Journal articles on the topic 'Averett College'

This essay explores the television productions of Ernie Kovacs and Charles and Ray Eames, analyzing their pioneering audio-visual experiments in the American network broadcast system of the mid-century period. It examines how their work with TV graphics, montage, collage, sound, video tricks and special effects relates to Jean Christophe Averty’s work in French TV in the same period. It explores the “experimental spirit” across the Atlantic before the rise of video art per se, demonstrating how all of these early TV artists challenged dominant conceptions of what TV should be in their respective national and industrial contexts. Finally, it calls for more historical research on and theoretical inquiry into the complex relationships between art, design and commercial TV at mid-century.

Purpose – The purpose of this paper is twofold: first, to extend existing knowledge on the nature, reach, causes and consequences of judgementoring; second, to present a new framework for mentoring beginner teachers that has the potential to forestall and combat judgementoring, and enable the full potential of institution-based mentoring to be realised. Design/methodology/approach – The paper draws on a thematic analysis of: previously published findings from three empirical studies undertaken between 2003 and 2015; new data from two empirical studies undertaken between 2012 and 2016; and recent literature (2013-2016) on judgementoring. Findings – The paper provides further evidence of the nature, reach, causes and consequences of judgementoring as a national and international phenomenon. In doing so, it extends previous knowledge about the conditions that enhance or detract from the successful enactment of beginner teacher mentoring. Practical implications – The findings presented have implications for the work of education policymakers, school and college leaders, mentor trainers, mentors and others concerned with enhancing mentorship and effectively supporting the professional learning, development and well-being of beginning teachers. Originality/value – The paper presents ONSIDE Mentoring as an original, research-informed framework for mentoring beginner teachers. The framework may also be applicable to other contexts, especially for the mentoring of early career professionals.

Ce texte examine, à travers l’oeuvre de Jean-Christophe Averty, les différences fondamentales entre cinéma et vidéo. La démarche du réalisateur y est mise en parallèle avec les utopies des artistes pionniers de la vidéo, qui visent une picturalité par la malléabilité de l’image vidéographique, tandis qu’Averty en expérimente la plasticité pour inventer une écriture inédite spécifiquement télévisuelle. Prenant en considération la dialectique essentielle réel/artificiel de la vidéo, Averty utilise le signal et le trucage (notamment l’incrustation) comme figures d’expression. Il compose avec la simultanéité de cette technologie de flux, et avec la planéité de l’écran du téléviseur, pour conférer des dimensions nouvelles à l’image — contre le réalisme perspectiviste. L’auteur propose ainsi d’étudier l’ontogenèse de l’image électronique, afin de concevoir ce qui détermine une esthétique du médium. Si la technique ouvre des potentialités de création et d’énonciation singulières, elle engage une logique créatrice, et infuse alors une pensée inventrice. En interrogeant les notions de montage, de mixage, d’assemblage et de collage, l’approche technique et théorique adoptée ici élabore des distinctions entre fixation et transmission, représentation et simulation, afin d’évaluer l’écart entre écriture cinématographique et écriture vidéographique.

Background: World Health Organization (WHO) defines sudden death as “deaths within 24 hours from the onset of the symptoms”. It is also defined as death, which is sudden, unexpected, clinically unexplained. Aims of the study was to classify underlying causes of sudden death, to find out risk factors, associated diseases and triggers of sudden deaths in the autopsy specimens received in the Department of Pathology, Government Medical College, South Gujarat.Methods: A review of autopsies of sudden deaths performed between January 2018 to August 2018 in age group 15-45 years at Department of Pathology, Government Medical College, South Gujarat were done.Results: A total of 150 cases were studied for sudden deaths during the study. The age ranged from 15 to 45 years. Maximum deaths occurred in the age group between 35-45 years. Males (n=120) were affected more than females (n=30). The cause of deaths in 84 cases (56%) were attributed to cardiac causes and the remaining cases (44%) were due to noncardiac causes like pulmonary diseases (17.3%) followed by hepatobiliary diseases (5.4%), cerebrovascular (2%) and others like suicide by ingestion of poisoning, hanging and asphyxia (9.3%). Major cardiac cause for sudden deaths was Coronary Artery Disease (CAD) (95.2%).Conclusions: Sudden deaths were common in young adults and most are attributed to a cardiac cause. This study highlights the serious health concern in our society and a necessity to create awareness among the population at risk so that sudden deaths can be averted and life expectancy can be improved.

Context:Selected muscles in the kinetic chain may help explain the body’s ability to avert injury during unexpected perturbation.Objective:To determine the activation of the ipsilateral rectus femoris (RF), gluteus maximus (MA), gluteus medius (ME), and contralateral external obliques (EO) during normal and perturbed gait.Design:Single-factor, repeated measures.Setting:University research laboratory.Participants:32 physically active, college-age subjects.Intervention:Subjects walked a total of 20 trials the length of a 6.1-m custom runway capable of releasing either side into 30° of unexpected inversion. During 5 trials, the platform released into inversion.Main Outcome Measures:Average, peak, and time to peak EMG were analyzed across the 4 muscles, and comparisons were made between the walking trials and perturbed trials.Results:Significantly higher average and peak muscle activity were noted for the perturbed condition for RF, MA, and EO. Time to peak muscle activity was faster during the perturbed condition for the EO.Conclusion:Rapid contractions of selected postural muscles in the kinetic chain help explain the body’s reaction to unexpected perturbation.

Receiving a ‘W’ for a class withdrawal differs from earning a grade of ‘D’ or ‘F,’ yet studies typically combine these elements. This study focuses on the ‘W’: 1) to urge teacher-scholars to investigate its importance and 2) scholarly teachers to engage in methods that may avert student withdrawals as well as to facilitate students to make more informed decisions before taking a ‘W.’ The article addresses the scant literature on the ‘W’ to re-contextualize a student’s decision to withdraw from a course in the broader student success literature. Studies of retention, persistence, and completion of higher educational goals widely recognize both academic and non-cognitive influences that may move a student to withdraw from college. Results of the authors’ case study presented here suggest parallels in student decisions to withdraw from a course, hoping to raise awareness within the scholarship of teaching community of the need to probe this topic, in view of in their wisdom for teaching and learning their passion to educate students for a better quality of life and work.

Introduction: Internet is one of the most essential elements in everyday life of everyone. Simultaneously, it’s an emerging public health issue also, especially in our country. Excessive and undisciplined use of internet may lead to many physical, social, psychological and behavioral disorders. Medical students have not only lengthy syllabus but also hefty study hours and internet addiction may affect their scholastic pattern and learning. Therefore, this study was designed to assess prevalence and pattern of internet addiction and its consequences among them. Aims and Objectives: The aim of this cross-sectional study is to determine prevalence and pattern of internet addiction and its ill-effects among medical students of M P Shah Government Medical College, Jamnagar. Methodology: We included all medical students (n=600) of all semesters of MP Shah Medical College and collected data using Dr. Kimberly Young’s Internet addiction scale from October 2019 to December 2019. Informed Consent was taken. Results: We observed that majority of students (82.67%) were average online users. The mean score of internet usage for male and female medical students was 44.22 and 38.48 respectively. Sleep disturbance, impulsiveness, anxiety, emotional liability, lack of interest in study were some of the major consequences of internet addiction among students observed in our study. The study also observed that students tried several methods like Yoga, meditation etc. to get rid of the internet addiction and concentrate on studies. Conclusion: Periodic screening of students should be carried out to identify internet addicts and a comprehensive program or strategies should be formed at institutional level for support and counselling of such students and to avert and cope up with ill effects of internet addiction.

Background: Treponema pallidum and HIV are among the most common public health problems in Ethiopia. These infections are interrelated. Treponema pallidum causes genital ulcer which enhances HIV transmission and complicates HIV by causing severe ulcer among HIV-positive individuals. Although Treponema pallidum and HIV have a similar route of transmission, screening services for Treponema pallidum are not available in most of the voluntary counseling and testing centers. Objectives: This study aimed to assess the seroprevalence of Treponema pallidum and sociodemographic factors among HIV-positive and HIV-negative individuals from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: In this research, a cross-sectional study was conducted and a total of 292 consecutive samples were collected from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College. Data were collected using an interviewer-administered questionnaire. A blood specimen was tested for the presence of Treponema pallidum using rapid plasma reagin and a rapid test kit for HIV. The data were entered and analyzed using SPSS version 20. Results: The overall prevalence of Treponema pallidum was 5/292 (1.7%). All HIV-positive clients were negative for Treponema pallidum. None of the risk factors were significantly associated with Treponema pallidum. Conclusion: In this study, the prevalence of Treponema pallidum was 5/292 (1.7%). None of the study participants were co-infected with Treponema pallidum and HIV. Recommendation: There was a lack of association between syphilis and HIV in this study, but still the prevalence of Treponema pallidum among voluntary counseling and testing center clients is a public health problem. Therefore, Treponema pallidum infection control strategies should be designed in parallel with HIV control strategy and actions should be taken to avert the problem, including the provision of better health education and screening services at voluntary counseling and testing centers parallel with HIV.

With the outbreak of deadly Coronavirus in China and other parts of the world, experts suggest that staying in well-ventilated areas can avert infection by the virus. The 1990s decade was the warmest and the year 1998 was the warmest recorded since 1861. More than half of the 110 known Harlequin frog species have vanished due to climate change and global warming. 14.6 million hectares of natural forest are lost each year in an area than England. Because of the rising temperature, polar bears are waking up early from their winter slumber. When they are not able to hibernate, they become grouchy and increasingly aggressive. UN secretary called climatically changes as the biggest challenge of 21stcenture. Exactly the changes worsen the lifestyle of manhood life and animal kingdom also. In 2020 we are facing Covid19 Pandemic crisis in the Urban-rural area. In an urban area, people are affected by this pandemic more than rural people. The environmental researchers stated in various studies that urban people are living in congested air due to inflation and lack of space for living to compare to the rural people. The urban public has a lack of ventilation in structural development. To Avoid Air Born Infection In Todays Era at Urban Area Needs Proper Home Ventilation with respect to Ventilation and Coronavirus (COVID-19). If you are using an air purifier, people must also ensure proper maintenance by following the advice of the manufacturer. If fans are used, they should be mounted where room air can be exhausted directly through a window into the outside area. Another way to reduce the spread of viruses according to experts is by letting fresh air in by keeping windows and doors open.

Background: There are numerous umbilical cord abnormalities ranging from false knots, which have no clinical significance, to vasa previa, which could cause foetal loss. With availability of more sophisticated prenatal ultrasound techniques, many can be detected early in utero, however many of these are not apparent till delivery. In this study primary objective was to study correlation of umbilical cord complications and foetal outcome. Authors also outlined available courses of action to avert their morbidity and mortality.Methods: Prospective case control study was conducted in Department of Obstetrics and Gynaecology of M.G.M. Medical College and M. Y. Hospitals, Indore. Antenatal women with more than 28 weeks gestation were included. 500 cases with cord abnormalities were followed till delivery and were compared to the 500 controls with normal cord findings. Data was recorded in predesigned coded case report forms and statistical analysis was performed.Results: Of all the cord complications studied nuchal cord was the commonest i.e. 66.2% followed by abnormal cord length 12.4%. Incidence of cord prolapse was 7.2%. Single umbilical artery, cord knot and abnormal umbilical artery flow were found in 4%, 1.38% and 0.68% respectively.Conclusions: The presence of nuchal cord per se is not found to be an indication of operative delivery. However, these cases require close intrapartum monitoring. Gross cord abnormality was associated with still birth, intra uterine growth restriction and intrapartum or immediate post-natal complication.

Background: LBW is a significant public health problem globally. In India every 3rd newborn is a LBW contributing to about 40% of the global burden. The objective of the study was to determine the prevalence of LBW and premature births and their associated maternal factors.Methods: A cross sectional study was done in antenatal women attending Rama Medical College Hospital& Research Centre, Hapur. Maternal factors and socioeconomic factors collected from 406 mothers were coded and analyzed using the SPSS 16. Chi square test was applied and p value less than 0.5 was considered as statistically significant.Results: Prevalence of LBW was 31.8% and prematurity was 25.6% in the study. LBW and premature babies were more associated with joint families, ≤Rs. 2999/- monthly income, maternal illiteracy and house wives. LBW and Premature babies decreased with increase in income, Hb >11.1 gms and ≥ 100 IFA tablets intake. The rates of LBW were the same whether mothers had no ANC or full ANC. This raises doubts about the content of the ANC.Conclusions: A good quality dedicated and sincere comprehensive ANC package including 4 ANCs, 100 IFA, 2TT/Booster, simple serial measurement of BP, weight, haemoglobin, fundal height and abdominal girth during each visit and screening for complications, counselling for birth and emergency preparedness, newborn care, breast feeding would help avert LBW and premature birth.

Introduction Modern health services utilization in developing countries has continued low. Financial shortage to access health-care services might be averted by stirring from out-of-pocket payment for health care at the time of use. The government of Ethiopia; depend greatly on foreign aid (50%) and out-of-pocket payments (34%) to fund health services for its population. This study was aimed to identify factors associated with households’ enrollment to CBHI scheme membership. Methods Case-control study design was conducted from May 18–July 27, 2019 among 332 participants (166 enrolled and 166 non-enrolled to CBHI scheme). Simple random sampling technique was used to select the study participants. Bi-variable and multivariable logistic regression model were fitted to identify factors associated with enrollment to community based health insurance. Adjusted odds ratio (AOR) with 95% CI was used to report association and significance was declared at P<0.05. Result A total of 332 (100% response rate) were involved in the study. Educational status (College and above, AOR = 3.90, 95%CI; 1.19, 12.75), good awareness about CBHI scheme (AOR = 21.595, 95% CI; 7.561, 61.681), affordability of premium payment (AOR = 3.403, 95% CI; 5.638–4.152), wealth index {(Poor, AOR = 2.59, 95%CI; 1.08, 6.20), (Middle, AOR = 4.13, 95%CI; 1.11, 15.32)} perceived health status (AOR = 5.536; 95% CI; 1.403–21.845), perceived quality of care (AOR: 21.014 95%CI; 4.178, 105.686) and treatment choice (AOR = 2.94, 95%CI; 1.47, 5.87) were factors significantly associated with enrollment to CBHI. Conclusion Enrolment to CBHI schemes is influenced by educational level, awareness level, affordability of premium, wealth index, perceived health status, perceived quality of care and treatment choice. Implementation strategies aimed at raising community awareness, setting affordable premium, and providing quality healthcare would help in increasing enrollment of all eligible community groups to the CBHI scheme.

IntroduzioneLa vicenda del Labour Party degli anni ottanta costituisce un caso altamente paradigmatico, al di là della peculiarità della sua forma organizzativa (partito confederato e indiretto) e del contesto politico-istituzionale in cui opera (Allum 1988), di molteplici problemi che la scienza politica ha sollevato negli ultimi decenni circa la prospettiva del partito di massa e di quello specificamente ad origine di classe. Le tesi del declino del partito di classe e dell'esaurirsi dell'opposizione politico-parlamentare (Massari 1990a) sembravano calzare perfettamente alla parabola sempre più declinante del Labour Party a partire dalla metà degli anni settanta fino a culminare nel quasi collasso dei primi anni ottanta. Nel 1981 il partito subisce una pesante scissione alla sua destra, con la formazione dell'SDP, che con i liberali formerà l'Alliance elettorale. Nelle elezioni del 1983 il partito rischiò seriamente di essere scavalcato dall'Alliance finendo al terzo posto e di perdere il ruolo di opposizione ufficiale. Il suo voto si restrinse, infatti, a solo 8 milioni e mezzo (27,6%, il più basso risultato della sua storia elettorale dal 1918) a fronte di 7 milioni e ottocentomila voti dati all'Alliance (25,4%) e a fronte di una sostanziale stabilità del voto conservatore (42,4%). Il 1983 sembrò, difatti, un punto di svolta sia riguardo al futuro del Labour sia riguardo alla natura del sistema partitico. Occorre guardare alla geografia elettorale per comprendere appieno la portata della trasformazione. Se a livello parlamentare il sistema bipartitico ancora reggeva - avendo ottenuto conservatori e laburisti assieme 606 dei 650 seggi, grazie agli effetti disproporzionali del sistema elettorale - ciò non era più vero al livello dei collegi. A questo livello, il sistema bipartitico sembrava definitivamente rotto. Occorre avere presente che nella competizione maggioritaria ad un turno l'interesse va rivolto non solo, ovviamente, al partito che è arrivato primo alla conquista del seggio, ma anche a chi è arrivato secondo, perché è questo che presumibilmente avrà le chances dell'alternanza al secondo round elettorale. L'Alliance, pur avendo ottenuto solo 23 seggi - e da questo punto di vista il Parlamento formatosi nel 1983 è risultato il meno «proporzionale» del mondo democratico (McLean 1988) - è arrivata seconda in 312 collegi, ossia in più della metà del totale. Il Labour arrivò primo in 209, secondo in 132, ma terzo (o anche peggio) in 292 collegi, corrispondenti a quasi metà dei seggi della Gran Bretagna.

Objective: To assessed the types 2 diabetic patient’s knowledge, the practice of, and attitude to lifestyle modification at University College Hospital (UCH), Ibadan. Methods: A cross-sectional descriptive study of types- 2 diabetic patients at the Medical outpatient clinic in UCH was done with a validated structured 48 item self-administered questionnaire that measured the socio-demographics, knowledge, practice of and attitude to lifestyle modifications. A purposive sampling of 99 consenting patients out of 103 determined with Yaro Tamane formulae was done. Data were entered into SPSS v. 21 for descriptive and inferential analysis. Results: About 59.6% of respondents were within ≥60 years age range, and 68.7% of them were females. Many (51.5%) of them had tertiary education qualifications. On knowledge of symptoms, the majority 78 (78.8%) had good knowledge and 21(21.2%) had poor knowledge of diabetes mellitus. While 64 (64.6%) respondents had a good attitude and 35(35.4%) had a poor attitude towards lifestyle modification. Besides, a vast majority (94.9%) reported that lifestyle modification helps attain normal blood glucose levels, preserves life, assuage symptoms, and avert extended complications. The respondents tend to strongly agree to have a good practice of lifestyle modification with a weighted mean of 3.76 to 4.69 on a 5point scale. Conclusion: The majority of the respondents had good knowledge, the practice of and attitude to lifestyle modification which can help patients in altering long-term habits, eating or physical activity, and maintaining these practices as part of the management of the disorder.

Background: Jaundice is the most common clinical condition in the newborn that requires medical attention. This study was carried out in order to assess the knowledge on neonatal jaundice management among the mothers in a selected tertiary level hospital of Dhaka city.Methodology: It was a descriptive type of cross-sectional study. 150 samples were selected by non randomized purposive sampling technique with the administration of a pretested, modified and semistructured questionnaire by face to face interview.Results: Study found that majority of the respondents (76.7%) was in the age group 17-27 years with mean age 23.78±5.397 years. Majority of the respondents (83.3%) had heard about neonatal jaundice previously and 16.7% did not hear about it. Regarding Knowledge on preventive measures of NNJ (neonatal jaundice) 90.6% respondents had knowledge on "Putting jaundiced baby under direct sun light", 62.7% said "Herbal remedies", 48% indicated "Consult with doctor" and 12% had knowledge on "phototherapy". Another major finding from the study was that 7.3% respondents had excellent level of knowledge regarding NNJ, whereas 40.0%, 34.0% and 18.7% had satisfactory, good and poor level of knowledge respectively. The Chi-square test model showed a significant association between previous knowledge of the respondents on NNJ with level of knowledge among the respondents (p= 0.027) and age of the respondents (p=0.012).Conclusion: Awareness should be created among the expecting mothers about neonatal jaundice and encourage them to take preventive measures to avert neonatal mortality and morbidity.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 121-127

Breastfeeding has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of children. Breastfeeding is also considered as the most economical and easily accessible complete nutrition for every new born child1. Poor breastfeeding practices are widespread. It is estimated that sub-optimal breastfeeding, especially non-exclusive breastfeeding in the first 6 months of life, results in 1.4 million deaths and 10% of the disease burden in children younger than 5 years of age2. Reviews of studies from developing countries showed that infants who were not breast fed were 6 to 10 times more likely to die in the first months of life than infants who are breast fed3. The World Health Organization has stated that in 2000, only 16% of mothers in Pakistan exclusively breast feed for a period of three months, as compared to other developing countries where the ratio is higher like Bangladesh (46%), India (37%), and Sri Lanka (84%)4. More than 15% of 24 lakh child deaths could be averted in India by optimal breastfeeding practices5. The key to successful breastfeeding is Information, Education and Communication (IEC) strategies aimed at behavior change6. The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) strongly recommends exclusive breastfeeding (EBF) for the first six months of life7. Variables that may influence breastfeeding include race, maternal age, maternal employment, level of education of parents, socio-economic status, insufficient milk supply, infant health problems, method of delivery, maternal interest and other related related factors8,9. Over the last decade, overwhelming scientific evidence supporting the integral role of breastfeeding in the survival, growth and development of a child, as well as the health and well-being of a mother has come to light10. Different studies were designed at national and international level to explore the knowledge, attitude and practices (kap) towards breastfeeding among postnatal mothers and factors that determine them1. Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 76-83

Aims: The objective of the paper is to study the role of partogram in the outcome of spontaneous labour in primigravidae at term with singleton pregnancy and vertex as the presenting part. Methods: This prospective observational study was carried out in the labour room of the department of Gynaecology and Obstetrics of Medical College & Hospital, Kolkata, over a period of one year i.e. from June 2011 to May 2012 after obtaining approval from the institutional ethical committee. Analysis of the progress of labour was done in five hundred women with the help of modified WHO partograph. The study population was divided into three groups. Group I had a total observed duration of active stage six hours or less and their cervicograph remained on or to the left of the alert line. Group II had total observed duration of active phase between more than six hours and less than ten hours and their cervicograph remained between the alert and action line. Group III, who had the duration of observed active phase more than 10 hours, had their cervicograph crossing the action line. The different types of abnormal labor were studied. The maternal and fetal outcomes were assessed. Results: 80.8% of the women belonged to group I, 15.2% to group II and 4% to group III. Surgical interference increased as the labour curve moved to the right of the alert line. Use of partogram helped in overall reduction in the duration of labour. Timely intervention reduced the incidence of prolonged labour and its sequelae. 19.2% of the women showed abnormal labour . Severe complications were successfully averted. There were no cases of maternal death, puerperal sepsis, ruptured uterus or fresh still births. Overall neonatal mortality rate was also reduced. Conclusions: The use of modified WHO partograph significantly improves the outcome of labour in both maternal & neonatal perspective. The WHO partograph should be used in all maternity units with incorporated management guidelines. DOI: http://dx.doi.org/10.3126/njog.v9i1.11189 NJOG 2014 Jan-Jun; 2(1):52-57

Background: The most common cause of post-partum hemorrhage (PPH) is uterine atony. Treatment for atony follows a well-defined stepwise approach, including drugs and mechanical interventions followed by surgery as a last resort. Early use of intrauterine balloon tamponade is a way of limiting ongoing uterine blood loss while initiating other measures and can be readily implemented by providers with minimal training.Methods: This prospective interventional study was conducted in 112 consecutive patients attended department of obstetrics and gynecology, Gandhi Medical College and Associated Sultania Zanana Hospital, Bhopal, Madhya Pradesh, India, in one year of study period.Results: In this study most of the patients had gestational age >37 weeks [83 (74.1%)]. Most of the patients in the study had vaginal delivery [64 (57.1%)]. In 84 (75%) patients Bakri balloon was used followed by Burke balloon in 17 (15.2%) patients, condom catheter in 7 (6.2%) patients and CG balloon in 4 (3.6%) patients. Different types of balloons were used according to availability of balloon at the time of management. Most of the patients [71 (63.3%)] had trans-vaginal route of balloon placement and 41 (36.7%) patients underwent trans-abdominal balloon placement. Most of the patients 69 (61.65%), responded to tamponing within 20 minutes of balloon placement while 9 patients had negative tamponade and continued to bleed. Bakri balloon tamponade was most commonly used in 84 (75.0%) patients. CG balloon and condom catheter were used only in 4 (3.6%) and 7 (6.3%) patients respectively. Tamponading was effective and successful in 103 (92%) patients.Conclusions: PPH is still a leading but preventable cause of maternal morbidity and mortality. In the majority of cases, relatively simple methods are used to avert a disaster, although these are not always employed. Uterine tamponade using intrauterine balloons appears to be an effective tool in the management of PPH.

Background. Urinary tract infection (UTI) is considered as the most common bacterial infection seen among the pediatric patients. Objective. This study was carried out in order to determine the prevalence of urinary tract infection in pediatric patients, identify bacterial uropathogens responsible for the infection, and study the antibiotic sensitivity patterns of bacterial isolates. Materials and Methods. A cross-sectional study designed and conducted from January to April 2014. Clean-voided midstream urine specimens were obtained from 384 pediatric patients less than or equal to 15 years in sterile universal bottles. Urine collected from each patient was inoculated onto CLED and blood agar plates using a calibrated inoculating loop with a capacity of 0.001 ml. Inoculated plates were incubated for 24–48 hours at 37°C at inverted position aerobically. Bacterial isolates were indentified and characterized by Gram stain and by using an array of standard routine biochemical tests. The antimicrobial susceptibility test was carried out by using the Kirby–Bauer disc diffusion method. Frequency distribution tables were used to describe the findings. Logistical regression was also used to estimate crude odds ratio (COR) with 95% confidence interval (CI) of positive responses to the different variables, and P values less than 0.05 were taken as statistically significant. Result. In this study, a total of 384 patients (199 males and 185 females) aged less than or equal to 15 years from whom urine samples were collected were enrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36 (19.5%) came up with positive cultures, while 25 (12.6%) of the 199 males had significant bacteriuria, and the largest number of study subjects were below the age of 3 years, and the largest positive culture was obtained from this age group, accounting for 35 (57.4%.) out of 61 positive cultures. Bacterial species belonging to six genera were isolated and identified from 61 positive cultures, and the genera were Escherichia, Klebsiella, Staphylococcus, Proteus, Acinetobacter, and Enterococcus. E. coli was isolated in 28 cases (49.5 %), followed by Klebsiella spp. in 17 cases (27.9%), Staphylococcus spp. in 5 patients (8.2%.) (S. aureus in one and coagulase-negative staphylococci in 4 cases), Enterococcus in 7 cases (11.5%), Proteus spp. in 3 cases (4.9%), and Acinetobacter in one case (1.6%). Of the bacterial isolates, E. coli was found out to be the most common pathogen followed by Klebsiella spp. Furthermore, E. coli and Klebsiella spp. were the most common pathogens in female patients accounting for 71.4% and 64.7%, respectively. Regarding susceptibility tests, E. coli and Klebsiella spp. were not 100% susceptible to any of the 11 antibiotics tested. Acinetobacter spp. had 100% resistance to three antibiotics: gentamicin (GN), trimethoprim-sulfamethoxazole (SXM), and augmentin (AMP). But they were 100% susceptible to ciprofloxacin (CIP), cefuroxime (CXM), norfloxacin (NOR), and ceftazidime (CAZ). On the contrary, Proteus spp. was 100% sensitive to all drugs except to nitrofurantoin. Species of Enterococcus had resistance of 71.4% to chloramphenicol (C) and 85.7% to both SXM and erythromycin. S. aureus was 100% susceptible to almost all drugs, while coagulase-negative staphylococci were not as susceptible as S. aureus. Multidrug resistance to two or more drugs was observed in 73.7% of the bacterial isolates. Conclusion. This study determined the prevalence of urinary tract infection in pediatric patients and highlighted the major bacterial uropathogens involved in UTI for the first time in the country. Furthermore, bacterial pathogen species and their frequency was consistent with the usually reported pattern, with E. coli being the most common organism isolated in cases of urinary tract infections followed by Klebsiella spp. Most of the bacterial isolates were multidrug resistant, and it is therefore suggested that appropriate antimicrobials should be administered to reduce the risk of multidrug resistant organisms developing and avert ineffectiveness of antibiotics. This condition indicates that antibiotic selection should be based on knowledge of the local prevalence of bacterial organisms and antibiotic sensitivities rather than empirical treatment. The present study indicated that ciprofloxacin (CIP), ceftazidime (CAZ), cefotaxime (CTX), cefuroxime (CXM), clindamycin (DA), and ceftriaxone (CRO) were the best antibiotics for the treatment of Gram-negative and Gram-positive bacterial uropathogens, respectively, in the study area relatively.

BACKGROUND COVID-19 a disease caused by SARS CoV-2 virus ever since its emergence as a pandemic in March 2020 has taken a toll on human race. Social distancing and use of face masks in public places, are globally recognized as two vital components of the preventive strategy for slowing down the transmission of SARS CoV-2. The purpose of the current study was to quantify the behaviour of wearing masks and practice of social distancing amongst general population and also observing the same in one of the red zones of Jammu and Kashmir. METHODS A cross-sectional study, was conducted by the Department of Community Medicine, SKIMS Medical College, Srinagar [red zone] of UT Jammu & Kashmir during the 2nd lockdown announced from 15th April 2020 to 5th May 2020 that had made provision for relaxation of essential services. One hundred randomly selected locations [wards] within the city especially around the food outlets, bank, grocery stores, mohalla centres within the red zone which could operate during the lock down were included in the study to get the requisite sample. RESULTS From randomly chosen locations, 895 persons available for observation were taken up for the study. Mask use was seen in 67.3 % of population. Majority were wearing woven fabric masks (33.6 %) followed by 23.2 % (all women) using dupatta [head cover] as mask & 19.5 % using surgical masks. Reasons for not wearing the masks were that necessity of wearing them was not perceived in 68.4 % whereas 20.5 % reported discomfort on wearing masks. Social distancing was least observed by majority of 65 % (N = 582). CONCLUSIONS Despite awareness generation, use of mask and social distancing was not being practised. Robust behaviour change communication efforts with frequent reinforcement about the preventive measures can avert large morbidity & mortality from COVID-19 till vaccine becomes available and accessible to masses at large. KEYWORDS COVID-19, Masks, Social Distancing

<p><strong>Objective:</strong> The present study has been conducted to investigate the role of plasma homocysteine on neonatal birth weight.</p><p><strong>Methods:</strong> This prospective cross sectional analytical study was conducted in the inpatient department of obstetrics &amp; gynecology, Dhaka Medical College Hospital on 120 term, singleton pregnant women. Pregnant women with plasma total bomocysteine &gt;15 µmol/L were termed as having hyperhomocysteinemia (case, n = 25), while women with plasma total homocysteine ≤15 µmol/L were considered as notmal (control, n = 95). Neonatal birth weight was the main outcome variable which was compared between case and control groups. <strong></strong></p><p><strong>Result:</strong> The entire women in the case group were in their 3rd decades, while 80% of the control group were in this age range and 10% was below 20 and 10% above 30 years old. The cases were older than the controls (25.6 ± 2.0 vs. 23.7 ± 4.7 years, p = 0.051 ). Over three-quarters (76%) of the cases were SSC level educated, while majority (84.2%) of the controls was primary level educated. Eighty percent of the neonates born of mothers with hyperhomocysteinemia were of low birth weight as opposed to only 9.5% in the control group. The mothers of case-group carry nearly 40(95% of CI= 11.5 - 126.4) times higher risk of having low birth weight babies than the mothers with nonnal homocysteine level. The mean birth weight of neonates of case group was observed to be significantly higher (2.8 ± 0.4 kg) than that of control group (2.2 ± 0.4 kg). Correlation between the two variables shows that as plasma homocysteine level of women increases the birth weight of neonates decreases bearing an inverse relationship between these two variables (r = - 0.326, p &lt; 0.001 ). <strong></strong></p><p><strong>Conclusion:</strong> Pregnant women with elevated plasma total homocysteine carry much higher risk of giving low birth weight babies than the women with normal or low level of total homocysteine. Thus, measuring total homcysteine during pregnancy is of much clinical importance as corrective measure could be taken to avert the adverse pregnancy outcome.</p>

Indonesia, as a tropical region, shows high potential for rainfall. At highlands, enormous rainfall triggers both soil and coastal erosion. Landslides are frequently occured in Semarang in which some of whose areas are indicated as highlands with unstable soil. This study was carried out in DeliksariSukerejo, Gunungpati sub-district of Semarang. Various effort have been done to prevent the disaster such as socialization of preventing landslide given by government, private institutions, colleges, and non-governmental organizations. However, most of those method only involve for the adults, involving of the children in effort to understandthe disaster mitigation concept are less. One of the effort used was FHP (Funny Hand Puppet) Story Telling. This method tried to draw childrens attention by handy-puppets shows, so the the purpose which is hoped could be well-transferred. As many as 24 children attended this shows. From the pre-test, it was gained 84.3% of those who did not know simple ways to avert the landslide. After the socialization had been given, post-test results showed 94.8% of the children significantly understood the danger of landslide. From the results depicted the increasing of landslide awareness as 10.5%. All respondent were children between 4-13 years old.This method provided broader education about landslide happening in their surroundings. Indonesia sebagai negara tropis memiliki potensi curah hujan yang tinggi. Pada daerah perbukitan, curah hujan yang tinggi merupakan faktor pemicu terjadinya longsoran baik pada tanah maupun batuan. Bencana longsor juga sering terjadi di kota Semarang yang sebagian wilayahnya perbukitan dengan kondisi tanah yang tidak stabil. Dilaksanakan penelitian yaitu di kawasan Dukuh Deliksari, Kelurahan Sukorejo, Kecamatan Gunungpati Semarang. Berbagai upaya telah dilakukan dalam pencegahan bencana tersebut, misalnya sosialisasi pencegahan bencana longsor yang dilakukan oleh pemerintah, swasta, perguruan tinggi, dan LSM. Kebanyakan upaya tersebut hanya melibatkan orang dewasa, sehingga anak-anak belum memiliki pemahaman sejak dini mengenai lingkungan tempat tinggal mereka yang rawan longsor. Salah satu metode yang digunakan adalah FHP (Funny Hand Puppet) Story Telling. Metode ini mencoba menarik perhatian anak-anak dengan menggunakan boneka tangan yang ditujukan kepada anak-anak sehingga pesan yang dibawa dapat tersampaikan dengan baik. Sebanyak 24 anak-anak yang mengikuti metode ini didapatkan dari hasil pre test 84,3% belum mengetahui cara sederhana menangani bencana longsor. Hasil dari post testmenunjukkan bahwa 94,8% anak-anak menjadi lebih paham. Dengan hasil tersebut anak-anak mengalami peningkatan sebesar 10,5%. Melalui metode ini, sesungguhnya anak-anak mendapatkan pendidikan yang jauh lebih luas tentang bencana longsor yang benar-benar terjadi di tempat mereka tinggal.

Times have changed and seasons have changed. I remember with nostalgia the cool December mornings of my childhood, the predictable rains, the smell of clean air in open city spaces, and the sight of stars in the evening sky. There were fewer cars on the road then, travel time was much faster, and there were more rice fields to be seen by the road as one left the city limits. How different things are now. How amazingly fast have changes happened in one lifetime. Where the trees and cogon fields once were, buildings now stand. The city is immersed in a soup of soot and chemicals. The sky is grey and, sometimes, light brown. So many vehicles clog the city’s thoroughfares. My eyes tear with the chemicals in the air. The heat is worrisome. I have to deal with a chronic cough that improves with asthma medications or disappears whenever I leave the city for a cleaner environment. My sense of smell has greatly declined with the increased time and frequency of my driving through the city roads. Worst, the wonderful December mornings that heralded the coming of Christmas are gone… they have been gone for a long time. Is this what I want to bequeath to my children? Is this what you want for the generations to come? Are we going to fail as the previous generations have? What is it going to take to save our environment and avert climate change? Acting in numbers often gets results faster than acting alone. On my own, I have been trying to make a difference but, now, I look to the specialty society that I belong to as a vehicle for greater change. As more and more people are realizing the urgency of actions to save the environment that sustains us, I am sure that there are members in the Philippine Society of Otolaryngology-Head and Neck Surgery (PSO-HNS) who are willing to commit themselves to actions and lifestyle changes for a safe planet. The PSO-HNS is ideally positioned to make a difference. Spread throughout the country, we, its members, see patients who suffer from environmentally influenced and lifestyle influenced illnesses. Thus, we know what effects worsening climate conditions can have on health. We are in a position, not just to prescribe appropriate medications, but also to reach out and give meaningful advice. To give convincing advice to patients, we must start with ourselves. Seventeen years ago, I began a journey that I ask my colleagues to now take. To decrease garbage and lessen wastage, I began to segregate my garbage into dry paper products, tin and aluminum products, glass and recyclable plastic products, dry non-recyclable items, organic material, and wet non-recyclable materials. I would bring my newspapers, dry paper products, glass and plastic items, old rubber tires, and old car batteries to a junk shop. Later on, I would not have to do this anymore since garbage men and other individuals would come to the house to pick up the items that they could sell for recycling. The wet garbage went into my garden soil and into a composting drum. Even now, I re-use envelopes, gift wrappers, ribbons, and papers with print on only one side. I use baskets, not plastic bags when I buy my fruits and vegetables at the organic market. I bring my own stainless steel and glass food containers when I buy cooked food in the same market. To decrease the amount of chemicals that seep back into the environment, I refrain from the use of chemical sprays and artificial scents at home. I do not use chemicals in my garden. I don’t burn garbage. I don’t use diesel as a fuel. I regularly maintain my vehicles to keep them running efficiently. I plan my trips to lessen my contribution to air pollution. I support and patronize organic food growers as well as producers of natural products. I have greatly decreased my family’s use of plastic food containers. Every chance I have, I encourage people to minimize their use of chemicals, plastic and styrofoam. Knowing that the earth’s resources are used inefficiently with meat-centered diets, I eat more vegetables than meat. After all, it does not make sense to use so much land and energy to plant crops for feeding cows when we could use the land to plant vegetables and fruit-bearing trees for direct human consumption! As we develop ourselves into role models, it shall become easier to talk about environmental concerns to those around us. The PSO-HNS must make a stand on threats to the environment and the need to actively address the problem of climate change. It must make this stand public. Then it must affiliate itself with other groups that are committed to saving the environment. The Society could launch information campaigns on the interconnections of environment, lifestyle and otorhinolaryngologic health. It could tap its own members as speakers or initiate joint projects with other like-minded organizations. In the early 90’s, I organized a symposium in my hospital with air pollution as the topic. The speakers were specialists and non-doctors who were knowledgeable about the subject matter. Even at that time, the increased appreciation for environmental discussions was obvious with so many people in the audience. The interest that information campaigns would generate now would definitely be greater! The Society could raise funds and sponsor activities that increase environmental awareness and create positive results for the environment. How about raising money with a fun run or fun walkathon in the La Mesa Dam Nature Reserve? Why not a Doctors on Bikes event to underscore the significance of fuel-less travel? Or a Doctors Go Organic Festival? Perhaps a Mahabang Buhay sa Gulay activity? We could also do a Tulong sa Ilong, Tulong sa Kapaligiran mission wherein giving medical help is coupled with lectures on lifestyle and environment. We could collate and publish the contents of our environment and lifestyle lectures and sell these or give away to patients. We could incorporate environment games in our Society sportsfest during conventions. We could come up with PSO-HNS Recipes (For Health of Self and Health of Environment), Nose-Friendly Natural Aromatherapy Oils, Ear-Friendly Biodegradable Cotton Tips, and Recyclable Masks and sell these in our clinics, at conventions and in organic markets. In the PSO-HNS office as well as PSO-HNS conventions, the commitment to the environment must be evident. The use of long-lasting low wattage lights, recycled paper, natural soaps and scents, prudent use of electricity, and environmental posters on the walls will strengthen the Society’s image as a champion for the planet. During conventions, pharmaceuticals may be required to use only recyclable, non-glossy fliers and posters. These same companies may be reminded to refrain from giving away non-recyclable souvenirs. The convention bag should be made of natural, not synthetic, material. Certificates of attendance should be given only to those who need them. Clothing made from natural materials should be encouraged. Meals may focus more on salads, grains, vegetables and fruits and less on meats. After starting with ourselves and reaching out to others, the PSO-HNS could go international! Strengthened by local experience, the Society could embark on international pro-environment activities in coordination with otorhinolaryngology organizations in other countries. The PSO-HNS, having interests in health, science, and otorhinolaryngology, has great potential to be an agent for change. I hope my passion for nature shall become its collective passion too. This society is blessed with intelligent, highly skilled, creative, and similarly abled individuals capable of using its influence and resources to make a significant contribution towards saving the environment. My cool December mornings may never come back, but the PSO-HNS can still help avert the slide towards planet disaster!

Pelvic floor prolapse is a frequent condition in the female population, inevitably deemed to increase with the population average age increase. If quality of life of women suffering from pelvic prolapse is investigated, the impact of symptoms may result dramatic, causing psychological, relational, sexual, working problems. Posterior vaginal wall defects are classified as rectocele and enterocele. Rectocele means hernia or protrusion of the anterior wall of rectum in vagina, such condition being determined both by softening of posterior vaginal wall and by damaging of lateral insertions of the vagina to the pelvic wall. RIASSUNTO Il descensus del pavimento pelvico &egrave; una condizione frequente nella popolazione femminile, destinata inevitabilmente ad aumentare con l&rsquo;aumento dell&rsquo;et&agrave; media della popolazione. Se si indaga sulla qualit&agrave; della vita delle donne affette da descensus pelvico, risulta che l&rsquo;impatto dei sintomi pu&ograve; essere drammatico, creando problemi psicologici, relazionali, sessuali ed occupazionali. I difetti della parete vaginale posteriore vengono classificati come rettocele ed enterocele. Per rettocele s&rsquo;intende l&rsquo;ernia o protrusione della parete anteriore del retto in vagina, tale condizione pu&ograve; essere determinata sia da un&rsquo;attenuazione della paAim of the study is to use a surgical technique for the treatment of posterior vaginal wall defects and a type of prosthetic material that solves the pathology, being in the meanwhile the least invasive as possible, not having high costs and not leaving physical and/or psychological invalidating problems. In the choice of the type of surgical intervention to be carried out for the correction of an anatomical and/or functional defect is necessary to carefully evaluate the impact that this intervention may cause to women&rsquo;s life and - as the evidencebased medicine imposes - it is necessary to evaluate the adequacy of medical interventions as to the possibility that they offer to promote or regain health. The surgical technique used foresees a transversal incision of the posterior vaginal wall at the rima vulvae with detachment of the vagina and exposure of the rectovaginal septum up to the posterior fornixes. Exposing the ischial spine, a Vicryl point is given bilaterally 1 cm forward and upward to the spine itself. Thus the PelvocolTM tape is fixed with the same thread that consequently anchors the wall of the vaginal fundus, De Lancey II-III point. With this technique the musculi levatoris ani are not medialized, there are no sutures in the vagina, thus guaranteeing a normal anatomy and a normal vaginal axis, avoiding the onset of dyspareunia and pain in the sacral region, as a consequence of the traditional posterior colporrhaphy or the suspension correction to the ligamentum sacrospinalis. rete vaginale posteriore che da un danneggiamento delle inserzioni laterali della vagina alla parete pelvica. Scopo dello studio &egrave; quello di utilizzare per la cura dei difetti della parete vaginale posteriore, una tecnica chirurgica e un tipo di materiale protesico che al contempo risolva la patologia, sia il meno possibile invasivo, non abbia costi elevati e non lasci esiti invalidanti fisici e/o psichici. Nella scelta del tipo d&rsquo;intervento chirurgico da effettuare per la correzione di un difetto anatomico e/o funzionale &egrave; necessario valutare attentamente l&rsquo;impatto che tale intervento pu&ograve; avere sulla vita della donna e come c&rsquo;impone la medicina basata sull&rsquo;evidenza, &egrave; necessario valutare l&rsquo;appropriatezza degli interventi medici in relazione alla possibilit&agrave; che offrono di promuovere o recuperare il bene salute. La tecnica chirurgica utilizzata prevede un&rsquo;incisione trasversale della parete vaginale posteriore a livello della rima vulvare con scollamento della vagina ed evidenziazione del setto rettovaginale fino ai fornici posteriori. Repertando la spina ischiatica, si appone un punto di vicryl bilateralmente ad 1 cm in avanti ed in alto alla spina stessa. La bendarella di Pelvicol &trade; viene cos&igrave; fissata con lo stesso filo che conseguentemente ancora la parete del fondo vaginale, II-III punto di De Lancey. Con tale tecnica i muscoli elevatori dell&rsquo;ano non vengono medializzati, non vi sono suture in vagina il ch&egrave; garantisce una normale anatomia ed un normale asse vaginale evitando l&rsquo;insorgenza di dispareunia e dolore in regione sacrale, quale conseguenza della tradizionale col- 14 UROGYNAECOLOGIA INTERNATIONAL JOURNAL P. LIGUORI, R. RIPOLI The utilized material is Pelvicol, a sterile, biocompatible fabric, made up of acellular collagen matrix and elastin fibres, derived from pig dermis. The correction of grade I, II and III rectocele has been rarely applied in the past due to the concern of creating an excessive reduction in the vaginal caliber with complications such as reduced vaginal capacity and dyspareunia. Our experience demonstrated that the carrying out of the above described surgical technique not only guarantees the anatomical preservation of the posterior segment, but represents an optimal repair of the pelvic statical defect. The Pelvicol implant guarantees to women the return to normal social and sexual life, so that this method is to be privileged with respect to traditional surgical techniques. However, this surgery needs a wider usage trial by other surgeons, in order to find its definite role in rectocele surgical therapy.

Abstract Background To assess the potential impact of a tax-induced cigarette price increase on financial and health outcomes by different socioeconomic groups. Methods In a modeled condition using pooled cross-section data from Household Income and Expenditure Survey (2002–2017) and Iran 2019 population data, a methodology of an extended cost effectiveness analysis (ECEA) was applied to model the impact on cigarette consumption of hypothetically increased cigarette tax. The methodology was employed to evaluate: [1] health benefits (premature deaths averted); [2] health expenditures regarding smoking-related disease treatment averted; [3] additional tax revenues raised; [4] change in household expenditures on cigarettes; and [5] financial risk protection among male Iranian smokers in a time span of 60 years following a one-time increase in cigarette price of 75%. The Stata version 15.1 (StataCorp., College Station, TX, USA) was used to perform the relevant analysis and estimate regression models. Results A 75% increase in cigarettes price through taxation would reduce the number of smokers by more than half a million, 11% of them in the poorest quintile; save about 1.9 million years of life (11% of which would be gained in the lowest quintile compared to 20% in the highest one); eliminate a total of US$196.4 million of health expenditures (9% of which would benefit the bottom quintile). Such a policy could raise the additional annual tax revenues by roughly US$ 1 billion, where the top two quintiles bear around 46% of the total tax burden. We estimated that the tax increase would avert an estimated 56,287 cases of catastrophic expenditure that wholly concentrated among the bottom two expenditure quintiles. Conclusion Increasing cigarette tax can provide health and financial benefits, and would be pro-poor in terms of health gains, Out-of-Pocket (OOP) savings, and financial risk protection against smoking-related diseases.

Stressing the generic skills among learners is an essential component of producing graduates who would be employable and highly competitive in the world of work situations. This study empirically examined the influence of soft skill elements on building technology graduates’ employability at technical colleges in Nigeria. The study tested six hypotheses on soft skill elements influencing building technology graduates’ employability. Data were collected through personal-administered questionnaire from 314 building technology teachers at technical colleges in the north-western States of Nigeria. The instrument was embraced from an earlier study and distributed to Building technology teachers at technical colleges in North West, Nigeria. The results revealed through Partial Least Square (PLS) analysis that ICT skills, and resource management skills have a significant positive relationship with building technology graduates’ employability while personal skills and problem-solving skills have a positive but insignificant relationship with building technology graduates’ employability at technical colleges in Nigeria. It is recommended that teachers or academicians should come out with more interactive ways to develop soft skills among students at every stage to make them become more employable hence, avert them from being unemployed in the future.

Abstract Introduction Physical activity (PA) is proven to be an effective strategy to avert the life threatening cardiovascular diseases. There is need for developing feasible aids to improve compliance to PA. Hence, we conducted a study among medical college students a) to assess the prevalence of recommended PA level and b) to assess the effectiveness of installing a smartphone application (app) in improving PA. Methodology A quasi-experimental study was conducted among medical college students in Puducherry, India. The baseline PA was assessed using the Global Physical Activity Questionnaire (GPAQ) and anthropometric measurements such as height and weight were measured as per World Health Organization (WHO) standards. A smartphone app (Runtastic) was installed on the mobile phones of all study participants. At the end of 1 month, the end line PA and anthropometric measurements were captured using same scales. Results Of the total 350 students who were included, the mean age of the participants was 18.9 (0.9) years and 58% of them were male. The proportion of participants with the WHO recommended level of PA increased from 81% at the baseline to 91% after 1 month of installation of the mobile app (p < 0.001). There was also a statistically significant increase in the leisure time PA [median (interquartile range – IQR) of metabolic equivalents (METS): 0 (0–1600) vs. 1260.0 (0–1920)]. Clinically significant change was not seen in body mass index (BMI) though the reduction was statistically significant [(mean (standard deviation – SD) of BMI: 22.54 (2.49) vs. after intervention 22.46 (2.47); p = 0.018]. Conclusion This quasi-experimental study conducted among medical college students reported significant improvement in total and leisure time PA.

Background: Health professionals, the frontline fighters, are under high risk of being infected with a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many health workers in the world, including Nepal, have lost their lives in fighting with COVID-19. Thus, we assessed the knowledge, attitude, risk, and fear among health professionals towards COVID-19 and evaluated their satisfaction with local and governmental policies of Nepal. Methods: A self-administered questionnaire-based descriptive cross-sectional study included 150 (male-44% and female-56%) health professionals with mean age 26.14±6.092 years working at Chitwan Medical College, Nepal. The questionnaire included 40 statements having four categories to assess 1) the participant’s knowledge about COVID-19, 2) the risk and attitude, 3) their fears, and 4) stake holder’s role in encouraging health professionals to allay their fears and avert negative attitudes.

Background: The incidence of postpartum hemorrhage (PPH) in pregnancies with hepatitis E varies from 14-42%. Management of labor and PPH in these women with acute liver injury makes it a real obstetric challenge due to associated coagulopathies and contraindication for many drugs. Prophylactic insertion of condom balloon tamponade along with active management of the third stage of labour (AMTSL) prevent primary PPH in these women. Simultaneous use of injection tranexemic acid further gives reliable results. The present study was conducted to study the effectiveness of condom balloon tamponade in preventing PPH in pregnant women with acute hepatitis E in labor.Methods: The present study was conducted in the Department of Obstetrics and Gynecology, Pt. Jawaharlal Nehru Medical (JNM) College and associated Dr. Bhim Rao Ambedkar Memorial (BRAM) Hospital, Raipur, Chhattisgarh over period of two year from September 2018 to September 2020.Results: During the study period 32 women presented with hepatitis E in labor. Condom balloon tamponade was inserted prophylactically in all hepatitis E virus (HEV) positive cases immediately after delivery of placenta along with vaginal packing, irrespective of amount of bleeding. Inspite of so many odds in the form of unscanned pregnancies, multiparity, multifetal gestation, abruption, intrauterine fetal death (IUFD), prolonged labor, deranged liver and coagulation profiles, anemia and thrombocytopenia, our study showed high effectiveness of prophylactic condom balloon tamponade by encountering only one case of PPH.Conclusions: Prophylactic condom balloon tamponade insertion just after the removal of placenta is promising in averting PPH.

Fixed partial dentures/crowns have become the most common modality of treatment to replace missing teeth/tooth structure. They are also the most commonly preferred treatment option by the patients. The most important question to be answered is the success and failure rates of the fixed partial dentures/crowns. It is absolutely vital for us to know the reasons for the failure of the prosthesis so that adequate precautions and measures could be taken to avert the same. Failures could be mechanical, biological and esthetic. The following study will throw a light into the most common failures of the fixed partial dentures/crowns as well as the reasons for the failure of the prosthesis.

Abstract. β-Carotene exhibits antioxidant and hepatoprotective activities via a multitude of biochemical mechanisms. However, the action mechanism involved in antioxidant and anti-inflammatory effects of this carotene in chronic liver diseases is not fully understood. In the present investigation, we have attempted to outline a plausible mechanism of β-carotene action against liver fibrosis in albino Wistar rats. To induce hepatic fibrosis, diethylnitrosamine (DEN) was administered in experimental rats for two weeks. DEN treated rats were divided into four groups, wherein each group comprised of five rats. β-Carotene supplement attenuated DEN-induced elevation in LFT markers (P < 0.05); averted depletion of glycogen (24%, P < 0.05) and, increased nitrite (P < 0.05), hydroxyproline (~67%, P < 0.05) and collagen levels (~65%, P < 0.05). Confocal microscopy of tissue sections stained with picrosirius red revealed accrued collagen in DEN-administered group, which was found to be reduced by β-carotene supplementation. Furthermore, β-carotene decreased the expression of iNOS/NOS-2 and NF-κB, as revealed by immunohistochemistry and Western immunoblotting. Collectively, these results demonstrate that β-carotene mitigates experimental liver fibrosis via inhibition of iNOS and NF-κB in-vivo. Thus, β-carotene may be suggested as a possible nutraceutical to curb experimental liver fibrosis.

Abstract When children are exposed to serious life adversities, Ed Zigler believed that developmental scientists must expediently strive to illuminate the most critical directions for beneficial interventions. In this paper, we present a new study on risk and resilience on adolescents during COVID-19, bookended – in introductory and concluding discussions – by descriptions of programmatic work anchored in lessons learned from Zigler. The new study was conducted during the first two months of the pandemic, using a mixed-methods approach with a sample of over 2,000 students across five high schools. Overall, rates of clinically significant symptoms were generally lower as compared to norms documented in 2019. Multivariate regressions showed that the most robust, unique associations with teens’ distress were with feelings of stress around parents and support received from them. Open ended responses to three questions highlighted concerns about schoolwork and college, but equally, emphasized worries about families’ well-being, and positive outreach from school adults. The findings have recurred across subsequent school assessments, and strongly resonate with contemporary perspectives on resilience in science and policy. If serious distress is to be averted among youth under high stress, interventions must attend not just to the children's mental health but that of salient caregiving adults at home and school. The article concludes with some specific recommendations for community-based initiatives to address mental health through continued uncertainties of the pandemic.

Abstract Background Reducing cardiac myocyte (CM) death has been the major focus of cardioprotection in the treatment of myocardial infarction (MI). The post-MI role of cardiac fibroblasts (cFB) has received less attention compared to CM. miRNAs can multi-target in condition-dependent and/or cell type-oriented manner. Reduced miR-211 expression in myocardium is associated with severe cardiac fibrosis in patients with end stage heart failure. We previously reported that miR-221 mimics protect CM in vitro against hypoxic injury. Purpose Taking comprehensive in vivo and in vitro approaches, we tested our hypothesis that miR-221 regulate CM and cFB differently to reduce CM death and inhibit adverse fibrosis following MI. Methods In vitro, H9c2 and rat cFB were transfected with miR-221 mimics (miR-221) and mimic control (MC) and subjected to hypoxia/reperfusion (H/R). Apoptosis (Annexin V and 7-AAD), cell injury (LDH release), and autophagy LC3 II/I and p62 by Western blot (WB). Myofibroblast (myoFB) activation (α-SMA and gel contraction), and collagen synthesis (Sircol assay) were measured. In vivo, following left coronary artery ligation (MI), rats were treated with miR-221 mimics (i.v. 1mg/kg) immediately and 3-days post-MI. Hearts were collected at 2-, 7- and 30-days post-MI. Infarction and fibrosis were determined by Masson trichrome staining and myoFBs identified by α-SMA immunofluorescence. Cardiac function was assessed by echocardiography and LV catheterization. WB, qPCR and Luciferase reporter assays were applied. Results The novel findings of this study are: (1) miR-221 protects CM and cFB through different mechanisms, namely combined anti-apoptotic and anti-autophagic effects vs. anti-autophagic alone, respectively. (2) For the first time we demonstrated that p53 is a direct target of miR-221; downregulation of total and phosphorylated p53 is associated with reduced apoptosis in CM while this effect is completely missing in cFB. Direct targeting of Ddit4 is responsible for anti-autophagy effects in both cell types. (3) miR-221 increases cFB in number but inhibits α-SMA activation and collagen synthesis. (4) Multiple predicted and previously reported targets of miR-221, e.g. Bmf, Puma, p27 and Tp53inp1, are down-regulated in cultured cells but are not affected in the heart in vivo. (5) Working through CM and cFB, miR-221 reduces infarct size, post-MI fibrosis and α-SMA+ cells in both infarct and remote myocardium, and improves LV function (as indicated by preserved ejection fraction, LV developed pressure, +/− dP/dt and end diastolic pressure). Conclusion miR-221 prevents CM and cFB death without extension of injury-stimulated cardiac fibrosis in the infarct zone or adverse fibrosis in the peri-infarct zone. The integrated effects of miR-221 ameliorate adverse post-ischemic LV remodeling and augment cardiac functional recovery. Therefore miR-221 is a unique therapeutic target in the treatment of cardiac infarction.

Background: A retrospective and prospective study including LPA /AFB CULTURE proven cases of MDR TB. Data will be collected from the patient attending the OPD & IPD in the Dept. of Respiratory Medicine Index Medical College, Indore. Result: Out of 226 patients, 183 patients continue on treatment and 8 patients get cure and 12 patients dead and 12 patients defaulted the treatment. Out of 226 patients, the present study shows that Gastrointestinal side effects are the most common 42.5%. 12 patients have renal toxicity and 8 patients have Arthalgia and 6 patients have cutaneous reactions and 14 patients developed hepatitis and 7 patients have some psychiatric illenss and 7 patients developed hearing defect. Conclusion: Overall, these findings emphasize the importance of continuing the systematic surveillance of M. tuberculosis isolates to monitor the trends of drug resistance in different patient categories as well as its association with HIV across the country to timely modify and strengthen the national programs in order to prevent the emergence of MDR-TB strains and avert the threat of XDR-TB. Keywords: Profile, second Line Drug & TB.

Background: Diabetes mellitus is an emerging metabolic disorder of the 21st century and has continued to attract the attention of health practitioners, as it continues to decrease the efficiency of its victims without any promise of change in the near or far future if more is not done to avert the progressing chronic condition. Aim: To determine the attitudinal disposition and management perception among diabetics Mellitus patients in selected hospitals in Ibadan, Nigeria. Study Design: The study was a cross sectional survey design guided by a behavioral theory. Place and Duration of Study: using purposive sampling, the study was carried out among diabetic patient attending University College Hospital, Ring-Road State Hospital and Oluyoro Catholic Hospital, Ibadan, Oyo State. Materials and Methodology: A systematic random sampling was used to select 600 out of 2,115 diabetes patients receiving treatment at University College Hospital, Ring-Road State Hospital and Oluyoro Catholic Hospital. A semi-structured questionnaire was used for data collection on respondents’ socio-demographic characteristics, attitudinal disposition and management perception. Descriptive statistics was used for data analysis. Results: Mean age of the respondents was 63.9 ± 8.6 years, 75.3% were married and 62.7% were females. Majority (94.0%) of the respondents had a positive attitude towards compliance with management of DM. Majority (91.5%) were of the attitude that it is not necessary for people living with DM to do regular exercise as exercise will not make them to breakdown and 97.0% were of the attitude that diabetic patients cannot take any amount of alcohol beverages he/she wants. Respondents’ mean perception score was 21.8 ± 4.8 and 69.2% had a positive perception to management of DM. most (69.2%) of the respondents were of the perception that DM is a lifelong disease and can only be controlled but cannot be cured. Conclusion: Many of the respondents had appropriate perceptions needed to cope with the disease. However, the positive attitude sustenance demonstrated by the respondent should be promoted if compliance with the management of DM must be ensured.

Background:Vaccination is one of the most effective public health interventions. We investigate the impact of vaccination activities for Haemophilus influenzae type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, rotavirus, rubella, Streptococcus pneumoniae, and yellow fever over the years 2000–2030 across 112 countries.Methods:Twenty-one mathematical models estimated disease burden using standardised demographic and immunisation data. Impact was attributed to the year of vaccination through vaccine-activity-stratified impact ratios.Results:We estimate 97 (95%CrI[80, 120]) million deaths would be averted due to vaccination activities over 2000–2030, with 50 (95%CrI[41, 62]) million deaths averted by activities between 2000 and 2019. For children under-5 born between 2000 and 2030, we estimate 52 (95%CrI[41, 69]) million more deaths would occur over their lifetimes without vaccination against these diseases.Conclusions:This study represents the largest assessment of vaccine impact before COVID-19-related disruptions and provides motivation for sustaining and improving global vaccination coverage in the future.Funding:VIMC is jointly funded by Gavi, the Vaccine Alliance, and the Bill and Melinda Gates Foundation (BMGF) (BMGF grant number: OPP1157270 / INV-009125). Funding from Gavi is channelled via VIMC to the Consortium’s modelling groups (VIMC-funded institutions represented in this paper: Imperial College London, London School of Hygiene and Tropical Medicine, Oxford University Clinical Research Unit, Public Health England, Johns Hopkins University, The Pennsylvania State University, Center for Disease Analysis Foundation, Kaiser Permanente Washington, University of Cambridge, University of Notre Dame, Harvard University, Conservatoire National des Arts et Métiers, Emory University, National University of Singapore). Funding from BMGF was used for salaries of the Consortium secretariat (authors represented here: TBH, MJ, XL, SE-L, JT, KW, NMF, KAMG); and channelled via VIMC for travel and subsistence costs of all Consortium members (all authors). We also acknowledge funding from the UK Medical Research Council and Department for International Development, which supported aspects of VIMC's work (MRC grant number: MR/R015600/1).JHH acknowledges funding from National Science Foundation Graduate Research Fellowship; Richard and Peggy Notebaert Premier Fellowship from the University of Notre Dame. BAL acknowledges funding from NIH/NIGMS (grant number R01 GM124280) and NIH/NIAID (grant number R01 AI112970). The Lives Saved Tool (LiST) receives funding support from the Bill and Melinda Gates Foundation.This paper was compiled by all coauthors, including two coauthors from Gavi. Other funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Due to the global increase in diabetes, diabetic nephropathy is becoming a significant issue. Diagnosis and treatment in the early stages of nephropathy may avert this considerable complication, and new biomarkers other than microalbuminuria are required to detect diabetic nephropathy earlier in type 2 diabetes mellitus. Moreover, the pathogenesis of complications associated with diabetes as indicated in recent experimental studies showed that growth arrest-specific-6 protein (Gas-6) might have a role. We therefore, embarked on this study to determine the pattern of plasma Gas-6 elevation among type 2 diabetes mellitus patients and to describe any relationship with microalbuminuria using urinary albumin creatinine ratio. This research was a descriptive; a hospital-based cross-sectional study conducted at the Endocrinology Clinic, University College Hospital, Ibadan, Oyo State, Nigeria. We recruited 71 type-2 diabetic participants, and 71 apparently-healthy participants who served as the control. The study showed that the concentrations of Gas-6 protein and UACR in the diabetic participants were all significantly higher than in the healthy control participants (p ˂ 0.001). There was also a positive correlation between Gas-6 protein and UACR value which was statistically significant (rho = 0.41, p = ˂0.001). The sensitivity and specificity of Gas-6 was 75.0% and 19.1% respectively, with a PPV and NPV of 0.68 and 0.25 respectively. In conclusion, Plasma Gas-6protein correlated with microalbuminuria. However, Gas-6 protein alone may be of limited diagnostic value in diabetic nephropathy.

Almost 6.5 million people in United States suffer from heart failure (HF). Diastolic HF following non-ischemic cardiac insult is a progressive condition with limited effective therapies underscoring the urgency to invest in identifying novel therapeutic targets for treatment. Reactive fibrosis in response to pathological stress is one of the major causes of diastolic HF. Emerging data suggest an association of systemic inflammation with reactive fibrosis and HF. Canonical Wnt/beta-catenin signaling has been linked to HF and fibrosis with limited understanding of the precise cellular and molecular mechanism. We utilized thoracic aortic constriction (TAC), a well-defined model of HF, to study Wnt signaling mediated reactive fibrosis. TAC was induced in a transgenic mouse model with stabilized beta-catenin (Wnt signaling) in fibroblasts (Bcat/Postn). Wnt activation following TAC resulted in increased maladaptive reactive fibrosis, HF marker ANP, and cardiac hypertrophy with preserved Ejection Fraction (pEF) suggesting Wnt-mediated progression of diastolic heart failure with pEF. TAC also resulted in increased macrophage activation and recruitment of CD8+ cytotoxic T-cells. In vitro co-culture of Wnt3a-overexpressing fibroblasts with activated myeloid cells promoted fibroblast proliferation and collagen synthesis. Therefore, we hypothesize that Wnt signaling activation promotes interstitial fibrosis via recruitment of specific inflammatory cells. Genomic analysis further supports this by demonstrating distinct chemokine gene expression patterns in fibroblasts resulting from Wnt activation in these injury models. Our future goal is to elucidate the role of Wnt signaling in modulating the fibroblast-immune cell crosstalk in modulating interstitial fibrosis induced diastolic HFpEF. Currently, there is no approved therapy to specifically target reactive fibrosis to avert diastolic dysfunction. Our study is aiming to identify targetable cellular and molecular players that improve, prevent or avert reactive fibrosis mediated HFpEF in order to reduce the incidence and severity of pathology resulting from HF.

Albert Einstein once said, “in the midst of every crisis, lies great opportunity.” There’s no question that we’re in the midst of a global crisis. There’s no doubt that a crisis creates problems, lots of them, but it also creates opportunities. Something that every anaesthetist does day in day out safely, intubation of trachea, is now become a risk factor for spread of the disease. So where is the opportunity in this crisis? In the west, regional anaesthesia is often used as an adjunct rather than as sole anaesthetic technique, as part of multimodal analgesia in patients who are being operated under general anaesthesia. Unfortunately, general anaesthesia requires airway manipulation that is associated with aerosol generation and risks transmission of corona virus. This is a risk that can be averted with use of regional anaesthesia techniques for procedures that can be done with patient awake rather than asleep. At the beginning of the pandemic with surge of patients requiring endotracheal intubation and ventilation, increased intensive care admissions affected anaesthesia services in many ways. The increased number of patients needing critical care increased the demand for drugs used in both anaesthesia and critical care and this demand led to shortage of anaesthesia drugs and led the Association of Anaesthetists (AOA) and the Royal College of Anaesthetists (RCoA), working closely with the Chief Pharmaceutical Officer at NHS England to produce a guidance which summarised potential mitigations to be used in the management of such demand. Direct alternative drugs and techniques were offered (1). The options identified in the guidelines were not exhaustive but give a way of thinking about this situation we all have landed up in. We were unsure of how long this demand would continue and how we would manage the situation. This is where the opportunity to use regional anaesthesia for procedures that could be done purely under neuraxial or peripheral nerve blocks became

La produzione scientifica all’interno di corsi di laurea e laurea ha la sua importanza per la costruzione di un nuovo modo di pensare dello studente. Il Master Professionale in Formazione Professionale in Rete Nazionale (ProfEPT) unisce contenuti disciplinari, conoscenze pedagogiche e produzione accademica finale e li collega a situazioni reali di pratica educativa, e il lavoro finale può essere presentato in vari modi (articoli, libri, prodotti educativi). La produzione accademica, sia del consulente che della guida, oltre all’importanza legata alla divulgazione scientifica, ha peso nella valutazione del programma e anche nella sua manutenzione. L’obiettivo di questo lavoro è quello di mostrare quantitativamente la produzione accademica ed educativa di uno studente di master in Educazione Professionale e Tecnologica (EPT) dell’Istituto di Istruzione, Scienza e Tecnologia (IFAP) di Macapá, Amapá, Amazônia, Brasile. Durante il master, la produzione scientifica in varie forme si è rivelata necessaria durante il processo di formazione. Unire la teoria alla pratica della scrittura, ha facilitato la produzione della tesi che dovrebbe essere presentata alla fine del corso. Attraverso il processo di organizzazione, la pianificazione delle idee ha portato a un nuovo pensiero strutturato secondo gli standard dell’accademia, ma che non si limita a questo spazio e alle sue norme. La produzione durante il master cerca di contribuire sia quantitativamente che qualitativamente alla produzione scientifica della regione settentrionale, imprevolandosi positivamente e con il programma del master. Oltre all’importanza nel contributo della creazione e diffusione scientifica, le produzioni tendono ad avere un impatto positivo sulla valutazione e sul mantenimento del programma PROFEPT-IFAP, svolto da CAPES.

RiassuntoL’analisi dei dati in nostro possesso ha permesso di ricostruire le caratteristiche della syngraphe teopompea, sul piano del contenuto, del metodo compositivo adottato dallo storico nei Philippika, con particolare riguardo al debito nei confronti della storiografia erodotea. All’interno di una cornice cronologica di riferimento, che va dall’ascesa di Filippo II al 337 a. C., Teopompo inserisce, infatti, di continuo, excursus dentro altri excursus, attraverso i quali dà spazio alle vicende delle popolazioni greche e non greche, che abitavano anche aree remote del mondo fino ad allora conosciuto.D’altro canto, il fallimento della grecità poleica e la comparsa di Filippo comportò una nuova visione dell’oikoumene e conseguemente un nuovo modo di fare storia: l’attenzione della storiografia teopompea non si concentrerà esclusivamente sulla Grecia, come era accaduto precedentemente con gli Hellenika, ma si rivolgerà a nuove realtà, fino a quel tempo percepite come ‚periferiche‘, quali la Persia e l’Occidente. Proprio nel quadro dell’azione politica di Filippo in Adriatico si inseriva un ampio logos di storia occidentale (FF 184-205, ll. dal 39° al 43°), contenente al suo interno un’ampia digressione sulla Sicilia che, in quattro libri (FF 184-198, ll. dal 39° al 42°), trattava il periodo dal 406 al 343 a. C., cioè dalla tirannide di Dionisio I all’esilio di Dionisio il Giovane a Corinto. Ancora all’azione ‚occidentale‘ del Macedone si collega un excursus adriatico (FF 128-134), nel quale verosimilmente erano contenute res siculae. Il significato di tale spostamento di prospettiva da parte dello storico si può rintacciare nei grandi cambiamenti in atto in Occidente, dovuti all’avanzata dei Celti nella penisola italica e alla crisi della tirannide siracusana; si tratta di eventi che ebbero grande risonanza in Grecia e che accesero il dibattito sulla possibilità di un’espansione occidentale di Filippo.I frammneti teopompei sulla geografia dell’Adriatico conservano tracce della propaganda siracusana, elaborata da Filisto, relativamente a quell’area; di Dionisio, come di Filippo Teopompo darebbe un’immagine ambivalente nelle due sfere, pubblica e privata: il Macedone, in tutto simile al tiranno siciliano, agli occhi dello storico appare come il diretto erede della politica dionisiana in Grecia e in Occidente.Nell’antichità il debito nei confronti dell’opera di Teopompo da parte di Diodoro, Trogo e dei biografi fu di proporzioni considerevoli.Teopompo potrebbe avere costituito la ‚fonte guida‘ per il sedicesimo libro diodoreo; verosimilmente Diodoro nel corso della sua narrazione potrebbe avere utilizzato il Chiota a più riprese e non di continuo; potrebbe, cioè, essersi servito anche degli storici della guerra sacra, quali Demofilo, che scrisse fino al 341 a. C., e Diillo, che scrisse fino alla morte di Filippo. Inoltre, il racconto di storia siciliana che il Chiota inserì nei Philippika (Diod. XVI 71, 3) potrebbe essere stato utilizzato dall’Agirinense oltre che nel sedicesimo libro, per le vicende di Dione e di Timoleonte, anche nei libri precedenti, per le vicende relative a Dionisio I (XIII-XV).Trogo potrebbe avere utilizzato i Pilippika come modello, canovaccio di riferimento, non solo dal punto di vista delle informazioni storiche ma anche sul piano della struttura dell’opera e della tipologia degli excursus in essa contenuti. Le informazioni presenti nell’excursus sui popoli occidentali del ventesimo libro trogiano sembrano riflettere da vicino il contenuto della digressione adriatica di Teopompo; è, inoltre, possibile che Trogo, relativamente al racconto su Dionisio I (libri XIX-XX)432 e a quello sulle origines Venetorum et Graecorum et Gallorum (XX 1, 6-4. 5, 7-9), avesse utilizzato, fondendoli insieme, l’excursus adriatico (XXI) e quello siciliano (libri XXXIX-XLII) dei Philippika.L’atteggiamento filodioneo di Nepote, Plutarco e Diodoro e la posizione critica nei confronti dei costumi dissoluti del giovane Dionisio e dei Siracusani (Plutarco, Diodoro e Trogo), sembrano di matrice teopompea. Infine, la presenza del Chiota all’interno del racconto del bios timoleonteo di Plutarco, Diodoro e Nepote potrebbe essere di vasta portata in riferimento all’antefatto della vicenda timoleontea fino alla partenza del Corinzio alla volta della Sicilia.

Introduction: Physiologically, von Willebrand Factor (VWF) recruits platelets to sites of injury by binding to exposed collagen and platelet GPIbα, particularly at sites of high shear. VWF is critical to hemostasis, since complete deficiency leads to bleeding as severe as hemophilia. Conversely, VWF plays a key role in arterial thrombosis, as in myocardial infarction and stroke. Despite being an attractive therapeutic target, no agents directed against VWF are currently available. Our group is testing an RNA aptamer that blocks VWF binding to GPIbα as an antithrombotic. We have previously shown that leukocyte influx and cutaneous healing are impaired in a mouse model of hemophilia. We have also found that wound healing is delayed in mice given target specific oral anticoagulants. The purpose of the current study was to determine whether inhibiting VWF would similarly impair wound healing. Methods: We used C57BL/6J mice administered vehicle or VWF aptamer. At the dose selected, aptamer prolonged the saphenous vein bleeding time for the expected 10 day healing period. Healing was assessed in a skin punch biopsy model. Wound size was measured daily, and following sacrifice the wound area harvested for histology. Inflammation (in the absence of tissue injury) was induced by topical application of cantharidin for 24 hours, followed by tissue harvesting. Results: The in vivo efficacy of the aptamer was verified, since bleeding remained prolonged to a level slightly less severe than hemophilia at the end of the experiment (10 days after wounding). There was no difference in time to healing between control and aptamer-treated mice, with all wounds healed at 10 days. There was also no statistically significant difference in wound size at any time. Cantharidin induced a similar level of cellular influx in treated and control mice. Aptamer-treated mice exhibited a slight amount of inflammation-induced hemorrhage, though not the gross hemorrhage observed in thrombocytopenic mice. Conclusion: Inhibition of VWF activity does not delay cutaneous wound closure, despite inducing a severe hemostatic defect. Compared to other antithrombotic strategies, an aptamer against VWF could avert some undesirable side effects on host defense and tissue repair.

Scenario: You are exhausted after a long day at work and collapse in front of the television for some mindless entertainment. One of your favourite comedy shows is on. You begin to relax. You laugh a couple of times. There's a commercial break. You watch the first ad for a hardware store, giving it only half your attention. And then there's another ad, something about a father and son in a car together and then ". WOOOMPH! A truck slams into the car. The message is "Speed kills!" Or there are people playing and sunbathing on a beach, happy holidays, and then vultures descend and surround them. The message is "Slip! Slop! Slap! Don't die in the sun this summer". Or someone is shown smoking a cigarette and the caption reads : "Give up now. You'll soon stop dying for a cigarette". This might be accompanied by scenes of a post-mortem, dissections of human lungs or brain. Context Threat appeals are used frequently in health and road safety promotion. Many use the threat of death as the consequence of undesirable behaviours, for example, "Quit smoking or you'll die' (Henley and Donovan). ("Non-death threats' appeal to other consequences such as "Quit smoking or your skin will age'.) There is an implicit notion of premature death threat, although this is rarely stated explicitly. When reminded of our risk of premature death, we are reminded by extension of the ultimate inevitability of our death. An understanding of the philosophy of existentialism can help us understand why consumers may, quite reasonably, tune out, or literally switch off health promotion messages that remind them of their own death. This paper explores the effect on consumers of these mass media invocations of the fear of death, or "death threats'. Verbatim comments are included from six focus groups conducted on fear and health promotion. Groups were delineated by age (16-20 years, 21-29 years and 30-49 years), gender, and socio-economic status (blue collar/white collar) (Henley). What is existential dread? Fear is one of the primary human emotions (along with anger, sadness, love, joy and surprise) and "dread' is one of the emotion names associated with fear (Shaver et al. 1067). We do not need to learn how to feel fear. We have to learn what to fear, however. Despite the joke about death and taxes, death is uniquely inevitable. (Some people do manage to avoid taxes!) In his definitive work, Denial of Death, Becker stated his belief that knowledge of our own death is the source of 'man's peculiar and greatest anxiety' (70); it's what makes us human. Existentialists think that knowing about the inevitability of our own death can be overwhelming, arousing the worst fear imaginable, "existential dread' (Bugental 287). Existential philosophers and psychologists believe that part of this anxiety stems from the existential dread of "not being'. Discussing Heidegger's analysis of the meaning of death in Being and Time, Barrett put it this way: The point is that I may die at any moment, and therefore death is my possibility now. It is like a precipice at my feet. It is also the most extreme and absolute of my possibilities: extreme, because it is the possibility of not being and hence cuts off all other possibilities; absolute, because man can surmount all other heartbreaks, even the deaths of those he loves, but his own death puts an end to him (201). The essence of existential philosophy is this idea that we are all deeply, terribly afraid of death. Fear of death can be seen even in very young children (Anthony, The child's; Anthony, The discovery; Nagy) who express considerable anxiety about death, but quickly learn from their parents and others how to deny it (Yalom). Existential psychologists have suggested that the fear of our own death is the cause of much of our psychopathology (Yalom). Existentialists believe that the most common response to existential anxiety is to deny it, creating in oneself a 'state of forgetfulness of being' as far as possible. Weisman described three levels of denial in terminally ill patients: "first-order denial' of the facts of illness; "second-order denial' of the implications of the illness; and "third-order denial' of death itself. He noted that often a patient moves from first and second order denial into "middle knowledge' (i.e., acceptance of near death), but then relapses. Weisman remarked that this relapse is often the signal that the terminal phase has begun. This aspect of denial is a complicated factor in the complex measurement of death anxiety. When people say they are not afraid of death, who can say whether they are denying fear or truly not afraid? In either case, health promotion appeals that threaten death may not be effective, either because the fear is denied or because there is no fear. In focus groups exploring people's concepts of death (Henley 111), few people acknowledged being afraid of their own death and many specifically stated that they were not afraid of their own death. One woman voiced the universal difficulty of truly conceiving what it might be like "not to be' (Kastenbaum and Aisenberg) when she said: 'death seems like such an unrealistic proposition'. People did acknowledge fears about death, such as dying painfully, so health promotion messages that threaten these other dimensions of death anxiety may be more effective. Health promotion practitioners frequently use these related death fears. The fear of causing death, for example, is used in road safety advertisements. However, this discussion on existential fear is limited to threat appeals of death per se. Death threats in health promotion Is arousing existential dread an effective way to market healthy behaviours? At first sight, it seems logical that the threat of death would be more persuasive than lesser threats and yet it may not be the most effective approach. There is some evidence that lesser threats may be more effective for some groups of adolescents and young adults for smoking (Donovan and Leivers), and for road safety behaviours (Donovan et al.). For example, for some 18 year old males, the threat of being caught drinking and driving, of losing their driving licence and, thus, their new-found independence may be a more effective deterrent than the threat of dying in a car accident (Donovan et al.). The humiliation of being arrested and charged for drink-driving may be the most powerful persuader for adults of all ages (Bevins). For men attending the Jerusalem Centre for Impotency and Fertility, impotence was reported a more persuasive threat than death: 78% of men who were told that smoking causes impotence quit smoking, compared to 40% who quit when told that smoking causes heart attacks ("No smoking tip"). One woman in a focus group said, 'you tend to think short-term, "can I afford a $100 fine?" rather than long-term, "this is my life." If I stop to think about it, obviously I'm more afraid of dying than $100 [fine], but that's not what I think about' (Henley 95). This makes sense in the context of forgetfulness, the denial of death. We don't want to be reminded of our death so we switch off the death message. Lesser threats may be more easily internalised. Does arousing existential dread do any harm? Perhaps. Job suggested that fear arousal is likely to be effective only for specific behaviours that successfully reduce the level of fear arousal and that high-fear messages may actually increase behaviours that people employ to reduce anxiety, such as smoking and alcohol consumption. People high in anxiety are hypothesised to be hypersensitive to threats and likely to employ a restricted range of self-soothing coping behaviours to reduce negative affect (Wickramasekera and Price). Death threat appeals such as "Quit smoking or you'll die' may arouse defensive, counter-productive responses, at least in some people, because it is impossible to identify any specific behaviour that could successfully reduce the particular, unique fear of death per se. Firestone identified a number of psychological defences against death anxiety, including self-nourishing and addictive habits, such as smoking and overeating. Ironically, these same behaviours are frequently the subject of health promotion campaigns. If such campaigns arouse death anxiety in an effort to curb defensive responses to death anxiety, there clearly could be an increase rather than a decrease in those defensive responses. Arousing death anxiety might contribute to fatalistic thinking. Job described some people's defenses against very high fear, for example, "...you've got to go sometime' or "...when your number's up, your number's up'. In focus groups, people commented, 'if an accident is going to happen, it's going to happen' and 'what's the point of giving up [unhealthy behaviours] if you get run over by a bus tomorrow?' (Henley 95, 108). Rippetoe and Rogers found that fatalistic thinking occurred when subjects did not believe that the recommended behaviour would avert the threat. That is, people may realise that quitting smoking could avert lung cancer and even some causes of premature death but that nothing can avert death itself. Fatalism may be one of the most maladaptive responses because the threat is acknowledged but rendered ineffective (Rippetoe and Rogers). Social marketers can make some of their persuasive communications more effective if they are more mindful of consumers' existential fears. A sensitivity to consumers' psychological defences against existential fear may result in more effective use of threat appeals in health promotion. Mindfulness Mindful that the title of this paper itself may arouse some existential dread, I end with a comment on the existentialist alternative to denial. Existentialists advocate a state of 'mindfulness of being' or 'ontological mode' (Heidegger, quoted in Yalom 31) in which "one remains mindful of being, not only mindful of the fragility of being but mindful, too ... of one's responsibility for one's own being." (Yalom 31). The existentialist strives to be as mindful, as present in the moment, and therefore as authentic as possible. This involves the acceptance of existential anxiety as an appropriate and reasonable response to the human condition (Bugental). Some focus group participants wanted to know in advance that they were going to die, 'so you can fit things in you'd want to do and say goodbye'. Others thought it was better not to know or 'you'd start having regrets'. One person pointed out that we do know in advance: 'you know you're going to die sometime!'. This last comment was followed by a sober, almost shocked silence suggesting that, even while we are freely discussing death on one level, the full meaning of death may still elude us. As consumers of health promotion messages, we are exposed to many reminders of our finite existence. If we sit mindlessly in front of the television receiving these messages, we may feel some unresolved discomfort. People talk about looking away, or switching channels when particularly shocking ads are shown. The existentialist alternative response would be to embrace these reminders and use them to sustain a state of mindfulness. With this state of mindfulness comes a heightened sense of responsibility for one's own being. It is in this ontological mode that we are most likely to adopt the healthy behaviours recommended in health promotion messages. By hearing the death threat openly, and acting to protect ourselves from at least those causes of premature death that may lie within our control, we may be able to discover a fuller experience of what it means to be alive. References Anthony, Sylvia. The Child's Discovery of Death. New York: Harcourt, Brace & World, 1940. Anthony, Sylvia. The Discovery of Death in Childhood and After. Harmondsworth, Middlesex: Penguin Education, 1973. Barrett, W. Irrational Man, A Study in Existential Philosophy. London: Heinemann, 1958. Becker, Ernest. The Denial of Death. New York: The Free Press, 1973. Bevins, John. "Using Advertising to Sell and Promote Health and Healthy Products". Paper presented at the ACHPER Health Products and Services Marketing Seminar. Kuring-gai College, Sydney, 1987. Bugental, J. F. T. The Search for Authenticity: An Existential-analytic Approach to Psychotherapy. New York: Holt, Rinehart and Winston, Inc., 1965. Donovan, Robert J., and Sue Leivers. Young Women and Smoking. Report to Commonwealth Department of Human Services and Health. Perth: Donovan Research, 1988. Donovan, Robert J., Nadine Henley, Geoffrey Jalleh, and Clive Slater. Road Safety Advertising: An Empirical Study and Literature Review. Canberra: Federal Office of Road Safety, 1995. Firestone, Robert W. "Psychological Defenses against Death Anxiety." Death Anxiety Handbook: Research, Instrumentation, and Application. Series in Death Education, Aging, and Health Care. Ed. Robert A. Neimeyer. Washington, DC: Taylor & Francis, 1994. 217-241. Henley, Nadine R. "Fear Arousal in Social Marketing: Death vs Non-death Threats." Doctoral Dissertation, University of Western Australia, Perth, 1997. Henley, Nadine and Robert J. Donovan. "Threat Appeals in Social Marketing: Death as a "Special Case'". International Journal of Nonprofit and Voluntary Sector Marketing, 4.4 (1999): 300-319. Job, R. F. Soames. "Effective and Ineffective Use of Fear in Health Promotion Campaigns." American Journal of Public Health, 78 (1988): 163-167. Kastenbaum, R., and R. Aisenberg. The Psychology of Death. London: Duckworth, 1974. Nagy, Maria H. "The Child's View of Death." The Meaning of Death. Ed. Herman Feifel. New York: McGraw-Hill Book Company, 1959. 79-98. "No Smoking Tip for Lovers". Daily Telegraph, (1994, September 24): p. 4. Rippetoe, P.A. and Rogers, R.W. "Effects of components of protection-motivation theory on adaptive and maladaptive coping with a health threat." Journal of Personality and Social Psychology, 52.3 (1987): 596-604. Shaver, P., J. Schwartz, D. Kirson, and C. O'Connor. "Emotion Knowledge: Further Exploration of a Prototype Approach." Journal of Personality and Social Psychology, 52.6 (1987): 1061-1086. Weisman, A.D. On dying and denying: A psychiatric study of terminality. New York: Behavioral Publications, 1972. Wickramasekera, Ian and Daniel C. Price. "Morbid Obesity, Absorption, Neuroticism, and the High Risk Model of Threat Perception." American Journal of Clinical Hypnosis, 39 (1997): 291-301. Yalom, I. D. Existential Psychotherapy. New York: Basic Books, 1980. Citation reference for this article MLA Style Henley, Nadine. "You will die! " M/C: A Journal of Media and Culture 5.1 (2002). [your date of access] < http://www.media-culture.org.au/0203/youwilldie.php>. Chicago Style Henley, Nadine, "You will die! " M/C: A Journal of Media and Culture 5, no. 1 (2002), < http://www.media-culture.org.au/0203/youwilldie.php> ([your date of access]). APA Style Henley, Nadine. (2002) You will die! . M/C: A Journal of Media and Culture 5(1). < http://www.media-culture.org.au/0203/youwilldie.php> ([your date of access]).

IntroductionIn 2008, researchers at New York University’s Computational Neuroimaging Laboratory challenged our contemporary understanding of audience with an alternative approach to engaging some of the most essential questions regarding film consumption. The study itself used a functional magnetic resonance imaging (fMRI) scanner during the “free viewing of films” allowing researchers the opportunity to see which sections of the brain are activated during certain parts of the viewing (Hasson et al. 2). In an effort to overcome limitations of fMRI imaging, the researchers further utilized an inter-subjective correlation (ISC) technique to validate their findings. Simply put, ISC looks at the similar effects in neuroimaging across a range of viewers for the same rhetorical artifact; the higher the similarity, the more confident the researchers are that the impact of the film is the same for most or all viewers. This impact is said to “control” the viewers mental and emotional state in that they can be a reliable way to predict a viewer’s “emotions, thoughts, [and] attitudes” (Hasson et al. 2). The researchers termed their work “neurocinematics” and concluded that this new approach could “contribute to the cognitive movement in film theory, analogous to contributions that neuroscience has made to cognitive and social psychology.” (Hasson et al. 21).Since the publication of this research, there have been over a dozen academic essays published, including additional work in the hard sciences, and contributions from psychology and literary and film studies (see Cohen, Shavalian and Rube; Loschky et al.; Erincin; Kauttonen, Hlushchuk and Tikka; Christoforou et al.). Many seem to be responding to the original authors’ calls for neurocinematics to be “a new interdisciplinary field” between “cognitive neuroscience and film studies” that is “part of a larger endeavor that looks for connections between neuroscience and art” (Hasson et al. 1, 21). Noticeably missing from their call for an inter-disciplinary approach, however, is one that includes rhetorical studies. In fact, to date, there has only been a single publication referring to neurocinematics in communication studies – an essay that was not specific to film nor audience, and that limited its discussion to the effectiveness of fMRI imaging (see Weber, Mangus and Huskey). It is the argument of this essay that rhetorical studies should be included in neurocinematics for two reasons: first, rhetorical studies can provide an alternative theoretical understanding of narrative that should prove to be enlightening for this emerging field; and second, rhetorical studies can provide the necessary ethical positioning for this emerging field.The Rhetorical Studies AlternativeThe first justification for the inclusion of rhetorical studies in neurocinematics is the alternative theoretical approach to narrative that rhetoricians can provide. The original neurocinematics research found that structured stories provided a much higher degree of ISC than open-ended, unstructured “real life” depictions. The researchers showed 10 minutes of Sergio Leone’s film, The Good, The Bad, and The Ugly and a 10-minute stable shot of a Saturday afternoon in Washington Square Park that represented an unstructured, real-life event. The researchers concluded that, “a mere mechanical reproduction of reality, with no directorial intention or intervention, is not sufficient by itself for controlling viewer’s brain activity” (Hasson et al. 8). That the “slice of real life” didn’t have the same predictive functions as the “intentional construction of the film’s sequence through aesthetic means” has important implications for rhetorical studies (Hasson et al. 9). It’s not cinematic imagery alone that corresponds to brain activations, but the construction of story and the aesthetic elements of narrative presentations (that is to say, the creation of rhetoric) that has predictive functions. In A Grammar of Motives, Kenneth Burke notes that dramatism “invites one to consider the matter of motives in a perspective that, being developed from the analysis of drama, treats language and thought primarily as modes of action” (xxii). For Burke, all of our stories are the product of thought, whether it be conscious or unconscious, and this thought belies how we view the world of symbols in which we live. Michael Overington contends that dramatismaddresses the empirical questions of how persons explain their actions to themselves and others, what the cultural and social structural influences on these interpretations might be, and what effect connotational links among the explanatory (motivational) terms might have on these explanations and hence, on action itself. (133)Language is the vehicle for human behaviour and represents how we describe the world to ourselves and to others so that “a rhetor’s language can be used to discover motive” (Foss, Foss and Trapp 200). Film is nothing short of a dramatistic explanation that allows us the opportunity to dissect it with more detail to determine the worldview not only of the auteur, but of the spectator as well. Although film studies has its own theories on story and structure, a “systematic application” of Burke’s dramatism “enables an observer to reconstruct various perspectives of ‘reality’” (Stewart, Smith, and Denton 168). When compared to film studies, as an academic discipline, rhetorical studies offers an alternative understanding of narrative. Film studies asks us to apply a structural model to a narrative, while rhetorical studies asks us to apply a systems model that unmasks a narrative. As an example, film studies might examine a film’s structure, looking at the rising action of subplot B as it corresponds in the third reel to the declining action of the subplot A before denouement. As an alternative example, rhetorical studies could offer a dramatistic reading to examine the motivations of scenic ratios between the two subplots as it defines cinematic reality for the audience. Although neurocinematics may help predict the affective impact of the subplots for an audience, it is currently rooted in a structural assumption of audience and narrative, which fails to provide a full account of the spectator’s experience as it relates to the filmmaker’s rhetorical motivation. The addition of rhetorical studies to the conversation can provide an alternative approach and give an additional richness to our understandings of audience.While film studies may engage the ideological function of films, rhetorical studies amplifies their findings. In “The Storyteller,” Walter Benjamin writes,the storytelling that thrives for a long time in the milieu of work … is itself an artisanal form of communication, as it were. It does not aim to convey the pure ‘in itself’ or gist of a thing, like information or a report. It submerges the thing into the life of the story-teller, in order to bring it out of him again. (149)For Benjamin, the storyteller is an artisan that exists external to the rhetorical artifact itself, which, of course, means that the structural focus of film studies falls inevitably short. Further, Benjamin argues that there is an ideological component to both narrative and its medium. He writes, “Just as the entire mode of existence of human collectives changes over long historical periods, so too does their mode of perception. The way in which human perception is organized – the medium in which it occurs – is conditioned not only by nature but by history” (Benjamin "Reproducibility" 255, emphasis in original). The oral tradition of storytelling is different, as is the storytelling of the novel, film, and so on. Indeed, it is the goal of neurocinematics to illustrate how the rhetoric of film is distinct from other forms of narrative discourse, which necessarily demands an inter-disciplinary focus that allows for an interrogation of the ideological functions that exist both within and without the text, which is what Burke’s dramatism provides.Further, Walter Fisher’s work with narrative extends the role of rhetorical theory into what should be discussed in neurocinematics. Fisher contends that the narrative form is something that is unique to humans, but something that all humans engage in; for him, “stories are fundamental to communication because they provide structure for our experience as humans and because they influence people to live in communities that share common explanations and understandings” (Burgchardt 239). As noted earlier, neurocinematics argues that there is a coherence in cinematic narratives that don’t exist in “slice of life” filmic images. Similarly, Walter Fisher contends that this “coherence” is inborn in the narrative being (his homo narran) “their inherent awareness of narrative probability, what constitutes a coherent story, and their constant habit of testing narrative fidelity, whether the stories they experience ring true with the stories they know to be true in their lives” (8). The neurocinematics researchers conclude that, “the ISC analysis of brain activity can also serve as a measurement of systematic differences in how various groups of individuals … respond to the same film” (Hasson et al. 20). Fisher notes that the philosophical foundation of the rational world paradigm (which he sets opposite his narrative paradigm) “is epistemology. Its linguistic materials are self-evident propositions, demonstrations, and proofs, the verbal expressions of certain and probably knowing” (4). The danger with neurocinematics rooted in pure rationality is that it co-opts the narrative function, makes the spectator as agent and film as object separate from one another (when ISC begs that they interact), and brackets off questions such as ethics. Fisher concludes, “With knowledge of agents, we can hope to find that which is reliable or trustworthy; with knowledge of objects, we can hope to discover that which has the quality of veracity. The world requires both kinds of knowledge” (18). Of course, this question demands a discussion of ethics, which the current approach to neurocinematics explicitly denies as a subject of inquiry. The authors write, different filmmakers differ in the level of control they choose to impose on viewers, and out methods are not designed to judge this, but rather to measure the effect of a given film on different target groups. Thus the critical evaluation of each film is outside the domain of this research. (Hasson et al. 21-2)This is the danger Fisher warns of. The assumption that neurocinematics can be a purely descriptive project is not only unfeasible, but also unconscionable. Unlike researchers who deny the place of ideology and ethics, “rhetorical critics, of course, have long recognized the centrality of ideology to persuasive discourse” (Burgchardt 451). To illustrate why this is a vital issue for neurocinematics, let’s take its existing descriptive project to its logical conclusion. Theoretically, researchers could reach a point where there was a 100% ISC, meaning that there existed a cinematic formula that would impact every audience member the same way and would “control” their emotional and mental states – for neurocinematics this would constitute the “perfect” film. This “perfect” film, however, wouldn’t exist in a research vacuum, but in a morass of culture, politics, and ideology. Cultural critic Slavoj Žižek notes the impact that Nine-Eleven had on film:the ultimate twist in this link between Hollywood and the ‘war on terrorism’ occurred when the Pentagon decided to solicit the help of Hollywood: … at the beginning of November 2001, there was a series of meetings between White House advisors and senior Hollywood executives with the aim of co-ordinating the war effort and establishing how Hollywood could help in the war effort and establishing how Hollywood could help in the ‘war against terrorism’ by getting the right ideological meaning across not only to Americans, but to the Hollywood public around the globe – the ultimate empirical proof that Hollywood does in fact function as an ‘ideological state apparatus’. (16)The ethical implications are overwhelming: propaganda films are nothing new, but neurocinematics has the potential to usher in a whole new type of propaganda cinema, under the guise of entertainment, that is 100% effective. The original neurocinematic research argued that “the ISC measurement should probably not be used to evaluate the aesthetic, artistic, social, or political value of movies” (Hasson et al. 21). Conversely, rhetorical studies demands that criticism and scholarship not only comment on texts, but ethical considerations “will not be averted either by ignoring it or placing it beyond our provence” (Wander 18).Further, the very goal of neurocinematics demands the critical reaction that current rhetorical theory is prepared to provide. The stated end-game for neurocinematics is to determine how films discursively interact with a viewer’s mental state and, therefore, their affective response to an aesthetic experience. Raymie McKerrow notes that critical rhetorical theory must examine “the manner in which discourse insinuates itself in the fabric of social power, and thereby ‘effects’ the status of knowledge among the members of the social group” (92). Michael Calvin McGee argues, “We do not ‘observe’ objects and human actions … we construct these phenomena through rational acts of ‘selecting,’ ‘coordinating,’ ‘interpreting,’ and ‘applying’ sensory data” (48). There is no potential for a non-normative descriptive project inside of these parameters; there is no neutral observation by the spectator, the filmic experience is one that is constructed internally. Neurocinematics notes that there are interactions between brain spheres (e.g. neocortex and the amygdala) that create an intersubjective experience (which is quantitatively described with the ISC), but to explain, even descriptively, what is occurring in these viewers requires determining what the audience “knows” and how the discursive impact of the film effects them neurologically. The field of neurocinematics is not morally neutral, though it insists on presenting itself that way. At its most basic level, the researchers are not separate from the ethical and ideological functions of their studies: they make normative claims about which films are “worthy” of study, they manufacture inter-subjective reality with their critical reactions to the artifacts, and their communicative reporting in the essay itself provides agency to the film while simultaneously denying agency to the viewers. Further, when neurocinematics is taken to its logical conclusion (the ability to manufacture the descriptively “perfect” film – one with a 100% ISC), the ethical concerns are overwhelming. With Hollywood films operating more and more as a part of the ideological state apparatus, the potential for highly effective propaganda films becomes more and more real, and more and more frightening. If the conclusions by these researchers is true, that these films “control” our mental states, then the power of such propaganda films could be devastating.ConclusionThis essay has argued that rhetorical scholars have not only a unique opportunity, but an ethical obligation, to insert ourselves into one of the most innovative inter-disciplinary fields to emerge in recent history. Neurocinematics has the potential to transform cognitive neuroscience and film studies both and it is imperative that rhetoricians insert themselves into this dialogue. First, the work that rhetorical studies has done on storytelling, narrative, and dramatism provides unique perspectives that have been overlooked by the structural models of film studies. Further, the scientists driving neurocinematics forward deny the need for political and value claims to be assessed to their work. Rhetorical studies has the opportunity to challenge these illusions of neutrality and help neuroscientists to understand that their work is, indeed, ideological, and that the dangers of ideology manifest themselves when these perspectives are pushed to the side under the guise of neutrality. ReferencesBenjamin, Walter. "The Storyteller." Trans. Edmund Jephcott, Howard Eiland, and others. Selected Writings Volume 3, 1935-1938. Eds. Howard Eiland and Michael W. Jennings. Cambridge: Harvard University Press, 2002. ———. "Work of Art in the Age of Reproducibility." Trans. Edmund Jephcott and others. Selected Writings Volume 4, 1938-1940. Eds. Howard Eiland and Michael W. Jennings. Cambridge: Harvard University Press, 2003. Burgchardt, Carl, ed. Readings in Rhetorical Criticism. Third ed. State College: Strata Publishing, 2005. Burke, Kenneth. A Grammar of Motives. Berkeley: University of California Press, 1945. Christoforou, Christoforos, Spyros Christou-Champi, Fofi Constantinidou, and Maria Theodorou. "From the Eyes and the Heart: A Novel Eye-Gaze Metric That Predicts Video Preferences of a Large Audience." Frontiers in Psychology 6 (2015): 1-11. Cohen, Anna-Lisa, Elliot Shavalian, and Moshe Rube. "The Power of the Picture: How Narrative Film Captures Attention and Disrupts Goal Pursuit." PLoS ONE 10.12 (2015): 1-8. Erincin, Serap. "Dance in Translation: Subjectivity, Failed Spectatorship and Tolerance." Word & Text: A Journal of Literary Studies & Linguistics 2.2 (2012): 156-70. Fisher, Walter. "Narration as a Human Communication Paradigm: The Case of Public Moral Argument." Communication Monographs 51.1 (1984): 1-22. Foss, Sonja K., Karen A. Foss, and Robert Trapp. Contemporary Perspectives on Rhetoric. Third ed. Prospect Heights: Waveland Press, 2002. Hasson, Uri, Ohad Landesman, Barbara Knappmeyer, Ignacio Vallines, Nava Rubin, and David J. Heeger. "Neurocinematics: The Neuroscience of Film." Projections 2.1 (2008): 1-26. Kauttonen, Janne, Yevhen Hlushchuk, and Pia Tikka. "Optimizing Methods for Linking Cinematic Features to fMRI Data." NeuroImage 110 (2015): 136-48. Loschky, Lester C., Adam M. Larson, Joseph P. Magliano, and Tim J. Smith. "What Would Jaws Do? The Tyranny of Film and the Relationship between Gaze and Higher-Level Narrative Film Comprehension." PLoS ONE 10.11 (2015): 1-23. McKerrow, Raymie E. "Critical Rhetoric: Theory and Praxis." Communication Monographs 56.2 (1989): 91. Overington, Michael A. "Kenneth Burke and the Method of Dramatism." Theory & Society 4.1 (1977): 131. Stewart, Charles J., Craig Allen Smith, and Robert E. Denton Jr. Persuasion and Social Movements. Prospect Heights: Waveland Press, 1994. Wander, Philip C. "The Ideological Turn in Modern Criticism." Central States Speech Journal 34 (1983): 1-18. Weber, René, J. Michael Mangus, and Richard Huskey. "Brain Imaging in Communication Research: A Practical Guide to Understanding and Evaluating fMRI Studies." Communication Methods & Measures 9.1/2 (2015): 5-29. Žižek, Slavoj. Welcome to the Desert of the Real! Five Essays on September 11 and Related Dates. New York: Verso, 2002.

The Alt Right Are Not Alright Academic explorations complicating both the Internet and whiteness have often focussed on the rise of the “alt-right” to examine the co-option of digital technologies to extend white supremacy (Daniels, “Cyber Racism”; Daniels, “Algorithmic Rise”; Nagle). The term “alt-right” refers to media organisations, personalities, and sarcastic Internet users who promote the “alternative right”, understood as extremely conservative, political views online. The alt-right, in all of their online variations and inter-grouping, are infamous for supporting white supremacy online, “characterized by heavy use of social media and online memes. Alt-righters eschew ‘establishment’ conservatism, skew young, and embrace white ethnonationalism as a fundamental value” (Southern Poverty Law Center). Theoretical studies of the alt-right have largely focussed on its growing presence across social media and websites such as Twitter, Reddit, and notoriously “chan” sites 4chan and 8chan, through the political discussions referred to as “threads” on the site (Nagle; Daniels, “Algorithmic Rise”; Hawley). As well, the ability of online users to surpass national boundaries and spread global white supremacy through the Internet has also been studied (Back et al.). The alt-right have found a home on the Internet, using its features to cunningly recruit members and to establish a growing community that mainstream politically extreme views (Daniels, “Cyber Racism”; Daniels, “Algorithmic Rise; Munn). This body of knowledge shows that academics have been able to produce critically relevant literature regarding the alt-right despite the online anonymity of the majority of its members. For example, Conway et al., in their analysis of the history and social media patterns of the alt-right, follow the unique nature of the Christchurch Massacre, encompassing the use and development of message boards, fringe websites, and social media sites to champion white supremacy online. Positioning my research in this literature, I am interested in contributing further knowledge regarding the alt-right, white supremacy, and the Internet by exploring the sinister conducting of Zoom-bombing anti-racist events. Here, I will investigate how white supremacy through the Internet can lead to violence, abuse, and fear that “transcends the virtual world to damage real, live humans beings” via Zoom-bombing, an act that is situated in a larger co-option of the Internet by the alt-right and white supremacists, but has been under theorised as a hate crime (Daniels; “Cyber Racism” 7). Shitposting I want to preface this chapter by acknowledging that while I understand the Internet, through my own external investigations of race, power and the Internet, as a series of entities that produce racial violence both online and offline, I am aware of the use of the Internet to frame, discuss, and share anti-racist activism. Here we can turn to the work of philosopher Michel de Certeau who conceived the idea of a “tactic” as a way to construct a space of agency in opposition to institutional power. This becomes a way that marginalised groups, such as racialised peoples, can utilise the Internet as a tactical material to assert themselves and their non-compliance with the state. Particularly, shitposting, a tactic often associated with the alt-right, has also been co-opted by those who fight for social justice and rally against oppression both online and offline. As Roderick Graham explores, the Internet, and for this exploration, shitposting, can be used to proliferate deviant and racist material but also as a “deviant” byway of oppositional and anti-racist material. Despite this, a lot can be said about the invisible yet present claims and support of whiteness through Internet and digital technologies, as well as the activity of users channelled through these screens, such as the alt-right and their digital tactics. As Vikki Fraser remarks, “the internet assumes whiteness as the norm – whiteness is made visible through what is left unsaid, through the assumption that white need not be said” (120). It is through the lens of white privilege and claims to white supremacy that online irony, by way of shitposting, is co-opted and understood as an inherently alt-right tool, through the deviance it entails. Their sinister co-option of shitposting bolsters audacious claims as to who has the right to exist, in their support of white identity, but also hides behind a veil of mischief that can hide their more insidious intention and political ideologies. The alt-right have used “shitposting”, an online style of posting and interacting with other users, to create a form of online communication for a translocal identity of white nationalist members. Sean McEwan defines shitposting as “a form of Internet interaction predicated upon thwarting established norms of discourse in favour of seemingly anarchic, poor quality contributions” (19). Far from being random, however, I argue that shitposting functions as a discourse that is employed by online communities to discuss, proliferate, and introduce white supremacist ideals among their communities as well as into the mainstream. In the course of this article, I will introduce racist Zoom-bombing as a tactic situated in shitposting which can be used as a means of white supremacist discourse and an attempt to block anti-racist efforts. By this line, the function of discourse as one “to preserve or to reproduce discourse (within) a closed community” is calculatingly met through shitposting, Zoom-bombing, and more overt forms of white supremacy online (Foucault 225-226). Using memes, dehumanisation, and sarcasm, online white supremacists have created a means of both organising and mainstreaming white supremacy through humour that allows insidious themes to be mocked and then spread online. Foucault writes that “in every society the production of discourse is at once controlled, selected, organised and redistributed according to a certain number of procedures, whose role is to avert its powers and danger, to cope with chance events, to evade ponderous, awesome materiality” (216). As Philippe-Joseph Salazar recontextualises to online white supremacists, “the first procedure of control is to define what is prohibited, in essence, to set aside that which cannot be spoken about, and thus to produce strategies to counter it” (137). By this line, the alt-right reorganises these procedures and allocates a checked speech that will allow their ideas to proliferate in like-minded and growing communities. As a result, online white supremacists becoming a “community of discourse” advantages them in two ways: first, ironic language permits the mainstreaming of hate that allows sinister content to enter the public as the severity of their intentions is doubted due to the sarcastic language employed. Second, shitposting is employed as an entry gate to more serious and dangerous participation with white supremacist action, engagement, and ideologies. It is important to note that white privilege is embodied in these discursive practices as despite this exploitation of emerging technologies to further white supremacy, there are approaches that theorise the alt-right as “crazed product(s) of an isolated, extremist milieu with no links to the mainstream” (Moses 201). In this way, it is useful to consider shitposting as an informal approach that mirrors legitimised white sovereignties and authorised white supremacy. The result is that white supremacist online users succeed in “not only in assembling a community of actors and a collective of authors, on the dual territory of digital communication and grass-roots activism”, but also shape an effective fellowship of discourse that audiences react well to online, encouraging its reception and mainstreaming (Salazar 142). Continuing, as McBain writes, “someone who would not dream of donning a white cap and attending a Ku Klux Klan meeting might find themselves laughing along to a video by the alt-right satirist RamZPaul”. This idea is echoed in a leaked stylistic guide by white supremacist website and message board the Daily Stormer that highlights irony as a cultivated mechanism used to draw new audiences to the far right, step by step (Wilson). As showcased in the screen capture below of the stylistic guide, “the reader is at first drawn in by curiosity or the naughty humor and is slowly awakened to reality by repeatedly reading the same points” (Feinburg). The result of this style of writing is used “to immerse recruits in an online movement culture built on memes, racial panic and the worst of Internet culture” (Wilson). Figure 1: A screenshot of the Daily Stormer’s playbook, expanding on the stylistic decisions of alt-right writers. Racist Zoom-Bombing In the timely text “Racist Zoombombing”, Lisa Nakamura et al. write the following: Zoombombing is more than just trolling; though it belongs to a broad category of online behavior meant to produce a negative reaction, it has an intimate connection with online conspiracy theorists and white supremacy … . Zoombombing should not be lumped into the larger category of trolling, both because the word “trolling” has become so broad it is nearly meaningless at times, and because zoombombing is designed to cause intimate harm and terrorize its target in distinct ways. (30) Notwithstanding the seriousness of Zoom-bombing, and to not minimise its insidiousness by understanding it as a form of shitposting, my article seeks to reiterate the seriousness of shitposting, which, in the age of COVID-19, Zoom-bombing has become an example of. I seek to purport the insidiousness of the tactical strategies of the alt-right online in a larger context of white violence online. Therefore, I am proposing a more critical look at the tactical use of the Internet by the alt-right, in theorising shitposting and Zoom-bombing as means of hate crimes wherein they impose upon anti-racist activism and organising. Newlands et al., receiving only limited exposure pre-pandemic, write that “Zoom has become a household name and an essential component for parties (Matyszczyk, 2020), weddings (Pajer, 2020), school and work” (1). However, through this came the strategic use of co-opting the application by the alt-right to digitise terror and ensure a “growing framework of memetic warfare” (Nakamura et al. 31). Kruglanski et al. label this co-opting of online tools to champion white supremacy operations via Zoom-bombing an example of shitposting: Not yet protesting the lockdown orders in front of statehouses, far-right extremists infiltrated Zoom calls and shared their screens, projecting violent and graphic imagery such as swastikas and pornography into the homes of unsuspecting attendees and making it impossible for schools to rely on Zoom for home-based lessons. Such actions, known as “Zoombombing,” were eventually curtailed by Zoom features requiring hosts to admit people into Zoom meetings as a default setting with an option to opt-out. (128) By this, we can draw on existing literature that has theorised white supremacists as innovation opportunists regarding their co-option of the Internet, as supported through Jessie Daniels’s work, “during the shift of the white supremacist movement from print to digital online users exploited emerging technologies to further their ideological goals” (“Algorithmic Rise” 63). Selfe and Selfe write in their description of the computer interface as a “political and ideological boundary land” that may serve larger cultural systems of domination in much the same way that geopolitical borders do (418). Considering these theorisations of white supremacists utilising tools that appear neutral for racialised aims and the political possibilities of whiteness online, we can consider racist Zoom-bombing as an assertion of a battle that seeks to disrupt racial justice online but also assert white supremacy as its own legitimate cause. My first encounter of local Zoom-bombing was during the Institute for Culture and Society (ICS) Seminar titled “Intersecting Crises” by Western Sydney University. The event sought to explore the concatenation of deeply inextricable ecological, political, economic, racial, and social crises. An academic involved in the facilitation of the event, Alana Lentin, live tweeted during the Zoom-bombing of the event: Figure 2: Academic Alana Lentin on Twitter live tweeting the Zoom-bombing of the Intersecting Crises event. Upon reflecting on this instance, I wondered, could efforts have been organised to prevent white supremacy? In considering who may or may not be responsible for halting racist shit-posting, we can problematise the work of R David Lankes, who writes that “Zoom-bombing is when inadequate security on the part of the person organizing a video conference allows uninvited users to join and disrupt a meeting. It can be anything from a prankster logging on, yelling, and logging off to uninvited users” (217). However, this beckons two areas to consider in theorising racist Zoom-bombing as a means of isolated trolling. First, this approach to Zoom-bombing minimises the sinister intentions of Zoom-bombing when referring to people as pranksters. Albeit withholding the “mimic trickery and mischief that were already present in spaces such as real-life classrooms and town halls” it may be more useful to consider theorising Zoom-bombing as often racialised harassment and a counter aggression to anti-racist initiatives (Nakamura et al. 30). Due to the live nature of most Zoom meetings, it is increasingly difficult to halt the threat of the alt-right from Zoom-bombing meetings. In “A First Look at Zoom-bombings” a range of preventative strategies are encouraged for Zoom organisers including “unique meeting links for each participant, although we acknowledge that this has usability implications and might not always be feasible” (Ling et al. 1). The alt-right exploit gaps, akin to co-opting the mainstreaming of trolling and shitposting, to put forward their agenda on white supremacy and assert their presence when not welcome. Therefore, utilising the pandemic to instil new forms of terror, it can be said that Zoom-bombing becomes a new means to shitpost, where the alt-right “exploits Zoom’s uniquely liminal space, a space of intimacy generated by users via the relationship between the digital screen and what it can depict, the device’s audio tools and how they can transmit and receive sound, the software that we can see, and the software that we can’t” (Nakamura et al. 29). Second, this definition of Zoom-bombing begs the question, is this a fair assessment to write that reiterates the blame of organisers? Rather, we can consider other gaps that have resulted in the misuse of Zoom co-opted by the alt-right: “two conditions have paved the way for Zoom-bombing: a resurgent fascist movement that has found its legs and best megaphone on the Internet and an often-unwitting public who have been suddenly required to spend many hours a day on this platform” (Nakamura et al. 29). In this way, it is interesting to note that recommendations to halt Zoom-bombing revolve around the energy, resources, and attention of the organisers to practically address possible threats, rather than the onus being placed on those who maintain these systems and those who Zoom-bomb. As Jessie Daniels states, “we should hold the platform accountable for this type of damage that it's facilitated. It's the platform's fault and it shouldn't be left to individual users who are making Zoom millions, if not billions, of dollars right now” (Ruf 8). Brian Friedberg, Gabrielle Lim, and Joan Donovan explore the organised efforts by the alt-right to impose on Zoom events and disturb schedules: “coordinated raids of Zoom meetings have become a social activity traversing the networked terrain of multiple platforms and web spaces. Raiders coordinate by sharing links to Zoom meetings targets and other operational and logistical details regarding the execution of an attack” (14). By encouraging a mass coordination of racist Zoom-bombing, in turn, social justice organisers are made to feel overwhelmed and that their efforts will be counteracted inevitably by a large and organised group, albeit appearing prankster-like. Aligning with the idea that “Zoombombing conceals and contains the terror and psychological harm that targets of active harassment face because it doesn’t leave a trace unless an alert user records the meeting”, it is useful to consider to what extent racist Zoom-bombing becomes a new weapon of the alt-right to entertain and affirm current members, and engage and influence new members (Nakamura et al. 34). I propose that we consider Zoom-bombing through shitposting, which is within “the location of matrix of domination (white supremacy, heteropatriarchy, ableism, capitalism, and settler colonialism)” to challenge the role of interface design and Internet infrastructure in enabling racial violence online (Costanza-Chock). Conclusion As Nakamura et al. have argued, Zoom-bombing is indeed “part of the lineage or ecosystem of trollish behavior”, yet these new forms of alt-right shitposting “[need] to be critiqued and understood as more than simply trolling because this term emerged during an earlier, less media-rich and interpersonally live Internet” (32). I recommend theorising the alt-right in a way that highlights the larger structures of white power, privilege, and supremacy that maintain their online and offline legacies beyond Zoom, “to view white supremacy not as a static ideology or condition, but to instead focus on its geographic and temporal contingency” that allows acts of hate crime by individuals on politicised bodies (Inwood and Bonds 722). This corresponds with Claire Renzetti’s argument that “criminologists theorise that committing a hate crime is a means of accomplishing a particular type of power, hegemonic masculinity, which is described as white, Christian, able-bodied and heterosexual” – an approach that can be applied to theorisations of the alt-right and online violence (136). This violent white masculinity occupies a hegemonic hold in the formation, reproduction, and extension of white supremacy that is then shared, affirmed, and idolised through a racialised Internet (Donaldson et al.). Therefore, I recommend that we situate Zoom-bombing as a means of shitposting, by reiterating the severity of shitposting with the same intentions and sinister goals of hate crimes and racial violence. References Back, Les, et al. “Racism on the Internet: Mapping Neo-Fascist Subcultures in Cyber-Space.” Nation and Race: The Developing Euro-American Racist Subculture. Eds. Jeffrey Kaplan and Tore Bjørgo. 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