Investigating the Long-Term Impact of Adventure Education: A Retrospective Study of Outward Bound Singapore\u27s Classic 21-Day Challenge Course

This study was conducted to further our understanding of the impact an outdoor adventure education experience has on participants\u27 personal and professional life. Outdoor adventure education follows an experiential philosophy of learning and takes place primarily through sensory involvement with the natural world (Priest and Gass, 1997). Ewert and McAvoy (2000) have mentioned that the transfer of benefits of adventure programs and their components to work and everyday life have often been neglected in research

Socio-Demographic Factors which Significantly Relate to the Prediction of Burns Severity in Children

Background: Burns are considered one of the biggest wounds and the most devastating injuries humans can receive as they have prolonged consequences which are not only physical, but psychological in addition to the cost of treatment. The aim of the study was to explore the relationships between socio-demographic factors (SDF) and the incidence and mechanisms of burn injuries in children. The objectives were to identify the multiple and various factors responsible for the occurrence of significant burns in children; to explore and investigate the relationship between these factors; to critically analyse SDF on the incidence and mechanisms of burns and to develop a contextual model with a view to informing future health care policy and health promotion programmes. Methods: This observational, cross-sectional, descriptive study was performed in a UK Paediatric Burn Centre in the West Midlands. The research process followed the requirements for obtaining a PhD degree. The quantitative arm of this study consisted of a postal questionnaire sent to 228 parents and guardians who had visited the Burns Centre with a child during a one-year period (1st May 2011 to 30th April 2012). For the purpose of coding and analysis, a Statistical Package for the Social Science (SPSS) version-19-was used. Results: 160 completed questionnaires were returned and analysed. Several key SDF were identified that linked to an increase in the incidence of burns in children. Burn injuries was significantly higher in children ≤ 5 years old (P<0.001) and male children (58.1%). Burns were more frequent in minority ethnic groups (p<0.001); younger aged parents ≤ 25 years old (p=0.048); and children living with single parents (p=0.001). A majority of burns cases resulted from spills (74.4%) and during mealtimes (p<0.001). The distributions of the Index Multiple Deprivation (IMD) was not the same across ethnic groups (p<0.002), and burns in children was significant (p<0.0005) in families living in social accommodation. Conclusion: The findings potentially may have clinical utility in informing future health care policy and health promotion/education programmes. Consideration must be given to the timings of such programmes, which relate to treat significant burns in non-specialised hospitals

Nature and scope of outdoor education in the city-state of Singapore

This study focuses on the analysis of collective meaning associated with secondary school-teachers’ and outdoor practitioners’ beliefs about the value of outdoor education in the city-state of Singapore. A phenomenographical approach was employed to map the qualitatively different ways in which people understand, perceive, or experience various aspects of outdoor education. By conducting in-depth interviews with school-teachers and outdoor practitioners (n=11), a range of beliefs about the value of outdoor education were revealed. Through a phenomenographic analysis framework, three conceptions were identified that detail the participants’ collective meanings of the value of outdoor education; namely (a) belief in the value of outdoor environments in providing affordances for authentic, realistic learning, (b) belief in its value in fostering social emotional growth, physical and mental robustness, and (c) belief in the value of outdoor education as preparation for students’ futures. A secondary research question considered the factors that influence the beliefs of the two sets of actors, teachers and outdoor practitioners, who are the focus of this study. The analysis and discussion focus on the context and meaning of the values ascribed to outdoor education as well as the factors that influenced the beliefs. The findings indicate that school-teachers and outdoor practitioners have strong beliefs about the value of outdoor education. This strong intrinsic belief is constructed through 'sense-making' of their own experiences in the outdoors. This suggests that there is value in investing in the continuing professional development of school-teachers and outdoor practitioners in their outdoor education practice, so that this increased capacity in their complementary roles can bring about the added value of outdoor education to students. Several recommendations for policy, practice as well as further research in the field are offered

Spectrum of celiac disease in paediatric population: experience of tertiary care center from Pakistan

Objective: To determine clinical features and relevant laboratory investigations of patient with celiac disease (CD) and comparing classical celiac disease (CCD) with Non-diarrheal celiac disease (NDCD).Methods: This is a five years retrospective study conducted at The Aga Khan University Hospital Karachi, Pakistan from January 2010 to December 2015, enrolling children from one year to 15 years of either gender diagnosed as celiac disease in accordance with revised ESPGHAN criteria. Biopsy samples with grade 2 or more on Modified Marsh Classification were considered as consistent with celiac disease. Celiac patients were categorized into Classical celiac disease (with Chronic Diarrhea) and non-diarrheal celiac disease (Atypical celiac) and their clinical features and relevant laboratory investigations were documented.Results: Total 66 patients were selected with celiac disease according to inclusion criteria, 39 (59.09%) patients were labeled as CCD and 27 (40.91%) patients were labeled as NDCD. Marsh grading 3a and above were more marked in CCD as compared to NDCD. Mean titer for Tissue transglutaminase antibodies (TTG) were higher in CCD group in comparison to NDCD group. In CCD, the most common clinical presentations were abdominal distension whereas in NDCD, the most remarkable features were recurrent abdominal pain (62.9%). Frequency of failure to thrive is significantly high in CCD (82.05%) but patients merely with short stature were more common in NDCD (33.3%). Refractory anemia was present in 66.6% patients in NDCD group and 41.1% patients in CCD group. 74.3% patients in CCD group were vitamin D deficient whereas 85% patient had vitamin D deficiency in NDCD group (p= 0.03). Conclusion: NDCD is not uncommon in our population. Recurrent abdominal pain, failure to thrive or patients only with short stature and refractory anemia are prominent features in NCDC group whereas abdominal distension, failure to thrive and recurrent abdominal pain were noticeable features in CCD. High grade histopathology and raised antibodies titer is hallmark of CCD. Vitamin D deficiency is almost equally present in both groups

Le traumatisme du colon: l’expérience du CHU Hassan II de Fès

Les traumatismes du colon sont associés à un risque majeur de complications septiques et de mortalité. Le but de notre étude est d'évaluer les circonstances, la prise en charge, le suivi et les facteurs pronostic de morbidité postopératoire des malades victimes d'un traumatisme colique. Méthodes: Il s'agit d'une étude rétrospective sur une série de 49 patients opérés pour des plaies coliques aux services de chirurgie viscérale du CHU HASSAN II de Fès sur une période de 8 ans de juillet 2003 à juillet 2011. Résultats: L'âge moyen de nos patients était de 25ans (16-70) avec une nette prédominance masculine (93.8%). Les plaies coliques secondaires à un traumatisme par arme blanche représentent 85% des cas (42 patients), suivi par les plaies iatrogènes au cours d'une coloscopie chez 6 patients (13 %), puis les contusions abdominales chez 1 patient (2%). Les parties du cadre colique les plus touchées étaient le colon transverse chez 19 patients (38%) et le colon descendant chez 12 patients (24, 5%). Le colon sigmoïde était le segment le plus touché au cours d'une coloscopie4/6. Quarante-deux patients (85%) ont eu une suture primaire des plaies coliques, six patients (13%) une diversion fécale et un patient (2%) une résection-anastomose. Deux patients (4%) sont décédés suite à un choc septique. La morbidité globale était de 38,7% dominé essentiellement par l'infection de la paroi chez 14 patients et une péritonite post opératoire chez 3 patients. L'analyse univarié a montré une différence significatif en terme d'infection de la paroi entre le groupe colostomie versus suture simple (50% vs 20,9% p&lt;0,05). L'atteinte du colon gauche et la réalisation d'une colostomie sont associés à un risque plus élevés de complications postopératoires. Conclusion: La suture primaire peut être effectuée avec un faible taux de complications postopératoire chez la majorité des patients suite à un traumatisme du colon. Pan African Medical Journal 2012; 13:6

360-degree Evaluation of Postgraduate residents at Rawalpindi Medical University: Appraising the achievement of core competencies by comparing the scores of 1st &

Objectives: To compare 360-degree evaluation scores of postgraduate residents during 1st and 2nd cycles of evaluation to analyze the acquisition of core competencies. Materials & Methods: A cross-sectional analytical study was done to compare the acquisition of core competencies as per ACGME by MS/MD residents in 3 public sector teaching hospitals of Rawalpindi. The enrolled residents undergone 1st and 2nd cycle of 360-degree evaluation from Jan-June 2018 and July 2018 -Jan 2019 respectively. The data was gathered from supervisors, faculty, nursing staff, patients and their attendants by structured proforma. Data was analyzed by SPSS version 25.0. Specialty-wise scores were statistically presented with 95% CI. Differences in scores of core competencies during both cycles were determined by independent sample t-test. P < 0.05 was considered significant. Results: About 93 and 113 trainees were evaluated during 1st and 2nd cycle of evaluation respectively. Most (41.70%) of them were 1st year residents. 2nd cycle of evaluation revealed statistically significant improvement (P<0.00001) in all 6 core competencies. Feedback from the patients also illustrated significant difference in scores of both cycles (P = 0.01). Trainees of MS Surgery & Allied programs were determined as highly competent with 250.06 ± 38.57 score followed by those of MD Medicine & Allied (247.59 ± 42.15) and Gynecology & Obstetrics (246.71 ± 46.26) out of total score of 331. Residents of HFH and DHQ Hospital had statistically significant enhancement of competencies (P<0.0001) than those of BBH (P=0.003). Conclusion: There was substantial enhancement of core competencies among postgraduate trainees.

Test beam performance measurements for the Phase I upgrade of the CMS pixel detector

A new pixel detector for the CMS experiment was built in order to cope with the instantaneous luminosities anticipated for the Phase I Upgrade of the LHC. The new CMS pixel detector provides four-hit tracking with a reduced material budget as well as new cooling and powering schemes. A new front-end readout chip mitigates buffering and bandwidth limitations, and allows operation at low comparator thresholds. In this paper, comprehensive test beam studies are presented, which have been conducted to verify the design and to quantify the performance of the new detector assemblies in terms of tracking efficiency and spatial resolution. Under optimal conditions, the tracking efficiency is (99.95 ± 0.05) %, while the intrinsic spatial resolutions are (4.80 ± 0.25) μm and (7.99 ± 0.21) μm along the 100 μm and 150 μm pixel pitch, respectively. The findings are compared to a detailed Monte Carlo simulation of the pixel detector and good agreement is found.Peer reviewe

Trapping in irradiated p-on-n silicon sensors at fluences anticipated at the HL-LHC outer tracker

The degradation of signal in silicon sensors is studied under conditions expected at the CERN High-Luminosity LHC. 200 $\mu$m thick n-type silicon sensors are irradiated with protons of different energies to fluences of up to $3 \cdot 10^{15}$ neq/cm$^2$. Pulsed red laser light with a wavelength of 672 nm is used to generate electron-hole pairs in the sensors. The induced signals are used to determine the charge collection efficiencies separately for electrons and holes drifting through the sensor. The effective trapping rates are extracted by comparing the results to simulation. The electric field is simulated using Synopsys device simulation assuming two effective defects. The generation and drift of charge carriers are simulated in an independent simulation based on PixelAV. The effective trapping rates are determined from the measured charge collection efficiencies and the simulated and measured time-resolved current pulses are compared. The effective trapping rates determined for both electrons and holes are about 50% smaller than those obtained using standard extrapolations of studies at low fluences and suggests an improved tracker performance over initial expectations

Mechanical stability of the CMS strip tracker measured with a laser alignment system

Peer reviewe