Search results for: mother's right
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 566

Search results for: mother's right

386 Maternal and Neonatal Outcome Analysis in Preterm Abdominal Delivery Underwent Umbilical Cord Milking Compared to Early Cord Clamping

Authors: Herlangga Pramaditya, Agus Sulistyono, Risa Etika, Budiono Budiono, Alvin Saputra

Abstract:

Preterm birth and anemia of prematurity are the most common cause of morbidity and mortality in neonates, and anemia of the preterm neonates has become a major issue. The timing of umbilical cord clamping after a baby is born determines the amount of blood transferred from the placenta to fetus, Delayed Cord Clamping (DCC) has proven to prevent anemia in the neonates but it is constrained concern regarding the delayed in neonatal resuscitation. Umbilical Cord Milking (UCM) could be an alternative method for clamping the umbilical cord due to the active blood transfer from the placenta to the fetus. The aim of this study was to analyze the difference between maternal and neonatal outcome in preterm abdominal delivery who underwent UCM compared to ECC. This was an experimental study with randomized post-test only control design. Analyzed maternal and neonatal outcomes, significant P values (P <0.05). Statistical comparison was carried out using Paired Samples t-test (α two tailed 0,05). The result was the mean of preoperative mother’s hemoglobin in UCM group compared to ECC (10,9 + 0,9 g/dL vs 10,4 + 0,9 g/dL) and postoperative (11,1 + 1,1 g/dL vs 10,5 + 0,7 g/dL), the delta was (0,2 + 0,7 vs 0,1 + 0,6.). It showed no significant difference (P=0,395 vs 0,627). The mean of 3rd phase labor duration in UCM group vs ECC was (20,5 + 3,5 second vs 21,1 + 3,3 second), showed insignificant difference (P=0,634). The amount of bleeding after delivery in UCM group compared to ECC has the median of 190 cc (100-280cc) vs 210 cc (150-330 cc) showed insignificant difference (P=0,083) so the incidence of post-partum bleeding was not found. The mean of the neonates hemoglobin, hematocrit and erythrocytes of UCM group compared to ECC was (19,3 + 0,7 vs 15,9 + 0,8 g/dl), (57,1 + 3,6 % vs 47,2 + 2,8 %), and (5,4 + 0,4 g/dl vs 4,5 + 0,3 g/dl) showed significant difference (P<0,0001). There was no baby in UCM group received blood transfusion and one baby in the control ECC group received blood transfusion was found. Umbilical Cord Milking has shown to increase the baby’s blood component such as hemoglobin, hematocrit, and erythrocytes 6 hours after birth as well as lowering the incidence of blood transfusions. Maternal and neonatal morbidity were not found. Umbilical Cord Milking was the act of clamping the umbilical cord that was more beneficial to the baby and no adverse or negative effects on the mother.

Keywords: umbilical cord milking, early cord clamping, maternal and neonatal outcome, preterm, abdominal delivery

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385 Modelling Strategy Planning in Multi Business Companies

Authors: Gelareh Changizi, Mahsa Khajavi, Ladan Shahhosseini

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Corporate-level strategy, or simply ‘parent strategy’, is a topic that has received much attention since the very early days of the strategic planning field. Since the multi level enterprises have different sub enterprises which deal with different business environments, we cannot define the same strategic perspective for all of them. Therefore, the determination of a perspective to manage and deal with affiliates of such enterprises is the main challenge. The parent strategy in mother enterprises' level has been analyzed in this research. A case study has been carried to comprehensively describe the proposed model.

Keywords: parent strategy, multi-business companies, performance evaluation, lifecycle

Procedia PDF Downloads 335
384 Pro Life-Pro Choice Debate: Looking through the Prism of Abortion Right in the Indian Context

Authors: Satabdi Das

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Background:The abortion debate has polarized women, pitting them against each other in the binary of pro-choice and pro-life. While the followers of pro-choice views the right to an abortion as inherent to a women's right to sovereignty, the latter believes that it is unethical to kill a unborn baby as it is in a way denying the foetus' right to life. So there are innumerable arguments and counter arguments without hyphenation and the dilemma remains that which one is more significant – the mother's right to terminate pregnancy or the foetus' right to life. This pro-life and pro-choice debate has an western root which is more about reproductive freedom. But the Western standard of looking at abortion debate is not fully relevant in the Indian context. The situation is entirely different here. Sex selective foeticide is a social ill in India which cannot be explained through the prism of abortion debate only. It must take into account the problems of forced female foeticide. Objectives: Against this backdrop the study sheds light on the following issues: -How the Reproductive debate has been evolved? -How it is relevant in the Indian Context where female foeticide is a harsh reality? -How one should address the dilemma between life and death in the context of pro life-pro choice debate? Methodology: The study employs historical analytical and descriptive analytical methods and uses primary documents like governmental documents and secondary sources like analytical articles in books, journals, and relevant websites. Findings: -Fertility control is not a modern day phenomenon. It has its roots throughout ancient, medieval and present epochs. However, there existed debates over the rights of the foetus and the question of ethics pertaining to the act of abortion. -Pre-natal sex determination for sex selective abortion is a common phenomenon in India because of the wish for male heirs. The cultural preferences for male child over female ones have resulted in the disappearance of girl children. -When does the life begin has not been recognized by any law. Considering Indian case, it can be said that the Pro life/ pro choice is not that relevant as it is in the US. Here the women are often denied the basic human rights. They are murdered at the womb in many places. Their right to lives are jeopardised in that way. In the liberal abortion regime of India, women's choice to end a pregnancy is limited among very few enlightened families. In many cases, it is the decision of the family to end a pregnancy for boy preference. For that pre natal sex determination plays a crucial role. Conclusion: In India, we can be pro life only when the right to life of the unborn can be secured irrespective of its sex. Similarly we belong to pro-choice group only when the choice to terminate a baby is entirely decided by the mother for her own reasons.

Keywords: female foeticide, India, prolife/pro choice, right to abortion

Procedia PDF Downloads 163
383 Skin-to-Skin Contact Simulation: Improving Health Outcomes for Medically Fragile Newborns in the Neonatal Intensive Care Unit

Authors: Gabriella Zarlenga, Martha L. Hall

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Introduction: Premature infants are at risk for neurodevelopmental deficits and hospital readmissions, which can increase the financial burden on the health care system and families. Kangaroo care (skin-to-skin contact) is a practice that can improve preterm infant health outcomes. Preterm infants can acquire adequate body temperature, heartbeat, and breathing regulation through lying directly on the mother’s abdomen and in between her breasts. Due to some infant’s condition, kangaroo care is not a feasible intervention. The purpose of this proof-of-concept research project is to create a device which simulates skin-to-skin contact for pre-term infants not eligible for kangaroo care, with the aim of promoting baby’s health outcomes, reducing the incidence of serious neonatal and early childhood illnesses, and/or improving cognitive, social and emotional aspects of development. Methods: The study design is a proof-of-concept based on a three-phase approach; (1) observational study and data analysis of the standard of care for 2 groups of pre-term infants, (2) design and concept development of a novel device for pre-term infants not currently eligible for standard kangaroo care, and (3) prototyping, laboratory testing, and evaluation of the novel device in comparison to current assessment parameters of kangaroo care. A single center study will be conducted in an area hospital offering Level III neonatal intensive care. Eligible participants include newborns born premature (28-30 weeks of age) admitted to the NICU. The study design includes 2 groups: a control group receiving standard kangaroo care and an experimental group not eligible for kangaroo care. Based on behavioral analysis of observational video data collected in the NICU, the device will be created to simulate mother’s body using electrical components in a thermoplastic polymer housing covered in silicone. It will be designed with a microprocessor that controls simulated respiration, heartbeat, and body temperature of the 'simulated caregiver' by using a pneumatic lung, vibration sensors (heartbeat), pressure sensors (weight/position), and resistive film to measure temperature. A slight contour of the simulator surface may be integrated to help position the infant correctly. Control and monitoring of the skin-to-skin contact simulator would be performed locally by an integrated touchscreen. The unit would have built-in Wi-Fi connectivity as well as an optional Bluetooth connection in which the respiration and heart rate could be synced with a parent or caregiver. A camera would be integrated, allowing a video stream of the infant in the simulator to be streamed to a monitoring location. Findings: Expected outcomes are stabilization of respiratory and cardiac rates, thermoregulation of those infants not eligible for skin to skin contact with their mothers, and real time mother Bluetooth to the device to mimic the experience in the womb. Results of this study will benefit clinical practice by creating a new standard of care for premature neonates in the NICU that are deprived of skin to skin contact due to various health restrictions.

Keywords: kangaroo care, wearable technology, pre-term infants, medical design

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382 English and the Question of National Language in Nigeria

Authors: Foyewa R. A.

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This paper examined the role of English language and the quest for a national language in Nigeria. Various hindrances to the choice of a national language in Nigeria were observed. These include: The dominant role of English language, political instability and multilingual nature of the country. The writer suggested that ’’the three big’’ that is, Hausa, Igbo and Yoruba should be selected as the national languages. It was also suggested that a credit pass in a student’s mother tongue and one of “the three big” (Hausa, Igbo and Yoruba) should constitute the prerequisite for admission into Nigerian higher institutions.

Keywords: English, roles of English, national language, Nigerian languages, Hausa, Igbo, Yoruba

Procedia PDF Downloads 767
381 Aspects of Diglossia in Arabic Language Learning

Authors: Adil Ishag

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Diglossia emerges in a situation where two distinctive varieties of a language are used alongside within a certain community. In this case, one is considered as a high or standard variety and the second one as a low or colloquial variety. Arabic is an extreme example of a highly diglossic language. This diglossity is due to the fact that Arabic is one of the most spoken languages and spread over 22 Countries in two continents as a mother tongue, and it is also widely spoken in many other Islamic countries as a second language or simply the language of Quran. The geographical variation between the countries where the language is spoken and the duality of the classical Arabic and daily spoken dialects in the Arab world on the other hand; makes the Arabic language one of the most diglossic languages. This paper tries to investigate this phenomena and its relation to learning Arabic as a first and second language.

Keywords: Arabic language, diglossia, first and second language, language learning

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380 A Contrastive Analysis of English and Ukwuani Front Vowels

Authors: Omenogor, Happy Dumbi

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This paper examines the areas of convergence and divergence between English and Ųkwųanį (a language in Nigeria) vowel systems with particular emphasis on the front vowels. It specifies areas of difficulty for the average Ųkwųanį users of English and Ųkwųanį L1 users of English as a second language. The paper explains the nature of contrastive analysis, the geographical locations where Ųkwųanį is spoken as mother tongue as well as English and Ųkwųanį front vowels. The principles of establishing phonemes, minimal pairs in Ųkwųanį as well as the vowel charts in both languages are among the issues highlighted in this paper.

Keywords: convergence, divergence, English, Ukwųanį

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379 Chebyshev Wavelets and Applications

Authors: Emanuel Guariglia

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In this paper we deal with Chebyshev wavelets. We analyze their properties computing their Fourier transform. Moreover, we discuss the differential properties of Chebyshev wavelets due the connection coefficients. The differential properties of Chebyshev wavelets, expressed by the connection coefficients (also called refinable integrals), are given by finite series in terms of the Kronecker delta. Moreover, we treat the p-order derivative of Chebyshev wavelets and compute its Fourier transform. Finally, we expand the mother wavelet in Taylor series with an application both in fractional calculus and fractal geometry.

Keywords: Chebyshev wavelets, Fourier transform, connection coefficients, Taylor series, local fractional derivative, Cantor set

Procedia PDF Downloads 90
378 The Effect of Early Skin-To-Skin Contact with Fathers on Their Supporting Breastfeeding

Authors: Shu-Ling Wang

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Background: Multiple studies showed early skin-to-skin contact (SSC) with mothers was beneficial to newborns such as breastfeeding and maternal childcare. In cases of newborns unable to have early SSC with mothers, fathers’ involvement could let early SSC continue without interruption. However, few studies had explored the effects of early SSC by fathers in comparison to early SSC with mothers. Paternal involvement of early SSC should be equally important in term of childcare and breastfeeding. The purpose of this study was to evaluate the efficacy of early SSC by fathers in particular in their support of breastfeeding. Methods: A quasi-experimental design was employed by the study. One hundred and forty-four father-infant pairs had participated the study, in which infants were assigned either to SSC with their fathers (n = 72) or to routine care (n = 72) as the control group. The study was conducted at a regional hospital in northern Taiwan. Participants included parents of both vaginal delivery (VD) and caesarean section birth (CS) infants. To be eligible for inclusion, infants must be over 37-week gestational ages. Data were collected twice: as pretest upon admission and as posttest with online questionnaire during first, second, and third postpartum months. The questionnaire included items for Breastfeeding Social Support, methods of feeding, and the mother-infant 24-hour rooming-in rate. The efficacy of early SSC with fathers was evaluated using the generalized estimating equation (GEE) modeling. Research Result: The primary finding was that SSC with fathers had positive impact on fathers’ support of breastfeeding. Analysis of the online questionnaire indicated that early SSC with fathers improved the support of breastfeeding than the control group (VD: t = -4.98, p < .001; CS: t = -2.37, p = .02). Analysis of mother-infant 24-hour rooming-in rate showed that SSC with fathers after CS had a positive impact on the rooming-in rate (χ² = 5.79, p = .02); however, with VD the difference between early SSC with fathers and the control group was insignificant (χ² = .23, p = .63). Analysis of the rate of exclusive breastfeeding indicated that early SSC with fathers had a higher rate than the control group during first three postpartum months for both delivery methods (VD: χ² = 12.51, p < .001 on 1st postpartum month, χ² = 8.13, p < .05 on 2nd postpartum month, χ² = 4.43, p < .05 on 3rd postpartum month; CS: χ² = 6.92, p < .05 on 1st postpartum month, χ² = 7.41, p < .05 on 2nd postpartum month, χ² = 6.24, p < .05 on 3rd postpartum month). No significant difference was found on the rate of exclusive breastfeeding with both methods of delivery between two groups during hospitalization. (VD: χ² =2 .00, p = .16; CS: χ² = .73, p = .39). Conclusion: Implementing early SSC with fathers has many benefits to both parents. The result of this study showed increasing fathers’ support of breastfeeding. This encourages our nursing personnel to focus the needs of father during breastfeeding, therefore further enhancing the quality of parental care, the rate and duration of breastfeeding.

Keywords: breastfeeding, skin-to-skin contact, support of breastfeeding, rooming-in

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377 Moderating Effects of Family Structure on College Achievement

Authors: Jennifer Knudsen

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This study observes the moderating effects of family structure on College Achievement across cohorts. Over the past half-century, social stigmas surrounding non-traditional families have shifted, as they make up an increasing proportion of American families. Using the General Social Survey, this study employs a varying coefficient model to test if family structure moderates the effects of other background variables on respondents’ educational attainment. Initial analysis suggests that living in alternative family arrangements has an increasingly negative effect on college achievement, whereas living in an intact family with a mother and father has a positive effect on college achievement.

Keywords: education, family, college, family structure

Procedia PDF Downloads 89
376 The Effect of ‘Love Accounting’ on Gift Budgeting

Authors: Yanan Wang

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It is proposed that when people give a gift they engage in 'love accounting', so that they will spend less on it if they include a written expression of love with it. This hypothesis was tested with college students (N = 308). It was found that participants who wrote a love message to accompany a Mother's Day gift budgeted less for the gift itself than control participants (Experiment 1), and this effect was replicated for a Christmas gift (Experiment 2). The amount of effort expended by the giver on preparing the love message did not account for the effect (Experiment 3). It is concluded that a gift and its accompanying love message are mentally computed as belonging to the same love account, implying that consumers’ excessive splurging on gifts might be controlled by writing a love message before gift shopping.

Keywords: expression of love, gift-giving, gift-budgeting, mental accounting

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375 Knowledge Level of Mothers in Wet Nursery and Breast Milk Banking

Authors: Seyda Can, Meryem Unulu

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Objective: Breast milk is the most fundamental nutritional element for the healthy growth and development of newborns as they supply all the necessary components. Various obstacles such as diseases of mother and child, allergies of the baby, and insufficient breastmilk affect breast-feeding adversely. The wet nursery or breast milk banking is the most important source in providing the nutrients closest to the ideal for the newborn. Despite increasing opinions about its benefits, breast milk banking practice is controversial because of reasons such as ethical problems, traditional beliefs and attitudes, security concerns of families and lack of knowledge. It is thought that the results of this study will create the data for studies to raise the awareness of the society regarding wet nursery, and milk banks. Method: The study was planned and performed in descriptive type. The population of the study consists of mothers that gave birth between October-November 2017 in a public hospital in Turkey, and the sample consisted of 205 mothers chosen by improbable sampling method from the population and accepted to participate in the study. While gathering data, a survey consisting of 33 questions designed to determine the socio-demographic characteristics and their views on wet nursery and breast milk banking. Written ethical committee and institution permit was taken. Before the interview, participants were informed about the purpose and content of the study and oral permit was taken. Result: When the distribution of 205 mothers according to their individual characteristics, it was detected that their age average was 28,16±5,23 and 63,4 of mothers (n=130) had normal delivery. It was determined that clear majority of mothers, 75,6% (n=155) had no breast-feeding problems and 75,1% (n=154) fed the baby only with breast milk. It was detected that 18,5% (n=38) would accept a stranger to be a wet nurse and 60% (n=123) would donate milk if there is a breast milk bank. It was detected 33,2 % (n=68) of participant mothers want to make use of breast milk bank if there is a situation that prevents breast feeding, 38,5 % (n=79) of mothers think breast milk bank would be problematic religiously. Statistical difference was detected between the educational status of women and the rate of wanting breast milk bank practice. As the educational status of mothers increased, their rate of wanting breast milk bank practice increased. Conclusion: It is essential that every baby is breastfed by its mother primarily. However, when this is not possible, in order to implement wet nursery and breast milk banking as an extension of national breast-feeding policy, regulations need to be made and worries should be eased. Also, organizing training programs are also really important to raise awareness of the society and mothers.

Keywords: breast feeding, breast milk, milk banks, wet nursery

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374 An Analysis of Telugu Proverbs in the Light of Endangerment

Authors: Esther, Queeny

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The main goal of this paper is to reflect on the overwhelming, rich folklore of Telugu people through their proverbs, which are assumed to be in a state of endangerment. In order to prove the statement made that the proverbs in Telugu are endangered, we have to delve deeper. We hardly found two or three papers related to Telugu proverbs. So, though the process was weary of sorting out the different proverbs in Telugu, to translate them etc. we found it necessary to do a survey in the form of a questionnaire and draw conclusions so that we could address this issue to the readers. We began with a basic assumption that the older generation may have a wider knowledge of their folklore when compared to the younger generation. The results obtained are quite remarkable, which strengthened our assumptions. Statistical analysis was adopted for quantitative analysis. Through this paper, we hope to kindle cultural awareness among the youngsters regarding the use of one’s own mother tongue.

Keywords: sociolinguistics, Telugu proverbs, folklore, endangerment

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373 Writing Style in a Thousand Splendid Suns

Authors: Maroof Sakhi

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This article studies writing style in A Thousand Splendid Suns. It mainly discusses code-switching and usage of Persian words in the novel. Hosseini mainly writes in English; however, constantly he applies Persian words, phrases and syntax. Code-switching is used for different purposes in A Thousand Splendid Suns. It gives a voice to a character from Afghanistan. It is also used to mark a difference between the American and Afghanistan cultures and languages. Furthermore, representation of Persian language can be interpreted as valorization of the author’s mother tongue. In short, the writing style in A Thousand Splendid Suns represents Hosseini’s identity, culture and linguistic background.

Keywords: code-switching, hybridity, identity, linguistic background, Persian literature

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372 Trauma inside and Out: A Descriptive Cross-Sectional Study of Family, Community and Psychological Wellbeing amongst Pediatric Victims of Interpersonal Violence

Authors: Mary Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Exposure to violence not only has negative psychological impact on children but is a risk factor for children becoming recurrent victims of violence. However, little is known regarding the degree to which child victims of violence are exposed to trauma at home and in their community, or its association with specific psychological diagnoses. Objective: The aims of this study were to perform in-depth characterizations of family, community and psychological wellness amongst pediatric victims of interpersonal violence. Methods: As standard of care at the Saint Louis Children’s Hospital pediatric emergency department (ED), social workers perform in-depth interviews with all children presenting due to violent interpersonal encounters. In this retrospective cross-sectional study, we collected data from social work interviews on family structure, exposure to violence in the community and the home, as well as history of psychological diagnoses amongst children ages 8-19 years who presented to the ED for injuries related to interpersonal violence from 2014-2017. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed. The average age of studied youths was 14.7 years (SD 2.5). Youths were 97.5% African American ethnicity and 66.6% male. 67.8% described their home having a nonnuclear family structure, 50% of which reported living with a single mother. Of the 21% who reported having incarcerated family members, 56.3% reported their father being incarcerated, 15% reported their mother being incarcerated, and 12.5% reported multiple family members being incarcerated. 11.3% reported witnessing domestic violence in their home. 12.8% of youths reported some form of child abuse. The type of child abuse was not specified in 29.3% of cases, but physical abuse (32.8%) followed by sexual abuse (22.4%) were the most commonly reported. 14.5% had history of placement in foster care and/or adoption. 64% reported having witnessed violence in their community. 30.2% reported having lost friends or family due to violence, and of those, 26.4% reported the loss of a cousin, 18.9% the loss of a friend, 16% the loss of their father, and 12.3% the loss of their brother due to violence. Of the 22.4% youths with psychiatric diagnose(s), 48.4% had multiple diagnoses, the most common of which were ADD/ADHD (62.6%), followed by depression (31.9%), bipolar disorder (27.5%) and anxiety (15.4%). Conclusions: A remarkable proportion of children presenting to EDs due to interpersonal violence have a history of exposure to instability and violence in their homes and communities. Additionally, psychological diagnoses are frequent among pediatric victims of violence. More research is needed to better understand the association between trauma exposure, psychological health and violent victimization amongst children.

Keywords: community violence, emergency department, pediatric interpersonal violence, pediatric trauma, psychological effects of trauma

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371 Prediction of Coronary Heart Disease Using Fuzzy Logic

Authors: Elda Maraj, Shkelqim Kuka

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Coronary heart disease causes many deaths in the world. Unfortunately, this problem will continue to increase in the future. In this paper, a fuzzy logic model to predict coronary heart disease is presented. This model has been developed with seven input variables and one output variable that was implemented for 30 patients in Albania. Here fuzzy logic toolbox of MATLAB is used. Fuzzy model inputs are considered as cholesterol, blood pressure, physical activity, age, BMI, smoking, and diabetes, whereas the output is the disease classification. The fuzzy sets and membership functions are chosen in an appropriate manner. Centroid method is used for defuzzification. The database is taken from University Hospital Center "Mother Teresa" in Tirana, Albania.

Keywords: coronary heart disease, fuzzy logic toolbox, membership function, prediction model

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370 A Risk Pathway of Distal and Proximal Factors for Self-Injury among Adolescents

Authors: Sarit Gideoni Cohen

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The aim of the study was to examine possible risk pathway which initiated by the distal risk factors of insecure attachment to the mother, the father and peers and then developed by means of proximal risk factors: stressful life events and emotional distress. 275 participants (aged 13-26) from high-schools, youth groups and university were requited. Twenty-two percent participants reported at least one episode of self-injury. The relationship between paternal and peer attachment were partly mediated by stressful life events and depressive symptoms. Paternal and peer attachment influences during adolescence as contributing to risk pathway for self-injury were acknowledged.

Keywords: self-injury, attachment, depression, stressful life-events, adolescence

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369 Diarrheal Management Practices in Children Under Five Years and Its Associated Factors Attending Health Clinic in Kalimantan Timur Indonesia

Authors: Tri Murti, Muhammad Hanafiah Juni, Hejar Abdul Rahman, Salmiah Binti Said

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The diarrhoeal disease continues to be a leading cause of childhood mortality in countries such as Indonesia, where it is estimated to be responsible for 300,000 deaths annually in children under the age of years. Morbidity survey the Ministry of Health of Indonesia from 2000 to 2010 showed incidence diarrhoea remains a leading cause of infant mortality. Causes of death from diarrhoea is related to poor governance both at home and in health facilities. Despite the improvement of health facilities and government effort to reduce the occurrence of diarrhoea among children and death from diarrhoea, the incidence of diarrhoea among children area still high.

Keywords: management diarrheal disease, practices mother, treatment, diarrhoea among children

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368 Reading and Writing of Biscriptal Children with and Without Reading Difficulties in Two Alphabetic Scripts

Authors: Baran Johansson

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This PhD dissertation aimed to explore children’s writing and reading in L1 (Persian) and L2 (Swedish). It adds new perspectives to reading and writing studies of bilingual biscriptal children with and without reading and writing difficulties (RWD). The study used standardised tests to examine linguistic and cognitive skills related to word reading and writing fluency in both languages. Furthermore, all participants produced two texts (one descriptive and one narrative) in each language. The writing processes and the writing product of these children were explored using logging methodologies (Eye and Pen) for both languages. Furthermore, this study investigated how two bilingual children with RWD presented themselves through writing across their languages. To my knowledge, studies utilizing standardised tests and logging tools to investigate bilingual children’s word reading and writing fluency across two different alphabetic scripts are scarce. There have been few studies analysing how bilingual children construct meaning in their writing, and none have focused on children who write in two different alphabetic scripts or those with RWD. Therefore, some aspects of the systemic functional linguistics (SFL) perspective were employed to examine how two participants with RWD created meaning in their written texts in each language. The results revealed that children with and without RWD had higher writing fluency in all measures (e.g. text lengths, writing speed) in their L2 compared to their L1. Word reading abilities in both languages were found to influence their writing fluency. The findings also showed that bilingual children without reading difficulties performed 1 standard deviation below the mean when reading words in Persian. However, their reading performance in Swedish aligned with the expected age norms, suggesting greater efficient in reading Swedish than in Persian. Furthermore, the results showed that the level of orthographic depth, consistency between graphemes and phonemes, and orthographic features can probably explain these differences across languages. The analysis of meaning-making indicated that the participants with RWD exhibited varying levels of difficulty, which influenced their knowledge and usage of writing across languages. For example, the participant with poor word recognition (PWR) presented himself similarly across genres, irrespective of the language in which he wrote. He employed the listing technique similarly across his L1 and L2. However, the participant with mixed reading difficulties (MRD) had difficulties with both transcription and text production. He produced spelling errors and frequently paused in both languages. He also struggled with word retrieval and producing coherent texts, consistent with studies of monolingual children with poor comprehension or with developmental language disorder. The results suggest that the mother tongue instruction provided to the participants has not been sufficient for them to become balanced biscriptal readers and writers in both languages. Therefore, increasing the number of hours dedicated to mother tongue instruction and motivating the children to participate in these classes could be potential strategies to address this issue.

Keywords: reading, writing, reading and writing difficulties, bilingual children, biscriptal

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367 A Comparative Study of Maternal Health among Urban Slums and Non-Slums Women (Special Reference to Indore City, Madhya Pradesh, India)

Authors: Shiksha Thakur, Rashmi Jain

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Maternal health is the most crucial element in the primary health care delivery system of any healthy society. We aware that the maternal health situation in India has been a cause of concern for us, in spite of the rapidly progressing socio-economic environment overall. India has realized impressive gains in Mother & Child survival over the last two decades. MMR as per 2012-2013 in India is 167 as per MMR bulletin, though there are variations between states in the Country. In 2013, an estimated 2,89,000 women worldwide died from complications arising from pregnancy & childbirth. In view of the above facts, a study was conducted in Indore to analyse the maternal health status among urban slums and non-slums women.

Keywords: antenatal care, postnatal care, JSY, maternal health, child health, reproductive health

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366 Current Cosmetic Treatments in Pregnancy

Authors: Daniela F. Maluf, Fernanda Roters, Luma C. F. Silva

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The goal of this work is to report the main dermatological alterations occurring during pregnancy and actual cosmetic protocols available and recommended for safe use. Throughout pregnancy, woman's body undergoes many transformations such as hormonal changes and weight gain. These alterations can result in undesirable skin aspects that end up affecting the future mother's life. The main complaints of pregnant women involve melasma advent, varicose veins, edema, and natural skin aging. Even if most of the time is recommended to wait for the birth to use cosmetics, there are some alternatives to prevent and to treat these alterations during pregnancy. For all these cases, there is a need to update information about safety and efficacy of new actives and technologies in cosmetic products. The purpose of this study was to conduct a literature review about the main skin alterations during pregnancy and actual recommended treatments, according to the current legislation.

Keywords: pregnancy, cosmetic, treatment, physiological changes

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365 Enhancement of Cross-Linguistic Effect with the Increase in the Multilingual Proficiency during Early Childhood: A Case Study of English Language Acquisition by a Pre-School Child

Authors: Anupama Purohit

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The paper is a study on the inevitable cross-linguistic effect found in the early multilingual learners. The cross-linguistic behaviour like code-mixing, code-switching, foreign accent, literal translation, redundancy and syntactic manipulation effected due to other languages on the English language output of a non-native pre-school child are discussed here. A case study method is adopted in this paper to support the claim of the title. A simultaneously tetra lingual pre-school child’s (within 1;3 to 4;0) language behaviour is analysed here. The sample output data of the child is gathered from the diary entries maintained by her family, regular observations and video recordings done since her birth. She is getting the input of her mother tongue, Sambalpuri, from her grandparents only; Hindi, the local language from her play-school and the neighbourhood; English only from her mother and occasional visit of other family friends; Odia only during the reading of the Odia story book. The child is exposed to code-mixing of all the languages throughout her childhood. But code-mixing, literal translation, redundancy and duplication were absent in her initial stage of multilingual acquisition. As the child was more proficient in English in comparison to her other first languages and had never heard code-mixing in English language; it was expected from her input pattern of English (one parent, English language) that she would maintain purity in her use of English while talking to the English language interlocutor. But with gradual increase in the language proficiency in each of the languages of the child, her handling of the multiple codes becomes deft cross-linguistically. It can be deduced from the case study that after attaining certain milestone proficiency in each language, the child’s linguistic faculty can operate at a metalinguistic level. The functional use of each morpheme, their arrangement in words and in the sentences, the supra segmental features, lexical-semantic mapping, culture specific use of a language and the pragmatic skills converge to give a typical childlike multilingual output in an intelligible manner to the multilingual people (with the same set of languages in combination). The result is appealing because for expressing the same ideas which the child used to speak (may be with grammatically wrong expressions) in one language, gradually, she starts showing cross-linguistic effect in her expressions. So the paper pleads for the separatist view from the very beginning of the holophrastic phase (as the child expresses in addressee-specific language); but development of a metalinguistic ability that helps the child in communicating in a sophisticated way according to the linguistic status of the addressee is unique to the multilingual child. This metalinguistic ability is independent of the mode if input of a multilingual child.

Keywords: code-mixing, cross-linguistic effect, early multilingualism, literal translation

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364 A3 Strategy Deployment: A Case Study Applied to a City Government Department for Healthcare in Brazil

Authors: Samuel Bonato, Cineia Santos, Roberta Leite, Carla Ten Caten

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This paper aims to apply the A3 strategy deployment in a local department for healthcare. As a literature review, it was evaluated articles related to the period 2009 - 2018, considering the key-words A3, healthcare, public services and strategy deployment. The methodology used was action research, involving all the actors inside the secretary, beginning with the top management and deploying it through meetings and evaluation conferences with the participation of all secretary coordination. As main results, it is possible to highlight the development of 8 A3, one as the "mother A3" and 7 as "son A3", each one related to each coordination. In each A3, past results, new goals, new projects to achieve these goals and control deadlines were defined and implemented to a management strategy. In addition to this result, this paper is planning to present the use of this A3 during 6 months in 2019.

Keywords: A3 Strategy, strategy deployment, healthcare, Public services

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363 Enhancement of Pulsed Eddy Current Response Based on Power Spectral Density after Continuous Wavelet Transform Decomposition

Authors: A. Benyahia, M. Zergoug, M. Amir, M. Fodil

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The main objective of this work is to enhance the Pulsed Eddy Current (PEC) response from the aluminum structure using signal processing. Cracks and metal loss in different structures cause changes in PEC response measurements. In this paper, time-frequency analysis is used to represent PEC response, which generates a large quantity of data and reduce the noise due to measurement. Power Spectral Density (PSD) after Wavelet Decomposition (PSD-WD) is proposed for defect detection. The experimental results demonstrate that the cracks in the surface can be extracted satisfactorily by the proposed methods. The validity of the proposed method is discussed.

Keywords: DT, pulsed eddy current, continuous wavelet transform, Mexican hat wavelet mother, defect detection, power spectral density.

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362 Investigating the Pronunciation of '-S' and '-Ed' Suffixes in Yemeni English

Authors: Saif Bareq, Vivek Mirgane

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The present paper seeks to explicate the pronunciation of the ‘-s’ and ‘-ed’ suffixes when applied in their relative places in word endings. It attempts to investigate the problems faced by Yemenis in the pronunciation of these suffixes in all occurrences and realizations. It discusses the realization of ‘s’ in the four areas of plural, 3rd person singular and genitive markers, and contraction of ‘has’ and ‘is’ as in he’s, it’s ..,etc. and shows how they are differently represented by three different sounds /s/, /z/ and /z/ based on the phonological structure of the words in which they occur. Similarly, it explains the realization of the ‘-ed’ suffix of the past and past participle marker and how it is realized differently by three sounds governed by the phonological structure of these words. Besides, it tries to shed some light on the English morphophonemic and phonological rules that govern the pronunciation of such troublesome endings. It is hypothesized that the absence of such phenomenon in the mother tongue pronunciation of these suffixes.

Keywords: Suffixes' Pronunciation, Phonological Structure, Phonological Rules, Morpho-Phonemics, Yemeni English

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361 The Physiological Effects of Thyriod Disorders During the Gestatory Period on Fetal Neurological Development: A Descriptive Review

Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

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360 Pregnancy Outcome in Women with HIV Infection from a Tertiary Care Centre of India

Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

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Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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359 Stress and Overload in Mothers and Fathers of Hospitalized Children: A Comparative Study

Authors: Alessandra Turini Bolsoni Silva, Nilson Rogério Da Silva

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The hospitalization process for long periods and the experience of invasive and painful clinical procedures can trigger a set of stressors in children, family members and professionals, leading to stress. Mothers are, in general, the main caregivers and, therefore, have a high degree of sadness and stress with an impact on mental health. However, the father, in the face of the mother's absence, needs to assume other responsibilities such as domestic activities and healthy children in addition to work activities. In addition, he has to deal with changes in family and work relationships during the child's hospitalization, with disagreements and changes in the relationship with the partner, changes in the relationship with the children, and finding it difficult to reconcile the new tasks as a caregiver and work. A consequence of the hospitalization process is the interruption of the routine activities of both the child and the family members responsible for the care, who can go through stressful moments due to the consequences of family breakdown, attention focused only on the child and sleepless nights. In this sense, both the mother and the father can have their health affected by their child's hospitalization. The present study aims to compare the prevalence of stress and overload in mothers and fathers of hospitalized children, as well as possible associations with activities related to care. The participants were 10 fathers and 10 mothers of children hospitalized in a hospital located in a medium-sized city in the interior of São Paulo. Three instruments were used for data collection: 1) Script to characterize the participants; 2) The Lipp Stress Symptom Inventory (ISSL, 2000) 3) Zarit Burden Interview Protocol – ZBT. Contact was made with the management of the hospital in order to present the objectives of the project, then authorization was requested for the participation of the parents; after an agreement, the time and place were convenient for the participant to carry out the interview. Thus, they signed the Free and Informed Consent Term. Data were analyzed according to the instrument application manuals and organized in Figures and Tables. The results revealed that fathers and mothers have their family and professional routine affected by the hospitalization of their children, with the consequent presence of stress and overload indicators. However, the study points to a greater presence of stress and overload in mothers due to their role as the main caregiver, often interrupting their professional life to exercise care. In the case of the father, the routine is changed due to taking on household chores and taking care of the other children, with the professional life being less affected. It is hoped that the data can guide future interventions that promote and develop strategies that favor care and, at the same time, preserve the health of caregivers and that include mothers and fathers, considering that both are affected, albeit in a different way.

Keywords: stress, overload, caregivers, parents

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358 Effect of Maternal Factors and C-Peptide and Insulin Levels in Cord Blood on the Birth Weight of Newborns: A Preliminary Study from Southern Sri Lanka

Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

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357 Troubling Depictions of Gambian Womanhood in Dayo Forster’s Reading the Ceiling

Authors: A. Wolfe

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Dayo Forster’s impressively crafted Reading the Ceiling (2007) enjoys a relatively high profile among Western readers. It is one of only a handful of Gambian novels to be published by an international publisher, Simon and Schuster of London, and was subsequently shortlisted for the Commonwealth Writer’s Best First Book Prize in 2008. It is currently available to US readers in print and as an e-book and has 167 ratings on Goodreads. This paper addresses the possible influence of the book on Western readers’ perception of The Gambia, or Africa in general, through its depiction of the conditions of Gambian women’s lives. Through a close reading of passages and analysis of imagery, intertextuality, and characterization in the book, the paper demonstrates that Forster portrays the culture of The Gambia as oppressively patriarchal and the prospects for young girls who stay in the country as extremely limited. Reading the Ceiling starts on Ayodele’s 18th birthday, the day she has planned to have sex for the first time. Most of the rest of the book is divided into three parts, each following the chain of events that occur after sex with a potential partner. Although Ayodele goes abroad for her education in each of the three scenarios, she ultimately capitulates to the patriarchal politics and demands of marriage and childrearing in The Gambia, settling for relationships with men she does not love, cooking and cleaning for husbands and children, and silencing her own opinions and desires in exchange for the familiar traditions of patriarchal—and, in one case, polygamous—marriage. Each scenario ends with resignation to death, as, after her mother’s funeral, Ayodele admits to herself that she will be next. Forster uses dust and mud imagery throughout the novel to indicate the dinginess of Ayodele’s life as a young woman, and then wife and mother, in The Gambia as well as the inescapability of this life. This depiction of earthen material is also present in the novel’s recounting of an oral tale about a mermaid captured by fishermen, a story that mirrors Ayodele’s ensnarement by traditional marriage customs and gender norms. A review of the fate of other characters in the novel reveals that Ayodele is not the only woman who becomes trapped by the expectations for women in The Gambia, as those who stay in the country end up subservient to their husbands and/or victims of men’s habitual infidelity. It is important to note that Reading the Ceiling is focused on the experiences of a minority—The Gambia’s middle class, Christian urban dwellers with money for education. Regardless of its limited scope, the novel clearly depicts The Gambia as a place where women are simply unable to successfully contend against traditional patriarchal norms. Although this novel evokes vivid imagery of The Gambia through original and compelling descriptions of food preparation, clothing, and scenery, it perhaps does little to challenge stereotypical perceptions of the lives of African women among a Western readership.

Keywords: African literature, commonwealth literature, marriage, stereotypes, women

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