Search results for: case history
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13035

Search results for: case history

13005 An Evaluation of 6th Grade History Curriculum in Ghana

Authors: Abigail Amoako Kayser, Brian Kayser

Abstract:

This study aimed to examine Ghana's 6th-grade Basic School history curriculum to determine how Ghanaian history is taught. We used qualitative methods and document analysis. The document analysis served two primary purposes: (1) To gain insight into what the curriculum materials covered and from whom's perspectives, and (2) To triangulate with teacher interview data. Documents obtained included: (1) Textbooks used by 6th-grade students, (2) Teacher pacing guide provided by the Department of Education in Ghana, and (3) Student work samples. This study was guided through Post-colonial theory and criticisms to explore the remnants of colonial power and hegemony that persist in history curricula used in public schools in Ghana. We also applied African Feminist Thought and Black Feminist Thought to unpack the extent to which issues of patriarchy, race, traditions, underdevelopment, and sexuality impact how we see the experiences of people on the continent. The findings indicated that the remnant of colonial rule persisted in the contents of the history curriculum, and the atrocities of slavery were overlooked or eliminated from the curriculum. The findings also indicated that Ghana's history centered on men's experiences.

Keywords: history, curriculum, decolonialization, culturally relevant pedagogy

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13004 Literary Works as Historical Documents: A New Historicist Reflection on Ahmadou Kourouma's Texts

Authors: Busari Lasisi

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Literary works are often devalued to mere fictions and are left with no essence and contributions to history. The sub-structured rational delineating literary works from history is anchored on the aesthetic and flowery expressions that are therein embedded for artistic enrichment. This does not distance a literary work (from whichever genres it is drawn) reflecting the socio-economic, cultural and political cum religious perspectives of a given people and society. This is the very reason justifying the veracity that a writer does not anchor his writing outside of his society. He writes mirroring (his or a given society’s) events, places and duration of consciousness thereby making history evident. In the light of this reality, literary works are not just seen as fictions, imaginative and unrealistic pieces; for they are never unconnected to history. Thus, making authors of literary works historians and their works engrafted useful historical documents. Using the works of Ahmadou Korouma, a renown Ivorian writer, the praxis of this paper therefore in New Historicism approach postulates that literary works are underlying unexplored historic materials, and literature a jumelle to history.

Keywords: literature, history, New Historicism, authors

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13003 Thinking Historiographically in the 21st Century: The Case of Spanish Musicology, a History of Music without History

Authors: Carmen Noheda

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This text provides a reflection on the way of thinking about the study of the history of music by examining the production of historiography in Spain at the turn of the century. Based on concepts developed by the historical theorist Jörn Rüsen, the article focuses on the following aspects: the theoretical artifacts that structure the interpretation of the limits of writing the history of music, the narrative patterns used to give meaning to the discourse of history, and the orientation context that functions as a source of criteria of significance for both interpretation and representation. This analysis intends to show that historical music theory is not only a means to abstractly explore the complex questions connected to the production of historical knowledge, but also a tool for obtaining concrete images about the intellectual practice of professional musicologists. Writing about the historiography of contemporary Spanish music is a task that requires both a knowledge of the history that is being written and investigated, as well as a familiarity with current theoretical trends and methodologies that allow for the recognition and definition of the different tendencies that have arisen in recent decades. With the objective of carrying out these premises, this project takes as its point of departure the 'immediate historiography' in relation to Spanish music at the beginning of the 21st century. The hesitation that Spanish musicology has shown in opening itself to new anthropological and sociological approaches, along with its rigidity in the face of the multiple shifts in dynamic forms of thinking about history, have produced a standstill whose consequences can be seen in the delayed reception of the historiographical revolutions that have emerged in the last century. Methodologically, this essay is underpinned by Rüsen’s notion of the disciplinary matrix, which is an important contribution to the understanding of historiography. Combined with his parallel conception of differing paradigms of historiography, it is useful for analyzing the present-day forms of thinking about the history of music. Following these theories, the article will in the first place address the characteristics and identification of present historiographical currents in Spanish musicology to thereby carry out an analysis based on the theories of Rüsen. Finally, it will establish some considerations for the future of musical historiography, whose atrophy has not only fostered the maintenance of an ingrained positivist tradition, but has also implied, in the case of Spain, an absence of methodological schools and an insufficient participation in international theoretical debates. An update of fundamental concepts has become necessary in order to understand that thinking historically about music demands that we remember that subjects are always linked by reciprocal interdependencies that structure and define what it is possible to create. In this sense, the fundamental aim of this research departs from the recognition that the history of music is embedded in the conditions that make it conceivable, communicable and comprehensible within a society.

Keywords: historiography, Jörn Rüssen, Spanish musicology, theory of history of music

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13002 A Rare Case Report of Non-Langerhans Cell Cutaneous Histiocytosis in a 6-Month Old Infant

Authors: Apoorva D. R.

Abstract:

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

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

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13001 A Case Study of Response to Dual Genotype Chronic Hepatitis C/HIV Co-Infection to Fixed Dose Sofosbuvir/Ledipasvir

Authors: Tabassum Yasmin, Hamid Pahlevan

Abstract:

HIV/Hepatitis C co-infection treatments have evolved substantially and they have similar sustained virologic response rates as those of Hepatitis C monoinfected population. There are a few studies on therapy of patients with dual genotypes, especially in HIV/Hepatic C coinfected group. Most studies portrayed case reports of dual genotype chronic Hepatitis C coinfection treatment with Sofosbuvir/Ledipasvir and Ribavirin. A 79-year-old male with a history of HIV on Truvada and Isentress had chronic Hepatitis C with 1a and 2 genotypes. The patient has a history of alcohol intake for 40 years but recently stopped drinking alcohol. He has a history of intravenous drug use in the past and currently is not using any recreational drugs. Patient has Fibro score of 0.7 with Metavir score F2 to F4. AFP is 3.2. The HCV RNA is 493,034 IU/ML. The HBV viral DNA is < 1.30 (not detected). The CD4 is 687CU/MM. The FIB 4 is 3.34 with APRI index 0.717. The HIV viral load is 101 copies/ML. MRI abdomen did not show any liver abnormality. Fixed dose Sofosbuvir/Ledipasvir was used for therapy without Ribavirin. He tolerated medication except for some minor gastrointestinal side effects like abdominal bloating. He demonstrated 100% adherence rate. Patient completed 12 weeks of therapy. HCV RNA was undetectable at 4 and 12 weeks. He achieved SVR at week 12 and subsequently had undetectable RNA for 2 years. Dual genotype prevalence in chronic hepatitis C population is rare, especially in HIV/hepatic coinfection. Our case demonstrates that dual genotypic cases can still be successfully treated with Direct Acting Antiviral agents. The newer agents for therapy for pan genotypes were not available at the time the patient was being treated. We demonstrated that dual agent therapy was still able to maintain SVR in our patient.

Keywords: HIV/Hepatitis C, SVR (sustained virologic response), DAA (direct active antiviral agents, dual genotype

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13000 Capability of Available Seismic Soil Liquefaction Potential Assessment Models Based on Shear-Wave Velocity Using Banchu Case History

Authors: Nima Pirhadi, Yong Bo Shao, Xusheng Wa, Jianguo Lu

Abstract:

Several models based on the simplified method introduced by Seed and Idriss (1971) have been developed to assess the liquefaction potential of saturated sandy soils. The procedure includes determining the cyclic resistance of the soil as the cyclic resistance ratio (CRR) and comparing it with earthquake loads as cyclic stress ratio (CSR). Of all methods to determine CRR, the methods using shear-wave velocity (Vs) are common because of their low sensitivity to the penetration resistance reduction caused by fine content (FC). To evaluate the capability of the models, based on the Vs., the new data from Bachu-Jianshi earthquake case history collected, then the prediction results of the models are compared to the measured results; consequently, the accuracy of the models are discussed via three criteria and graphs. The evaluation demonstrates reasonable accuracy of the models in the Banchu region.

Keywords: seismic liquefaction, banchu-jiashi earthquake, shear-wave velocity, liquefaction potential evaluation

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12999 Content and Langauge Integrated Learning: English and Art History

Authors: Craig Mertens

Abstract:

Teaching art history or any other academic subject to EFL students can be done successfully. A course called Western Images was created to teach Japanese students art history while only using English in the classroom. An approach known as Content and Language Integrated Learning (CLIL) was used as a basis for this course. This paper’s purpose is to state the reasons why learning about art history is important, go through the process of creating content for the course, and suggest multiple tasks to help students practice the critical thinking skills used in analyzing and drawing conclusions of works of art from western culture. As a guide for this paper, Brown’s (1995) six elements of a language curriculum will be used. These stages include needs analysis, goals and objectives, assessment, materials, teaching method and tasks, and evaluation of the course. The goal here is to inspire debate and discussion regarding CLIL and its pros and cons, and to question current curriculum in university language courses.

Keywords: art history, EFL, content and language integration learning, critical thinking

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12998 The Perception of Teacher Candidates' on History in Non-Educational TV Series: The Magnificent Century

Authors: Evren Şar İşbilen

Abstract:

As it is known, the movies and tv series are occupying a large part in the daily lives of adults and children in our era. In this connection, in the present study, the most popular historical TV series of recent years in Turkey, “Muhteşem Yüzyıl” (The Magnificent Century), was selected as the sample for the data collection in order to explore the perception of history of university students’. The data collected was analyzed bothqualitatively and quantitatively. The findings discussed in relation to the possible educative effects of historical non-educational TV series and movies on students' perceptions related to history. Additionally, suggestions were made regarding to the utilization of non-educational TV series or movies in education in a positive way.

Keywords: education, history, movies, teacher candidates

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12997 The Potential Benefits of Multimedia Information Representation in Enhancing Students’ Critical Thinking and History Reasoning

Authors: Ang Ling Weay, Mona Masood

Abstract:

This paper discusses the potential benefits of an interactive multimedia information representation in enhancing students’ critical thinking aligned with history reasoning in learning history between Secondary School students in Malaysia. Two modes of multimedia information representation implemented which are chronological and thematic information representation. A qualitative study of an unstructured interview was conducted among two history teachers, one history education lecturer, two i-think expert and program trainers and five form 4 secondary school students. The interview was to elicit their opinions on the implementation of thinking maps and interactive multimedia information representation in history learning. The key elements of interactive multimedia (e.g. multiple media, user control, interactivity, and use of timelines and concept maps) were then considered to improve the learning process. Findings of the preliminary investigation reveal that the interactive multimedia information representations have the potential benefits to be implemented as instructional resource in enhancing students’ higher order thinking skills (HOTs). This paper concludes by giving suggestions for future work.

Keywords: multimedia information representation, critical thinking, history reasoning, chronological and thematic information representation

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12996 Social Imagination and History Teaching: Critical Thinking's Possibilities in the Australian Curriculum

Authors: Howard Prosser

Abstract:

This paper examines how critical thinking is framed, especially for primary-school students, in the recently established Australian Curriculum: History. Critical thinking is one of the curriculum’s 'general capabilities.' History provides numerous opportunities for critical thinking’s application in everyday life. The so-called 'history wars' that took place just prior to the curriculum’s introduction in 2014 sought to bring to light the limits of a singular historical narrative and reveal that which had been repressed. Consequently, the Australian history curriculum reflects this shifting mindset. Teachers are presented with opportunities to treat history in the classroom as a repository of social possibility, especially related to democratic potential, beyond hackneyed and jingoistic tales of Australian nationhood. Yet such opportunities are not explicit within the document and are up against pre-existing pedagogic practices. Drawing on political thinker Cornelius Castoriadis’s rendering of the 'social-historical' and 'paidea,' as well as his mobilisation of psychoanalysis, the study outlines how the curriculum’s critical-thinking component opens up possibilities for students and teachers to revise assumptions about how history is understood. This ontological shift is ultimately creative: the teachers’ imaginations connect the students’ imaginations, and vice versa, to the analysis that is at the heart of historical thinking. The implications of this social imagination add to the current discussions about historical consciousness among scholars like Peter Seixas. But, importantly, it has practical application in the primary-school classroom where history becomes creative acts, like play, that is indeterminate and social rather than fixed and individual.

Keywords: Australia, Castoriadis, critical thinking, history, imagination

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12995 Acute Superior Mesenteric Artery Thrombosis Leading to Pneumatosis Intestinalis and Portal Venous Gas in a Young Adult after COVID-19 Vaccination

Authors: Prakash Dhakal

Abstract:

Hepatic portal venous gas (HPVG) is diagnosed via computed tomography due to unusual imaging features. HPVG, when linked with pneumatosis intestinalis, has a high mortality rate and requires urgent intervention. We present a case of a 26-year-old young adult with superior mesenteric artery thrombosis who presented with severe abdominal pain. He had a history of COVID vaccination (First dose of COVISHILED) 15 days back. On imaging, HPVG and pneumatosis intestinalis were seen owing to the urgent intervention of the patient. The reliable interpretation of the imaging findings along with quick intervention led to a favorable outcome in our case. Herein we present a thorough review of the patient with a history of COVID-19 vaccination with superior mesenteric artery thrombosis leading to bowel ischemia and hepatic portal venous gas. The patient underwent subtotal small bowel resection.

Keywords: COVID-19 vaccination, SMA thrombosis, portal venoius gas, pneumatosis intestinalis

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12994 Bilateral Choroidal Metastases as the Presenting Manifestation of Lung Adenocarcinoma in a Young, Non-smoking Female: A Case Report

Authors: Paras Agarwal

Abstract:

Background: Initially believed to be rare, metastases to the eye are the most common ocular malignancy. The choroid’s high perfusion rate not only makes it the most susceptible ocular site for tumour seeding, but also promotes its growth. The cancers most frequently responsible for choroidal metastases originate from the breast and lung, although a significant proportion have unidentified primaries at the time of presentation. Case Presentation: This case report describes a 34 year old female presenting to the ophthalmology department with a one month history of painless distorted vision. On fundus examination, she was noted to have bilateral choroidal lesionsand subsequently underwent a comprehensive diagnostic work-up. The patient was diagnosed with metastatic pulmonary adenocarcinoma, despite lacking conventional risk factors. As she was found to have a mutation in EGFR, the patient was commenced on tyrosine-kinase inhibition with afatinib. The choroidal lesions regressed with a significant improvement in visual acuity and a dramatic anatomical reduction of the choroidal masses. Conclusions: Our case demonstrates the importance of considering metastases as a differential diagnosis for choroidal lesions. Appropriate and thorough history-taking, examination and investigations may be required in order to deduce the underlying cause. Our case is unusual in view of the choroidal lesion being the primary manifestation of metastatic lung cancer in a young patient with no known risk factors. Early recognition of choroidal metastases is important as it is often the first sign of tumour dissemination and will prompt earlier treatment with systemic medications such as chemotherapy, immunotherapy, targeted therapy or hormonal therapy. Our case report also demonstrates the efficacy of afatinib for the treatment of choroidal metastases, with morphological and functional improvements observed with regard to the choroidal metastatic tumour.

Keywords: choroidal neoplasm, choroidal naevus, pulmonary adenocarcinoma, metastases, lung cancer

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12993 Disrupting Certainties: Reimagined History Curriculum as Critical Pedagogy in Secondary Teacher Education

Authors: Philippa Hunter

Abstract:

How might history education support teachers and students to see the past as a provocation, be open to possible futures, and act differently? As teacher educators in an age of diversity and uncertainty, we need to question history’s curriculum nature, pedagogy, and policy intent. The cultural politics of history’s identity in the senior secondary curriculum influences educational socialization (disciplinary, professional, research) and engagement with curriculum decision-making. This paper reflects on curriculum disturbance that shaped a critical pedagogy stance to problematize school history’s certainties. The context is situated in an Aotearoa New Zealand university-based initial teacher education programme. A pedagogic innovation was activated whereby problematized history pedagogy [PHP] was conceptualized as the phenomenon and method of inquiry and storied in doctoral work. The PHP was a reciprocal research process involving history class’ participants and the teacher as researcher, in fashioning teaching identities, identifying with, and thinking critically about history pedagogy. PHP findings revealed evocative discourses of embodiment, nostalgia, and connectedness about living ‘inside the past’. Participants expressed certainty about their abilities as teachers living ‘outside the past’ to interpret historical perspectives. However, discomfort was evident in relation to ‘difficult knowledge’ or unfamiliar contexts of the past that exposed exclusion, powerlessness, or silenced voices. Participants identified history programmes as strongly masculine and conflict-focused. A normalized inquiry-transmission approach to history pedagogy was identified and critiqued. Individuals’ reflexive accounts of PHP implemented whilst on practicum indicate possibilities of history pedagogy as; inclusive and democratic, social and ethical reconstruction, and as a critical project. The PHP sought to reimagine history curriculum and identify spaces of possibility in secondary postgraduate teacher education.

Keywords: curriculum, pedagogy, problematise, reciprocal

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12992 Factors of Scientific Rise and Fall of the Islamic Empire

Authors: Saeed Seyed Agha Banihashemi

Abstract:

The history of mathematics as one of the trends in the field of mathematics has special importance and in most of the important universities of the world, this trend in the field of mathematics is taught and researched. In teaching the history of mathematics and mathematics books, special attention is paid to the scientific works of the four Greek-Indian-Islamic and European civilizations, although the history of mathematics in China and East Asia is a special category due to its ancient civilization. In this article, while examining mathematics in the Islamic empire, the factors of the scientific rise and fall of the Islamic empire, which can include mathematics, have been studied. In this article, according to my own research and other sources mentioned s, It is believed the factors of scientific rise and fall in the Islamic Empire.

Keywords: history of mathematics, alkandi, cryptology, manuscripts

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12991 Negative RT-PCR in a Newborn Infected with Zika Virus: A Case Report

Authors: Vallejo Michael, Acuña Edgar, Roa Juan David, Peñuela Rosa, Parra Alejandra, Casallas Daniela, Rodriguez Sheyla

Abstract:

Congenital Zika Virus Syndrome is an entity composed by a variety of birth defects presented in newborns that have been exposed to the Zika Virus during pregnancy. The syndrome characteristic features are severe microcephaly, cerebral tissue abnormalities, ophthalmological abnormalities such as uveitis and chorioretinitis, arthrogryposis, clubfoot deformity and muscular tone abnormalities. The confirmatory test is the Reverse transcription polymerase chain reaction (RT-PCR) associated to the physical findings. Here we present the case of a newborn with microcephaly whose mother presented a confirmed Zika Virus infection during the third trimester of pregnancy, despite of the evident findings and the history of Zika infection the RT-PCR in amniotic and cerebrospinal fluid of the newborn was negative. RT-PCR has demonstrated a low sensibility in samples with low viral loads, reason why, we propose a clinical diagnosis in patients with clinical history of Zika Virus infection during pregnancy accompanied by evident clinical manifestations of the child.

Keywords: congenital, Zika virus, microcephaly, reverse transcriptase polymerase chain reaction

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12990 Efficient Manageability and Intelligent Classification of Web Browsing History Using Machine Learning

Authors: Suraj Gururaj, Sumantha Udupa U.

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Browsing the Web has emerged as the de facto activity performed on the Internet. Although browsing gets tracked, the manageability aspect of Web browsing history is very poor. In this paper, we have a workable solution implemented by using machine learning and natural language processing techniques for efficient manageability of user’s browsing history. The significance of adding such a capability to a Web browser is that it ensures efficient and quick information retrieval from browsing history, which currently is very challenging. Our solution guarantees that any important websites visited in the past can be easily accessible because of the intelligent and automatic classification. In a nutshell, our solution-based paper provides an implementation as a browser extension by intelligently classifying the browsing history into most relevant category automatically without any user’s intervention. This guarantees no information is lost and increases productivity by saving time spent revisiting websites that were of much importance.

Keywords: adhoc retrieval, Chrome extension, supervised learning, tile, Web personalization

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12989 A Retrospective Study of Suicidal Deaths in Madinah for Ten Years

Authors: Radah Yousuf, Ashraf Shebl

Abstract:

Suicide is a tragic event with strong emotional repercussions for its survivors and for families of its victims. There were thousands of cases all over the world. There are many risk factors include mental disorders such as depression, and substance abuse, including alcoholism and use of benzodiazepines. Other suicides are impulsive acts due to stress such as from financial difficulties, troubles with relationships, or from bullying. The aim of work in this study is making a survey from archives of the suicidal cases, which had a medicolegal examination, in forensic medicine center in Al Madinah Almunawarah-KSA, for ten years in the period between 1428-1438h. In each case, some data are collected such as age, sex, time and place of an act, method of suicide, the presence of the witness, medical history. This study demonstrates that suicide is more common in male than female, and the 4th decade was the most period of age. The most common method of suicide was hanging followed by falling from the height. These results indicated that cultural and religious beliefs that discourage suicide and support self-preservation instinct, and suicide education programs provide information to students in high school, builds awareness, one of the most important issues in solving that problem. From the forensic view, circumstantial evidence of every forensic case must take and record, full history about the social, medical and psychological problems, attend the scene of death is a very important, complete medicolegal investigation for every case, and full autopsy with very skilled techniques and facilities can help in diagnosing what type of crimes.

Keywords: suicide, age, sex, hanging

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12988 Factors Associated to Down Syndrome Causes in Patients of Cytogenetics Laboratory, Faculty of Medicine, Universitas Padjadjaran in 2014─2015

Authors: Bremmy Laksono, Nurul Qomarilla, Riksa Parikrama, Dyan K. Nugrahaeni, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

Abstract:

Down syndrome is a chromosomal abnormality of chromosome 21 which can appear in man or woman. Maternal age and paternal age, history of radiation are the common risk factors. This study was conducted to observe risk factors which related as causes of Down syndrome. In this case control study using purposive sampling technique, 84 respondents were chosen from Cell Culture and Cytogenetics Laboratory patients in Faculty of Medicine, Universitas Padjadjaran, Indonesia. They were used as study samples and divided into 42 Down syndrome cases and 42 control respondents. This study used univariate and bivariate analysis (chi-square). Samples population were West Java residents, the biggest province in Indonesia in number of population. The results showed maternal age, paternal age, history of radiation exposure and family history were not significantly related to Down syndrome baby. Moreover, all of those factors also did not contribute to the risk of having a child with Down syndrome in patients at Cell Culture and Cytogenetics Laboratory, Faculty of Medicine, Universitas Padjadjaran. Therefore, we should investigate other risk factors of Down syndrome in West Java population.

Keywords: down syndrome, family history, maternal age, paternal age, risk factor

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12987 A Rare Case of Acquired Benign Tracheoesophageal Fistula: Case Report and Literature Review

Authors: Sarah Bouayyad, Ajay Nigam, Meera Beena

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Acquired benign tracheoesophageal fistula is a rare medical condition that usually results from trauma, foreign bodies, or granulomatous infections. This is an unusual presentation of a male patient with a history of laryngectomy who had had over a period of several years inappropriately and vigorously used valve cleaning brushes to clean tracheal secretions, which had led to the formation of a tracheoesophageal fistula. Due to the patient’s obsessive habit, we couldn’t manage him using conventional surgical methods. Instead, we opted for the placement of a salivary bypass tube, which yielded good results and recovery. To the best of our knowledge, no other case of similar etiology has been published. We would like to highlight the importance of appropriate patient selection and education prior to performing a tracheoesophageal puncture to avoid developing life-threatening complications as demonstrated in our case report.

Keywords: tracheoesophageal fistula, speech valve, endoscopic insertion of salivary bypass tube, head and neck malignancies

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12986 Palliative Care Referral Behavior Among Nurse Practitioners in Hospital Medicine

Authors: Sharon Jackson White

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Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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12985 Biographical Learning and Its Impact on the Democratization Processes of Post War Societies

Authors: Rudolf Egger

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This article shows some results of an ongoing project in Kosova. This project deals with the meaning of social transformation processes in the life-courses of Kosova people. One goal is to create an oral history archive in this country. In the last seven years we did some interpretative work (using narrative interviews) concerning the experiences and meanings of social changes from the perspective of life course. We want to reconstruct the individual possibilities in creating one's life in new social structures. After the terrible massacres of ethnical-territorially defined nationalism in former Yugoslavia it is the main focus to find out something about the many small daily steps which must be done, to build up a kind of “normality” in this country. These steps can be very well reconstructed by narrations, by life stories, because personal experiences are naturally linked with social orders. Each individual story is connected with further stories, in which the collective history will be negotiated and reflected. The view on the biographical narration opens the possibility to analyze the concreteness of the “individual case” in the complexity of collective history. Life stories contain thereby a kind of a transition character, that’s why they can be used for the reconstruction of periods of political transformation. For example: In the individual story we can find very clear the national or mythological character of the Albanian people in Kosova. The shown narrations can be read also as narrative lines in relation to the (re-)interpretation of the past, in which lived life is fixed into history in the so-called collective memory in Kosova.

Keywords: biographical learning, adult education, social change, post war societies

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12984 Literature and the Extremism: Case Study on and Qualitative Analysis of the Impact of Literature on Extremism in Afghanistan

Authors: Mohibullah Zegham

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In conducting a case study to analyze the impact of literature on extremism and fundamentalism in Afghanistan, the author of this paper uses qualitative research method. For this purpose the author of the paper has a glance at the history of extremism and fundamentalism in Afghanistan, as well the major causes and predisposing factors of it; then analyzes the impact of literature on extremism and fundamentalism using qualitative method. This study relies on the moral engagement theory to reveal how some extreme-Islamists quit the ideological interpretation of Islam and return to normal life by reading certain literary works. The goal of this case study is to help fighting extremism and fundamentalism by using literature. The research showed that literary works are useful in this regard and there are several evidences of its effectiveness.

Keywords: extremism, fundamentalism, communist, jihad, madrasa, literature

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12983 Acute Myocardial Infarction Associated with Ingestion of Herbal Mixtures Containing Acetylcholinesterase Inhibitors: A Case Study

Authors: M. Hakami, A. Jammaly, I. Attafi, M. Oraiby, M. Jeraiby

Abstract:

We reviewed an unusual case of a 65-year-old male taking an herbal mixture containing compounds with anticholinesterase activity for a long period of time, presented with acute my myocardial infarction and multiple organ dysfunction syndrome followed by death. Clinically, there are findings correlated with anticholinesterase activity, such as bilateral miosis, diaphoresis, vomiting and fasciculation without a history of any toxic ingestion or exposure. Gas chromatography–mass spectrometry screening studies identified the presence of thymol, anethole in the herbal extract and butylated hydroxytoluene in the blood sample. Hence, with this case report, we intend to highlight the necessity of evaluating the long-term use of the herbal mixture.

Keywords: cholinesterase inhibitors, thymole, anethole, butylatedhydroxytoluene, cardiac toxicity, myocardial infarction

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12982 Therapeutic Journey towards Self: Developing Positivity with Indications of Cluster B and C Personality Traits

Authors: Shweta Jha, Nandita Chaube

Abstract:

The concept of self has a major role to play in the study of personality which drives the current study in its present form. This is a case of Miss S, a 17-year-old Hindu, currently in eleventh standard, with no family history of mental illness but with a past history of inability to manage relationships, multiple emotional and sexual relationships, repeated self harming behaviour, and sexual abuse over a period of 2 months at the age of 10 years. She comes with a psychiatric history of one episode of dissociative fall followed by a stressful event which left the patient with many psychological disturbances matching the criterion of Cluster B and C traits. Current episode precipitated due to the relationship failure, predisposing factor is her personality traits, and poor social and family support. Considering the patient’s aspiration for positivity and demand of the therapy, ventilation sessions were carried out which made her capable of understanding and dealing with her negative emotions, also strengthened mother child bond, helped her maintain meaningful and healthy relationships, also helped her increase her problem solving ability and adaptive coping skills making her feel more positive and acceptable towards herself, family members and others.

Keywords: cluster B and C traits, personality, therapy, self

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12981 Spontaneous Pneumothorax in Mixed Poisoning Presented as Daisley Barton Syndrome

Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

Abstract:

Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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12980 Risk Factor of Anal Incontinence among Women in Makassar

Authors: Azizah Nurdin, Trika Irianta, Mardiah Tahir, Maisuri T. Chalid

Abstract:

Background: Studies of anal incontinence in the general population are rare however its financial healthcare cost is significant. Women attended Hasanuddin University Teaching Hospital and its networking in Makassar, Indonesia was surveyed between February to April 2015 about their obstetrical and gynecological history. Aims: To establish obstetrical risk factor of anal incontinence among women in Makassar. Methods: In a cross sectional face to face interview study, 135 women aged 30 years or more were selected randomly. Participants were asked to complete an anal incontinence questionnaire. Results: From a total sample of 135 respondents, 42,2 % reported has flatulence incontinence. Parity, history of anal sphincter laceration, history of having large baby, history of assisted vaginal delivery were shown have no significant association with anal incontinence, while history of episiotomy was shown have a significant association with anal incontinence (p value < 0.05). The risk of flatulence incontinence was higher among women with history of episiotomy (OR : 2,85, 95 % CI = 1,58- 5,13) Conclusions: This study has confirmed that fecal incontinence is a fairly common symptom. Flatulence incontinence is the most frequent even. An obstetrical factor like episiotomy is one of risk factor that could be avoided in order to prevent anal incontinence.

Keywords: anal incontinence, flatulence incontinence, obstetrical risk factor, women

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12979 Clinical Manifestations, Pathogenesis and Medical Treatment of Stroke Caused by Basic Mitochondrial Abnormalities (Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like Episodes, MELAS)

Authors: Wu Liching

Abstract:

Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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12978 Translating History in a Brazilian Graphic Novel: A Translation Project for Angola Janga by Marcelo D'Salete

Authors: Carolina Rezende, Julio Cesar Neves Monteiro

Abstract:

Traditionally, History and fiction are considered to be opposing fields of study. While one is linked to the study of facts, things that have happened within the limits of ‘reality’, the other explores a made-up world, originated from imagination and fantasy. However, despite their apparent discrepancies, there is a fundamental trait that brings them closer. Historical narratives, similarly to fiction ones, are produced based on multiple interpretations of an event, which are transmitted in a rather subjective way by language. It is within this perspective of history and fiction intertwined that this paper aims to discuss the translation of historical facts in the graphic novel Angola Janga, by Marcelo D’Salete, as well as presenting it as a historical document. The novel, which is divided into 11 short stories, narrates the rebellions that took place in Serra da Barriga, between the 16th and 17th centuries, that resulted in the Guerra dos Palmares. The graphic novel in question is a result of the author’s 11-year historical and bibliographical research, which combines history and fiction in order to shed a light of the confrontation that history seems to overlook. Also, the book includes a foreword, glossary, chronological line of Guerra dos Palmares, as well as maps and references used by the author during his research. For that, a few segments from the book will be selected and translated in order to show such connection between history and fiction, and the discussion resulted from it will be based on the works of Southgate (2009), Pym (2001) and D’hulst (2001).

Keywords: graphic novel, history, fiction, Palmares

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12977 Cultural Entanglements in the Urban Fabric: A Case of Festivals in Old Dhaka and its Impacts

Authors: Khandoker Upama Kabir, Mohammad Fuhad Anwar Sinha

Abstract:

Dhaka, the capital of Bangladesh, is known not only for its fast growing economy, lively atmosphere, rich history, and culture but is also known for having a reputation of being a vastly populated city. The historic city centre of Dhaka (currently known as Puran Dhaka or Old Dhaka) which was conceived around the Pre-Mughal era and holds a lot of history and heritage of the region. This historic site has further been neglected, and most of the urban development has been done without integrating this part of the city into the plans. As a result, the festivals that take place traditionally throughout the year in this area create a greater impact on the urban fabric of the whole city. These festivals generate a huge amount of visitors and play a huge role in shaping the identity of the people. This paper will attempt to look at the importance of these traditions, the way these festivals are influencing the urban life of the community, and whether or not it has any significant effect on the economy. Through the use of both primary and secondary sources and SWOT analysis, this paper will attempt to identify the issues faced during these festivals. This paper will also try to suggest some basic remedies based on general comparisons between case studies of similar festivals celebrated globally and how these countries are dealing with such issues while also promoting tourism.

Keywords: urban fabric, festivals, cultural celebration, impact, historic city centre urban memory, mega events

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12976 The Quest for Identity among African Americans: Life History of Imahkus Nzinga

Authors: Felicia Masenu

Abstract:

Identity formation remains central to diaspora populations as they are known to have multiple attachments to places, including the 'ancestral homeland.' This paper emphasizes the potency of the ancestral homeland in the imagination of diaspora populations and a 'yearning' for an eventual return. This has led to the repatriation and visits of many Diasporan Africans to Africa. What have also been highlighted are the motivations, experiences, and challenges associated with the return of African Americans to Africa, as well as some of the idealistic expectations that Diasporan Africans have regarding the ancestral homeland. When Diasporan Africans visit Africa, they are faced with different kinds of situations that are challenging. Yet, the number of visits to Africa by Diasporan Africans, particularly, African Americans, keep increasing. This paper draws on the life history of Imahkus Nzinga, an African American who repatriated to Ghana in the 1990s, as a case study of African Americans’ relentless quest to pursue the ancestral homeland, despite the challenges involved. The paper argues that the quest for identity construction remains the overriding motivation for African Americans in their decision to repatriate to Africa, and discusses how in this case, Imahkus Nzinga attempts to reconcile what is called in this paper 'identity struggle.'

Keywords: African Americans, Diaspora, identity formation, identity struggle, repatriation

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