoking during pregnancy and which may be used to examine the paternal contribution to offspring health outcomes.

Keywords: epigenome, health outcomes, paternal preconception environmental exposures, supervised machine learning

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691 Measuring Fundamental Growth Needs in a Youth Boatbuilding Context

Authors: Shane Theunissen, Rob Grandy

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Historically and we would fairly conventionally within our formal schooling systems, we have convergent testing where all the students are expected to converge on the same answer, and that answer has been determined by an external authority that is reproducing knowledge of the hegemon. Many youths may not embody the cultural capital that's rewarded in formal schooling contexts as they aren't able to converge on the required answer that's being determined by the classroom teacher or the administrators. In this paper, we explore divergent processes that promote creative problem-solving. We embody this divergent process in our measurement of fundamental growth needs. To this end, we utilize the Mosaic Approach as a method for implementing the Outcomes That Matter framework. Outcomes That Matter is the name of the measurement tool built around the Circle of Courage framework, which is a way of identifying fundamental growth needs for young people. The Circle of Courage was developed by Martin-Broken-Leg and colleagues as a way to connect indigenous child-rearing philosophies with contemporary resilience and positive psychology research. The Outcomes that Matter framework puts forward four categories of growth needs for young people. These are: Belonging, which on a macro scale is acceptance into the greater community of practice, Mastery which includes a constellation of concepts including confidence, motivation, self-actualization, and self-determination, Independence refers to a sense of personal power into autonomy within a context where creativity and problem solving, and a personal voice can begin to emerge, and finally Generosity which includes interpersonal things like conflict resolution and teamwork. Outcomes of Matter puts these four domains into a measurement tool that facilitates collaborative assessment between the youth, teachers, and recreation therapists that allows for youth-led narratives pertaining to their fundamental growth outcomes. This application of the Outcomes That Matter framework is unique as it may be the first application of this framework in an educational boatbuilding context.

Keywords: collaboration, empowerment, outcomes that matter, mosaic approach, boat building

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690 Understanding the First Mental Breakdown from the Families’ Perspective Through Metaphors

Authors: Eli Buchbinder

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Introduction. Language is the basis to our experience as human being. We use language in describing our experiences and construct meaning and narratives from experiences. Metaphors are a valuable linguistic tool commonly use. Metaphors link two domains that are ordinarily not related. Metaphors achieve simultaneously multi-level integration: abstract and concrete, rational and imaginative, familiar and the unfamiliar, conscious and preconscious/unconscious. As such, metaphors epistemological and ontological tool that are important in social work in every field and domain. Goals and Methods The presentation’s aim is to validate the value of metaphors through the first psychiatric breakdown is a traumatic for families. The presentation is based on two pooled qualitative studies. The first study focused on 12 spouses: 7 women and 5 men, between the ages of 22 and 57, regarding their experiences and meanings of the first psychiatric hospitalization of their partners diagnosed with affective disorders. The second study focused on 10 parents, between the ages of 47 and 62, regarding their experiences and meanings following their child's first psychotic breakdown during young adulthood. Results Two types of major metaphors evolved from the interviews in farming the trauma of the first mental breakdown. The first mode - orientation (spatial) metaphors, reflect symbolic expression of the loss of a secure base, represented in the physical environment, e.g., describing hospitalization as "falling into an abyss." The second mode- ontological metaphors, reflect how parents and spouses present their traumatic experiences of hospitalization in terms of discrete, powerful and coherent entities, e.g., describing the first hospitalization as "swimming against the tide." The two metaphors modes reflect the embodiment of the unpredictability, being mired in distress, shock, intense pain and the experience the collapse of continuity on the life course and cuts off the experience of control. Conclusions Metaphors are important and powerful guide in assessing individuals and families’ phenomenological reality. As such, metaphors are useful for understanding and orientated therapeutic intervening, in the studies above, with the first psychiatric hospitalization experienced, as well as in others social workers’ interventions.

Keywords: first mental breakdown, metaphors, family perspective, qualitative research

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689 Use Cloud-Based Watson Deep Learning Platform to Train Models Faster and More Accurate

Authors: Susan Diamond

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Machine Learning workloads have traditionally been run in high-performance computing (HPC) environments, where users log in to dedicated machines and utilize the attached GPUs to run training jobs on huge datasets. Training of large neural network models is very resource intensive, and even after exploiting parallelism and accelerators such as GPUs, a single training job can still take days. Consequently, the cost of hardware is a barrier to entry. Even when upfront cost is not a concern, the lead time to set up such an HPC environment takes months from acquiring hardware to set up the hardware with the right set of firmware, software installed and configured. Furthermore, scalability is hard to achieve in a rigid traditional lab environment. Therefore, it is slow to react to the dynamic change in the artificial intelligent industry. Watson Deep Learning as a service, a cloud-based deep learning platform that mitigates the long lead time and high upfront investment in hardware. It enables robust and scalable sharing of resources among the teams in an organization. It is designed for on-demand cloud environments. Providing a similar user experience in a multi-tenant cloud environment comes with its own unique challenges regarding fault tolerance, performance, and security. Watson Deep Learning as a service tackles these challenges and present a deep learning stack for the cloud environments in a secure, scalable and fault-tolerant manner. It supports a wide range of deep-learning frameworks such as Tensorflow, PyTorch, Caffe, Torch, Theano, and MXNet etc. These frameworks reduce the effort and skillset required to design, train, and use deep learning models. Deep Learning as a service is used at IBM by AI researchers in areas including machine translation, computer vision, and healthcare. 

Keywords: deep learning, machine learning, cognitive computing, model training

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688 Ethno-Botanical Research on Medicinal Plants Commonly Used for Children’s Health in South East Nigeria

Authors: Chioma J. Nwakamma, Blessing O. Oyedemi, Garuba Omosun

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This research surveys and documents information on medicinal plants and their botanical preparations used in the treatment of children’s ailments in South-Eastern Nigeria. Children under the age of 5 in developing countries suffer from diseases with high morbidity and mortality rate yearly due to inaccessible and unaffordable healthcare. Structured questionnaires were administered to herbal sellers, traditional medicine practitioners, nursing mothers, and adult dwellers to collect data on the names of plants used to treat the conditions, methods of preparation, duration of treatment, adverse effects, and the methods of administration of the plant materials. A total of 135 plants belonging to 55 families were identified for the management of children’s health in the area. Common pediatric ailments which were said to be treated with herbal remedies by the respondents included malaria, pneumonia, stomach ache, diarrhea, dysentery, measles, chickenpox/smallpox, convulsion, jaundice, pile, ringworm, scabies, eczema, stubborn cough, scurvy, catarrh, wounds, boils, insect bites, food poison, cholera, and umbilical cord complications. Percentages of respondents were; herbal sellers (48.2%), traditional medical practitioners (21.6%), nursing mothers (11.1%), and others (19.1%). The most occurring plant families were Euphorbiaceae, Fabaceae, and Apocynaceae, with 8 species of plants each followed by Annonaceae and Asteriaceae with 7 and 6 species, respectively. The recipes were made from the combination of different parts of two or more plant species, and others were made from single plant parts. Methods of extraction were mostly decoction and raw-squeezing out of the juice and infusion, while oral administration was the main route of administration.

Keywords: ethno-botanicals, children’s health, medicinal plants, South-Eastern Nigeria

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687 Pain Assessment in Patients at a Tertiary Hospital in the Central Region of Ghana

Authors: Douglas Arthur, Oluwayemisi Ekor, Ernest Obese, Andrew Kissi Agyei, Elvis Ofori Ameyaw

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bjective: Pain negatively impacts every aspect of health, and patients with pain disorders create enormous demands on healthcare systems globally, costing economies up to $635 billion annually. The study was therefore conducted at the Cape Coast Teaching Hospital (CCTH), the only Tertiary Hospital in the Central Region of Ghana and was designed to assess pain disorders in patients between 18 and 90 years attending Urology Clinic. Methods: The study employed a descriptive cross-sectional design, and 149 subjects (16-24, 25-34, 35-44, 45-54, 55-64, 65-90 years) were conveniently selected. The McGill Pain Questionnaire (MPQ), a multidimensional instrument that assesses several aspects of pain by the use of words (descriptors) that the patient chooses to express his/her pain, was used as the primary instrument for data collection. A patient profile form (PPF) was also designed to document the demographics and history of patients. Results: The prevalence of pain disorders was higher among females compared to males. The univariate and multivariate analysis showed that females were more likely to experience pain while being married correlated with a lower likelihood of pain. Again, the 45-54 age group exhibited the highest prevalence of pain disorders. Results from the MPQ showed that half of the patients experienced pain on a daily basis, 15.91% had experienced pain for 3-6 months and 37% experienced pain for more than one year. Pain intensity was described by 25% of the subjects as excruciating for their worst pain experience, followed by 21% for the distressing experience. The most frequently reported area of pain was the abdominal region (22.72%). The co-administration of NSAIDs and opioid compounds was provided for 17.46% of the patients with chronic pain. Conclusion: The treatment interventions improved the pain and associated symptoms such as nausea, improved daily activities and ability to sleep. However, attention and resources should be devoted to 45-54 age group.

Keywords: pain, opioids, distressing, excruciating

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

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

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

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

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685 Gut Mycobiome Dysbiosis and Its Impact on Intestinal Permeability in Attention-Deficit/Hyperactivity Disorder

Authors: Liang-Jen Wang, Sung-Chou Li, Yuan-Ming Yeh, Sheng-Yu Lee, Ho-Chang Kuo, Chia-Yu Yang

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Background: Dysbiosis in the gut microbial community might be involved in the pathophysiology of attention deficit/hyperactivity disorder (ADHD). The fungal component of the gut microbiome, namely the mycobiota, is a hyperdiverse group of multicellular eukaryotes that can influence host intestinal permeability. This study therefore aimed to investigate the impact of fungal mycobiome dysbiosis and intestinal permeability on ADHD. Methods: Faecal samples were collected from 35 children with ADHD and from 35 healthy controls. Total DNA was extracted from the faecal samples, and the internal transcribed spacer (ITS) regions were sequenced using high-throughput next-generation sequencing (NGS). The fungal taxonomic classification was analysed using bioinformatics tools, and the differentially expressed fungal species between the ADHD and healthy control groups were identified. An in vitro permeability assay (Caco-2 cell layer) was used to evaluate the biological effects of fungal dysbiosis on intestinal epithelial barrier function. Results: The β-diversity (the species diversity between two communities), but not α-diversity (the species diversity within a community), reflected the differences in fungal community composition between ADHD and control groups. At the phylum level, the ADHD group displayed a significantly higher abundance of Ascomycota and significantly lower abundance of Basidiomycota than the healthy control group. At the genus level, the abundance of Candida (especially Candida albicans) was significantly increased in ADHD patients compared to the healthy controls. In addition, the in vitro cell assay revealed that C. albicans secretions significantly enhanced the permeability of Caco-2 cells. Conclusions: The current study is the first to explore altered gut mycobiome dysbiosis using the NGS platform in ADHD. The findings from this study indicated that dysbiosis of the fungal mycobiome and intestinal permeability might be associated with susceptibility to ADHD.

Keywords: ADHD, fungus, gut–brain axis, biomarker, child psychiatry

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684 I Don’t Know How I Got Here and I Don’t Know How to Get out of It: Understanding Male Pre-service Early Child Education Teachers’ Construction of Professional Identity

Authors: Sabika Khalid, Endale Fantahun Tadesse

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Unlike other professional sectors, a great deal of studies has addressed the overwhelming gender disparity phenomena in the early childhood education (ECE) workforce, which is acknowledged for the dominance of women over men teachers. The irony of ECE being a gendered working environment is not only observed in societies that are ruled by gender roles but also in Western countries that claim to margin the gender gap in several professions. The participation of male teachers in ECE across most countries ranged from 1% to 3% of the total preschool or kindergarten teachers. When it comes to a dynamic Chinese society tempered with a deep-rooted tradition and cultural ideology, the ECE has no less place for males, and males have a low place for ECE. According to the Ministry of Education of China (2020), there are over 5 million kindergarten teachers and staff members, while only 2.3% are accounted for male teachers. The traditional gender-based discourse asserts that giving care and guidance for young children related to nurturing ‘mothering’ labels the profession in ECE as women’s work derived from originated from their ‘naturality.’ Although a large volume of evidence sheds light on the cause for low male teachers, the perception of parents, female teachers working with male teachers, and the experience of male teachers working in ECE, less is known and understood before being a teacher. Hence, this study argues that the promotion of the involvement of male teachers in light of their masculinity identity asset in the children's learning environment is comprehended to understand the construction of male student teachers' (preservice) professional identity during early childhood teacher training that allows obtaining substantial evidence that provides a feasible and robust implication in the preparation of competent and professional male preschool teachers that understand, cherish, and bring harmony in Chinese ECE through professionalism socialization with the stakeholders. This study intended to reveal male ECE preservice teachers’ knowledge of their professional identity, i.e., how they perceive themselves as a teacher and what factors agents these perceptions towards their professional identity.

Keywords: male teachers, Early Childhood Education (ECE), self-identity, perception of stakeholders

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683 Annual August Meetings as a Stimulator for Female Empowerment: Case Study Udi Local Government Area of Enugu State, Nigeria

Authors: Nneka Evelyn Udeh

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Women’s economic participation and empowerment are fundamental to strengthening women’s rights and enabling women to have control over their lives and exert influence in the society. The economic empowerment of women is a prerequisite for sustainable development, pro-poor growth and the achievement of all the millennium development Goals (MDGs). For women to be in development they need to be empowered morally, socially, economically, and financially and this is why women in Udi Local Government Area of Nigeria meet every August, the eighth month of the year to discuss matters relating to the pursuit of women empowerment, community welfare, and national development. This exploratory study depicts how annual august meetings serve as a stimulator for female empowerment with a case study Udi Local Government area of Enugu state, Nigeria. The paper finds that ‘August Meeting’ is a regular annual occurrence in Udi Local Government Area, Enugu State, Nigeria particularly for married women and is designed to better the lot of women, the child, family, the church, and the Community. Through this forum, with its seminars and workshops, women have the opportunity to learn everything about womanhood and how to chart new courses of action and sources of empowerment. The gathering gives women the opportunity to be integrated into their community development projects, and having women as stakeholders and not mere observers helps guarantee a speedy and steady community and overall national development progress. Funds are raised for community development projects through annual dues, levies, donations, fines, sales, income from money-yielding ventures, endowment and investiture. Annual August meeting also known as ‘Mothers Summit’ is indeed a powerful stimulator for female empowerment. Support and invigoration of this women initiative is essential for sustainable emancipation of female gender, not just in Udi Local Government Area of Nigeria but globally.

Keywords: women empowerment, annual august meeting, Udi Lga, mothers' summit, stimulator, emancipation, sustainability, community welfare, national development, millennium development goal

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682 Special Education in the South African Context: A Bio-Ecological Perspective

Authors: Suegnet Smit

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Prior to 1994, special education in South Africa was marginalized and fragmented. Moving away from a Medical model approach to special education, the Government, after 1994, promoted an Inclusive approach, as a means to transform education in general, and special education in particular. This transformation, however, is moving at too a slow pace for learners with barriers to learning and development to benefit fully from their education. The goal of the Department of Basic Education is to minimize, remove, and prevent barriers to learning and development in the educational setting, by attending to the unique needs of the individual learner. However, the implementation of Inclusive education is problematic, and general education remains poor. This paper highlights the historical development of special education in South Africa, underpinned by a bio-ecological perspective. Problematic areas within the systemic levels of the education system are highlighted in order to indicate how the interactive processes within the systemic levels affect special needs learners on the personal dimension of the bio-ecological approach. As part of the methodology, thorough document analysis was conducted on information collected from a large body of research literature, which included academic articles, reports, policies, and policy reviews. Through a qualitative analysis, data were grouped and categorized according to the bio-ecological model systems, which revealed various successes and challenges within the education system. The challenges inhibit change, growth, and development for the child, who experience barriers to learning. From these findings, it is established that special education in South Africa has been, and still is, on a bumpy road. Sadly, the transformation process of change, envisaged by implementing Inclusive education, is still yet a dream, not fully realized. Special education seems to be stuck at what is, and the education system has not moved forward significantly enough to reach what special education should and could be. The gap that exists between a vision of Inclusive quality education for all, and the current reality, is still too wide. Problems encountered in all the education system levels, causes a funnel-effect downward to learners with special educational needs, with negative effects for the development of these learners.

Keywords: bio-ecological perspective, education systems, inclusive education, special education

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681 Leveraging on Application of Customer Relationship Management Strategy as Business Driving Force: A Case Study of Major Industries

Authors: Odunayo S. Faluse, Roger Telfer

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Customer relationship management is a business strategy that is centred on the idea that ‘Customer is the driving force of any business’ i.e. Customer is placed in a central position in any business. However, this belief coupled with the advancement in information technology in the past twenty years has experienced a change. In any form of business today it can be concluded that customers are the modern dictators to whom the industry always adjusts its business operations due to the increase in availability of information, intense market competition and ever growing negotiating ideas of customers in the process of buying and selling. The most vital role of any organization is to satisfy or meet customer’s needs and demands, which eventually determines customer’s long-term value to the industry. Therefore, this paper analyses and describes the application of customer relationship management operational strategies in some of the major industries in business. Both developed and up-coming companies nowadays value the quality of customer services and client’s loyalty, they also recognize the customers that are not very sensitive when it comes to changes in price and thereby realize that attracting new customers is more tasking and expensive than retaining the existing customers. However, research shows that several factors have recently amounts to the sudden rise in the execution of CRM strategies in the marketplace, such as a diverted attention of some organization towards integrating ideas in retaining existing customers rather than attracting new one, gathering data about customers through the use of internal database system and acquiring of external syndicate data, also exponential increase in technological intelligence. Apparently, with this development in business operations, CRM research in Academia remain nascent; hence this paper gives detailed critical analysis of the recent advancement in the use of CRM and key research opportunities for future development in using the implementation of CRM as a determinant factor for successful business optimization.

Keywords: agriculture, banking, business strategies, CRM, education, healthcare

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680 Implementation of an Induction Programme to Help the International Medical Graduates in the NHS

Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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679 Association between Dental Caries and Asthma among 12-15 Years Old School Children Studying in Karachi, Pakistan: A Cross Sectional Study

Authors: Wajeeha Zahid, Shafquat Rozi, Farhan Raza, Masood Kadir

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Background: Dental caries affects the overall health and well-being of children. Findings from various international studies regarding the association of dental caries with asthma are inconsistent. With the increasing burden of caries and childhood asthma, it becomes imperative for an underdeveloped country like Pakistan where resources are limited to identify whether there is a relationship between the two. This study aims to identify an association between dental caries and asthma. Methods: A cross-sectional study was conducted on 544 children aged 12-15 years recruited from five private schools in Karachi. Information on asthma was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The questionnaire addressed questions regarding child’s demographics, physician diagnoses of asthma, type of medication administered, family history of asthma and allergies, dietary habits and oral hygiene behavior. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth) index The data was analyzed using Cox proportional Hazard algorithm and crude and adjusted prevalence ratios with 95% CI were reported. Results: This study comprises of 306 (56.3%) boys and 238 (43.8%) girls. The mean age of children was 13.2 ± (0.05) years. The total number of children with carious teeth (DMFT > 0) were 166/544 (30.5%), and the decayed component contributed largely (22.8%) to the DMFT score. The prevalence of physician’s diagnosed asthma was 13%. This study identified almost 7% asthmatic children using the internationally validated International Study of Asthma and Allergies in Childhood (ISAAC) tool and 8 children with childhood asthma were identified by parent interviews. Overall prevalence of asthma was 109/544 (20%). The prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. The adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.59-1.29). After adjusting for carious food intake, age, oral hygiene index and dentist visit, the association between asthma and dental caries turned out to be non-significant. Conclusion: There was no association between asthma and dental caries among children who participated in this study.

Keywords: asthma, caries, children, school-based

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678 Psychosocial Consequences of Discovering Misattributed Paternity in Adulthood: Insider Action Research

Authors: Alyona Cerfontyne, Levita D'Souza, Lefteris Patlamazoglou

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Unlike adoption and donor-assisted reproduction, misattributed paternity occurring within the context of spontaneous conception and outside of formally recognised practices of having a child remains largely an understudied phenomenon. In adulthood, to discover misattributed paternity, i.e., that the man you call your father is not related to you genetically, can have profound implications for everyone affected. Until the advent of direct-to-consumer DNA testing 20 years ago, such discoveries were relatively rare. Despite the growing number of individuals uncovering their biogenetic paternity through genetic testing, there is very limited research on misattributed paternity from the perspective of adult children affected by it. No research exists on how to support these individuals through counselling post-discovery. Framed as insider action research, this study aimed to explore the perceived psychosocial consequences of misattributed paternity discoveries and coping strategies used by individuals who discover their misattributed paternity status in adulthood. In total, 12 individuals with misattributed paternity participated in semi-structured interviews in July-August 2022. The collected data was analysed using reflexive thematic analysis. The study’s results indicate that discovering misattributed paternity in adulthood can be likened to a watershed moment forever changing the trajectory of one’s life. Psychological experiences consistent with trauma, as well as grief and loss, re-evaluation of close family relationships, reestablishment of one’s identity, as well as experiencing a profound need to belong are the key themes emerging from the analysis of psychosocial experiences. Post-discovery, individuals with misattributed paternity employ a wide range of emotional and problem-focused coping strategies, amongst which seeking connection with those who understand, searching for information on the new biogenetic family and finding new meanings to life are most prominent. The study contributes both to the academic and practical knowledge of experiences of misattributed paternity and highlights the importance of further research on the topic.

Keywords: discovery of misattributed paternity, misattributed paternity, paternal discrepancy, psychosocial consequences, coping

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677 Associations between Physical Activity and Risk Factors for Type II Diabetes in Prediabetic Adults

Authors: Rukia Yosuf

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Diabetes is a national healthcare crisis related to both macrovascular and microvascular complications. We hypothesized that higher levels of physical activity are associated with lower total and visceral fat mass, lower systolic blood pressure, and increased insulin sensitivity. Participant inclusion criteria: 21-50 years old, BMI ≥ 30 kg/m2, hemoglobin A1C 5.7-6.4, fasting glucose 100-125 mg/dL, and HOMA IR ≥ 2.5. Exclusion criteria: history of diabetes, hypertension, HIV, renal disease, hearing loss, alcoholic intake over four drinks daily, use of organic nitrates or PDE5 inhibitors, and decreased cardiac function. Total physical activity was measured using accelerometers, body composition using DXA, and insulin resistance via fsIVGTT. Clinical and biochemical cardiometabolic risk factors, blood pressure and heart rate were obtained using a calibrated sphygmomanometer. Anthropometric measures, fasting glucose, insulin, lipid profile, C-reactive protein, and BMP were analyzed using standard procedures. Within our study, we found correlations between levels of physical activity in a heterogeneous group of prediabetic adults. Patients with more physical activity had a higher degree of insulin sensitivity, lower blood pressure, total visceral adipose tissue, and overall lower total mass. Total physical activity levels showed small, but significant correlations with systolic blood pressure, visceral fat, lean mass and insulin sensitivity. After normalizing for the race, age, and gender using multiple regression, these associations were no longer significant considering our small sample size. More research into prediabetes will decrease the population of diabetics overall. In the future, we could increase sample size and conduct cross sectional and longitudinal studies in various populations with prediabetes.

Keywords: diabetes, kidney disease, nephrology, prediabetes

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676 Nabokov’s Lolita: Externalization of Contemporary Mind in the Configuration of Hedonistic Aesthetics

Authors: Saima Murtaza

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Ethics and aesthetics have invariably remained the two closely integrated artistic appurtenances for the production of any work of art. These artistic devices configure themselves into a complex synthesis in our contemporary literature. The labyrinthine integration of ethics and aesthetics, operating in the lives of human characters, to the extent of transcending all limits has resulted in an artistic puzzle for the readers. Art, no doubt, is an extrinsic expression of the intrinsic life of man. The use of aesthetics in literature pertaining to human existence; aesthetic solipsism, has resulted in the artistic objectification of these characters. The practice of the like aestheticism deprives the characters of their souls, rendering them as mere objects of aesthetic gaze at the hands of their artists-creators. Artists orchestrate their lives founding it on a plot which deviates from normal social and ethical standards. Their perverse attitude can be seen in dealing with characters, their feelings and the incidents of their lives. Morality is made to appear not as a religious construct but as an individual’s private affair. Furthermore, the idea of beauty incarnated, in other words hedonistic aesthetic does not placate a true aesthete. Ethics and aesthetics are the two most recurring motifs of our contemporary literature, especially of Nabokov’s world. The purpose of this study is to peruse these aforementioned motifs in Nabokov’s most enigmatic novel Lolita, a story of pedophilia, which is in fact reflective of our complex individual psychic and societal patterns. The narrative subverts all the traditional and hitherto known notions of aesthetics and ethics. When applied to literature, aesthetic does not simply mean ‘beautiful’ in the text. It refers to an intricate relationship between feelings and perception and also incorporates within its range wide-ranging emotional reactions to text. The term aesthetics in literature is connected with the readers whose critical responses to the text determine the merit of any work to be really a piece of art. Aestheticism is the child of ethics. Morality sets the grounds for the production of any work and the idea of aesthetics gives it transcendence.

Keywords: ethics, aesthetics and hedonistic aesthetic, nymphet syndrome, pedophilia

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675 Developing a Complete Profile: Vocational Assessment, Rehabilitation, and Management for Adults with Intellectual Disability in India

Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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674 Multidimensional Poverty and Its Correlates among Rural Households in Limpopo Province, South Africa

Authors: Tamunotonye Mayowa Braide, Isaac Oluwatayo

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This study investigates multidimensional poverty, and its correlates among rural households in Sekhukhune and Capricorn District municipalities (SDM & CDM) in Limpopo Province, South Africa. Primary data were collected from 407 rural households selected through purposive and simple random sampling techniques. Analytical techniques employed include descriptive statistics, principal component analysis (PCA), and the Alkire Foster (A-F) methodology. The results of the descriptive statistics showed there are more females (66%) than males (34%) in rural areas of Limpopo Province, with about 45% of them having secondary school education as the highest educational level attained and only about 3% do not have formal education. In the analysis of deprivation, eight dimensions of deprivation, constructed from 21 variables, were identified using the PCA. These dimensions include type and condition of dwelling water and sanitation, educational attainment and income, type of fuel for cooking and heating, access to clothing and cell phone, assets and fuel for light, health condition, crowding, and child health. In identifying the poor with poverty cut-off (0.13) of all indicators, about 75.9% of the rural households are deprived in 25% of the total dimensions, with the adjusted headcount ratio (M0) being 0.19. Multidimensional poverty estimates showed higher estimates of poor rural households with 71%, compared to 29%, which fall below the income poverty line. The study conducted poverty decomposition, using sub-groups within the area by examining regions and household characteristics. In SDM, there are more multidimensionally poor households than in CDM. The water and sanitation dimension is the largest contributor to the multidimensional poverty index (MPI) in rural areas of Limpopo Province. The findings can, therefore, assist in better design of welfare policy and target poverty alleviation programs and as well help in efficient resource allocation at the provincial and local municipality levels.

Keywords: Alkire-Foster methodology, Limpopo province, multidimensional poverty, principal component analysis, South Africa

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673 Assessment of Ocular Morbidity, Knowledge and Barriers to Access Eye Care Services among the Children Live in Offshore Island, Bangladesh

Authors: Abir Dey, Shams Noman

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Introduction: Offshore Island is the remote and isolated area from the terrestrial mainland. They are deprived of their needs. The children from an offshore island are usually underserved in the case of health care because it is a remote area where the health care systems are quite poor compared to mainland. So, the proper information is required for appropriate planning to reduce underlying causes behind visual deprivation among the surviving children of the Offshore Island. Purpose: The purpose of this study was to determine ocular morbidities, knowledge, and barriers of eye care services among children in an Offshore Island. Methods: The study team visited, and all data were collected from different rural communities at Sandwip Upazila, Chittagong district for screening the children aged 5-16 years old by doing spot examination. The whole study was conducted in both qualitative and quantitative methods. To determine ocular status of children, examinations were done under skilled Ophthalmologists and Optometrists. A focus group discussion was held. The sample size was 490. It was a community based descriptive study and the sampling method was purposive sampling. Results: In total 490 children, about 56.90% were female and 43.10% were male. Among them 456 were school-going children (93.1%) and 34 were non-school going children (6.9%). In this study the most common ocular morbidity was Allergic Conjunctivitis (35.2%). Other mentionable ocular morbidities were Refractive error (27.7%), Blepharitis (13.8%), Meibomian Gland Dysfunction (7.5%), Strabismus (6.3%) and Amblyopia (6.3%). Most of the non-school going children were involved in different types of domestic work like farming, fishing, etc. About 90.04% children who had different ocular abnormalities could not attend to the doctor due to various reasons. Conclusions: The ocular morbidity was high in rate on the offshore island. Eye health care facility was also not well established there. Awareness should be raised about necessity of maintaining hygiene and eye healthcare among the island people. Timely intervention through available eye care facilities and management can reduce the ocular morbidity rate in that area.

Keywords: morbidities, screening, barriers, offshore island, knowledge

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672 Colonialism, Health and Women’s Print Culture in South Asia: A Study of Urdu Journals in Colonial India 1900-1930

Authors: Khanday Pervaiz Ahmad

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It was in 19th century when the Indian educated class started to reform their socio-religious set up as an imperative to respond to the challenges put forward by the colonial empire. The colonial discourse on India from the very beginning was gendered, as the colonized society was feminized and its ‘effeminate’ character, as opposed to ‘colonial masculinity’ was held to be a justification for its loss of independence. The ‘women health figure’ is prominently in these gender discourses. The women’s health received a much place in the colonial discourse. Lack of health consciousness, illiteracy, and belief in myths, rituals and superstitions were deemed the main factors taken as an indicator of miserable condition of Indian women’s health. As the low position of women caused shame to the natives, reforming the condition of women, its health occupied a major place in their intellectual as well as activist engagements. Magazines (journals) for women began to appear in various Indian languages in the mid to late 19th century with Bengal leading the front. These sources (Magazines) like Harm, Tehzib un Niswan, Saheli, Khatoon etc. are essential for the study of the emergence of an ideology of respectable domesticity in Indian Muslim upper middle class. Similarly for the study of development of Women’s health consciousness, women’s magazines are very essential. These earliest women Urdu magazines were first started by men, and then followed by the women’s own magazines. Various health issues, like pregnancy, child-rearing, menstruation, midwives training, Pardah, and health etc. were discussed at a time when it was impossible to discuss them in public sphere. These women magazines were brave pioneers, expanding the frontiers of women’s roles, and consciousness at a time when those frontiers were severely limited. This paper will try to focus on how women responded to the question of colonial discourse about their bodies. How health consciousness developed among Indian Muslim women and in what way it contributed in the development of feminist consciousness in South Asian Muslim Women community.

Keywords: Ashraf class, khatoon, haram women, feminism

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671 Exposure to Ionizing Radiation Resulting from the Chernobyl Fallout and Childhood Cardiac Arrhythmia: A Population Based Study

Authors: Geraldine Landon, Enora Clero, Jean-Rene Jourdain

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In 2005, the Institut de Radioprotection et de Sûreté Nucléaire (IRSN, France) launched a research program named EPICE (acronym for 'Evaluation of Pathologies potentially Induced by CaEsium') to collect scientific information on non-cancer effects possibly induced by chronic exposures to low doses of ionizing radiation with the view of addressing a question raised by several French NGOs related to health consequences of the Chernobyl nuclear accident in children. The implementation of the program was preceded by a pilot phase to ensure that the project would be feasible and determine the conditions for implementing an epidemiological study on a population of several thousand children. The EPICE program focused on childhood cardiac arrhythmias started in May 2009 for 4 years, in partnership with the Russian Bryansk Diagnostic Center. The purpose of this cross-sectional study was to determine the prevalence of cardiac arrhythmias in the Bryansk oblast (depending on the contamination of the territory and the caesium-137 whole-body burden) and to assess whether caesium-137 was or not a factor associated with the onset of cardiac arrhythmias. To address these questions, a study bringing together 18 152 children aged 2 to 18 years was initiated; each child received three medical examinations (ECG, echocardiography, and caesium-137 whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests. The findings of the study, currently submitted to an international journal justifying that no results can be given at this step, allow us to answer clearly to the issue of radiation-induced childhood arrhythmia, a subject that has been debated for many years. Our results will be certainly helpful for health professionals responsible for the monitoring of population exposed to the releases from the Fukushima Dai-ichi nuclear power plant and also useful for future comparative study in children exposed to ionizing radiation in other contexts, such as cancer radiation therapies.

Keywords: Caesium-137, cardiac arrhythmia, Chernobyl, children

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670 The Effect of Post Spinal Hypotension on Cerebral Oxygenation Using Near-Infrared Spectroscopy and Neonatal Outcomes in Full Term Parturient Undergoing Lower Segment Caesarean Section: A Prospective Observational Study

Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

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Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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669 Learning Environment and Motivation of Cavite National High School Students

Authors: Madelaine F. Gatchalian, Mary Jane D. Tepora

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This study was designed to determine the relationship between learning environment and motivation of CNHS, SY 2012-2013. There were 376 respondents taken randomly. Frequency distribution, percentage, mean, standard deviation, Mann Whitney Test, Kruskall Wallis One-way ANOVA and Spearman Rank Correlational Coefficient were used in analyzing the data. As to age, most of the respondents were 13 years old while female students outnumbered the male students. Majority of parents’ educational attainment of CNHS students were high school/vocational graduates. Most fathers worked in the private sector, while majority of the mothers were unemployed whose family income range from Php 5,000.00 to Php 14,999.00. Most of the respondents were first child composed of five family members. Findings showed no significant differences in perceived learning environment when respondents were grouped in terms of age, sex, parents’ educational attainment, parents’ occupation, sibling order and number of family members. Only monthly family income showed significant differences in perceived learning environment. There are no significant differences in perceived learning motivation when respondents were grouped in terms of age, sex, parents’ educational attainment (father), parents’ occupation (father), sibling order, and number of family members. Parents’ educational attainment (mother), parents’ occupation (mother) and monthly family income showed significant differences in perceived learning motivation. There is significant relationship between the six subscales of perceived learning environment, namely: student cohesiveness, teacher support, involvement, task orientation, cooperation and equity and perceived learning motivation of CNHS students, SY, 2012-2013. The results of this study indicated that learning environment including student cohesiveness, teachers support, involvement, task orientation, cooperation and equity is significantly related to students’ learning motivation.

Keywords: learning environment, motivation, demographic profile, secondary students

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668 Female Entrepreneurship in Transitional Economies: An In-Depth Comparative Study about Challenges Facing Female Entrepreneurs in Nigeria and Egypt

Authors: Dina Mohamed Ayman, Rafieu Akin

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In an attempt to increase the female total entrepreneurial activities (TEA) within Egypt and Nigeria, this paper aims to investigate the challenges facing female entrepreneurs operating in Egypt, in relative to Nigeria. In this regard, both researchers undertook a qualitative approach due to the scarcity of the literature reviewed on the topic; in those particular countries, and as an in-depth comparative mode. Therefore, ten Egyptian entrepreneurs in relative to ten Nigerian entrepreneurs were in-depth investigated. The research findings prove that female entrepreneurs face complex problems for being both gender and country-specific. Regarding the gender-specific obstacles, the work/life imbalance due to the scarcity of child-care nurseries and the prevalence of the gender-role division while performing the house chores rather than the concept of co-operation, acted as a main source of cultural challenge because women are considered mostly as 'housewives'. However, interestingly, this specific gender-discrimination challenge is proven to have no grounded effect in terms of the business-establishment and daily dealings neither in Egypt nor Nigeria, as one of the sample exclaimed 'as long as you pay, then no gender difference is set on the table'. Other country-specific challenges facing female entrepreneurs, lied in, the aggregate weak entrepreneurial framework governing both countries, also, women faced the difficulty of access to financial institutions with collateral requirements that are usually "hardly to be met", besides, the absence of the "micro-credit-Grameen-banks" concept. As well, the scarcity of incubators and business training centers providing network, consultancy and well-trained workforce to female entrepreneurs constitute a major hurdle for women entrepreneurs operating in both countries. Finally, this paper will conclude the research by offering a set of public-policy recommendations to pave the way for females to choose self-employment as a career path.

Keywords: entrepreneurship, female entrepreneurship, obstacles, framework conditions, culture, micro-credit

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