Constipation is a common problem in childhood and can significantly impact on the overall wellbeing of the affected child and their family. The estimated prevalence is around 5–30% of children worldwide. Functional constipation is by far the most common, however secondary causes of constipation can be serious, and more importantly treatable. A comprehensive clinical evaluation should identify red flags, contribute to bespoke management with appropriate advice, provide support for the specific challenges that the child and family might face and identify children needing specialist referral.
Abstract This study investigated the anatomy and histology of the olfactory organ of the Korean amur goby Rhinogobius brunneus from Jeonjucheon stream. This species lives in shallow, stagnant, and intermittently low-oxygenated streams, reservoirs, and ponds affected by seasonal rainfall. Anatomically, its olfactory organ consisted of a short tubular anterior nostril, a posterior nostril, a single longitudinal lamella, and two accessory nasal sacs (ethmoidal and lacrymal sacs). Its single lamella structure resembles other gobiid fishes with a simplified olfactory surface. Histologically, the sensory epithelium comprised olfactory receptor neurons, supporting cells, and basal cells, while the non-sensory epithelium contained stratified epithelial cells, basal cells, and mucous cells. In particular, the mucous cells stained intensely red with Hematoxylin and eosin and Masson’s trichrome, indicating proteinaceous granular mucins rich in glycoproteins; such secretions likely protect the epithelium against particles, toxins, and low-oxygenated freshwater. Overall, the goby’s olfactory organ exhibits traits uniquely adapted to stagnant and hypoxic conditions.
Abstract This article examines the linguistic landscapes (LL) of two communities in Beijing, China, to investigate the agency and structure embodied in them. A geosemiotic and discursive approach is employed to the collected data based on geosemiotics and discursive frame. It reveals the LL in the surveyed communities in Beijing can be mainly divided into three discursive frames: the civic frame, the promotional frame, and the livelihood frame, each with its own exclusive geosemiotic characteristics of agency and structure. A separate examination of each frame reveals the specific representations of and interactions between agency and structural factors within each one. Furthermore, a longitudinal analysis of these three frames indicates the existence of a concrete dynamic equilibrium relationship between agency and structure. It can be summarized that one of the existing landscape construction modes in the communities in Beijing is characterized by the balanced agency-structure dynamics, which can serve as a reference for LL construction and research in other regions.
History of scholarship and learning. The humanities, Social Sciences
Nicole L. Matthews, Hannah Honda, Melissa M. Mitchell
et al.
Abstract Background Research is needed to better understand the specific challenges for autistic learners in informal STEM learning settings. This study aimed to increase inclusion in STEM museums, with a larger goal of increasing the impact (i.e., learning and application of knowledge during and after visits) of informal STEM learning settings for autistic youth. We conducted an online parent attitudes survey with 93 parents of autistic adolescents and 53 parents of adolescents in the general population to better understand the experiences of autistic adolescents when visiting STEM-related museums. Parent responses informed professional development training for museum staff at four partner museums, which taught strategies to better support autistic learners. Then, autistic adolescents (n = 20) and their parents were randomly assigned to visit one partner and one control museum. They were asked to report their experiences through an online survey and semi-structured interviews. Results Participants who completed the parent attitudes survey indicated significantly lower inclusion, engagement, and general impact of STEM museum visits among autistic adolescents compared to the general population comparison group. Parents of adolescents who visited partner and control museums reported higher STEM impact during visits to partner museums; however, parent-reported inclusion, engagement, and general impact did not differ significantly between partner and control museums. Qualitative analysis identified four themes (Spectrum of Museum Impact; Adolescent-Environment Fit; Barriers to Engagement, and Barrier Breakers), providing context for quantitative findings. Conclusions Findings underscore the need for increased inclusion for autistic individuals in informal STEM learning environments like museums. This project demonstrated feasibility of professional development training of forward-facing staff and identified several themes that should inform future efforts to improve inclusion in informal STEM learning settings.
Kadek Ayu Widia Fransiska, Ni Ketut Suarni, I Gede Margunayasa
Kemampuan kognitif adalah kemampuan anak untuk berpikir secara lebih kompleks, bernalar, dan mampu memecahkan masalah. Pada masa kini tenaga pendidik sudah menggunakan berbagai media pembelajaran digital yang sesuai dengan perkembangan teknologi di abad 21. Penguasaan guru dalam penggunaan teknologi dalam membuat media pembelajaran yang baru serta ketertarikan siswa dalam pembelajaran berkaitan dan memiliki pengaruh terhadap kognitif, karena dengan media pembelajaran yang menyenangkan maka siswa akan semakin memahami pembelajaran sejarah dan pengetahuan siswa akan bertambah. Penelitian ini menggunakan metode kajian literatur sistematis dengan studi desain PRISMA (Prefferes Reporting Items for Systematic Reviews and Meta-Analysis), yang terdiri dari beberapa tahapan yaitu strategi pemilihan data, kriteria penelitian, dan ekstraksi data. Penelitian kajian literatur sistematis ini bertujuan untuk mengetahui bagaimana perkembangan kognitif siswa yang diajarkan menggunakan media pembelajaran digital yang ditinjau dari teori kognitif Jean Piaget. Berdasarkan hasil penelitian ini diketahui bahwa media pembelajaran digital berpengaruh dalam meningkatkan dan menstimulus perkembangan kogntif anak yang ditinjau dari teori kognitif Jean Piaget. Penggunaan media pembelajaran digital kedepannya diharapkan mampu menunjang perkembangan kognitif anak dalam proses pembelajaran di sekolah dengan tetap memperhatikan karakteristik anak.
Liisa Hantsoo, Kathleen M. Jagodnik, Andrew M. Novick
et al.
The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women’s mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.
Diseases of the endocrine glands. Clinical endocrinology
Abstract Introduction Evidence suggests gender disparities in medical education assessment, including differences in ratings of competency and narrative comments provided in resident performance assessments. This study explores how gender manifests within the content of qualitative assessments (i.e., narrative comments or performance feedback) of resident performance. Methods Qualitative content analysis was used to explore gender-based differences in narrative comments included in faculty assessments of resident performance during inpatient medicine rotations at six Internal Medicine residency programs, 2016–2017. A blinded, multi-analyst approach was employed to identify themes across comments. Patterns in themes with resident gender and post-graduate year (PGY) were explored, focusing on PGY2 and PGY3 when residents are serving in the team leader role. Results Data included 3,383 evaluations with narrative comments of 385 men (55.2%) and 313 women residents (44.8%). There were thematic differences in narrative comments received by men and women residents and how these themes manifested within comments changed with training time. Compared to men, comments about women had a persistent relationship-orientation and emphasized confidence over training including as interns and in PGY2 and PGY3, when serving as team leader. The relationship-orientation was characterized not only by the residents’ communal attributes but also their interpersonal and communication skills, including efforts supporting others and establishing the tone for the team. Comments about women residents often highlighted confidence, including recommendations around behaviors that convey confidence in decision-making and team leadership. Discussion There were gender-based thematic differences in qualitative assessments. Comments about women resident team leaders highlight relationship building skills and urge confidence and actions that convey confidence as team leader. Persistent attention to communal skills suggests gendered expectations for women resident team leaders and a lost opportunity for well-rounded feedback to the disadvantage of women residents. These findings may inform interventions to promote equitable assessment, such as providing feedback across the competencies.
Sterilisation is one of many methods of contraception available to men and women. Primary care has a key role in sterilisation counselling and referral. This article outlines the risks and benefits of male (vasectomy) and female (laparoscopic tubal occlusion) sterilisation and how they compare to similarly effective methods, particularly long-acting reversible contraception. The article provides an innovative decision-aid algorithm and sterilisation counselling checklist to promote a ‘best practice’ approach.
O texto dá a ver um fazer poético tradutório espiritográfico possível na educação contemporânea. Defende que o espiritografista ocupa três lugares funcionais e de autoformação constante – do estudante, do escritor e do educador (EEE) – em laboratório próprio e singular que age através da variação de si. Toma o método espiritográfico como agente capaz de movimentar corpo-espírito-mundo, para realizar processos tradutórios didáticos no espaço da aula. Utiliza-se dos variados procedimentos de escrita do pensador e poeta Paul Valéry e os transforma em processos experimentais e literários que ativam o eu-empírico de um espírito aventureiro que lê e escreve. Mostra e concluique o professor-pesquisador, ao valer-se dos procedimentos de tal método, dissemina aventuras didáticas do desejo de educar, transcriando por esta via arealidade curricular
The world pandemic situation has forced the implementation of online classes. In Chile, the urgency has made invisible the unequal amount of technological knowledge between teachers, and the limited variety of strategies to establish a new way of transmitting their knowledge. This lockdown becomes an opportunity to make the changes that Chilean education needs in this field.
Abstract Aim To co‐produce consensus on the key issues important in educating mental health‐care professionals to optimize mental health medication adherence in Black, Asian and Minority Ethnic (BAME) groups. Objectives To identify perceptions of factors enabling or disabling medication adherence. To achieve consensus on content and delivery of an educational intervention for mental health‐care professionals. Methods Data were collected from 2016 to 2018. Using individual interviews and a consensus workshop with carers and service users (SUs treated under the 1983 Mental Health Act 1983/revised 2007 for England and Wales), the experience of taking prescribed mental health medication and perspectives on adherence were explored. Data were analysed using 2‐stage qualitative coding via the software tool NVivo version 11 to analyse transcribed data and to produce the main explanatory categories. Results SU and carer participants' perspectives substantially altered the original research design. The need to educate students rather than trained professionals was emphasized, and they suggested that educational content should be packaged in a contemporary manner (a virtual reality experience). Findings indicated that education should focus upon understanding the impact of taking prescribed antipsychotic medication on both SUs and carers. Discussion The importance of effective communication between health professionals, SUs and carers and a willingness to learn about and appreciate how BAME culture influences perception of mental illness and mental well‐being were highlighted. Conclusion In working co‐productively, researchers need to be flexible and adaptable to change.