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Cambridge Journal
of Education and Science
No.1. (15), January-June, 2016
VOLUME II
Cambridge Journal of Education and Science, 1(15), (January - June). Volume II.
CONTENTS
Medicine, Pharmacy, Biology & Chemistry
Parag Deepak Dabir, Jens Johannes Christiansen
Not to be Missed Entity: Dieulafoys Lesion!.............................................................................................................9
Ebtesam M. Al-Zabedi, Mahmoud A. Ogaili, Mohamed T. Al-Maktari, Mohamed S. Noman
Hepatitis B Virus Seropositivity among Schistosomiasis and Diabetes Mellitus Patients
in Sanaa City, Yemen................................................................................................................................................13
Hamid Soori, Ali Nasermoadeli, Elaheh Ainy
The Role of Graduated Drivers Licensing on Incidence and Severity of Road Traffic Injuries in Iran.................39
P.S. Pastides, W.S. Khan
Cell-Based Therapies in Musculoskeletal Injuries: The Evolving Role of Bone Marrow-Derived Mesenchymal
Stem Cells..................................................................................................................................................................49
Yu.V. Odinets, N.I. Makieieva, V.A. Golovachova, K.K. Iarova, N.P. Alyeksyeyeva
Macro- and microelement composition of blood and hair and ecological related renal pathology
in children ................................................................................................................................................................71
Vladimir Gryn
The structure of the appendix fetuses, infants, people chest age, mature and senile..............................................82
Ye.N. Pronina, Yu.N. Dovbnya, G.A. Yeroshenko
Morphological and functional features of human frontal sinus anterior wall glands............................................89
Firuza Maksudova, Ekut Karieva
Application of the mathematical planning method for creation of combined capsules of non-steroidal
anti-inflammatory action.........................................................................................................................................93
O.V. Korobka, N.I. Hasjuk, M.N. Fastovets, Z.I. Rossocha, O.M. Kovalova
Association between the I/D polymorphism of the ACE gene and the development
of asphyxia in newborns.........................................................................................................................................101
Y. Chernjavskaja, N. Artemova, E. Kozakevitch, O. Kovalova, V. Pokhylko
4a/4b of the eNOS gene polymorphism is not associated with systemic hemodynamic disorders
in preterm infants with early neonatal sepsis.........................................................................................................110
Ziyoda Fayzieva, Zakira Usmanova
The study of specific activity of diabenit, glikoinuvit and stevil-50 on various models
of experimental hyperglycemia...............................................................................................................................118
. Sharipova, M.Kh. Tursunova, K.S. Makhmudjanova
Data chronic toxicity of the preparation Dragee Leoglisirflom.........................................................................125
Mahamadzarif Kadirov, Ahmadhodja Yunuskhodjaev, Kamoliddin Shadmanov
Coordination compound of cobalt(II) with -amino acids showing blood-forming and antidote activity.........134
E.G. Shvarev, L.V. Dikareva, D.L. Ovodenko, A.K. Aupova, G.E. Shvarev
Markers of Endometrial Biological Fluids in Inner Genitalia Diseases Diagnostics............................................142
Revazi Melkadze, Ketevan Kintsurashvili
The Phenolic complex and antioxidant activity of Caucasian Blackberry (Rubus caucasicus L) leaves.............150
Michael Koptev, Elena Pronina, Sergey Bilash, Angelina Prog-Zakaznikova, Anatoly Bilych
Comparative characteristics of morphological changes in the lungs and the heart of rats,
caused by acute stress..............................................................................................................................................156
Olga Sermukhamedova, Zuriyadda Sakipova, Liliya Ibragimova
Development and validation assessment of flavonoids quantification technique in the grass
of Leonurus turkestanicus......................................................................................................................................163
A.A. Opletin
Facilities of the physical culture in creating the pedagogical system of a personality self development
on base of the synergy theory about realized and nonrealized in psyche of the person.....................................355
Natalia Chebotareva, Svetlana Kovaleva
Social and Communicative Strategies of Influence on Society in Information Warfare......................................362
Ann Moseychuk
Diagnostics of research competence of future middle ranking medical workers.................................................372
Valentina Bilan
Psychological and pedagogical conditions of formation aesthetic relations future defectologist
to correctional and pedagogical work....................................................................................................................378
Valentina Lyapunova
Sources of development of the ideas of tolerance in Ukraine................................................................................386
Valery Panachev
Pedagogical aspects of the public home rule in university for improvement of sanitary
and atheletic-mass work.........................................................................................................................................395
Valeriia Gutman, Natalia Shklyar
Methods of instrumentation in the process of subjectivation of education content in the institutes
of higher education.................................................................................................................................................401
Volodymyr Mokliak
The autonomy of higher educational establishments of Ukraine in the statute of 1835......................................408
Vugar Mammadzade
Participation of non-governmental organizations (NGO) in the Republic of Azerbaijan for the formation
of civil society at the present stage..........................................................................................................................415
Galina Alekseeva, Dang Chuynh Mai, MSc. Huynh Ngoc Hong Nhung
The system of program events for social-labor integration of disabilities into Russian social environment
through development of the decorative and applied arts (in view of the experience of Vietnam)......................424
Gohar Meliksetyan
Recitatives and Fugues for piano of Aram Khachaturian..................................................................................431
Greta Hakobyan
Some peculiarities of communication between lecturers and students at higher education institutions...........438
Gyuzel Antropova, Semen Matveev, Svetlana Shishkina
Using of factorial and cluster type analysis in pedagogical researches.................................................................444
Dimitrina Hamze
The communicative dynamic of the grotesque a direct successor of the communicative essence
of language..............................................................................................................................................................450
Denis Kislov
Mythological component of marketing communications......................................................................................461
Yelena Kuvarova
Variation of onymous and appellative vocabulary in structure of Russian epistolary vocative...........................469
Elena Osmina, Ekaterina Ponomarenko
Subjective Image of Educational Interaction as a Social-Psychological Factor of Its Development....................477
Irina Astrakhantseva, Zinaida Kuznetsova, Aleksandr Nazarenko
The initial stage of the environmental education as a basis of rational human interaction with nature.............482
I. Parfanovich
Comparative analysis of psychological and pedagogical reculiarities of underage girls with normative
and deviant behavior..............................................................................................................................................491
Inna Boyko
Doctrinal Approaches to the Definition of Legal Validity Concept of International
Judicial Institutions Decisions................................................................................................................................497
Inna Semenets-Orlova
The economic mechanism of public administration of educational changes.......................................................505
Irina Bondarenko
Ethical Category of Honor, Dignity nd Professional Standards of Ukrainian Journalist...................................512
Iryna Pogorska
Strategic ulture: specificities of discourse about the concept efficiency in analyzing the international
political...................................................................................................................................................................518
Larysa Udovyka
Areas of national legal systems in the context of globalization.............................................................................526
Lesya Petrenko
The fundamentals of the new ukrainian educational system in Gr. Vashchenkos pedagogic heritage...............534
Liudmyla Bakhmat
Pedagogical conditions for developing self-assessment of learning achievements of future teachers.................541
Ludmila Pastushenko
Ethical Principles of Constantia in the German Romance of XVII century.........................................................548
Lyudmila Savchenko
Interaction between the family and the institution in the national-patriotic education
hildren and youth.................................................................................................................................................554
Lyudmila Filimonyuk, Viktoria Burljaeva, Konstantin Chebanov
The process of multicultural socialization of young..............................................................................................562
Lyudmila Chikonova
Constitutional right to land: the problem of judicial protection..........................................................................568
Zhamila Mamyrkhanova, Coauthor Zhantas Zhakupov
Dialect problem of the Kazakh people living abroad............................................................................................578
Marina Shulenkova
An interdisciplinary study of the process of education of young people as the subject-oriented forecasting
capacity of educational systems..............................................................................................................................595
Mehriban Tagirova
Paints, describing time ..................................................................................................................................... 604
Valentina Vladymyrova, Nadeschda Kyrylenko
The motive of loneliness in the Olena Pechornas novel The sinner...................................................................615
Namir Al-Ani
Ontology as the doctrine of the divine essence (substance) in neo-Platonism and philosophy
of the European Middle Ages and Renaissance......................................................................................................621
Natalya Bilous
Emotional-philosophical dominants in Annette von Droste-Hulshof s life and creative work...........................631
N.V. Shklyar, O.V. Karynbaeva, E.S. Dunaeva, Y.V. Hodos, E.V. Popova
Teachers professional readiness to the learning skills formation of schoolchildren with disabilities
in the process of inclusive education......................................................................................................................638
Oksana Bukatov
Competence aspect of training future teachers of vocational education..............................................................644
44. World
Polina
VerbytskaHealth Organization. International classification of functioning, disability and
Actualization of ultural heritage potential in modern social and cultural conditions.......................................658
health (ICF). Published May, 2001. Accessed April 7, 2014. Available: http://www.
Rafiq Noruzov
who.int/classifications/icf/en.
For interpretation the piece from the Bible............................................................................................................665
45. Lee BY, Bartsch SM, Wong KF, Yilmaz SL, Avery TR, Singh A, et al. Simu-
2010.
atyana
VorovaAm J Infect Control. 2012;40:194-200. Available: http://dx.doi.org/10.1016
Ciphered
Content of the Literary Fairy Tales by V. F. Odoyevsky.........................................................................690
/j.ajic.2012.02.001.
Tatiana
Gera
47. Nijhuis
M, Van Maarseveen NM, Boucher CA. Antiviral resistance and impact on
Working with professional case as a means of psychological support future teachers: the mastery
viral replication
capacity:
of viruses under antiviral pressure occurs
of the situation,
the problem,
the task of evolution
teaching.................................................................................................697
in three
phases.
Handb
Exp Pharmacol.
Viacheslav
Zhdan, Viktor
Bobyriov,
Serhii Bilash,
Tetiana Klymach2009;189:299-320. Available: http://
Motivational
factors of students readiness to professional activity in the process of training at HSEEU
dx.doi.org/10.1007/978-3-540-79086-0_11.
Ukrainian Medical Stomatological Academy.....................................................................................................704
48. Kaci L, Kelemen S, Mandle KD, Weitzman ER. Willingness to share personal
Inform
2012;12:39. Available: http://dx.doi.org/10.1186/1472TatianaMed
Mineeva,
TatianaDecisMak.
Migunova
Analogies between the courts of justice in medieval England and the conscientious court
6947-12-39.
of Catherine II........................................................................................................................................................716
49. Buckeridge DL. Outbreak detection through automated surveillance: A review of
Tatyana Ustinova
the determinants
of detection.
Biomed
Inform. 2007;40: 370-379. Available:
E.M. Forsters
Novel The Longest
Journey: the JProblem
of Translation............................................................722
http://dx.doi.org/10.1016/j.jbi.2006.09.003.
Hursand
Mahmudov, Umida Parpieva, Feruza Jumanazarova
Forms and methods of formation of culture of free thinking at pupils at the lessons on social
50. Kukafka R, Yasnoff WA. Public health informatics. J Biomed Inform. 2007;40:365and humanitarian disciplines in extracurricular activities in professional colleges............................................728
369. Available: http://dx.doi.org/10.1016/j.jbi.2007.07.005.
10
2. CLINICAL SCENARIO
69 years old male with previous two episodes of apoplexy and lumbar L4/L5
disc prolaps was known to have single right-sided kidney. He was living in a retirement
home and was being treated for chronic anemia of normocytic normochromic type.
He was admitted in the Department of Medicine with a confused state of mind and
a preliminary diagnosis of septicemia. He had a high C-reactive protein and
peripheral blood smear examination revealed neutrophilic leucocytosis. He was
initially treated with Ciprofloxacin and later with Tazocin, as Gram positive bacteria
were cultured in his blood with an unknown focus. He was regularly on antiplatelet
medicines (Aspirin, Dipyridamole), antihypertensive drugs (Amlodipine, Losartan) and
hypolipidemic drug (Simvastatin). He used to consume about 1-2 alcoholic drinks daily.
He had deteriorating renal function with rising creatinine and a low Glomerular
Filtration Rate. He had no abdominal complaints and was hemodynamically stable.
He was found dead in his bed. He was referred for autopsy to our institute in order to
determine the exact cause of death.
At autopsy, about 2 liters of fresh blood were found in the stomach and 3 small
defects at the gastroesophageal junction measuring about 5-7 mm were noted. On
microscopy, one of the sections revealed a large ruptured artery (size 2.15 mm) at
the submucosal level with a thrombus-like material (Fig. 1). DL was the cause of
sudden massive bleeding leading to hypovolemic shock and death. Other autopsy
findings included atherosclerosis of the coronary arteries and the aorta, lung
congestion, liver steatosis, and a single right-sided kidney with nephrosclerosis.
dieulafoys
Fig. 1. Ruptured dieulafoy
s lesion x 2 haematoxylin & eosin stain
stain
and weigert-Van
weigert-Van gieson
gieson stain
11
3. DISCUSSION
A DL was diagnosed as the underlying cause of death. This was in accordance
with the case report by Christoffersen RK et al. [1] and using established pathological
diagnostic criteria such as the presence of a relatively large artery at the level of
muscularis mucosae or higher accompanied by a vein of similar caliber with a
significant risk of ulceration and bleeding [5]. In the literature, this is also described
as a histologically normal vessel that has an abnormally large diameter (1-3 mm)
and runs a tortuous course within the submucosa protruding through a small
mucosal defect varying from 2-5 mm, with a fibrinoid necrotic base [3]. Importantly,
there is an absence of inflammation at the edge of the mucosal defect in contrast to
that present in peptic ulcer disease [6].
DL can be clinically diagnosed by endoscopy and by using Dys criteria,
angiography or red cell scanning [3] with a clinical presentation of massive
hemorrhage which is often recurrent. But in our case there were neither episodes of
bleeding, nor abdominal pain, which was similar to the clinical presentation in the
publication [1].
The pathogenesis in DL may be related to peptic ulcer disease, alcohol abuse
and/or drugs such as NSAIDs, warfarin or aspirin [2]. Despite a lack of direct evidence
that the presentation of this lesion is caused by mucosal erosions due to use of aspirin,
coumadin, or NSAIDs, the use of these medications has been reported in more than
DLininour
ourcase.
case.The
The
rupture
ulcer was
was not
not seen
seenalong
alongwith
withDL
50% of patients. Peptic ulcer
rupture
of
of DL
was
visualizedhistologically
histologicallyinincontrast
contrast toto the
the publication
publication [1]. Comorbidities
DL
was
visualized
12
therefore clinically
clinically important
important to
toreport
reportthis
thissecond
secondcase
caseofofmissed
missedDL,
DL,asas
It is therefore
a
a potentially
threatening
entity.
We would
also conclude
thatautopsy
these autopsy
potentially
life life
threatening
entity.
We would
also conclude
that these
findings
findings
are valuable
contribution
the retrospective
diagnosis
and autopsy
holds
are
valuable
contribution
to the to
retrospective
diagnosis
and autopsy
still still
holds
its
its value
in this
modern
of diagnostics.
value
in this
modern
eraera
of diagnostics.
CONSENT
Autopsy consent was given by the dead persons sister. The manuscript is
anonymous.
ETHICAL APPROVAL
Not applicable.
COMPETING INTERESTS
Authors have declared that no competing interests exist.
REFERENCES:
1. Christoffersen RK, Nielsen TS, Vesterby A. Dieulafoy lesion of the esophagus
causing massive upper gastrointestinal bleeding and death: a case report. Am J
Forensic Med Pathol. 2012;33(2):186-187.
2. Treesaranuwattana S, Khemtai C. Dieulafoys Lesion: Pathology, Diagnosis
and Treatment. Thai Journal of Surgery. 2002;23:87-96.
3. Baxter M, Aly EH. Dieulafoy's lesion: current trends in diagnosis and management. Ann R Coll Surg Engl. 2010;92(7):548-554.
4. Njeru M, Seifi A, Salam Z, Ognibene L. Dieulafoy lesion: a rare cause of gastrointestinal bleeding. South Med J. 2009;102:336-337.
13
EbtesamM.
M.Al-Zabedi,
Al-Zabedi,Mahmoud
MahmoudA.
A.Ogaili,
Ogaili,Mohamed
MohamedT.
T.Al-Maktari
Al-Maktari,
Ebtesam
and Mohamed S. Noman,
Department of Biochemistry, Faculty of Medicine
and Health Sciences, Sanaa University, Sana'a, Yemen,
Department of Medical Laboratories, Faculty of Medical Sciences,
Hodeidah University, Hodeidah, Yemen,
National Centre of the Public Health Laboratories (NCPHL), Sana'a, Yemen,
Department of Medical Parasitology, Faculty of Medicine
and Health Sciences, Sanaa University, Sana'a, Yemen,
Department of Internal Medicine, Faculty of Medicine
and Health Sciences, Sana'a University, Sanaa, Yemen
14
15
16
reported among diabetic patients who share a blood glucose meter, which has been
attributed to a limited awareness of the high risk for HBV transmission during
fingerprick blood glucose monitoring [17]. Some studies have suggested that
schistosomiasis increases HBV and HGV morbidity and chronicity, and have
identifyed hepatitis as a significant factor influencing the severity of schistosomiasis
[18,19]. That said, other studies have found that schistosomiasis does not affect the
outcome of HGV infection [20]. A recent study reported a higher prevalence of
serological markers for HBV and a lower prevalence of anti-HGV among patients
diagnosed with a hepatosplenic form of schistosomiasis [12]. HBV is a subject of some
controversy when discussing its role as a risk factor for developing DM, as the disease
is known have multiple etiologies and a pandemic image. Therefore, further studies
are needed in order to clarify these questionable associations.
Yemen is classified among areas of intermediate endemicity for HBV infection,
with previous studies revealing that the prevalence of HBV chronic infection in
different Yemeni cities ranges from 1.8% to 34% [21-25]. Moreover, schistosomiasis
is considered as the second most frequent cause of death in Yemen, after malaria,
with both urinary schistosomiasis due to S. haematobium and intestinal schistosomiasis due to S. mansoni being prevalent [26]. Recent estimates showed that
more than 3 million people in the region are infected, with at least three-quarters of a
million suffering from severe, chronic morbidity. A recent study revealed that 59% of
the squamous cell carcinoma reported in 53 Yemeni patients with urinary bladder
cancer was associated with chronic infection by S. hematobium [27]. With regards to
diabetes, the prevalence of type 2 DM in Yemen ranges between 4.6% and 9.8% [2830]. As such, the association between HBV and other diseases that affect a large
sector of the Yemeni population is an important issue to address. Hence, the aims of
the present study were to investigate the seroprevalence and potential risk factors of
HBV infection, and to examine the possible association of HBV infection with
diabetes mellitus, as well as looking at schistosomal hepatic fibrosis (SHF) with or
without super added diabetes mellitus.
2. MATERIALS AND METHODS
2.1 Study Design
This hospital-based case-control study was carried out in Sanaa city, the
capital of Yemen. All patients attending internal medical departments and diabetes
17
centres in Sanaa city public and private hospitals between January and July 2012
were invited to participate in this study.
2.2 Study Subjects
The minimum sample size required for this study was calculated according to
the formula provided by Lwanga and Lemeshow [31]. At a 5% level of significance
and a 95% confidence level, the minimum number of participants required for the
study was estimated at 288, assuming that the prevalence of HBV infection in
Yemen was about 25% as previously reported [32]. Overall, a total of 300 individuals
aged between 10 and 82 years of age (160 males and 140 females) agreed to take
part in this study. The participants were recruited into 6 different groups based on final
clinical diagnosis, with 50 individuals per group (Fig. 1). The groups were type 1
diabetes mellitus (Group 1),
1), type
type 22diabetes
diabetesmellitus
mellitus(Group
(Group 2),
2),schistosomal
schistosomalhepatic
hepafibrosis
(Group
3), type
1 diabetes
mellitus
and schistosomal
hepatichepatic
fibrosisfibrosis
(group
tic
fibrosis
(Group
3), type
1 diabetes
mellitus
and schistosomal
4), type4),2 type
diabetes
mellitus
and schistosomal
hepatic
fibrosis
(Group
5), and
the
(group
2 diabetes
mellitus
and schistosomal
hepatic
fibrosis
(Group
5), and
control
group
(Group
6) which
involved
individuals
apparently
free free
fromfrom
diabetes
with
the
control
group
(Group
6) which
involved
individuals
apparently
diabetes
with
no hepatitis
B related
history
or schistosomal
infection
background.
no hepatitis
B related
history
or schistosomal
infection
background.
2.3 Questionnaire
All subjects of the present study were asked to fill out a questionnaire regarding
their personal and demographic data (e.g. age, sex, and residence), socioeconomic
data (e.g. marital status, occupation, educational level, incom etc), habitual information (e.g. smoking, alcohol intake, addiction etc), health history related to diabetes
mellitus (e.g. type, age of onset, complications, medications etc), health history
related to schistosomiasis (e.g. type, course, any complication, medications
etc),
18
AM after
after an overnight
Blood samples were
were collected
collected between
between 8.00
8.00 and
and 10.00
10.00AM
fasting. For diabetic patients, 2 hours postprandial samples were also collected. About
19
allowed to clot at room temperature before serum was collected. The serum sample
was divided into 2 portions; one portion was stored at 20C to be used for ELISA
test and the other portion was used for the other biochemical analyses. Moreover, the
2 hours post-prandial serum glucose level for the diabetic patients was measured by
using Bio-Analytical Kit (enzymatic colorimetric method according to Trinder). The
normal value is <180 mg/dl. Furthermore, oral glucose tolerance test was done for all
non-diabetic cases. A fasting blood sample was collected and then the subject was
given a drink of 75 gm glucose in 300 ml water over a course of 5 minutes. Another
blood sample was collected 2 hours after the test load. The patients with fasting
blood sugar value of >126 mg/dl or 2 hours after glucose load value of >200 mg/dl
were considered diabetic while those with fasting blood sugar value of >110 and
<126 mg/dl or 2 hours after glucose load value of >140 and <200 mg/dl were
considered having impaired glucose tolerance.
On the other hand, glycosylated haemoglobin (HbA1c) for the diabetic patients
was measured by using ion-exchange chromatography according to StanbioGlycohaemoglobin procedure No. 0350. The percentage of HbA1c was determined
and the values of 6.0-8.0%, 7.5-8.9%, 9.0-10.0% and >10.0% were considered as
normal range, good control, fair control and poor control.
2.7 Serological Analysis
Detection of hepatitis B core total antibody (Anti-HBV) was performed using
TM
rd
DETECT-HBV (3 generation) ELlSA kits using Biochem lmmuno Systems DetectHBV (BioChem lmmuno Systems lnc., Montreal, Canada).
2.8 Statistical Analysis
Statistical analysis of the collected data was done using SPSS (version 13,
2004; SPSS, lnc., Chicago, lL, USA) and EPl-lnfo for windows 2002 software (Centers for Disease Control and Prevention, Atlanta, GA, USA). The distribution of
quantitative variables was examined using the Kolmogorov-Smirnov test. For descriptive analysis, a proportion was used to present the prevalence of categorical
variables in the form of mean and standard deviation (SD). For inferential statistical
analysis, a Chi-square test was used to assess the influence of different categorized
variables on hepatitis B virus seropositivity. Unadjusted odd ratios (OR) with 95%
confidence intervals (Cl) were also computed. Moreover, a multiple logistic regression
model was used to investigate the association between dependent variables and
20
21
as both sexes had 20% anti-HBV positive enzyme immunoassay (ElA) results. With
regards to residence, it is noted that the rural population is exposed to an increased
risk for being HBV seropositive compared to those from urban areas (21.5% vs 16.8%;
OR=1.35; 95% Cl=0.69, 2.67). Similarly, socioeconomic class showed as having
an influence on the risk of disease development, a step ladder pattern of increasing
risk was noted when directed toward the poorer lower classes compared to individuals
in the high class (33.3% vs 13.3%; OR=3.25; 95% Cl=0.68, 15.83). However, these
differences were not statistically significant (P>0.05).
Other variables showed no remarkable signs of additional risk, as in general
none of the other socio-demographic variables reached a statistically significant value
(P>0.05).
The relationship between past medical history and the risk of developing a
hepatitis B viral infection was also investigated. lt is clear that a past history of clinically
manifested jaundice was significantly associated with the risk of being HBV
seropositive (OR=2.51, 95% Cl=1.30, 4.85), as people who had previously suffered
from jaundice showed a significantly higher seropositivity compared to individuals
without such a history. ln addition, a history of using glass syringes (OR=2.05; 95%
Cl=0.94, 4.50) doubled the risk of HBV seropositivity.
Other variables including a family history of jaundice, a past history of surgical
intervention, repeated parenteral injections, occasional or infrequent dental
manipulations, a history of blood transfusion, dental visits on a regular bases, as
well as a host of medical illnesses (e.g. Rheuamtoid artheritis, systemic lupus
erythematosus, renal insuffeciency, fascioliasis, amoebic dysentry etc) showed no
additional risk or significant association with HBV seropositivity.
Table 2 further shows the possible relationship between some personal habits
and the risk of hepatitis B viral seropositivity. A higher risk of acquiring HBV was
noted among 110 individuals who had a history of smoking when compared to non
smokers (22.7% vs 18.4%). Similarly, those with a history of addiction (i.e. cannabis
and/or alcohol) faced double the odds of being HBV seropositive (OR=2.47, 95%
Cl=0.45, 12.34). However, these differences were not statistically significant (P > 0.05).
Group name
Sample size
Age (years) (MeanSD)
Males
Females
Hepatitis B seropositivity
Working
Urban
Married
Low socioeconomic level
Smoking
Blood transfusion
Jaundice
Variables
Group 2
DM type 2
50
54.610.2
7 (14)
43 (86)
8 (16)
2 (4)
34 (68)
38 (76)
14 (28)
8 (16)
1 (2)
1 (2)
Group 3
SHF
50
40.314.
36
4 (72)
14 (28)
12 (24)
1 (2)
1 (2.0)
40 (80)
31 (62)
26 (52)
13 (26)
15 (30)
Groups
Group 4
DM type 1+SHF
50
42.212.4
44 (88)
6 (12)
13 (26)
5 (10)
0 (0.0)
46 (92)
45 (90)
26 (52)
5 (10)
11 (22)
Group 1
DM type 1
50
34.011.6
25 (50)
25 (50)
6 (12)
9 (18)
34 (68)
34 (68)
15 (30)
12 (24)
8 (16)
7 (14)
Group 5
DM type 2+SHF
50
51.510.0
29 (58)
21 (42)
14 (28)
4 (8)
2 (4.0)
43 (86)
20 (40)
23 (46)
7 (14)
13 (26)
22
Cambridge Journal of Education and Science
23
illness with the HBV seropositive EIA test. The results show that there are 82 cases
that have a history of a household member suffering from schistosomal hepatic
fibrosis (SHF), with 29 of them (35.4%) being anti-HBV EIA positive. The history of
such illness
illnesswas
was
significantly
associated
withrisk
the
HBV seropositivity
significantly
associated
with the
of risk
HBV ofseropositivity
(OR=3.72;
(OR=3.72;
95% 7.23).
CI=1.92,
7.23). Furthermore,
liver cirrhosis
theofodds
HBV
95% CI=1.92,
Furthermore,
liver cirrhosis
doubleddoubled
the odds
HBVof seroseropositivity,
butassociation
the association
not statistically
significant
(OR=2.91;
95%
positivity, but the
was notwas
statistically
significant
(OR=2.91;
95% CI=0.90,
CI=0.90,
9.13).
9.13).
Table 2. Associations of hepatitis B virus seropositivity with
demographic, socioeconomic, past medical history and personal
habits factors (n=300)
Variables
Socio-demographic factors
Sociodemographic
Age in years
030
31 50
>50
Sex
Male
Female
Residence
Urban
Rural
Marital status
Single
Married
Widowed
Occupation
Not farmer
Farmer
Socioeconomic class
High
Middle
Low
Very low
Past medical history
Blood transfusion
No
Yes
Surgery
No
Yes
AntiHBV EIA
OR (95% CI)
8 (16.3)
26 (17.1)
26 (26.3)
1.0
1.06 (0.42, 2.77)
1.83 (0.71, 4.85)
160
140
32 (20.0)
28 (20.0)
1.0
1.00 (0.57, 1.76)
95
205
16 (16.8)
44 (21.5)
1.0
1.35 (0.69, 2.67)
45
229
26
10 (22.2)
43 (18.8)
7 (26.9)
1.0
0.81 (0.35, 1.90)
1.29 (0.37, 4.49)
219
81
43 (19.6)
17 (21.0)
1.0
1.09 (0.55, 2.13)
45
154
86
15
6 (13.3)
28 (18.2)
21 (24.2)
5 (33.3)
1.0
1.44 (0.52,
(0.52, 4.21)
4.21)
1.44
2.10 (0.72, 6.40)
2.10
3.25 (0.72,
(0.68, 6.40)
3.25
(0.68, 15.83)
15.83)
261
39
53 (20.3)
7 (17.9)
1.0
0.86 (0.33, 2.18)
134
166
25 (18.7)
35 (21.1)
1.0
1.16 (0.63, 2.15)
24
Table 2 Continued...
Continued
..
Parental injection
No
Yes
Glass syringes usage
Dental manipulation
No
lnfrequent
Regular
Family history of jaundice
No
Yes
Personal history of jaundice
No
Yes
Associated diseases**
No
Yes
Personal habits
Smoking
No
Yes
Addiction
No
Yes (Cannabis and/or
alcohol)
104
115
81
16 (15.4)
55 (19.1)
22 (27.2)
1.0
1.30 (0.61, 2.80)
2.05 (0.94, 4.50)
101
136
63
18 (17.8)
33 (24.3)
9 (14.3)
1.0
1.48 (0.74, 2.96)
0.77 (0.29, 1.97)
221
79
42 (19.0)
18 (22.8)
1.0
1.26 (0.67, 2.35)
247
53
42 (17.0)
18 (34.0)
1.0
2.51 (1.30, 4.85)*
156
144
32 (20.5)
28 (19.4)
1.0
0.94 (0.53, 1.65)
190
110
35 (18.4)
25 (22.7)
1.0
1.30 (0.70, 2.41)
292
8
57 (19.5)
3 (37.5)
1.0
2.47 (0.45,
10.66)
OR: Odds ratio; Cl: Confidence interval, *Significant association (P < 0.05), ** Associated diseases include
rheumatoid artheritis, systemic lupus erythematosis, renal insufficiency, fascioliasis, amoebic
dysentery etc.
etc
dysentery
25
reported to have the highest risk (OR=1.91; 95% Cl=0.85, 4.29), however it was not
statistically significant.
3.3.3 Aspects of diabetes mellitus
Table 4 shows the association between diabetes mellitus and the risk of HBV
seropositivity. The results reveal that the presence of either type 1 or type 2 DM
apply no extra risk of being HBV seropositive when compared with non-diabetic
cases. Although a higher risk of acquiring HBV was reported in cases with poor control
for blood glucose (OR=2.05; 95% Cl=0.67, 6.71), among those with a history of
gestational diabetes (OR=1.93; 95% Cl=0.68, 5.42) and in those who developed DM
after the age of 40 (OR=1.52; 95% Cl=0.76, 3.02), the differences were not statistically
significant. Likewise, associations of HBV seropositivity in terms of a family history of
DM, duration of diabetic illness, the presence of secondary causes contributing to the
development of DM, and the presence of diabetic complications were not statistically
significant.
Table 3. Associations of hepatitis B virus seropositivity with factors related to
schistosomiasis (n=300)
Variables
AntiHBV
EIA
Anti-HBV
EIA
No. examined
Family history of liver
Diseases
No
195
Cirrhosis
20
SHF
82
Others**
3
Personal history of schistosomiasis
No
150
Yes
150
Schistosomiasis duration
<=10 years
9
>10 years
141
Schistosomiasis course
Stationary
100
Progressive
50
Ascitis
No
114
Yes
36
History of lV anti-schistosomal drugs
No
47
Yes
103
OR (95% CI)
Positive
Positive N
N (%)
(%)
25 (12.8)
6 (30.0)
29 (35.4)
0 (0.0)
1.0
2.91 (0.90, 9.13)
3.72 (1.92,7.23)*
-
21 (14.0)
39 (26.0)
1.0
2.16 (1.20,3.89)*
1 (11.1)
38 (27.0)
1.0
2.95 (0.35,64.99)
24
15
24.0
30.0
1.0
1.36 (0.64, 2.90)
26 (22.8)
13 (36.1)
1.0
1.91 (0.85, 4.29)
6 (12.8)
33 (32.0)
1.0
3.22 (1.16,9.40)*
OR: Odds ratio; Cl: Confidence interval; SHF: Schistosomal hepatic fibrosis,* Significant association
(P<0.05), ** Two cases with family history of chronic hepatitis and one with HCC, Ascitis was selected out
of other complications of hepatosplenic schistosomiasis e.g. organomegaly, oesophageal varices with or
without
treatment
without haematemesis
haematemesis
etc,
etc, Past
Past history
history of
of parenteral
parenteral tartar
tartar emetic
emetic anti-schistosomal
anti-schistosomal drug
drug treatment.
26
Analysisfor
for the
the risk
Riskfactors
Factors
HBV
seropositivity
3.3.4 Multivariate analysis
ofof
HBV
seropositivity
The results of a multiple logistic regression analysis for the different possible
risk factors that contribute to the development of HBV seropositivity revealed four
variables that were retained in the final model as significant risk factors for HBV
seropositivity. Those variables are a family history of a household member suffering
with cirrhosis (OR=4.34; 95% Cl=1.98, 6.94), family history of a household member
suffering with SHF (OR=3.41; 95% CL=1.16, 11.23), a personal history of jaundice
(OR=1.94; 95% Cl=1.12, 5.57) and a personal history of schistosomal illness
(OR=1.88; 95% Cl=1.09, 12.14). Other factors including a personal history of dental
manipulations, multiple parenteral injections, diabetes and the subjects socioeconomic class were removed from the final logistic regression model.
3.4 Further Analyses for The Association of Schistosomiasis and
Diabetes with HBV Seropositivity
The distribution of the studied population according to their age group, their
history of schistosomiasis and the results of the EIA anti-HBV seropositivity were
analyzed further with the results being shown in Table 5.
It was found that the percentages of HBV seropositivity increased significantly
with age among those who had a history of schistosomiasis, with the percentages
among those aged <=30, 31-50, and >50 years being 12.8%, 35.9%, and 51.3%,
respectively (P<0.002). On the other hand, the pattern of association between HBV
seropositivity and age among the non schistosomal cases was not statistically
significant (P=0.343).
Table 4. Associations of hepatitis B virus seropositivity with factors related to
diabetes mellitus (n=300)
Variables
Variables
Family history of DM
No
Yes
Personal history of DM
No
DM type 1
DM type 2
Age of onset
<= 40 years
> 40 years
AntiHBV EIA
AntiHBV EIA
OR (95% CI)
OR (95% CI)
No. examined
Positive N (%)
176
124
38 (21.6)
22 (17.7)
1.0
0.78 (0.44, 1.40)
81
81
78
19 (19.0)
19 (19.0)
22 (22.0)
1.0
1.00 (0.47, 2.15)
1.20 (0.57, 2.53)
94
65
20 (17.5)
21 (24.4)
1.0
1.52 (0.76, 3.02)
27
Duration
<= 10 years
97
> 10 years
62
Secondary cause of DM
No
153
Yes
6
Gestational diabetes
No
146
Yes
13
Control of DM (Glycated Hb A1c)
Good
32
Fair
46
Poor
81
Diabetic complications
No
19
Yes
140
30 (23.6)
11 (15.1)
1.0
0.57 (0.25, 1.30)
40 (20.7)
1 (14.3)
1.0
0.64 (0.07, 5.45)
35 (19.3)
6 (31.6)
1.0
1.93 (0.68, 5.42)
5 (13.5)
10 (17.9)
26 (24.3)
1.0
1.39 (0.39, 5.23)
2.05 (0.67, 6.71)
8 (29.6)
33 (19.1)
1.0
0.56 (0.23, 1.39)
OR: Odds ratio; Cl: Confidence interval, Secondary causes of DM e.g. steroids intake, Diabetic
complications: (infection, microangiopathy, and macroangiopathy)
With regards to the diabetes illness aspects, the mean values of blood glucose
among the studied population in relation to anti-HBcAb EIA results were compared
(Table 6). Among non diabetic cases, the mean values of fasting blood glucose and
glucose levels after 2 hours of 75 gm oral glucose challenge were found to be lower
in anti-HBV EIA positive cases than their negative counterparts, however the
differences were not statistically significant (P > 0.05). Among 200 diabetic cases,
almost similar levels of 2 hours post prandial mean glucose were found among HBV
seropositive and negative cases (275.85 mg/dl vs 271.33 mg/dl).
When the 100 cases with a history of both schistosomiasis and diabetes
mellitus illnesses were compared with the 50 individuals free from both diseases
(control/reference), the results showed that 27 (27%) individuals were anti-HBV EIA
seropositive in those with a history of both illnesses, compared to only 7 individuals
(14%) in the control group. The risk of being HBV positive was higher in the illness
group (OR=2.27; 95% CI=0.85, 6.29) compared to the control group, however the
difference was not statistically significant.
Finally, the fraction attributable risk of the most influential risk factors for
developing an HBV seropositive was calculated. It is evident that the highest values
of attributable fraction were due to a family history of a household member with chronic
liver disease (SHF or cirrhosis) (61.6%), followed by being a member of the very low
socioeconomic class (60.0%), with a personal history of jaundice (50.0%) also being
a significant indicator of risk. The lowest value of attributable fraction was due to the
presence of diabetes mellitus (7.3%).
28
Finally, the fraction attributable risk of the most influential risk factors for developing an HBV
seropositive was calculated. It is evident that the highest values of attributable fraction were
due to a family history of a household member with chronic liver disease (SHF or cirrhosis)
Cambridge
Journal
of Education
and Science
(61.6%), followed by being
a member
of the
very low socioeconomic
class (60.0%), with a
personal history of jaundice (50.0%) also being a significant indicator of risk. The lowest
value of attributable fraction was due to the presence of diabetes mellitus (7.3%).
Age group
(years)
N
<= 30
31-50
> 50
2
0
P-value
Schistosomiasis
Negative (N=150)
Positive (N=150)
-ve HBcAb EIA
+ve HBcAb EIA
-ve HBcAb EIA +ve HBcAb EIA
N (%)
N (%)
N (%)
N (%)
129
21
111
39
29 (22.5)
3 (14.3)
12 (10.8)
5 (12.8)
52 (40.3)
12 (57.1)
74 (66.6)
14 (35.9)
48 (37.2)
6 (28.6)
25 (22.5)
20 (51.3)
2.14
12.72
0.343
0.002
FBG*
(MeanSD)
89.4719.49
82.2615.08
1.51
0.135
PGL**
(MeanSD)
140.2730.12
136.4220.76
0.53
0.599
2PPG***
(MeanSD)
271.33100.69
275.85106.91
0.25
0.800
*Fasting blood glucose measurement done for non-diabetic cases; **Two hours after 75 gm oral
glucose challenge (Load) done for non-diabetic cases; ***Two hours post prandial serum glucose
assessment done for diabetic patients
4. DISCUSSION
Hepatitis B virus infection, schistosomiasis and diabetes mellitus are major
global public health problems, especially in developing countries. The interactions
between these diseases are still unclear and of great interest.
The findings of the present study show that 20% of the participants tested
positive using the total HBcAb EIA test. Many previous studies conducted in Yemen
revealed that the prevalence of HBV infection ranges between 1.8% and 34% based
on the subjects being studied. A community-based study in Ibb, Gacche and Kaid
found that the prevalence of HBV among 554 participants was 1.8% when examined
for hepatitis B surface antigen (HBsAg) [34]. However, a recent community-based
study conducted in the Taiz province showed a higher HBsAg prevalence at 16.9%
[35]. A similar level of prevalence (16%) was reported by a hospital-based study in
Aden city based on anti-HBV core antibodies (antiHBc) and HBsAg [23]. However,
a comparable higher prevalence was reported among liver disease patients (33.6%)
and among blood donors (28.8%) [36,37]. Moreover, a lower HBsAg prevalence was
reported among schoolchildren in Taiz (10.6%), pregnant women in Sanaa (10.8%)
and among mothers and their infants in Sanaa (13.2% and 4%, respectively)
29
[21,26,38]. In agreement with previous studies, our findings confirm that Yemen is an
area of intermediate endemicity for HBV infection (10%-60%). Moreover, only 5% of
the patients recruited to the present study had declared prior hepatitis B vaccination.
The findings of the current study also show that the seropositivity of HBV based
on total HBcAb was higher among participants aged >50 years when compared to
younger participants, however the difference is not statistically significant. Previous
studies from Yemen and other countries showed that the prevalence of HBV has an
age-dependency factor, with infection patterns increasing with age, the highest
prevalence being among subjects aged >40 years [23,24,35,39].
We found similar levels of HBcAb seropositivity among both male and female
participants, which is in agreement with previous studies conducted in Yemen
[34,35]. However, it is worth noting that some studies in Yemen and other countries
have shown a significantly higher prevalence of HBV among males than females
[24,40]. On the other hand, a WHO collaborative study on HBV in which 20 countries
participated did not find a statistically significant difference in the prevalence of HBsAg
between males and females [41].
Furthermore, the present study investigated the possible factors associated
with HBcAb seropositivity among the participants and revealed that a personal history
of juandice, a family history of schistosomal hepatic fibrosis (SHF), as well as a
personal history of schistosomiasis and using IV anti-schistosomal drugs were key
factors found to be associated with HBV seropositive results. Participants who had a
history of juandice were at higher risk of HBV seropositivity than their counterparts.
These finding are consistent with results reported previously in Thailand, Morocco and
Bangladesh [40,42,43]. Juandice is a classical sign of liver diseases, therefore a
history of juandice may indicate the high succeptablitity of individuals to these
diseases.
In addition, our findings show that participants who live in houses with family
members who have a history of SHF were at 3 folds higher risk of being HBcAb
seropositive. This is in agreement with previous reports from other countries [44]. The
results of the logistic regression also show that a history of household members
having liver cirrhosis increases the risk of participants being infected with HBV.
Although liver cirrhosis is present in the majority of patients with HBV, an increased
risk for hepatitis B-related liver cirrhosis in relatives of patients with hepatocellular
30
carcinoma was reported in Taiwan, which may indicate familial clustering of hepatitis
B-related liver cirrhosis [45].
An earlier serological survey for hepatitis B markers was carried out in Yemen
among 654 individuals (243 pregnant females, 294 male blood donors and 108
patients with chronic liver disease), which found that the detection rate of HBsAg was
significantly higher among patients with chronic liver diseases (including liver cirrhosis)
compared to healthy individuals (24.1% vs 18.5%). There was also significantly higher
evidence of HBV infection among the chronic liver diseases patients than their healthy
counterparts (75.9% vs 59.8%) [46].
The findings of the present study show significant associations between the
high prevalence of HBV seropositivity and several aspects of schistosomiasis,
including history of schistosomiasis onset and the use of intravenous schistosomiasis
treatment. We found that participants with a history of being infected with Schistosoma
species are at double the risk of HBV seropositivity compared to those never infected
with Schistosoma. Co-infection of HBV and Schistosoma is of significant concern, as
patients with both infections have been shown to have increased histological activity,
as well as higher incidences of liver cirrhosis and hepatocellular carcinoma (HCC),
with a greater mortality rate when compared with patients suffering from only a single
infection [47].
It has been previously reported that patients with hepatosplenic schisto-somiasis were at an increased risk from other infections, including a 10-fold higher risk for
co-infection with HBV, as well as an increased frequency of liver failure when
compared to healthy individuals [12,48]. Similarly, Pereira et al. reported that coinfection of Schistosoma mansoni and other liver disease, particularly HBV or HCV
infections, will trigger the progression of hepatic fibrosis into cirrhosis and
hepatocellular carcinomacan, occuring within a few years [49]. Such co-infections
were reported in Egypt and Brazil [47,50,51]. Furthermore, HCV but not HBV has
been reported to influence the severity of schistosomiasis among Egyptian patients
[52]. In Yemen, the only study on the co-infection of schistosomiasis and HBV
was conducted in Taiz and reported that 10.6% of schoolchildren diagnosed as having
schistosomiasis were also found to be positive for HBV, though it is worth noting that
the percentage was as high as 22.2% in some areas [38].
31
32
Our findings show that diabetic patients with poor control of blood glucose are
at almost double risk of HBcAb seropositivity when compared to those with good or
fair control levels. However, the difference was not significant. This is in agreement
with a previous study from Nigeria [56]. We also compared the level of blood glucose
between HBcAb seropositive and negative participants, and found no significant
difference between both groups. In the present study, the results of the multivariate
logistic regression analysis confirmed that a family history of a household member
suffering cirrhosis, a family history of a household member suffering with SHF, a
personal history of jaundice, and a personal history of schistosomiasis were the
significant risk factors of anti-HBV EIA positive results among these participants.
The findings of the present study further revealed that the presence of
concomitant schistosomiasis and DM did increase the risk of HBcAb seropositivity
by more than 48%, and the increment was greatly attributed to the schistosomal
impact of this association. We also found a higher anti-HBV EIA positivity (28%)
among type 2 dieabetic participants who also had SHF (group 5), followed by those
with type 1 DM and SHF (group 4), when compared with the lowest positivity rate of
12% among participants with type 1 DM (group 1). However, these differences were
not statistically significant when compared with the control group.
Although the interaction between schistosomiasis and DM is still unclear,
previous studies revealed a protective role for Schistosoma infection, reporting a lower
prevalence of diabetes and a better metabolic profile among Chinese participants with
previous schistosome infection [60]. Moreover, a previous study showed that
S. mansoni soluble egg antigens can profoundly regulate the immune system of the
infected host and thus can be used to prevent type 1 diabetes in non-obese diabetic
mice [61].
The findings of the present study should be interpreted with caution due to few
limitations. First, this study had to rely on the results of total HBcAb while HBsAg was
not examined. Data for HBsAg detection would be essential in order to identify positive
patients as those with past or current HBV infection. Second, majority of the
participants were from rural areas this could explain the absence of prior hepatitis B
vaccination. Third, the hospital-based design limits the interpretation of our findings,
and a community-based study is required.
33
5. CONCLUSION
The findings of this study revealed high HBV seropositivity among the
participants. Schistosomiasis was found to be associated with HBV, particularly
among individuals who are older in age, received parenteral anti-schistosomal
treatment, have a history of clinical jaundice, and have a household member with a
history of SHF. There was no association between HBV and DM among the subjects,
with no additional risk being reported when DM was considered in examining the
relationship between schistosomiasis and HBV. Large-scale community-based studies
are needed to investigate the epidemiology of HBV infection and to evaluate its
relationship with other diseases. Proper attention should be given to the high
seropositivity rate of HBV, and effective measures should be implemented in order to
reduce the prevalence of this life-threatining infection in Yemen.
CONSENT
All participants agreed that their participation in the research is voluntary and
they may withdraw from the research at any time without citing the reasons. Written
and signed or thumb-printed informed consents were obtained from the participants.
ETHICAL APPROVAL
The protocol of this study was approved by the Medical Ethics Committee of
the Faculty of Medicine and Health Sciences, Sanaa University, Yemen and
permissions were also given from the related hospitals.
COMPETING INTERESTS
Authors have declared that no competing interests exist.
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39. Daw MA, Siala IM, Warfalli MM, Muftah MI. Seroepidemiology of hepatitis B
virus markers among hospital health care workers: Analysis of certain potential
risk factors. Saudi Med. J. 2000;21(12):1157-1160.
40. Chiarakul S, Eunumjitkul K, Vuttiopas S, Vorapimol AR, Kaewkungwal J,
Poovorawan Y. Seroprevalence and risk factors of hepatitis B virus infection
among health care workers at the Institute of Neurology. J. Med. Assoc. Thai.
2007;90(8):1536-1545.
41. Sobeslavsky O. Prevalence of markers of hepatitis B virus infection in
various countries: a WHO collaborative study. Bull WHO. 1980;58(4):621-628.
42. Baha W, Foullous A, Dersi N, They-they TP, El alaoui K, Nourichafi N, Oukkache B, Lazar F, Benjelloun S, Ennaji MM, Elmalki A, Mifdal H, Bennani A.
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Prevalence and risk factors of hepatitis B and C virus infections among the general
population and blood donors in Morocco. BMC Public Health. 2013;13:50.
43. Ashraf H, Alam NH, Rothermundt C, Brooks A, Bardhan P, Hossain L, Salam MA, Hassan MS, Beglinger C, Gyr N. Prevalence and risk factors of hepatitis
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44. Berhe N, Myrvang B, Gundersen SG. Intensity of Schistosoma mansoni, hepatitis
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Massoud M, Koziel MJ, Afdhal NH. Progression of fibrosis in hepatitis C with
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and C infections among immigrants to a newly reclaimed area endemic for
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39
Infectious-like
an Agent
to 2,
Safety
Promotion and lnjurySpread
Preventionof
Research
Center, Leading
7th Floor, Building
Beheshti University
of Medical
Sciences, Evin,and
Chamran
Highway,
lran
Shahid
Increased
Medical
Admissions
Deaths
inTehran,
Wigan
ABSTRACT
The
higher death and medical admissions in the Wigan local authority, part of the greater
Manchester
area of England, during 2011 and 2012.
ABSTRACT
Study
Longitudinal
study
of deaths
hospital drivers
admissions.
Aims: Design:
This study
investigated
the
role of and
graduated
licensing, imPlace
Duration
of of
Study:
Deaths
(all-cause
mortality)
for the resident
plemented
byand
the Traffic
Police
Iran, on
reducing
the severity
and incidence
of road
population
of Wigan from January 2006 to February 2014. Patients admitted to the
traffic
injuries.
Design:
It acute
was an
evaluation
the effectiveness
of intervention
by
Wigan Study
Infirmary,
a large
hospital
on theofoutskirts
of Manchester,
England, belooking
at theand
data2013.
before
and after intervention.
tween 2008
Methodology:
Running twelve month totals for deaths and
Place
and Duration
of Study:
Data
on roadincreases
traffic crashes
andfactors.
injuries Addifrom
medical
admissions
were used
to detect
step-like
in these
one
before,
afterofand
two
years
after the of
implementation
tionalyear
analysis
byone
age,year
length
stay
and
for clusters
persons livingofineducated
over 40
drivers
licensing
were
obtained
from Iran
Traffic
Police database
in 2010.
small areas
(called
mid
super output
areas)
containing
approximately
5,000 popula-
the periodThis
January
2011
2012.
appear
be aflicensing.
measure
felltotoApril
15.5%
and Certain
16.1% inmedical
the firstconditions
and second
years to
following
fected
earlier than
others,
the pattern
of increased
show(p<0.001).
evidence of
the
intervention
among
theand
holders
of provisional
81 typeadmissions
driving license
saw-tooth
behavior with
age, which
antigenic
original
and which
Conclusion:
Intervention
is is
anindicative
effective ofway
of reducing
thesinnumber
and
severity
traffic
injuries, particularly
among
the young
and novice
has alsoofbeen
demonstrated
for deaths
in England
and Wales
duringdrivers
2012. are at a
greaterConclusion:
risk of RTIs.
Such
drivers
particularly
benefit infectious
from graduated
The
spread
of a can
previously
unidentified
agent isdrivers
implilicensing
program
which is
proven toinreduce
the incidence
and severity ofand
road
synchronous
increases
death (both
in- and out-of-hospital)
in traffic
medcated
in the
injuries.
ical
admissions (some of which result in death). This is not the first occurrence of an
Keywords: traffic injuries; graduated drivers licensing; accident; transport; fatal.
outbreak of this agent and urgent research is required to identify both the agent and
clarify its mode of action which appears to be via immune modulation. The ubiquitous
40
1. INTRODUCTION
Road traffic injuries constitute a major cause of death and disability globally,
with a disproportionate number occurring in developing countries. In 1998, developing
countries accounted for more than 85% of all deaths due to road traffic crashes globally
and for 96% of all children killed. Moreover, about 90% of disability-adjusted lives
worldwide, due to road traffic injuries, occur in developing countries [1,2]. Meanwhile,
human factors, according to some studies, have had the most influence on the
occurrence of road traffic injury. These factors include drivers behavior, high speed,
violation of the traffic laws, insufficient driving skill, decentralization, fatigue, and physical disability [3]. Graduated drivers licensing is designed to delay full licensure
while allowing teens to get their initial driving experience under low-risk conditions.
It allows beginners to get their initial experience under controlled conditions with lower
risk, while gradually exposing them to more complex driving conditions.
Educated drivers licensing was first proposed in the early 1970s by Waller in
response to the over representation of young drivers in car crashes in North Carolina
[4]. Graduated drivers' licensing framework included three stages. In the first stage,
the learner period, all driving occurs under supervision. Given this period's relative
safety, recent initiatives have tried to encourage the learner to experience a wide
range of driving conditions as frequently as possible. In the second stage, the
intermediate or provisional licensing period, driving is allowed without supervision. The
third stage, full licensing, occurs when the first two stages have been completed [5].
''A three-stage graduated driver licensing (GDL) system that applied to all new
drivers aged 15-24 years was studied by Begg and Stephenson. Component of GDL
were a 6-month learner license (supervised driving) and an 18-month restricted
license stage (with restrictions on night driving and carrying passengers). Findings
suggested that GDL restrictions had contributed to the reduction in crashes among
young people and that it was not simply a case of reduced exposure to risk. This
suggests that the impact of GDL has not diminished over time'' [6]. The impact of the
new road traffic safety law in Serbia showed 26.5% reduction in road traffic fatality
after intervention [7]. The study specifically investigated the role of educated drivers
licensing in reducing the frequency and intensity of injuries (fatal or non-fatal) in Iran.
In this regard, the current study was conducted, as an external evaluation, to
examine the level of success of the scheme (intervention) carried out by the Traffic
Police in Iran.
41
3. RESULTS
42
According to the results, the number of accidents dropped from a total of 71607 to 63642
Cambridge
of Education
cases in three years, i.e.
from a Journal
year before
and to and
two Science
years after the implementation of
educated drivers licensing. A significant reduction (7.0%) of accidents was observed in
drivers under 23 years after the law enforcement (p<0.001, Table 1) policies.
1. Frequency(%)
of total
accidents
in inner
and outer
city roads,
TableTable
1. Frequency
(%) of total
accidents
in inner
and outer
city roads,
from a
year before
to
two
years
after
the
implementation
of
temporary
educated
drivers
from a year before to two years after the implementation of temporary
licensing
licensing 81, based on driver's
age and type of driving license
Time of law
enforcement
Temporary driving
license
Table 2. Frequency (%) of accidents from one year before to two years after the
implementationof
of temporary
temporaryeducated
educated drivers
drivers licensing
licensing 81,
81, as
as measured
measured by
by
implementation
driver's
driver's offender
offenderfor
for age
age and
and type
type of
of driving
driving license
license
Time of implementing
Temporary driving license
There was also a significant reduction in fatal and non-fatal injuries in drivers under 23 years,
following
thecompares
enforcement
of the
lawand
(p <0.001,
3).
*P < 0.001
one year
before
two yearsTable
after enforcing
the new regulations; **numbers in
parenthesis are presented in percent
Fatal injuries significantly varied according to sex of the drivers (4.2% males and 1.6%
females) in the first and second years after the implementation of law enforcement policies (p
<0.001, Table 4).
Table 3. Frequency(%) of total accidents in one year before to two years after
temporary educated drivers licensing 81 based on driver's age, type of driving
license and type of accident
Time of law enforcement for
Temporary driving license
(70.0)
9302
(72.4)
11125
(73.1)
34702
(18.0)
43
There was also a significant reduction in fatal and non-fatal injuries in drivers
< 0.001 compares one year before and two years after enforcing the new regulations; **numbers in
under*P23
years, following the enforcement
of the law
(p <0.001, Table 3).
parenthesis are presented
in percent
Fatal injuries significantly varied according to sex of the drivers (4.2% males
and
There was also a significant reduction in fatal and non-fatal injuries in drivers under 23 years,
following
the enforcement
the law
(p <0.001,
Table
3). after the implementation of law
1.6% females)
in theof first
and
second
years
Fatal injuries
significantly
variedTable
according
(p <0.001,
4). to sex of the drivers (4.2% males and 1.6%
enforcement
policies
females) in the first and second years after the implementation of law enforcement policies (p
<0.001, Table 4).
Table
(%) of
after
Table3.3.Frequency
Frequency(%)
of total
total accidents
accidents in
in one
one year
year before
before to
to two
two years
years after
temporary
temporary educated
educated drivers
drivers licensing
licensing 81
81 based
based on
on driver's
driver's age,
age, type
type of
of driving
driving
license
license and
and type
type of
of accident
accident
Time of law enforcement for
Temporary driving license
Total
40559
3006
16396
26864
Table 4. Frequency (%) of total accidents from one year before to two years
Table 4. Frequency (%) of total accidents from one year before to two years
after enforcing temporary educated drivers licensing 81, based on driver's
after enforcing temporary educated drivers licensing 81, based on driver's
age, sex and type of driving license
age, sex and type of driving license
81 and type 2
driving license of
those under 23 years
Female
Number (percent)
Non-fatal
Fatal
Number (percent)
Oneyear
yearbefore
before enforcing
enforcing the
520
One
the
520
2929
temporary
(94.7)*
(5.3)
temporarydriving
driving license
license
(94.7)*
(5.3)
One
temporary 190
1414
Oneyear
yearafter
after enforcing
enforcing temporary
190
drivinglicense
license
(93.1)
(6.9)
driving
(93.1)
(6.9)
Two
2424
Twoyears
yearsafter
after enforcing
enforcing temporary 312
312
temporary
(92.9)*
driving
(7.1)
drivinglicense
license
(92.9)**
(7.1)
*1022
Total
6767
Total
1022
(93.8)
(6.2)
(93.8)
(6.2)
Time of law enforcement for
temporary driving license
*P < 0.001, Difference in injury reduction one year before, and one to two years after law enforcement,
with gender
**numbers
in parenthesis
are
presented
in percent
*P < 0.001, Difference
in matched;
injury reduction
one year
before, and
one
to two years
after law enforcement,
with gender matched; **numbers in parenthesis are presented in percent
4. DISCUSSION
This study shows the noticeable effect of B1 type drivers licensing education in reducing
traffic injuries. A significant reduction in accidents and fatal and non-fatal injuries was
observed among drivers under 23 years after enforcement of the new regulations. Likewise,
there was a significant reduction in accidents between drivers with B1 and those with type 2
driving licenses in the first and second year after the new law regulations. Rate of fatal
injuries by sex in the first and second years after law enforcement policies showed significant
differences between men and women drivers. In general, reduction in the number of injuries
was apparently accounted for by two main reasons: reduction in risk factors and safer
driving. Some major risk factors that were subjected to certain restrictions were as follows:
44
4. DISCUSSION
This study shows the noticeable effect of B1 type drivers licensing education
in reducing traffic injuries. A significant reduction in accidents and fatal and nonfatal injuries was observed among drivers under 23 years after enforcement of the
new regulations. Likewise, there was a significant reduction in accidents between
drivers with B1 and those with type 2 driving licenses in the first and second year
after the new law regulations. Rate of fatal injuries by sex in the first and second
years after law enforcement policies showed significant differences between men and
women drivers. In general, reduction in the number of injuries was apparently
accounted for by two main reasons: reduction in risk factors and safer driving.
Some major risk factors that were subjected to certain restrictions were as follows:
Overnight traffic light, drivers' age and skill, driving speed and alcohol use. The risk of
overnight poor light was removed by abandoning driving in poor light; this was
quite significant as driving under inadequate light could cause fatigue as well;
additionally very young or novice drivers were not allowed to drive; speeding
restrictions and alcohol prohibition also helped to reduce the number of injuries. Safe
driving the second major cause for fewer injuries mainly dealt with ways of
encountering those violating driving regulations. For example driving license could just
be issued for those who did not violate traffic (driving) rules. The results are in line with
some studies like Hasselberg according to which, compared to control groups, in the
experimental groups with parent accompanying their young children, the novice drivers
underwent more restrictions [8].
Despite the new restrictions, some people were still likely to drive without having
any driving license; this indicates the need for heavy presence of the Traffic Police on
the one hand and introduction of driving tips on the other. Based on seven published
evaluations, dealing with the impact of graduated licensing and driving restrictions on
young driver crashes, educated drivers licensing reduced all types of crashes by 7%
and injury crashes by 9%, with both reductions being statistically significant [9]. In line
with such measures, driving license was issued in New Zealand in 1997 in three
stages. In the first stage, after passing a theory test and an eye sight check-up, novice
drivers might drive with an observer in his 20s or more, with a two-year-old permanent
driving license. This period would take nearly six months, after which a conditional
driving license with 18 months duration would be issued. There were restrictions for
45
driving at night; passenger under 20 years of age and those with blood alcohol levels
up to 0.03 per 100 mg in this period were not allowed to drive. A permanent license
would then be issued at the end of this period, after passing a driving exam. The
intervention in New Zealand reduced injuries by 18% in five years. Of course this
reduction implies a decrease in risk factors as well. According to a review of thirteen
educated drivers licensing evaluations, carried out in the US, Canada, New Zealand
and Australia, crash reduction among young first year drivers ranged from 26% to 41%
[10]. In Frith's report, there were no significant differences in rate of injuries before
and after law enforcement of temporary driving license [11]. Reduction of injuries
after law enforcement might be due to fewer driving hours by those with a temporary
driving license. To clarify the truth of this claim, the number of accidents per distance
should have been calculated, but there was not any such information. To solve the
problem, the driver might be forced to drive in the presence of an observer, within a
certain time period. Before obtaining a permanent driving license, it would be an
opportunity for the novice drivers to experience the traffic environment under a
controlled condition. They would be able to gain some valuable experience in a
difficult driving condition. Comparison of novice drivers, fewer than 20 years,
with older ones indicated that the former had fewer accident risks, although they
had less ability to evaluate such risks [12-14]. Begg findings showed the impact of
graduated driver licensing has not diminished over time [6]. The impact of the new
road traffic safety law in Serbia showed road traffic fatality reduction [7]. Antic finding
showed "new RTSL implementation in Belgrade and Serbia caused by the new
legislation decrees and increased fines, in 2010 which was the first year of new
RTSL implementation led to positive effects manifested by the previously described
decrease in the number of traffic accidents casualties" [15]. Other studies,
however, came to a different conclusion. Male young drivers caused more severe
problems than female young drivers, indicating higher risk propensity in male drivers
[16-19]. The number of fatality among males dropped from 1710 a year before to 431
and 783 during the first and second years after enforcing the law respectively. This
feature among females was 29, 14 and 24 respectively. The number of non-fatality
among males dropped from 18570 a year before to 9916 and 10993 during the first
and second years after enforcing the law respectively. This feature among females
was 520, 190 and 312 respectively. Overtime, effect of intervention was reduced
46
in the second year after enforcing. Not permission to driving in outer city roads and
risk taking behavior looked to be reason of high non fatal injuries among males. First
year was baseline in the study. Overtime effect of intervention was reduced in the
second years after enforcing.
One of the strengths of this study was the number of participants; it was the first
study on this subject in Iran. However, the data collected by the Traffic Police at the
scenes of accidents included a limited number of items, without going into details for
closer look at the impact of intervention; so, as part of the weakness of this study, it
is difficult to say how much of this reduction in injuries or fatalities is just due to the
intervention. Further studies should be done to show the role of fatigue and lack of
concentration on novice drivers with temporary driving license. Continuous
assessment system for temporary driving license and restriction for novice drivers are
recommended. It seems that the continuation of a conditional driving license,
cancellation of driving credit of violators and inclusion of negative points for violators
would be effective in preventing traffic injuries.
5. CONCLUSION
The efficiency of intervention in reducing the intensity of traffic injuries is well
obvious; likewise, the benefits of educated drivers licensing in reducing the crude
number of traffic injuries are well documented. Nonetheless, further interventions such
as demerit points, license suspension and vehicle confiscation might also be
implemented to prevent RTIs in long term.
CONSENT
All authors declare that 'written informed consent was obtained from the patient
(or other approved parties) for publication of this case report and accompanying
images.
ETHICAL APPROVAL
All authors hereby declare that all experiments have been examined and
approved by the appropriate ethics committee and have therefore been performed in
accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.
47
FUNDING
This project was supported financially by World Health Organization.
ACKNOWLEDGEMENTS
The authors would like to express their gratitude to the personals at the
Information and Communication Technology of Traffic Police Department. They also
thank the Traffic Police Department in Tehran for financially supporting this project
which was jointly carried out by the Rahvar Research Center of Islamic Republic of
Iran's Security Forces (NAJA) and the Safety Promotion and Injury Prevention
Research Center of Shahid Beheshti University of Medical Sciences.
COMPETING INTERESTS
Authors have declared that no competing interests exist.
REFERENCES:
1. Nantulya VM, Reich MR. The neglected epidemic: Road traffic injuries in
developing countries. BMJ: British Medical Journal. 2002;324(7346):1139.
2. Krug EG. Injury: A leading cause of the global burden of disease/edited by
E. Krug; 1999.
3. McFarland RA, Moore RC. Human factors in highway safety; a review and
evaluation. The New England journal of medicine. 1957;256(17):792.
4. Waller PF. The genesis of GDL. Journal of Safety Research. 2003;34(1):17-23.
5. Gregersen NP, Nyberg A, Berg H-Y. Accident involvement among learner drivers
48
49
50
Keywords: musculoskeletal; bone marrow; mesenchymal stem cells; scaffold; injection; cell culture; differentiation; integration.
1. INTRODUCTION
Tissue engineering is an exciting strategy being explored to deal with
damaged or lost tissue. Tissue engineering can include the use of cells, scaffolds
and growth factors in any combination (Mahapatra and Khan 2011; Nannaparaju
et al., 2011). Stem cells are a self-renewing, slow-cycling cell population that
exhibit high clonogenity, low cellular proliferation and the ability to undergo multilineage differentiation. Stem cells can be derived from a number of sources
and are able to undergo chondrogenic, osteogenic and adipogenic differentiation (Pittenger et al., 1999). These cells are identified by a number of cell surface
markers that they express on their cell surface including CD105 as shown in Figure 1. These cells are often used with scaffolds that provide a three-dimensional
structural template. Scaffolds are natural (e.g. collagen and alginate) or synthetic
(e.g. polyglycolic acid and polyacrylonitrile polyvinyl chloride) materials used for
cell attachment and proliferation. The ideal scaffold is biocompatible and meets
the biological needs of growing tissue.
Bone marrow derived stem cells have been widely studied and there
is a wealth of information in literature concerning those (Mafi et al., 2011). Adult
mammalian bone marrow contains two discrete stem cell populations, haematopoietic stem cells and MSCs (Pittinger et al., 1999; Short et al., 2003). Protocols
for the culture (Freidenstein et al., 1970) and, chondrogenic, steogenic and adipogenic differentiation of bone marrow-derived mesenchymal stem cells (BMMSCs) have been described (Johnstone et al, 1998; Pittenger et al, 1999; Sekiya
et al., 2002; Thanabalasundaram et al., in press). BM-MSCs have been associated with the repair and regeneration of musculoskeletal injuries.
Musculoskeletal injury can involve muscle, tendon, ligament, bone, meniscus and cartilage. The high incidence of such injuries highlights the need for novel,
more effective treatments. Currently a lot of research is being carried out into this
area. The use of BM-MSCs is one such option (Tucker et al., in press) and the
aim of this review is to critique and clarify their findings.
51
52
53
group; tendon stiffness, modulus of elasticity, maximum stress and strain energy
increased by 15%, 7%, 16% and 32% respectively as compared to the control
group. This may suggest an advantageous biomechanical effect which is not apparent histologically and may simply be due to an increased cross sectional area
provided by the cells.
Damage at the tendon bone interface in rabbits was also explored
(Ouyang et al., 2004) using fibrin glue with and without BM-MSCs. Both groups
showed evidence of perpendicular collagen type fibre formation. However, the
control group had type I and III fibres only while the treatment group had a higher
proportion of fibres and consisted of collagen type I, II and III. This demonstrates
the ability of BM-MSCs to promote fibrocartilage-like tissue formation and thus
aids in the healing process.
The results from these studies show improved biomechanical properties and
healing rates of tendons when BM-MSCs are inserted.
3.3 Ligament
Ligaments stabilize joints and control their movements. During sporting
activities, they are subjected to higher stress and strain rates as the joints are
subjected to more forceful and exaggerated movements. Additionally, they help
coordinate the
54
right (Al-Rashid and Khan, 2011). Kanaya et al. (2007) injected BM-MSCs into
partial torn rat anterior cruciate ligaments and found that this appeared to accelerate their healing and concluded that they may be a viable treatment option.
The ultimate failure load of the femur-ACL-tibia complex of the BM-MSC treated
group was significantly higher than the control group. The transected area of the
ACLs in the BM-MSC group demonstrated no retraction and a better histological
grading score. The BM-MSCs survived the intra-articular environment and enhanced the healing of partial tears resulting in more biomechanically and histologically viable results.
This potential benefit is supported by other studies (Oe et al., 2011; Wei et
al., 2011). In fact, Wei et al concluded that not only do BM-MSCs promote ligamentous healing, but expression of TGF1 and VEGF(165) within these cells significantly promoted angiogenesis of the reconstructed ligament at 3, 6, 12 weeks,
with the best mechanical properties being achieved at 24 weeks.
Bilateral ACL reconstructions using hamstring tendon autografts were carried out on rabbits to investigate whether the use of BM-MSCs would reduce
the incidence of early tendon autograft pull out following ligament reconstruction
(Lim et al., 2004). The treatment limb autograft was coated with autologous BMMSCs within a fibrin glue carrier. The control limb autograft received only fibrin
glue. At 8 weeks post surgery the control had a distinct fibrous interface with the
bone, containing collagen type I and III with occasional fibres resembling
Sharpeys fibres bridging the gap. Conversely the treatment group had matured
zones of cartilage rich in collagen type II resembling normal entheses. The overall
mean failure load and stiffness where 66% and 51% respectively, which was statistically significantly higher in the BM-MSC group. Despite this benefit, 44% of
BM-MSC limbs failed by pullout highlighting that although the resulting
biomechanical properties are apparent, more work is needed to evaluate this
benefit.
BM-MSCs appear to be the optimum cell sources for ligament repair and
produce better results biomechanically, histologically and physiologically.
3.4 Bone
The management of bone defects is challenging. Although bone defects
commonly occur after musculoskeletal injury, they can also be caused by surgery
or disease (Khan et al., 2009). Non-union is a significant problem affecting up
55
to 10% of fractures (Axelrad et al., 2007). Any approach to deal with bone defects
need to address three fundamental features for bone repair: osteoconduction,
osteoinduction and osteogenesis. The current gold standard autologous cancellous bone grafting is limited by tissue availability and donor site morbidity. Allogenic bone grafting has the potential for disease transmission. The use of
growth factors including BMPs has shown promising results (Friedlaender et al.,
2001) but their role is limited in the absence of an osteoconductive and osteogenic
component.
A possible alternative is to use BM-MSCs (Gidado et al., 2009). Some
clinical sites are deficient in MSCs and may benefit from BM-MSCs to reactivate fracture healing. The therapeutic options include the use of bone marrow,
the use of selected but unexpanded BM-MSCs, or the use of expanded BM-MSCs
(Chimutengwende-Gordon et al., in press).
Petite et al. (2000) investigated the results of using a coral scaffold with
and without BM-MSCs, and with fresh bone marrow (FBM) in sheep. The BMMSC seeded scaffold allowed bone deposition at the same rate as scaffold degradation. It was the only composite that resembled physiological bone and allowed bony union to occur after 16 weeks. Although the coral scaffold was osteoconductive resulting in bone deposition in the medullary centre, scaffold
degradation outweighed bone deposition in coral and FBM scaffolds.
A different study evaluating the effect of BM-MSCs in healing rates of
femoral fractures in rats, a porous hydroxyapatite-tricalcium phosphate ceramic
cylinder was used. In one leg the rat received the cylinder alone and in the contralateral leg received the cylinder embedded with BM-MSCs. By 12 weeks union
was complete in the BM-MSC group with bony ingrowth into the pores of the
scaffold displaying increased strength (215%), stiffness (245%) and torsional
energy absorbed (212%) compared to the scaffold side (Bruder et al., 1998b).
In a similarly designed study by Bruder et al. (1998a), a ceramic cylinder
composed of hydroxyapatite and -tricalcium phosphate was used to investigate
fracture healing in a canine model. The dogs received a cylinder with or without
BM-MSCs. In the dogs with cell-free cylinders union occurred between the implant
and the bone cortex in ten of twelve dogs by 16 weeks however no callus was
visible and most of the pores were filled with fibrous tissue. In the BM-MSC
group, bone was distributed evenly throughout the implant and integrated well
56
with the host bone. By 8 weeks solid union had occurred in all 12 bone implant
interfaces with a continuous bridge of mineralized bone surrounding the defect.
An osseous callus formed around the implant and the adjacent host bone in 84%
of specimens. The implant pores were filled with woven or lamellar bone in direct
contact with the ceramic (Bruder et al., 1998a). This finding is supported by
another study using mice models and fracture of the tibia (Granero-Molto et al.,
2009).
The preferred treatment for large bone defects is currently autologous bone
grafts. However, the supply of suitable bone is limited and its collection is painful,
with a risk of infection, nerve damage, and a loss of function (Calori GM et al
2011). Hence BM-MSC embedded scaffolds offer a safer, less destructive alternative with good results (Khaled et al., 2011).
3.5 Meniscus
The meniscus is a vital part of the joint. It acts to prevent the deterioration
and degeneration of articular cartilage and the onset and development of
osteoarthritis. For this reason, research into meniscus repair has been the
recipient of particular interest from the orthopedic and bioengineering communities. They also function to absorb shock during dynamic loading and have a
major role in the tribological properties of the knee joint (Makris et al., 2011).
Meniscal tears often occur in conjunction with ACL injuries (Noyes et al.,
1980). Although lesions in the peripheral vascular region of the meniscus heal
well but lesions in the central avascular area fail to do so (Klompmaker et al.,
1996). The results with allograft are variable. Isolating meniscal cells from the
resected region is another option that has been explored but the quantity and
quality of these cells limits applications (Ha et al., 2011). Prosthetic replacement
has received promising results from early animal studies but further studies are
needed.
Another approach currently being investigated is the use of BM-MSCs
seeded scaffolds. Fibrin glue scaffolds were inserted into meniscal lesions in rats
with and without BM-MSCs.
At 12 weeks, the cell-free scaffold group had many small round cells within
the fibrin glue that were synthesising ECM in 25% of the specimens. The BMMSC group at that stage contained an abundance of round cells within the
57
58
and appear well-suited to defects within this area. In vitro studies have demonstrated that the matrix forming phenotype of human meniscus cells can be
enhanced by expansion in growth factors and altering the oxygen tension
(Adesida et al., 2006; Adesida et al., 2007) and further work on these aspects is
ongoing.
3.6 Cartilage
Articular cartilage is intregral to the tribological properties of joints. Cartilage lesions are common in sporting activities, with some studies showing up
to 49% of injuries associated with athletic activity (Aroen et al., 2004). Their
high load bearing and shock absorbing capacity help to withstand the mechanical
force exerted across joints during sporting activity (Williams et al., 2007). Once
damaged cartilage, is vulnerable due to its poor ability to heal, even small defects
may degenerate over time, ultimately causing osteoarthritis (Redman et al., 2005).
Articular cartilage is particularly suitable for tissue engineering applications
as it is avascular, aneural and alymphatic (Khan and Hardingham, 2009). Articular
cartilage shows a limited capacity for repair following injury. Cartilage injuries
that extend to the subchondral bone show some signs of repair due to the release
of BM-MSCs from the subchondral bone, and this principle is employed in microfractures (Punwar and Khan, 2011). Current treatments such as arthroscopic
management, autologous osteochondral transfer and autologous chondrocyte
implantation (ACI) have all shown positive results. However a systematic review
comparing autologous chondrocyte implantation, osteochondral autograft transfer, matrix-induced autologous chondrocyte implantation and microfracture failed
to identify a single technique consistently showing superior results compared
with the others. It did however find that outcomes for microfracture tended to be
worse in larger lesions (Magnussen et al., 2008).
Im et al. investigated the ability of BM-MSCs to treat cartilage defects (Im et
al., 2001). They suspended BM-MSCs in Ham F-12 medium before injecting
into full thickness cartilage defects in the patellar groove of rabbits. The control
group received cell free medium. At 14 weeks the BM-MSC group contained reparative tissue resembling articular cartilage with a fully repaired subchondral
bone layer. However, the reparative tissue of the control defects was thin, irregular
and undifferentiated with less matrix collagen type II. Histological grading scores
59
indicated the treatment group performed significantly better than the control (14.8
vs 8.9). Thus, the findings suggest the use of BM-MSCs in this way enhances
cartilage repair but does not guarantee cartilaginous healing.
Wakitani et al. (1994) used BM-MSCs or periosteum derived mesenchymal
stem cells (PD-MSCs) from rabbits and seeded them into a type 1 collagen gel.
They were then implanted into large (3x6 mm), full thickness osteochondral
defects located in the weight bearing surface of the medial femoral condyle.
The contralateral knee served as a control with its defect either left empty or
filled with collagen free gel. The BM-MSC group produced reparative tissue
more similar to hyaline cartilage with better integration by week 4. However by
week 24, the quality of this tissue progressively declined as the thickness of the
articular cartilage portion reduced below that of normal cartilage. The control group
showed markedly inferior repair throughout the assessment. PD-MSCs yielded
results very similar to BM-MSCs but in addition exhibited a progressive increase
in surface irregularity.
Hybrid designs for scaffolds have also been used. Shao et al. (2006) seeded
BM-MSCs into a Polycaprolactone (PCL) scaffold for the cartilage portion and
a tricalcium phosphate-reinforced PCL scaffold for the bone portion. With fibrin
glue, the seeded scaffolds were implanted into large osteochondral defects in
the load bearing medial femoral condyle of rabbits. Controls received a cell free
scaffold. After 6 months, repair tissue from the BM-MSC group was well integrated
with host bone in all specimens. Most samples were hyaline like in nature with
identifiable collagen type II and glycosaminoglycan, and an almost normal
physiological stiffness. Defects in the control group were incompletely filled
with fibrous repair tissue with little resemblance to cartilage or bone. However,
some repair tissues in the BM-MSC
group
also
experienced
fissures
and
60
of zonal organization within the newly formed cartilage were similar to the previous scaffold studies. Although in support of Wakitani et al. (1994), it did not,
however, report the trend in thinning of the reparative cartilage at 12 weeks.
Unlike Shao et al there were signs of zonal organisation of the newly formed cartilage. Additionally, the PLGA scaffold was able to prevent leakage of the injected
cells away from the defect, as reported by Im et al. (2001).
It is clear that BM-MSCs do have a role to play in the treatment of osteochondral defects, however it is an area of research that must be investigated
further. The use of scaffolds, growth factors and altered culture conditions for in
vitro expansion are synergistic factors that also require further evaluation (Khan
et al., 2007; Khan et al., 2008).
3.7 Spinal Cord and Nerve Tissue
Spinal cord injuries have a significant socioeconomic impact on patients and
on society as a whole. Even though endogenous stem cells are present in the
spinal cord, recovery from spinal cord injuries is unpredictable. Sanchez-Ramos
et al. (2000) have shown that BM-MSCs can successfully differentiate down the
neuronal lineage in vitro. In a spinal cord injury animal model, Akiyama et al.
(2002) have shown that BM-MSC implantation results in the formation of neural
and myelin-producing cells, axonal regeneration and functional recovery. There
have only been limited studies in humans. Park et al. (2005) showed that intralesional injections of bone marrow mononuclear cell fraction in five patients with
acute spinal cord injury resulted in improvement in sensory and motor functions.
Sykova et al. (2006) found similar results in 20 patients who were given intravenous injections in the acute post-injury period.
Nerve tissue is currently routinely replaced using autografts that results
in variable regeneration and is associated with donor site morbidity. Current
tissue engineering strategies are exploring nerve guidance conduits, and cultureexpanded Schwann cells with polylactic acid and polylactic-co-glycolic acid scaffolds for regeneration through the conduit (Hadlock et al., 1998; Hadlock et al.,
1999). There are currently no randomised controlled trials and better quality studies are needed before any definitive conclusions can be drawn on the role of stem
cells in spinal cord and nerve tissue repair (Khan et al., 2009).
61
4. CONCLUSION
Unlike other sources of stem cells, bone marrow is easy to obtain requiring
minimal donor site morbidity, invasiveness and anaesthetic and these properties make BM-MSCs an appropriate choice for musculoskeletal injuries (Kennard
et al., 2011; Malik and Khan, 2011). For example, to obtain ACL fibroblasts an
arthroscopy is required in an already injured knee, whereas BM-MSCs can be
aspirated from the iliac crest. BM-MSCs can be isolated with relative ease due
to their superior ability to bind to tissue culture plastic relative to other bone marrow
cells (Petite et al., 2000). Once isolated, BM-MSCs can be easily proliferated in
vitro without losing their capacity for differentiation. Due to their multi-lineage potential, repair of complex injuries is possible. For example, when injected into a
knee joint with injuries to the ACL, medial meniscus and cartilage of the femoral
condyles, BM-MSCs mobilize to affected areas and contribute to regeneration
(Agung et al., 2006).
Bone marrow derived cells appear to have several advantages over other
mesenchymal cells (Khan et al., 2010). They undergo a higher degree of mineralisation when differentiating down an osteogenic lineage compared with aminiotic
fluid (AF-MSC) and equine umbilical cord MSCs (EUC-MSC) (Lovati et al., 2011).
In addition, their autologous nature eliminates the issue of immunoreactions and
ethical problems.
Any successful future therapy is likely to involve the use of scaffolds has
been shown to be efficacious. They provide architectural support and prevent leakage of cells from the defect.
The limitation of the evidence to date is that most of the studies involve
small numbers of animal models with inflicted injuries; this does mean that they
findings may not be translated to trauma patients or human subjects. Further work
in larger animal and ultimately ethically approved clinical trials should be explored
before any clinical relevance can be assessed.
Key Points:
(i) Damage to musculoskeletal tissues can be treated with BM-MSCs.
(ii) BM-MSCs can be administered directly into the tissue defects via
injection however there is a growing body of evidence to support the use of
scaffolds. When scaffolds are used, there is still inconclusive evidence to support one medium over another.
62
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71
Yu.V. Odinets,
Kharkiv National Medical University, Professor,
Doctor of Medical Sciences, Department of Pediatrics 2,
N.I. Makieieva,
Kharkiv National Medical University, Professor,
Doctor of Medical Sciences, Department of Pediatrics 2,
V.A. Golovachova,
Kharkiv National Medical University, Assistant,
Candidate of Medical Sciences, Department of Pediatrics 2,
K.K. Iarova,
Kharkiv National Medical University, Assistant Professor,
Candidate of Medical Sciences, Department of Pediatrics 2,
N.P. Alyeksyeyeva,
Kharkiv National Medical University, Assistant Professor,
Candidate of Medical Sciences, Department of Pediatrics 2
72
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6 - ; 7 - ; 8 - ; 9 - ; 10 - ; 11 .
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94 1 18 ,
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34 , .
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74
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,
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: .
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- , 36,15,5%
( 1 / 2 -,
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.
/ 27,15,5%
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, ,
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75
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:
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1 2
, (-, -, )
, . , (51% ) ,
.
,
, , . 1, 2.
1
,
,
(m)
,
n=34
, n=34
I, n=15
I, n=19
1
2
1
2
n=11
n=8
n=7
n=8
, n=26
I, n=11
I, n=15
n=7
n=4
n=10
n=5
,
/
3,87
0,16
3,96
0,21
4,12
0,1
3,5
0,53
4,36
0,25
4,14
0,52
4,02
0,24
3,69
0,2
4,61
0,8
Na,
/
Ca,
/
143,16
3,35
2,53
0,06
134,7
2,81
2,26
0,15
135,2
2,91
2,21
0,2
131,5
4,98
1,98
0,16
**
138,4
3,82
2,07
0,14
***
143
3,21
2,01
0,08
*
139,6
6,99
2,09
0,08
***
135,6
2,3
2,16
0,2
***
149,7
12,4
2,09
0,2
***
76
Mg,
/
0,83
0,05
0,88
0,13
0,86
0,06
0,87
0,06
0,78
0,16
0,85
0,09
1,18
0,35
Zn,
/
27,17
0,75
23,1
1,97
22,5
2,59
28,6
8,74
17,88
0,79
18,71
3,04
19,18
1,32
14,1
1,15
*
23,81
2,79***
22,5
2,11
Cu,
/
16,37
0,88
Fe,
/
17,93
0,48
18,65
0,43
18,86
1,32
14,9
2,15
*
33,91
2,07
*
18,34
0,78
18,07
0,87
20,67
2,06
Mn,
/
0,21
0,01
0,2
0,03
0,25
0,02
0,19
0,03
0,21
0,03
0,25
0,01
17,71
0,74
*
23,51
2,7
***
0,17
0,05
1,26
0,2
***
12,6
0,8
*
29,97
2,3
*
18,85
1,0
1,91
0,1
*
12,0
1,3
*
35,09
2,7
*
16,49
1,1
0,14
0,01
*
0,13
0,03*
**
: :
1. * - <0,001 ;
2. ** - <0,01 ;
3. *** - <0,02 ;
4. - <0,001 , I;
5. - <0,01 , I;
6. - <0,05 , I;
7. - <0,01 2 ;
8. ;
9. Na ;
10. Ca ;
11. Mg ;
12. Zn ;
13. Cu ;
14. Fe ;
15. Mn .
2
,
,
(m, /)
, n=34
,
n=14
I, n=15
1
2
n=8
n=7
, n=26
I, n=19
1
2
n=11
n=8
I, n=11
1
2
n=7
n=4
I, n=15
1
2
n=10
n=5
319,4
21,6
352,5
20,5
312,8
20,7
391,8
68,1
361,7
40,9
296,0
11,9
327,1
31,4
309,1
12,4
315,2
48
Na
604,3
27,7
2437,4
142
673,6
94,1
2478,3
344
572,6
29,7
3081,5
608
679
48,4
2962,5
305
642,4
42,7
2815,7
262
571,4
11,1
2647
304
130,4
9,81
173,4
146
12
168,9
572,5
23,3
3015,9
256
***
144,9
14,3
175
626,8
91,9
2716
442
131,9
6,12
148,4
579,2
50,3
3871
666,7
***
109,3
27,1
189,6
128,5
9,54
163,8
149
11
172,4
152
9,6
174,8
Ca
Mg
Zn
115,8
9,04
186,8
77
4,3
**
6,2
2,34
1,08
0,14**
8,89
1,43
5,3
3,99
0,44
0,31
7
1,83
Pb
0,03
0,02
0,12
0,05
0,13
0,09
Fe
22,0
1,2
36,2
6,6
**
20
1,78
Cu
Mn
Ni
9,5
25,3
**
7,6
1,04
0,74
0,49
13,73
0,75*
6,2
*
7,6
1,42
0,56
0,25
10,85
2,01
7,3
***
8,2
0,28
0,71
0,3
9,1
1,04
14,2
8,3
8,9
1,55
0,9
0,21
8,84
1,48
8,2
0,9
1,11
0,1**
11,99
1,5**
4,8
**
7,5
0,4
1,05
0,1**
13,4
0,8*
0,34
0,1
*
14,8
3,04
***
0,27
0,06
*
21,4
3,01
0,03
0,02
0,03
0,02
19,8
2,73
18,9
4,17
0,18
0,04
*
28,9
4,6
0,26
0,09
**
20,9
1,1
: :
1. * - <0,01 ;
2. ** - <0,02 ;
3. *** - <0,05 ;
4. - <0,01 , I;
5. - <0,05 , I;
6. - <0,02 2 .
,
, ,
. 3, 4.
3
,
, (m)
,
n=34
, n=34
I, n=13
II, n=21
4,020,1
138,81,8
2,070,1*
0,670,03***
11,030,5*
30,41,55
****
15,40,7
, /
Na, /
Ca, /
Mg, /
Zn, /
Cu, /
3,870,16
143,163,35
2,530,06
0,830,05
27,170,75
17,880,79
4,270,21
143,11,9
2,230,1***
0,670,03***
22,81,14**
17,40,81
Fe, /
17,930,48
21,11,6
Mn, /
0,210,01
0,230,01
: :
1. * - <0,001 ;
2. ** - <0,01 ;
3. *** - <0,02 ;
4. ****- <0,05 ;
5. - <0,001 , I.
0,270,02
***
78
4
,
,
(m, /)
Na
Ca
Mg
Zn
Cu
Mn
Ni
Pb
Fe
,
n=14
319,421,6
604,327,7
2437,4142
131,96,12
148,410
8,30,48
0,660,11
8,11,35
0,030,02
22,01,2
, n=34
I, n=13
II, n=21
310,915,8
643,614,7
2690161
149,75,9***
161,72,9
8,90,4
0,390,1
6,41,4
0,0080,03
19,91,0
334,512,3
597,513,4
2719,8109
146,97,4
176,22,4**
10,40,4*
0,90,1
12,30,4**
0,150,04**
23,92,2
: :
1. * - <0,01 ;
2. ** - <0,02 ;
3. ***- <0,05 ;
4. - <0,001 , I;
5. - <0,02 , I.
: , , , II,
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(<0,001)
80
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, ,
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, , .
:
, ,
(, )
(, , , .)
.
, .
- ,
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.
:
1. .. .
, 5, 2007. . 45-47.
81
2. .. ,
. , 6(9),
2007. . 82-87.
3. ..
. , 6, 2007. . 613.
4. . - . ,
1976. . 368.
5. .. . , 1978. . 296.
6. Oelzner P., Lehmann G., Eidner . et al. Hypercalcemia in rheumatoid arthritis:
relationship with disease activity and bone metabolism. Rheumatol. Int., N26,
Issue 10, 2006. P. 908-915.
82
Vladimir Gryn,
Higher State Educational Institution of Ukraine
Ukrainian Medical Stomatological Academy,
Docent, Candidate of Medical Sciences, Cathedra of Human Anatomy
,
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2- 4- ; : 12, 14, 30 , 1,5
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-812 (Epon 812, Fluka Chemie, Switzerland)
[4].
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.
[9], 40
. :
?
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. (,
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.
:
1. . / . , . , . .
.: , 2006. 320 .
2. ..
/ .. , .. //
. 2011. . 3 (89), . 3. . 6-9.
3. Zahid A. The Vermiform appendix: not a useless organ. J Coll Physician and
Surgeons, April 2004; 14(4): 256-8.
4. .. , , / .. , .. ,
.. . .: . 2007. 5. . 94-96.
5. Malas M.A. Development of the vermiform appendix during the fetal period /
M.A. Malas, A. Gkimen, O. Sulak // Surgery Radiologics Anatomy. 2004.
Vol. 26, 3. . 202-207.
6. Paul UK, Naushaba H, Begum T, Alam J. Position of vermiform appendix: a
postmortem study. Bangladesh Journal of Anatomy. 2009;7(1):3436.
88
7. ..
/ .. // . 2011. 8. . 140-143.
8. Searle AR, Ismail KA, Macgregor D, Hutson JM. Changes in the length and
diameter of the normal appendix throughout childhood. Journal of Pediatric
Surgery. 2013;48(7):15351539.
9. Rehman MM, Begum J, Khalid M, Latif SA, Nessa A, Jahan MK, Shafiquzzaman M, Parvin B, Akhunda AK. Histomorphological study of lymphoid follicle of
vermiform appendix. Mymensingh Med J, 2008 July; 17(2): 134-40.
89
90
91
92
disposed nucleolus, indicating about the prevalence of heparin, including into secretory
granules.
References:
1. .. -
/
.. , .. // . 2011.
. 2, . 1. . 38-41.
2. ..
- / .. //
. 2004. . 3, 1. . 62-64.
3. .. / .. // .
2005. . 5. . 62-63.
4. ..
/ .. // . 2004. . 7, 1. . 202-206.
5. / .. , .. ,
.. [ .] // . ., 2003. . 205.
6. .. / .. : ,
1984. 207 .
7. Lynn J. Rapid toluidine blue staning of Epon-embeded and mounted adjactnt
sections / J. Lynn // Am. J. Clin. Path. 1965. 44. H. 5758.
93
the
opportunity for decreasing the frequency of appearing adverse effects and toxicity of
medicinal aids, convenience of using regimen and profit from economical point of view.
With it all of no small importance is paid to the convenient medicinal form, rational
selection of auxiliary substances, ways of use and etc. [4,5,6].
94
95
Table 1
Results of selection capsules size
Benzketozone and
diclofenac sodium
Capsules number
Average volume of
capsules, cm3
Volume of
therapeutic
dose, %
Free volume,
%
5
0,13
4
0,21
3
0,30
2
0,37
1
0,5
0
0,68
00
0,95
000
1,37
> 100
68,1
47,7
38,6
28,6
21,0
15,1
10,4
31,9
52,3
61,4
71,4
79,0
84,9
89,6
As it can be seen from the data, given in table 1, capsules 5 dont contain
therapeutic dose of benzketozone and diclofenac sodium that excludes the use of this
capsules size in further researches. And in capsules 3, 2, 1, 0, 00, 000 active
substances take not less than 50% that involves groundless increase of the amount of
the applied auxiliary substances. Thus, more optimal capsules are of 4, in those the
therapeutic dose of substances occupies 68.1%, and the rest volume (31.9%) will be
for the complex of auxiliary substances.
The next stage of researches was directed to scientifically-based selection of
the type and amount of auxiliary substances, necessary for improving not positive
technological parameters benzketozone and diclofenac sodium substances.
As it is known nowadays the pharmaceutical industry uses a large amount of
auxiliary substances, differing in their origin, cost price, carried out function and etc.
Selection of auxiliary substances in this case was conducted taking into account their
ability do not to impede the release of active substances from the elaborated medicinal
form. Special attention was paid to pharmacological indifference, availability and cost
price of the substance itself.
Into the capsulated mass, containing two active substances (benzketozone and
diclofenac sodium) is necessary the introduction of the filler and binding substance.
Since both benzketozone and diclofenac sodium are chemically synthesized
substances, that unlike the substances of plant origin the introduction to the
composition the adsorbents mass is not required.
It has been decided in selection of auxiliary substances to use the method of
two-factors disperse analysis with repeated observations [11]. With it all it has been
studied the influence of fillers type (factor ) and moistening agent (factor ) for
releasing active substances in vitro experiments.
96
As fillers have been approved the following auxiliary substances: polyvinylpyrolidone (1), lactose (2), calcium carbonate (3), calcium phosphate doublesubstituted (4), and magnesium carbonate (5). As moistening agent have been
selected 5% gels of sodium carboxymethylcellulose (b1), methylcellulose (b2), 5%
starch paste (b3), 60% and 40% ethyl alcohol (b4 and b5).
The plan of experiment 55 and research results of combined capsules on
releasing of diclofenac sodium and benzketozone during 45 minutes are presented in
table 2.
The evaluation of the obtained results when studied the release of diclofenac
sodium allowed to reveal, that for the factor two effects were positive (3=3.59 and
5=4.80), the rest 3 effects had negative mark (1= -5.54; 2= -2.57 4= -0.28). For
the factor 2 effects had positive mark (b2=0.67 and b3=4.06), and 3 effects were
negative (b1= -0.25; b4= -1.35 and b5= -3.13). The response (% of the released active
substance) should be increased, therefore calcium carbonate (3) and magnesium
carbonate (5), and also 5% gel MC (b2) and 5 % starch paste (b3) increase the release
of diclofenac sodium from capsules. In consideration of interaction effects the positive
results give the following combinations of fillers and moistening agent: 1b2, 1b4, 1b5,
2b3, 2b4, 3b1, 3b4, 3b5, 4b1, 4b2, 4b3, 5b2, 5b4, 5b5. Interaction effects testify
to the complex influence of factors. For example, levels 3, 4 5 in average have
positive influence to response, but their action depends on combination with other
levels. So, for example, level 3 in complex with b1, b4, b5 increases the percentage of
dissolution and, correspondingly, the release of diclofenac sodium from medicinal
form.
Conduction of analogous calculations during the research of benzketozone
release allowed to reveal, that for the factor (type of filler) positive were the following
effects: 3=3.75, 4=0.29 and 5=5.31, the rest two effects had negative mark (1=
-6.37; 2=-2.98). For the factor 2 effects were positive (b2= 0.36 and b3= 4.34), and
3 effects had negative mark (b1= -0.39; b4= -1.04 and b5= -3.27). Therefore for the
release of benzketozone from medicinal form is useful to apply fillers calcium
carbonate (3), calcium phosphate double-substituted (4) and magnesium carbonate
(5), and moistening agent is advisable to select from 5% gel of MC (b2) and 5 % starch
paste (b3). Positive results give the following combinations of 2 factors 1b4, 1b5, 2b3,
2b4, 3b2, 3b4, 3b5, 4b1, 4b2, 4b3, 5b2, 5b4, 5b5.
Sums on
levels of
factor
Factor
b2
87,85
87,29
84,94
260,08
89,10
87,48
86,52
263,10
96,44
93,07
96,80
286,31
93,50
95,42
90,67
279,59
96,61
97,36
97,11
291,08
1380,16
b1
82,37
87,34
84,02
253,73
84,17
90,71
86,93
261,81
94,52
92,40
97,26
284,18
96,81
92,24
90,54
279,59
95,16
97,04
94,90
287,10
1366,41
1431,02
89,40
91,16
84,57
265,13
94,37
92,82
96,78
283,97
97,22
99,46
96,87
293,55
99,70
94,16
97,20
291,06
98,15
99,42
99,74
297,31
b3
b4
1349,80
86,88
83,19
86,93
257,00
91,74
89,04
87,68
268,46
96,32
92,03
95,72
284,07
85,32
83,75
85,10
254,17
93,12
95,40
97,58
286,10
Diclofenac sodium
Factor
1323,13
81,16
85,18
84,65
250,99
83,90
86,71
83,66
254,27
93,14
90,53
92,15
275,82
89,21
87,77
84,52
261,50
92,29
92,43
95,83
280,55
b5
6850,52
1442,14
1365,91
1423,93
1331,61
1286,93
Sums on
levels of
factor
Sums on
levels of
factor
Factor
3 repeated experiments %
1326,40
80,31
83,47
81,72
245,50
81,06
87,34
82,64
251,04
92,48
88,16
95,61
276,25
93,88
90,16
88,76
272,80
93,40
95,66
91,75
280,81
b1
1337,67
83,18
82,64
80,91
246,73
85,92
84,61
81,67
252,20
94,72
91,28
94,31
280,31
91,15
94,67
88,40
274,22
94,38
95,01
94,82
284,21
b2
1397,40
86,11
88,47
82,68
257,26
92,27
89,60
93,44
275,31
95,78
96,17
94,66
286,61
96,37
92,58
95,60
284,55
97,11
96,93
99,63
293,67
b3
b4
1316,66
83,25
80,34
82,19
245,78
89,51
87,36
87,06
263,93
94,13
88,49
93,70
276,32
83,92
81,16
85,37
250,45
90,53
94,28
95,37
280,18
Benzketozone
Factor
b5
1283,29
78,08
82,59
80,73
241,40
82,67
82,39
80,11
245,17
90,27
88,29
90,41
268,97
85,94
86,06
82,67
254,67
90,12
89,72
93,24
273,08
Release of diclofenac sodium and benzketozone from combined capsules in two-factors plan 55 with
6661,42
1411,95
1336,69
1388,46
1287,65
Sums on
levels of
factor
1236,67
Table 2
97
98
To check the homogeneity of disperses the criteria of Kochren has been applied.
Table value of Kochren criteria for f1=2 and f2=25 at significance level of =0.05, was
0.2354 for the both active substances, that is considerable than experimental value
(yex for diclofenac sodium equals to 0.1018, and for benzketozone 0.1189.). This ratio
confirms the equal exactness of experiments.
Disperse analysis of the obtained results is presented in table 3.
Table 3
Disperse analysis of experimental data on determination of release
of diclofenac sodium and benzketozone from capsules
Dispersion sources
Factor
Factor
-interaction
Error
Total sum
Factor
Factor
-interaction
Error
Total sum
Number of
Sum of
freedom
squares
degrees
Diclofenac sodium
4
1100,3
4
429,64
16
180,09
50
228,51
74
1938,54
Benzketozone
4
1377,07
4
463,22
16
180,16
50
235,49
74
2255,94
Average
squares
Fexp
Ftable
275,08
107,41
11,26
4,57
60,19
23,50
2,46
2,56
2,56
1,85
344,27
115,81
11,26
4,71
73,09
24,59
2,39
2,56
2,56
1,85
The obtained data, Fex > Ftable (60.19>2.56; 23.50>2.56; 2.46>1.85 for
diclofenac sodium, 73.09>2.56; 24.59>2.56; 2.39>1.85 for benzketozone) is the
confirmation of direct influence of fillers type and moistening agent on release ability
of active substances from the capsules.
With the applying of Dunkans multi rank criteria [11] have been conducted
researches on studying the difference of average values of release data for diclofenac
sodium and benzketozone from capsules. It has been revealed that, according to the
influence of fillers on completeness of diclofenac sodium release they can be arranged
in the following line: 5 (3) > 4 (2, 1), and for benzketozone the action
effectiveness of 5 fillers types is close in value, that is why in selecting the best one it
is necessary to head for availability and economy. The difference in the effectiveness
of moistening agents to the studied response, i.. to completeness of release of the
both active substances was not considerable.
99
100
4. .., .., ..
// Advances in current
natural sciences. 2011. - 8 . . 110.
5.
6. ..
// . 2012 - 3. . 13-17.
7.
101
I/D ACE
: I/D ACE
. ,
II
. , ,
,
.
: , , , I/D ,
, .
. , .
, -
102
2 [1].
,
, . , , ,
[2].
. ,
. - ACE
- [3], [4] [5] .
-
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enzyme
) -,
I -
II, .
. I-
- ,
, [6,7].
(, I) (, D)
287 (bp) [8].
[9], [10].
, ,
.
. I/D .
. (n=108) 37 ,
2500 ,
2011-2013 .
103
( -10). : ,
, 37
, 2500 .
ACE .
(n=38), ,
.
:
(),
() , , , ,
, ,
, .
.
. ACE - .
EXCEL-2003 STATA 11
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: ();
(m), () 95% ,
, - (
[Q1-Q3]). ,
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.
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ACE
104
. 1
D/D, I/D.
I/I I/D
I/I (. 1).
1
,
ACE , +m
/
(n=17)
1 .
4,31,57
5 .
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0,225
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.
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/D
44,7% 57,41% , D/D
- 15,8% 25,0% (. 2).
/ 0,28
(95% 0,11-0,72), =0,005.
2
/
/D
D/D
(n=38), % (n)
39,5 (15)
44,7 (17)
15,8 (6)
(n=108), % (n)
15,74 (17)
57,41 (62)
25,0 (27)
(95%)
0,28 (0,11-0,72)
1,34 (0,59-3,02)
1,78 (0,63-5,75)
0,005
0,453
0,270
105
. 3, / 0,34, =0,037,
D/D 2,77, =0,055. , /
, , D/D
.
3
(n=38), % (n)
(n=38), % (n)
(95%)
39,5 (15)
41,2 (7)
0,34 (0,103-1,09)
0,037
/D
44,7 (17)
29,03 (18)
1,11 (0,41-3,02)
0,500
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15,8 (6)
48,15 (13)
2,77 (0,83-10,09)
0,055
, ,
(, ) (. 4).
4
,
/
(n=17)
I/D
(n=62)
D/D
(n=27)
1-2
1-3
2-3
, . .,
(+m)
140,913,29
140,613,94
135,912,33
0,919
0,218
0,123
,
. ., (+m)
61,710,06
59,619,92
60,119,97
0,452
0,610
0,829
106
,
. ., (+m)
33,067,0
31,028,0
30,87,15
0,310
0,319
0,924
,
. ., (+m)
43,299,41
40,538,96
42,487,94
0,288
0,769
0,311
,
//, (+m)
1,331,0
1,581,05
1,240,91
0,378
0,770
0,138
, n (%)
6 (35,29)
25 (40,32)
12 (44,44)
0,707
0,548
0,717
.
. 5,
.
5
,
1-2
/1
I/D2
D/D3
(n=17)
(n=62)
(n=27)
29,41 (5)
41,94 (26)
44,44 (12)
2-3
0,349
0,319
, % / (n)
1-3
0,826
5,51,12
5,973,41
4,632,33
0,593
, //.,
0,332
(+m)
0,195
, (+m)
3,21,92
2,81,38
2,71,42
1,710
0,651
0,846
107
.
.
, ,
.
. I/I
, D/D
.
, ,
.
D/D -
, [11].
E.Sivas, D/D ACE
[12].
G.Dimitriou ACE
[13]. , ,
[14]. I/I ACE
, D/D - [11].
ACE , , , . , .
, ID/DD
.
,
.
108
.
:
1. http://www.who.int/maternal_child_adolescent/ru.
2. / .., .., .., .., .., .., .., .. : "", 2011. 451 .
3. Different
Mechanisms
for
the
Progression
of
CKD
with
ACE
Gene
109
11. The angiotensin converting enzyme (ACE) DD genotype is associated with worse
perinatal cardiorespiratory adaptation after preterm birth / D. Harding, S. Dhamrait,
N. Marlow et al // J Pediatr. 2003. Vol. 143. P. 746-749.
12. ACE gene deletion/deletion polymorphism may be a protective factor for
respiratory distress in preterm infants / E. Sivasl, M. Yurdakk, E. Babaolu // Turk
J Pediatr. 2007. Vol. 49. H. 69-74.
13. Association of circulating angiotensin converting enzyme activity with respiratory
muscle function in infants / G.l Dimitriou, D. Papakonstantinou, E.F. Stavrou // Respiratory Research. 2010. - Vol. 11. P. 57.
14. Role of angiotensin-converting enzyme gene polymorphism in persistent
pulmonary hypertension of the newborn / L.C. De Jesus, S.N. J Kazzi,
M.K. Dahmer // Acta Paediatrica. 2011. Vol. 100, Issue 10. H. 13261330.
110
4a/4b eNOS
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.
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. (NO).
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,
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.
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[4].
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). - 4a/4b 4- eNOS 2
, 4 5 27
. 5 ( 4b),
4 (4a). 4a
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112
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eNOS [5]. NO2 NO3 , NO
NO2, NO3 [3, 4].
NO2 NO3 (95%)
[6]. , eNOS
.
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.
, 120 , 57 () 61 .
. .
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,
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.
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STATA 11 Windows
(StataCorp, , ).
. 4a/4b eNOS
.
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4a/4a 3,88 % (=0,577),
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( 0,65, =0,422). 4a/4a
, 4 .
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114
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.
,
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, , ,
;
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1
,
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(...)
32,50,82
33,71,21
0,412
(//.)
2,30,20
2,00,15
0,142
(. .)
154,61,43
153,32,15
0,612
(...)
61,10,87
63,20,77
0,067
(...)
30,80,80
33,10,98
0,066
(...)
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0,088
(//.)
4,00,17
4,00,21
0,937
6-
, 4a/4b eNOS
.
. ,
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(40 % 37,8% , =0,482),
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(4,1 % 0 , =0,176). ,
, (28,82,16
115
,
eNOS,
(. 2).
2
,
, eNOS , Mm
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4bb
=73
=47
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5329,7399
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116
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[11] .
,
NOS, ,
,
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- , .
:
1. Stefanovic I.M. Neonatal sepsis / I.M. Stefanovic // Biochemia Medica. 2011.
Vol. 21, 3. P. 276-281.
117
2. Plachta N. Nitric oxide is involved in establishing the balance between cell cycle
progression and cell death in the developing neural tube / N. Plachta, A. Traister,
M. Weil // Exp Cell Res. 2003. Vol. 288, 2. P. 354-362.
3. Mattila J.T. Nitric oxide synthase: non-canonical expression patterns / J.T. Mattila,
A.C. Thomas // Front Immunol. 2014. Vol. 5. P. 478.
4. Miyahara K. Cloning and structural characterization of the human endothelial nitricoxide-synthase gene / K. Miyahara, T. Kawamoto, K. Sase [et al.] // Eur J Biochem.
1994. Vol. 223, 3. P. 719-726.
5. Demirubuk A.G. Endothelial NOS gene Glu298Asp polymorphism in preterm
neonates with respiratory distress syndrome / A.G. Demirubuk, M.Y. Cokun,
S. Demiryrek [et al.] // Pediatr Pulmonol. 2013. Vol. 48, 10. P. 976-980.
6. Tsukada T. Evidence of association of the ecNOS gene polymorphism with plasma
NO metabolite levels in humans / T. Tsukada, K. Yokoyama, T. Arai [et al] //
Biochem Biophys Res Commun. 1998. Vol. 245. P. 190-193.
7. Evans N. Assessment and support of the preterm circulation / N. Evans // Early
Hum Dev. 2006. Vol. 82. P. 803-10.
8. Kluckow M. Low superior vena cava flow and intraventricular hemorrhage in
preterm infants / M. Kluckow, N. Evans // Arch Dis Child Fetal Neonatal Ed. 2000.
Vol. 82. P. 188-94.
9. Miall-Allen V.M. Mean arterial blood pressure and neonatal cerebral lesions /
V.M. Miall-Allen, L.S. de Vries, A.G. Whitelow // Arch Dis Child. 1987. Vol. 62.
P. 1068-9.
10. Tyszczuk L. Cerebral blood flow is independent of mean arterial blood pressure in
preterm infants undergoing intensive care / L. Tyszczuk, J. Meek, C. Elwell [et al.]
// Pediatrics. 1998. Vol. 102. P. 337-41.
11. Dempsey E.M. Permissive hypotension in the extremely low birthweight infant with
signs of good perfusion / E.M. Dempsey, F. Hazzani, K.J. Barrington // Arch Dis
Child Fetal Neonatal Ed. 2009. Vol. 94. P. 241-4.
118
Ziyoda Fayzieva,
The Tashkent Pharmaceutical Institute,
Doctor of Medical Sciences,
The Faculty of Pharmacy,
Zakira Usmanova,
The Tashkent Pharmaceutical Institute,
Assistnt, The Faculty of Pharmacy
119
This work is devoted to the study of specific activity diabenit, glikoinuvita and
Stevo-50 in various experimental models of hyperglycemia.
ethods. Model of acute hyperglycemia caused by the procedure described in
the book O.V Remizov and T.L Kuraev [2]. In order to eliminate the effect of food on
the absorption of the test substance, animals stopped feeding for 4-6 hours prior to the
experiment. Longer fasting undesirable due to the fact that in this case is reduced the
severity hypoglycemic effect of the drug.
Experimental hyperglycaemia induced in rats by a single intraperitoneal
administration of hypertonic glucose solution at a dose 4.5 g/kg. 30 minutes before
administration of glucose was administered test substances orally by gavage as a 10%
aqueous solution. After 30, 60, 90 and 120 minutes to determine the level of blood
glucose by enzymatic method [3].
On the model of acute hyperglycemia compared the activity diabenit, glikoinuvita
and Stevil-50 with known hypoglycemic agents - domestic glipil (50 mg/kg) and foreign
glibenclamide (5 mg/kg). For this diabenit used in a dose of 25, 50 and 100 mg/kg,
Stevil-50 100 and 500 mg/kg, glikoinuvit 100 mg/kg. The experiments were performed
on 60 adult white rats weighing 140-165 g.
In a separate series of experiments to study the effect diabenit, glikoinuvit and
Stevil-50 for adrenaline hyperglycemia following the procedure described in the book
V.G. Baranov et al. [7]. Experiments were performed on 30 rats weighing 170-200 g
for animals of the experimental group were orally administered diabenit, glikoinuvit
50 mg/kg, stevil-50 100 mg/kg. Control animals received physiological saline in the
corresponding volume. After 30 minutes, epinephrine was administered at a dose of
50 mg/kg and blood sugar was determined by an enzymatic method dynamics. Before
the experiment the rats were fasted by the method for 8 hours.
Model of alloxan diabetes reproduced by the method described in the book
O.V Remizov and T.L Kuraev. For research use mature laboratory rats with normal
weight. Provided diabetogenic single intravenous dose of alloxan was 150 mg/kg. For
a full conviction to determine the level of sugar in the blood enzymatic method. On the
model of alloxan diabetes studied the effect diabenit, glikoinuvit and Stevil-50 on the
level of glucose in the blood of laboratory animals and compared with the effect of their
action Glipil and glibenclamide.
In these experiments, the hypoglycemic effect of drugs from Stevia, Rhodiola
and Helianthus tuberosus studied in a model of diabetes oksihinolinovogo. Diabetes is
120
reproduced by the method of [7] on 24 rabbits of both sexes, weighing 2.3-2.9 kg. To
confirm diabetes after 2 days, blood was collected from the ear vein and the glucose
level was determined by enzymatic method. Animals were treated by oral
administration diabenit, glikoinuvit 50 mg/kg, stevil-50 100 mg/kg as a 10% aqueous
solution. The experiment continued for 30 days; 15 and 30 days, blood glucose levels
were observed in the dynamics.
Results. Revealed that drugs used significantly reduces the level of glucose in
the blood (fig. 1).
8
7
6
5
4
3
2
1
0
7,6*
6,42*
4,72
intact
diabenit 50
5,45^
5^ 5,12^
6,1 6,3*
6,8*
5,5* 5,3* 5,2* 5,3*
4,98* 5,1*
3,87
60
cont
diabenit 100
glipil 50
stevil-50 100
120
glibenclamid 5
stevil-50 500
4,25^ 4,4
5,15*
diabenit 25
glikoinuvit 100
121
fast diabenit, but a few short, the effect of stevil-50 was shown slowly and continuously.
It was therefore of interest to investigate the hypoglycemic properties diabenit with a
longer action.
10
8
6
4,96
4,96
4,96
4,96
6,8
8,3
7,5
5,6 5,4 5,3
5,45
5 5,12
5,9
4
2
0
intact
30 min
control
G+diabenit 25
60 min
G+diabenit 50
90 min
24 h
G+diabenit 100
122
glycemia. The action diabenit manifested more pronounced glikoinuvit has prolonged
action and Stevil-50 was less effective.
It should be said that the earlier models used hyperglycemia damage insular
apparatus of the pancreas did not occur and therefore the level of insulin in the
peripheral blood remained within the physiological range. However, the mechanism of
the development of type 1 diabetes is insulin deficiency, due to atrophy of the -cells
of the islets of Langerhans. It was therefore of interest to investigate the hypoglycemic
action of medicinal plants on the model of alloxan diabetes. Alloxan, activating the freeradical processes in -cells of the islets of Langerhans of the pancreas, causing them
damage and necrosis apparatus insulinarnogo pancreas. The level of insulin in the
peripheral blood is sharply reduced, which slows the glucose transport system and
peripheral tissues in their intake of energy substrates, changes in cell metabolism.
Conducted studies in this respect have shown that in rats with alloxan diabetes
glucose level changes within wide limits, which allowed us to divide the animals into 2
groups: with mild to moderate degree of alloxan diabetes.
Analysis of the dynamics of change in blood glucose in rats with alloxan diabetes
mild prolonged administration of drugs it showed marked reduction, especially in their
20-day injection (Table 1).
Table 1
After the
injection of
alloxan
20
%
Glucose
mmoles/l
BP + fiz.r-p
11,90,7
11,10,9
100,0
10,51,0
100,0
BP + Glipil
12,30,9
10,10,8
91,0
7,750,7*
73,8
BP + glibenclamide
11,40,9
9,30,9
83,8
7,40,6*
70,5
BP + diabenit
12,01,3
9,21,6
82,9
7,70,5*
73,3
BP + Stevil-50
12,60,9
9,260,8
83,4
7,50,6*
71,4
BP + glikoinuvit
10,91,1
9,30,6
83,8
8,20,7*
78,1
Note: * - Differences with respect to the data of the control group significant (* - P <0,05)
123
BP + fiz.r-p
22,61,1
BP + Glipil
23,00,9
18,91,0
88,7
15,11,2
81,6
BP + glibenclamide
21,61,0
17,81,4
83,6
13,51,2*
73,0
BP + diabenit
22,81,8
18,10,7*
85,0
13,90,8*
75,1
BP + Stevil-50
23,90,7
18,60,9
87,3
14,20,9*
76,7
BP + glikoinuvit
22,41,3
19,80,7
93,0
14,81,6
80,5
Groups
After the
injection of
alloxan
Note: * - Differences with respect to the data of the control group significant (* - P <0,05)
124
drugs in the initial values of alloxan diabetes, it should be noted a more pronounced
effect of the drugs glibenclamide and diabenit.
Consequently, new therapeutic compounds with insulin deficiency also exert a
hypoglycemic effect. Particularly promising in this respect is diabenit at a dose of
50 mg/kg for prolonged use.
Conclusions: thus diabenit herbal preparations, stevia glikoinuvit 50 and
various models of hyperglycemia have hypoglycemic action. All models hypoglycemic
effect diabenita exhibit more pronounced. If the action was fast diabenita a short
duration, the effect of stevia-50 was shown slowly, but more long-lasting. Drugs is
recommended for type 2 diabetes.
References:
1. Rakhmatullaeva M.M. Diss ... cand. Pharm. Sciences. - 2007. 135.
2. Remizov O.V., Kuraeva T.L. Experimental Laboratory. 2003; 3: 90-91.
3. Collection methods of clinical laboratory tests / Ed. Yunuskhodzhaev A.N. 2000.
703 p.
4. Shagazatova B.H., Babadjanov A.S. Medical Journal of Uzbekistan. 2003; 1: 110115.
5. Shagazatova B.X., Akbar Z.S., Ismailov S.I. Medical Journal of Uzbekistan. 2001;
1: 93-94.
6. Shamansurova Z.. Diabet in Uzbekistan. 2006; 4:2-3.
7. Experimental diabetes / Under. Ed. Baranov V.G., Sokoloverova I.M., Galkaryan E.G. et al. L. 1983. 240.
125
126
"Leoglisirflom" in doses of 25 mg/kg; 50 mg/kg and 250 mg/kg, respectively. Doses are
selected in relation to the dose of 50 mg/kg is effective therapeutic dose, however, we
studied dose 2 times smaller; 25 g/kg (minimum) and 5 times greater - 250 mg/kg
(highest). Control animals were injected with 1-2 ml distilled water.
Throughout the experiment, the animals were under daily observation; selected
food and water consumption, state of hair integument and mucous membranes
behavior. 1 times a week, animals were weighed regularly examined the functional
state of the cardiovascular, nervous, endocrine, excretory and digestive systems. Once
a month studying morphological and biochemical indices of blood and urine. All
animals that died during the experiment were subjected to autopsy to establish the
nature of the damaging effect of dragee "Leoglisirflom". After the end of the introduction
of dragee, "Leoglisirflom" carried out the most complete survey of experimental
animals using hematological, biochemical and physiological tests. Some of the animals
from each group were sacrificed for pathological studies. The weight of their bodies
and carried out a histological study [3].
For hematological studies in rat`s blood was collected from the tail vein before
the start of the experiment, after one, two and three months after the reference drug.
The peripheral blood hemoglobin content is determined, the number of erythrocytes,
leukocytes, platelets. The percentage of hemoglobin determined by the method of Sali
that the number of red blood cells, white blood cells and platelets were determined by
microscopic method in the counting chamber of Goryaev [5].
For histological studies were taken internal organs (brain, heart, liver,
esophagus, stomach, small and large intestines, spleen, adrenal, kidney, gonads).
Studies were conducted on serial sections. The material was fixed in 10% formalin
neutral, followed by the standard wiring of alcohols of increasing concentration and
pouring paraffin. Sections were stained with hematoxylin and eosin according to the
method of Van Gizon [6,7].
Statistical calculations were performed by the method of variation statistics with
the calculation of Student's t test [8].
The results. The effect of drage "Leoglisirflom" on indicators of the functional
state of white rats: It is found that the dragee "Leoglitsirflom" in doses of 25 mg/kg,
50 mg/kg and 250 mg/kg body weight daily endogastric administration of 90 adult rats
causes no death of the animals, does not have a damaging effect on the general state
of the rats. Throughout the experiment, the animals of the experimental groups in their
127
behavior and vernal view did not differ from control rats. All animals remained active,
readily eat the food and to adequately respond to external stimuli. Monitoring of the
body weight gain in rats showed that the animals in the groups receiving dragees
"Leoglisirflom". There was no difference with the control animals. By the end of the
experiment after prolonged endogastric administration dragees "Leoglisirflom" within
the peripheral blood of experimental groups of animals were observed physiological
changes (Table 1).
Table 1
The composition of the peripheral blood of white rats after prolonged
endogastric administration of dragee "Leoglitsirflom"
Indicators
Hemoglobin,
g/%
Before the
test
Control
100
500
14,4 0,3
14,7 0,2
14,9 0,3
14,5 0,3
26,85 0,2
7,05 0,2
7,0 0,3
7,3 0,2
Erythrocyte,
2
one million
1000
14,3 0,2
6,7 0,4
cells/mm
3
Platelets
736,8 6,4
728,7 2,4
732 5,0
736,2 5,4
741,83,7
Leukocytes
11 0,6
10,1 1,1
11,1 0,9
10,8 0,7
11,2 0,7
128
129
130
131
preserved. The brain of the adrenal chromaffin cells retain the characteristic structure
and size. Venous sinuses are not changed or slightly extended.
Stomach - surface epithelium covered with a layer of mucus, which defines the
exfoliated cells. In the lamina propria found some lymphocytes, plasma cells of
lymphoid follicles. The glands of the stomach are the usual structure. Vessels
moderately full-blooded.
Small intestine - villi are covered with a single layer of prismatic epithelium,
among the cells which in large quantities - goblet cells. In the lamina propria of the
mucosa occur lymphocytes and plasma cells, and lymphoid follicles. There moderately
severe vascular congestion.
The colon without any pathological features. Crypt regular shape, are arranged
densely. The ratio of prismatic and goblet cells on the surface corresponds to the crypt.
Mostly found in the submucosal layer of the lymphoid system. Blood vessels are filled
with blood, marked perivascular edema.
Thus, as architectonic gastrointestinal mucosal and submucosal rat experimental groups correspond to the control animals.
Uterus. The endometrium is lined with a single layer of prismatic epithelium.
Good different functional and the basal layer of endothelium. There are different
lengths of uterine cancer, some of them expanded, low cylindrical epithelium glands,
cytoplasm is basophilic. The nuclei elongated, occupy most of the cells stained
intensely and homogeneously. Mitoses absent. The stroma is rich in cells and fibers
argyrophilic.
Ovary. Cortex and medulla are clearly distinguishable. Last formed coarse
connective tissue craters, major vessels, nerves. The cortical part of ovary follicles are
located primordial. Follicles are at different stages of development up to the breaks
graph bubbles. Degenerative changes were observed. Hemorrhage and no atrophy.
Growing follicles different maturity without pathological changes. The brain of the
ovarian connective tissue main vessels and nerves, multiple sclerosis, collagenization
and fragmentation were observed.
Testicle. Microscopy testicular tissue of rats did not reveal any pathological
changes in the tubules and the stroma. In the testes convoluted tubules epithelium
contain all stages of spermatogenesis. Well differentiated spermatogonia, spermaceti
1 and 11 orders, prespermatidis and spermatids. Also in a large number of sperm cells
in various stages of maturation. Basement membranes are thin. There is no signs of
132
degeneration of Setroli follicular cells and Leydig interstitial cells, the number
corresponding to their control. The inner diameter of the seminiferous tubules are not
reduced, sclerosis and ischemia basement membrane were observed. Convoluted
tubules are lined in the control animals, multicore epithelium, including a spermicide
first and second orders, prespermatotsidy, spermatids. Degenerative changes in the
cytoplasm of epithelial cells were observed. There were found Sertoli cells in small
quantities in the thickness seminiferous epithelium. Their number is about the same in
all cases studied. Interstitial Leydig cells are seen as a continuous band near the
capillaries. Recently expanded and filled with blood. In conclusion, it should be noted
that the dystrophic, necrobiotic and inflammatory changes in experimental animals, as
well as significant differences in the structure of the internal organs between the
experimental and control groups were found. Marked structural features of normal
tissues examined reflect the functional activity of internal organs.
Based on a comparative histological study of organs and tissues of control and
experimental animals can be concluded that prolonged endogastric administration
dragees "Leoglisirflom" for 90 days in doses of 25 mg/kg, 50 mg/kg and 250 mg/kg
body weight causes no pathological changes.
Conclusions. Dragee "Leoglisirflom" in doses of 25 mg/kg, 50 mg/kg and
250 mg/kg body weight at 3-monthly endogastric adult rats causes no death of the
animals, does not have a damaging effect on the general state of the rats of the body
weight, the cell the peripheral blood and histomorphological pattern of internal organs.
References:
1. Kiseleva T.L. Ancient tradition of folk medicine in modern sedatives and antianxiety
drugs. VIII Russian National Congress "Man and medicine". Materials from a
satellite symposium. - M.: Galena A S 2001. P. 8-21.
2. Guskov T.A. Toxicology medicaments, Moscow, 2008. - P. 27-30.
3. Golikov S.N., Sanotsky I.V., Tiunov L.A. General mechanisms of toxicological
action. L.: Medicine, 1986. - P. 279.
4. Guidelines for the Study of common toxicity of pharmacological substances / The
Manual on experimental (preclinical) study of new pharmacological substances.
Edited by corresponding Member of the Academy of Medical Sciences, Professor
R. U. Khabrieva. Second edition, revised and supplemented / M.: - 2005. - M.: OAA
"Publisher" Medicine", 2005. P. 41-54.
133
134
Mahamadzarif Kadirov,
Tashkent Pharmaceutical Institute, Doctoral Candidate,
Ahmadhodja Yunuskhodjaev,
Tashkent Pharmaceutical Institute, Rector,
Doctor f Pharmaceutical Sciences,
Kamoliddin Shadmanov,
Tashkent Pharmaceutical Institute,
Assistant Professor, Faculty f Industrial Pharmacy
135
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,
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, - . [2,3].
(II) U,
(GluH2) I (II) - (KgaH2)
II.
136
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: -, -, - .
0,35%.
-
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- 1.
.
(
2).
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MemSClH
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1405
as()
1590
1640
1645
s()
1380
1380
1410
(=)
1748
1715
(NH3+)
3007,2975
3200
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1642,1553
(NH2)
3350,
3320,
3200
3270
137
, (-1)
41g(4F)
42g(4F)
2g(4F)
41g(4)
6020
14200
18400
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6320
14400
18900
:
I
H2O
CH3
H2
Cl S H2C H2C
HC N
CH3
OC=O
Co
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138
1 ( 1). () ,
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, 1012 /
139
II
69,6 0,5
69,8 0,4
49,30,5
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10
5
10
45,3 0,6
68,30,3
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, //
140
Cambridge Journal of Education and Science
141
:
1 (). ,
;
2 3 ().
, I, 5 / 10 / ;
4 5 (). , II 5 / 10 / .
. 7 , 4. . 4,
,
.
,
-
.
:
1. .., .. U (S-) , , . , 1973. . 3-7.
2. .. , -, 2008. . 206.
3. .. . , 1987. - . 239.
4. ..
3d- . . . 15. . 3-24.
142
E.G. Shvarev, L.V. Dikareva, D.L. Ovodenko, A.K. Aupova, G.E. Shvarev,
Obstetrics and Gynecology Department,
Astrakhan State Medical Academy,
Astrakhan, Russia
143
What do we know about it? Do we use the given diagnostic opportunities for preserving
reproductive health and lives of our patients? It is the necessity of regular prophylactic
measures, in the aspect of forming the considered diseases, that consists in high
chances of their elimination just when they are early revealed.
As it is known, the problem of intensification and optimization of pre-hospital
diagnostics largely determines the success of treatment and is one of its most
important items. It is this approach that gives an opportunity for effective, preserving
organs, treatment and thus at most saves reproductive abilities of women. It wont be
an exaggeration to say that early and, furthermore, differential diagnosing diseases of
inner genitalia remains one of the most complicated problems of gynecology. It gains
peculiar significance while forming the concept of revealing precancer, early forms of
endometrial cancer and cancer of uterine appendages, when there are no symptoms
or they are very scarce and sizes of pathological tumors are minimal, and are not
spread on other organs (as it is known, in such cases, treatment is more sparing and
effective, and maximally favourable). WHO experts opinion of the absence of reliable
screening programs of precancerous and cancerous pathology of uterine body
(endometrial cancer) and appendages should be also mentioned.
And, meanwhile, statistical data of Russian and foreign scientists convincingly
testify not only steady increase of sick rate, but also rejuvenation of patients with
benign and malignant hormone-dependent tumors of reproductive organs. This fact is
explained not only by increase of an average life span, but also by the essential
increase in population of such diseases of civilization as adiposity, anovulation,
chronic hyperestrogeny, infertility, inflammatory diseases of uterine and appendages,
and also by repeated aggressive obstetrical and gynecological manipulations
[1, 2, 3]. That is why the necessity of forming a new approach to active search for
patients with precancerous and early cancerous diseases of inner genitalia should be
considered first of all from the position of elaborating the new screening test as one of
the most perspective methods of their second prevention [4].
It is known that at cancerous growth mitochondrial oxygenation is forced out by
glycolysis, more primitive way of energy supply. It is accompanied by active oxygen
forms and is the basis of stimulating free radical oxygenation in the organism. During
this process a state called the oxydative stress (OS) is developed and results in
accumulating the highly toxic combinations leading to morphological disturbances of
cells and tissues [5,6,7].
144
Free radicals hit all kinds of biological macromolecules, furthermore, the most
studied are processes of lipids peroxide oxygenation. However, only active forms of
oxygen also cause oxygenative destruction of proteins. It is considered that in a state
of OS lipids are not attacked by the active oxygen forms first and foremost, but proteins
of cells and biological fluids (BF) are. This process may also be the basic in structural
and functional disturbances of the reproductive system organs, including the
development of precancerous and cancerous transformation of endometrial and
ovarian tissues. However, it needs a considerable amount of pathologic deformation
of molecular ingredients of a cell and, consequently, a prolonged time interval, in the
final stage of which traditional cytologic and histologic methods of research are already
available. In it lies one of the reasons of the displacement of the forming clinical picture
and, consequently, the initiation of diagnostic measures of the disease for a later
period.
It is important to note that structural changes of endometrium (E), as a hormonedependent tissue, largely depend on the functional condition of ovaria. It is the
endometrial tissue that reacts most sensitively upon the changes of homeostasis of
the reproductive system organs, also including functional disturbances while forming
tumors of gonades. According to it, we should point out the ability of a number of
enzymes and their isoforms to accumulate during hyperplastic processes and cancer
of endometrium in the apical parts of glandular cells, and then to secrete into the
endometrial secretion [8]. It should be noted that besides blood and fragments of
sloughing endometrial tissue, endometrial and endocervical secretion is also included
into menstrual fluid (MF). By the drawn analogy the OS markers, among which the
earliest is the carbonyl group of proteins (CGP), may also be found with the help of
simple methods in MF and endometrial lavages (EL) of examined patients long before
appearing manifesting symptoms of the disease.
Choosing MF (and EL), as an object of research, is explained not only by
scientific curiosity (because they are poorly studied!), but also by the fact that once a
month this BF in enough volume for examining (from 10 to 80 ml in healthy women) is
spontaneously secreted from the uterine cavity and can be collected by patients
themselves (into sanitary napkins or special caps) for the laboratory examination.
Traditionally morphological research in medicine is mainly concentrated on
tissues and cellular elements whilst structural peculiarities of BF remain poorly studied.
In this respect microscopy of the structures of a dry drop (facies), forming in BF when
145
it turns into a solid state as a result of dehydration, is long-range. This new scientific
trend was called morphology of BF [2]. The essence of the new method of
diagnostics is in the fact that normally the microscopic picture of the examined drop of
BF has more or less homogeneous structure and by slight influence of different
damaging factors (oxidizing, toxic) the hydrate membranes of proteins change, and
processes of molecular aggregation start.
In professors V.N. Shabalina and S.N. Shatohina opinion (1995, 2007), facies
(F) is a structural portrait of molecular correlation in BF which allows to put deep
microprocesses on the macrolevel. A microscopic picture of F has structures which are
characteristic for every kind of human BF, connected with peculiarities of physiologic
and pathologic processes action in the organism.
Using technologies of the morphological analysis Lithos-system [10] one can
observe even the earliest pathologic changes of molecular structures immediately,
without incubation period, which is necessary at cellular, organic and/or systemic
levels. Therefore, the morphologic analysis of BF gives an opportunity for the earliest
diagnostics of the developing pathologic process.
We offer a quantitative content analysis of the OS markers with a simultaneous
defining structural microscopic peculiarities of the solid phase of MF and EL as a new
diagnostic (and prognostic) approach to evaluating the state of inner genitalia in
women of reproductive and (especially) perimenopausal ages.
The inner anatomical localization, complexity of the microscopic structures of
neoplasms of the female gonades, indistinct borders between the neoplasms of a
different maturation degree and diversity of their combinations all these complicate
the early revealing of ovarian tumors (OT) and hinder rational planning for patients
treatment.
As it was already told, endometrial tissue is extremely sensitive to
the homeostatic changes of the reproductive system organs also including the
increase of the OS markers content in EL , in particular, CGP by forming OT. Thus,
according to D.L. Ovodenko et al. (2008), women from the control group with the
normal ovarian structure had 0-1.9(0.9 +_0.14) nmol/mg. While increasing the index
up to 2.0 3.5 (2.8 _+ 0.28) nmol/mg in the majority of cases there were revealed
benign tumors (p<0.05) and at 3.6 4.9 (4.8 _+0.25) nmol/mg malignant OT
(p <0.01).
146
The CGP content in the MF of the patients with the benign ovarian tumors
(BOT) was higher than the patients with chronic inflammatory processes of uterine
appendages (CIPUA) and those from the control group had (p <0.01).
The microscopic picture of F of EL in the women from the control group was
characterized by sharply shaped zone borders. In the majority of cases there were two
zones peripheral with radial cracks and central, containing crystals of salts, more
rarely straight radial cracks as a prolongation of the peripheral zone cracks (fig. 1).
Besides that, in 24.8 % of the cases in F of EL of the women from this group appeared
the third intermediate zone, located between the two above mentioned zones,
containing three-rayed cracks.
147
148
149
10. Shabalin, V.N., Shatokhina, S.N. Diagnostics markers in the structures of human
biological liqulds // Singaporo Med. J. 2007. Vol. 48(5). - P. 440-446.
11. Ovodenko, D.L., Shvarev, E.G., Dikareva, L.V. Diagnostic value of identification of
carbonyl groups of proteins in biological fluids of patients with the ovarian tumors
// Journal of Obstetrics and Women Disease, vol. LVII, suppl. 3, St. Petersburg,
2008. P. 50-54.
150
Revazi Melkadze,
Institute of Machine Mechanics, Doctor f Technical Science, Professor,
Ketevan Kintsurashvili,
Akaki Tsereteli State University, Doctor f Technical Science, Professor
151
152
Months
maximum accumulation
of phenolic compounds
in %
1.
May
16,700,24
82,1
2.
Jun
18,840,22
82,5
3.
Jul
19,610,33
96,4
4.
August
20,350,37
100,0
5.
September
16,650,21
81,8
Average
18,430,30
Antioxidant Activity. The Ferric Reducing Ability of Plasma (FRAP) assay was
used to measure the concentration of total anioxidants. UV/Vis spectrophotometer
M501 (Camspec Ltd, UK) was used for measurements of absorption changes that
appear when the TPTZ-Fe3+ complex reduces to the TPTZ-Fe2+ form in the presence
of antioxidants. An intense blue colour with absorption maximum at 593 nm develops.
Standard solutions of 5.7 mM ascorbic acid in deionised water were prepared. Diluted
standards or diluted extract samples were used on the day of preparation except the
ascorbic acid solutions, which were used within 1h of preparation. An aqueous solution
of 1000 mol/L FeSO4x7H2O was used for calibration of the instrument.
To measure FRAP value, 300 ml of freshly prepared FRAP reagent was warmed
to 37 C and a reagent blank reading is taken at 593 nm; then 10 ml of sample and
30 ml of water are added. Absorbance readings were taken after 0.5 s and every 15 s
until 4 min. The change of absorbance (A = A4min - A0min) is calculated and related to
153
Sample
1810
10600
11000
Control
1015
6000
6500
154
References:
1. Bokuchava M.A. On the nature and significance of tannins tea leaves // Bioh. Tea.
Manuf. M. 1950 (in Russian).
2. Bokuchava M.A., Volkov A.G. The conversion of the different fractions of tannins
in the growth and development of tea leaves and its processing // Ref. Works
established. Dep. Biol. sci. USSR Academy of Sciences, M. 1946 (in Russian).
3. Bokuchava M.A. Novozhilov N.P. Taste properties of the individual fractions tea
tannin and to the quality of tea // Bioh of tea production. M. 1946 (in Russian).
4. Bohinsky R. Modern views in biochemistry: M.: 1987. - 544 p.
5. Goodwin T, Mercer E. Introduction plant biochemistry. In 2 volumes. M. Science,
1986, with V. 2. 312 p.
6. Dzhemukhadze K.M. Tea tannin in connection with the processing and quality of
tea // Biochem. Tea production. M.: 1940 (in Russian).
7. Dzhemukhadze K.M. Tanin substance and quality of the raw tea // Biochem. Tea
production. M. 1950 (in Russian).
8. Kretovich V.L. The Basics Biochemistry of plants. M.: Graduate School, 1971. 464 p.(in Russian).
9. Kursanov A.L. Determination of different forms of tannins in plants // Biochemistry,
M.: 1941 (in Russian).
10. Kursanov A.L. The transformation of tannins in the processing of tea leaves //
Biochemistry. M.: 1943 (in Russian).
11. Kursanov A.L. Tanin tea leaf material in connection with the problem of improving
the quality tea // AS USSR. Ser Biol. 1951 (in Russian).
12. Kursanov A.L. Synthesis and transformation of tannins in the tea plant // 7th
Bach reading. USSR Academy of Sciences. M. 1952 (in Russian).
13. Melkadze R., Chikovani N., Kachniashvili E. Characteristics of the Composition of
Caucasian Blackberry (Rubus caucasicus L.) Leaves as a Raw Material for Tea
Production, J. Applied Biochemistry and Microbiology, 2008.
14. Melkadze R.G. Research an elemental composition Blackberry of a sheet and
mining of thetechnological rules of effecting phytotea of products, Georgian
Academy of Sciences, Tbilisi, 2000.
15. Oparin A.I. Biochemical theory of tea production M.: Bioch. tea prod. 1935 (in
Russian).
155
156
Michael Koptev,
Ukrainian Medical Stomatological Academy, Assistant, Ph.D. in Medical
Sciences, Department of Operative Surgery and Topohraphic Anatomy,
Elena Pronina,
Ukrainian Medical Stomatological Academy, Professor, Doctor of Medical
Sciences, Department of Operative Surgery and Topohraphic Anatomy,
Sergey Bilash,
Ukrainian Medical Stomatological Academy, Professor, Doctor of Biological
Sciences, Department of Operative Surgery and Topohraphic Anatomy,
Angelina Prog-Zakaznikova,
Ukrainian Medical Stomatological Academy, Associate Professor, Ph.D. in
Medical Sciences, Department of Operative Surgery and Topohraphic Anatomy,
Anatoly Bilych,
Ukrainian Medical Stomatological Academy, Associate Professor, Ph.D. in
Medical Sciences, Department of Operative Surgery and Topohraphic Anatomy
157
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:
1. European convention for the protection of vertebrate animals used for
experimental and other scientific purposes. Council of Europe, Strasbourg, 1986.
53 p.
2. 3447 IV
21.02.2006 ., 2006. 18 .
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163
164
Statistica 12. As the auxiliary equipment and materials were used: analytical scale
(Shimadzu, Japan).
Method of quantification. The test is performed by absorption spectrophotometry in the visible area [1, 2.2.25].
5.00 g of the powdered raw material poured with 80 ml of 70% ethanol and
heated under reflux on a boiling water bath for 30 minutes. Extraction cooled and
filtered into a volumetric flask of 100 ml, and adjusted the volume after extraction with
70% ethanol to the mark (solution A).
The test solution. 2 ml of the solution A placed in a volumetric flask of 25 ml,
added 0.5 ml of 33% acetic acid, 1.5 ml of aluminum chloride and adjusted to the mark
with 96% ethanol (solution B).
Compensation solution. 2 ml of solution A, 0.5 ml of 33% acetic acid and
adjusted to the mark with 96% ethanol in a volumetric flask of 25 ml.
After 40 minutes, measured the optical density of the solution B in a
spectrophotometer at a wavelength of 415 ( 5) nm in a cuvette with working layer
thickness of 10 mm.
The content of sum of flavonoids in terms of rutin percentage (X), is calculated
by the formula:
X
D 504 .03
D 25 100 100
,
165
Optical
number
density
Sample
Optical
number
density
Extrcta-
The quantitative
content of sum of
bility, %
flavonoids,%
0.4405
80
0.4369
0.48
79.35
99.18
0.4622
85
0.4681
0.51
86.08
101.27
0.4926
90
0.4903
0.54
89.59
99.54
0.5176
95
0.5253
0.58
96.41
101.49
166
0.5515
100
0.5415
0.59
98.19
98.19
0.5732
105
0.5729
0.63
104.94
99.95
0.6014
110
0.6141
0.67
112.33
102.12
0.6246
115
0.6301
0.69
116.02
100.88
0.6533
120
0.6602
0.72
121.28
101.07
Average X ,%
100.41
1.2512
1.2460
SD
100 ,%
X
The relative confidence interval of the mean result t (95%,8) SD 1.860 1.2512 ,%
2.3272
0.41
true
true
correct
From the data presented in Table 1, it follows that for the sum of flavonoids the
analysis technique has sufficient accuracy and convergence is correct throughout the
concentration range of 80-120% and has no significant bias, the relative standard
deviation (RSD) is less than 2.0%.
Linearity was investigated within the application range of the analytical
procedure on nine independent concentrations in the range of 80-120% of the nominal
content of the sum of flavonoids in the studied raw material [3]. Metrological
characteristics of the technique linear dependence are presented in Table 2.
Based on these data we can assert that a linear dependence is satisfied over
all the eligibility criteria in the specified range of application of the analytical technique.
Graphical representation of the linear dependence of the technique is shown in Figure 3 in normalized coordinates.
Table 2. Metrological characteristics of linear dependence
of the technique
Parameter
The regression
equation
B
Demands
Values
y = 1.0385x 3.38444
1.0385
Comment
Matches
167
Sb
0.03231
6.16
-3.38444
Matches
1.89 sa
Sa
3.25739
SD
2.0
1.2512
Matches
7.290710-9
Matches
0.97
0.99663
Matches
168
Day 1
Day 2
Day 3
sample /
indicators of
Analyst 1
Analyst 2
Analyst 1
Analyst 2
Analyst 1
Analyst 2
0.61
0.59
0.62
0.62
0.6
0.6
0.6
0.61
0.6
0.62
0.62
0.59
0.62
0.61
0.61
0.63
0.62
0.6
0.61
0.6033
0.61
0.6233
0.6133
0.5967
RSD
1.6393
1.9139
1.6393
0.9262
1.8827
0.9676
the method
correctness
0.6094
RSD
1.9063
Results
100 0.001
0.217
0.46
balance
100 0.0002
0.004
5
0.12
2 ml pipette uncertainty
0.5
25 ml flask uncertainty
0.23
V, r
0.563
A, r
0.2
cell, r
0.1
169
2
sp, r 2 S2A, r Scell
,r
0.447
0.04709+0.1998+0.317=0.56389
0.7512
As upper
correct
170
content of sum of flavonoids in terms of rutin in dry raw material should be at least
0.2%.
References:
1. The State pharmacopoeia of the Republic of Kazakhstan. V.1. - Almaty: The
publishing house "Zhibek moly", 2008.
2. The State pharmacopoeia of the Republic of Kazakhstan. V.2. - Almaty: The
publishing house "Zhibek moly", 2009.
3. Grizodub A.I. Validation of spectrophotometric methods of quantitative analysis of
drugs in accordance with the requirements of SPU // Farmakom. - 2002. - 3. P. 42-50.
171
Snizhana Feysa,
Ph.D., Associate Professor of the Department of Therapy and Family Practice,
Deputy Dean of the Faculty of Postgraduate and Pre-University Education in State
Higher Educational Establishment Uzhhorod National University,
Svitlana Opalenyk,
Master of the Department of Therapy and Family Practice, Doctor-Intern,
State Higher Educational Establishment Uzhhorod National University
Laboratory characteristics of patients with non-insulindependent diabetes mellitus with multiple complications
Abstract: The article describes the laboratory characteristics of patients with
non-insulin-dependent diabetes mellitus (DM) and multiple complications from other
organs and systems. It is proved that for patients with diabetes type II (DM-II) is
characterized by the violation of not only carbohydrate, and lipid, electrolyte
metabolism and also protein synthesis and enzymatic functions of the liver.
Keywords: diabetes mellitus type II, non-insulin-dependent diabetes mellitus,
non-alcoholic fatty liver disease, laboratory examination, glycosylated hemoglobin,
dyslipidemia.
,
,
,
,
,
,
,
172
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. 2012. . 11, 2. . 13-18.
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2011. 4 (60). . 510.
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4. .. / .. // Therapia
. 2007. 9. 2834.
177
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. 2012. - 3-4(1). . 30-34.
6. Hurjui D. The central role of the nonalcoholic fatty liver disease in metabolic
syndrome / D. Hurjui, O. Ni, L. Graur // Rev. Med. Chir. Soc. Med. Nat. Iasi.
2012. Vol. 116, 2. . 425431.
7. Chalasani N. The Diagnosis and Management of Non-Alcoholic Fatty Liver
Disease: Practice Guideline by the American Association for the Study of Liver
Diseases, American College of Gastroenterology, and the American Gastroenterological Association / N. Chalasani, Z. Younossi, J.E. Lavine et al. //
Hepatology. 2012. Vol. 55, 6. P. 20052023.
8. Dowman J.K. Pathogenesis of non-alcoholic fatty liver disease / J.K. Dowman,
J.W. Tomlinson, P.N. Newsome // QJM. 2010. Vol. 103. P. 7183.
178
Kovalenko Tatiana,
Assistant f the Department f Microbiology,
Virology nd Immunology,
Kharkiv National Medical University,
Klimova Yelena,
Doctor f Biologist, Professor,
Kharkiv National Medical University,
Minukhin Valeriy,
Doctor f Medical, Professor,
Kharkiv National Medical University,
Kuzmenko Andrei,
Assistant f Medical f the Department f Microbiology,
Virology nd Immunology,
Kharkiv National Medical University
investigated parameters of
phagocytosis did not differ from control animals of different ages. On the model of
induced inflammation after administration of E. coli and the use of an experimental
drug inhibition of cellular immunity in young experimental animals was observed.
Infection of immune drug into animals of older group with inflammation increased
activity of phagocytosis, probably because of secondary adaptive immune response.
Keywords: E. coli, immunity, phagocytosis, the neutrophils, the age of the
animals immune drug.
,
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,
,
179
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185
Svirina-Abramian Tetiana,
Kharkiv Regional Clinical Narcological Hospital, Narcologist
186
Suicides are the result of the combined effect of social stress factors and
psychopathological factors, in particular, alcohol dependence [7, 8]. As suicide is a
potentially preventable kind of death the specialists in the field of public health have an
urgent task that to develop preventive measures to reduce suicides. One of the key
programs for the prevention of suicide is to reduce the level of alcohol abuse among
the population [9, 10].
Unfortunately, despite an active search by scientists and narcologists decisions
on the definition of socio-unstable risk male groups the problem of self-destruction
behavior, which according to modern views belongs to suicidal behavior, and alcohol
dependence remains relevant. The problem of link between alcohol abuse and suicide
is extremely actual today. Consideration of alcohol dependence as a disease with
severe auto-aggressive foundation has become axiomatic a long time ago [11]. Alcohol
dependence is considered as a variant of "chronic" suicidal behavior, disease with a
distinct anti-vital character [12].
According to research of Linskyy I.V. et al., 28 % of all completed suicide
attempts were carried out under alcoholic intoxication [13]. The relationship between
alcohol abuse and suicidal behavior was proved. Some authors consider alcohol abuse
as equivalent of chronic suicide. In studies conducted in various countries it was shown
that in 30 to 66 % of suicide victims alcohol in the blood was present at the time of
death. In Sweden, alcohol is involved in 35 % of the suicides. In Finland 30.5 % of
suicides are associated with alcohol. In Brazil in 32.2 % of the victims of suicide alcohol
in the blood was found. 33 % of suicides in New York at the time of death had alcohol
in the blood [10].
The presence of head injuries, experiencing physical violence, patients
experienced feeling of loneliness, despair, depression, feeling of guilt are of great
importance in the initiation of suicidal behavior. The presence of life-threatening hobby
is a marker of suicidal behavior as well as a tendency to unnecessary risks. However,
such factors as the tragic death of close relatives and intimate experience with future
suicide do not have significant differences in the different to suicide risk factor groups
and require further research and qualitative analysis.
The aim of the research was to study of suicidal danger factor indexes in men
with alcohol dependence syndrome (F 10.24, F 10.25, F 10.26, F 10.30).
Materials and methods. The study of suicidal danger factor was conducted in
Kharkiv Regional Clinical Narcological Hospital during the period from May to October
187
of 2015. It involved 58 male patients with alcohol dependence. All men were between
the age of 26 to 64 years. Diagnosis of dependence syndrome was conducted
according to the criteria of 10th ICD. Duration of alcohol dependence according to
anamnesis data ranged from 10 to 40 years. Testing was conducted due to the method
elaborated by O.V. Merinov. The suicide danger factor created by him allows validly to
assess compliance risk in men with alcohol dependence. This factor is used for the
screening assessment of suicide risk and identification of patients groups that need
specific prevention and/or therapy due to the auto-aggressive component of the
disease [14].
Results and discussions. It was found that in 6 patients (10.3 % of patients)
the suicide danger factor is low.
In 27 patients (46.6 % of patients) the suicide danger factor is equal to its
intermediate average values reflecting the population risk of suicide behavior. And in
25 patients (43.1 % of patients) the suicide danger factor is high.
In this case 12 people (48 % of the group) in this category had suicide ideas in
anamnesis. In the group where the suicide danger factor is equal to its intermediate
average values reflecting the population risk of suicide behavior only 1 man had suicide
ideas (3.7 % of the group).
And in patients with low suicide danger risk suicide ideas did not exist (table 1).
Conclusions. Thus, the present study showed that important in the initiation of
suicidal behavior is the presence of head injuries, experiencing physical violence,
patients experienced feeling of loneliness, despair, depression, feeling of guilt. It is
also can be noticed that the presence of life-threatening hobby as well as a tendency
to unnecessary risks are the markers of suicidal behavior.
However, factors such as the tragic death of close relatives and intimate
experience with future suicide do not have significant differences in the different to
suicide risk factor groups.
The prospect of further research is to find the correlation of obtained results with
I-functions model of Ammon I-structural test(ISTA) that to determine subsequent
psychological help for the prevention of auto-agressive behavior.
188
Table 1
Suicadal danger factor indexes
Levels of suicidal danger factor indexes
Questions fro test
low
intermediate
high
abs
%
abs
%
abs
%
Has your family the tragic death of close 4
66,7
14
51,9
22
88
relatives?
Have you thought to commit a suicide? 0
0
1
3,7
12
48
You have intimate experience with the 0
0
12
48
9
36
future suicide?
Is it typical for you to feel a guilt for a 1
16,7
15
55,6
24
96
long time?
Do you tend to obsessive sense of 3
50
14
51,9
23
92
shame?
Have you experienced an acute sense 0
0
16
59,3
20
80
of loneliness?
Did you ever have causeless episodes 0
0
12
44,4
20
80
of depression?
Did you ever have episodes of despair? 0
0
15
55,6
21
84
Do you tend to periodic moments of 0
0
14
51,9
18
72
overeating or refusing food?
0
4
14,8
9
36
Have you ever a serious physical 0
violence?
Did you ever apply a serious damage to 0
0
2
7,4
3
12
yourself?
Did you ever feel that there is no any 0
0
7
25,9
18
72
sense in life?
Do you often feel a worm of 2
33,3
12
44,4
20
80
conscience?
Have you had any head injuries?
0
0
8
29,6
15
60
6
Do you have a life-threatening hobbies 0
0
22,2
12
48
and habits?
Do you tend to unnecessary risk?
1
16,7
8
11
References:
1. UKRSTAT. 2010 - 2015. Database of the State Statistics Committee of Ukraine. http://www.ukrstat.gov.ua.
2. Yuryeva L.N. A suicide situation in Ukraine: Realities and Prospects / L.N. Yuryeva // Ukrains'kyi Visnyk Psykhonevrolohii. 2007. V. 15, no. 1 (50).
P. 34-36.
3. Yuryeva L.N. Dynamics of suicides in Ukraine and its regional characteristics /
L.N. Yuryeva, E.N. Zinchenko, A.E. Yuryev // Psihchne Zdorovye. 2010.
Is. 2 (27). P. 75-78.
4. Yuryeva L.N.
A.E. Yuryev // Ukrains'kyi Visnyk Psykhonevrolohii. 2012. Vol. 20, Is. 3 (72).
P. 239.
189
5. Wrono E.M. Suicidology of the Ukraine - a little history / E.M. Wrono // Journal of
Applied Psychology and Psychoanalysis. 2014. 1-2. P. 21.
6. Yuryeva L. Rural-Urban Variation in Suicide Rates // Suicide in Eastern Europe,
the CIS, and the Baltic Countries: Social and Public Healt Determinants A
Foundation for Designing Interventions Summary of a Conference. 2013.
P. 5464.
7. Varnik A. Do alcohol restrictions reduce suicide mortality? / Varnik A., Kolves K.,
Vali M., Tooding L.M., Wasserman D. // Addiction. 2007. 102(2). . 251-256.
8. Wasserman D. Suicide-preventive effects of perestroika in the former USSR: the
role of alcohol restriction / Wasserman D., Varnik A. // Acta Psychiatr. Scand.
1998. Suppl. 394. . 14.
9. Razvodovsky Y.E. Medical and social aspects of alcoholism. Grodno, 2005.
128 p.
10. Razvodovsky Y.E. Alcohol and suicide: aspects of the relationship / Y.E. Razvodovsky, S.V. Kondrichin // Psychiatry. 2010. 2. P. 4-8.
11. Wasserman D. Female suicides and alcohol consumption during perestroika in the
former USSR / Wasserman D., Varnik ., Eklund G. // Acta Psychiatr. Scand.
1998. Suppl. 394. . 2633.
12. Linskyy I.V. Completed suicide attemps made in alcoholic intoxication for the
period of 2008-2010 / I.V. Lynskyy, A.M. Bacherykov, E.G. Matuzok, R.V. Lakynskyy, T.V. Tkachenko // Dovzhenkivski readings: "Rehabilitation and reintegration of persons with depending states of different origin". 2012. P. 91.
13. Merinov A.V. Auto-aggressive behavior and assessment of suicidal risk in patients
with alcohol dependence and their families: Author. dis. ... D. med. sciences:
01.14.27 - narcology, 14.01.06 - psychiatry / Merinov Alexey; Acad. I.P. Pavlov
Ryazan State Medical University. Moscow, 2012. 46 p.
190
,
,
.
: (),
, , , .
Early diagnostics of inactive adenomas of hypophysis (IAH) relates to difficult
questions of modern neuroendocrinology as even high-informative computer
tomographs (CT) and magnetic resonance tomographs (MRT) and also clinicallaboratory, immunofermental - hormonal researches do not provide the right answer in
30-55% of cases, and atmicroadenomas (the tumor sizes is up to 1 mm) in 90-100%
191
of cases [8,10,12]. At a stage of microadenoma IAHs are seldom diagnosed and more
often casually found [4,6,13]. The diagnosis is, as a rule, verified when adenoma
already reaches aconsiderable size, causing sight violations, headache and other
neurologic symptoms connected with an invasion of tumor in the cavity of skull and
structure of the basis of skull [1,5]. As references show IAH is met in 25-43% of
hypophysial adenomas and up to 10% of all intracranial tumors [4,8,9]. Due to the
progress of medical genetics, molecular biology there was a possibility to expand the
pathogenesis representation of IAH [2,3,7]. Molecular and genetic researches
established that up to 5% of IAH cases refer to genetically predisposed people [11,22].
At the same time in literature there is practically no comparative data on clinical flow
and disease diagnostics in populations between sporadic and family IAH disease
[2,12]. Researches implementation in this direction will allow to improve preclinical
diagnostics, to differentially approach to tactics of treatment of IAH patients.
Due to the foregoing the research objective was to study features of clinical
semiology, their value for differential diagnostics in population of patients with the
sporadic and family IAH anamnesis.
Materials and methods. Researches were implemented on the basis of the
Republican specialized scientific practical medical center of obstetrics and
gynaecology from 2007 to 2013 (the director is MD, professor S.I.Ismailov). The
inspection included 71 IAH patients with intracellar adenoma of a hypophysis - the
tumor sizes were from 1 and more mm. The IAH diagnosis was verified on the basis
of the carefully collected anamnesis, studying of dynamics of course of the disease,
results of a magnetic and resonant tomography and also enzyme linked
immunosorbent assay-definitions of the contents of hypophysial hormones: prolactin,
luteinizing hormone, follicle stimulating hormone, somatotropin, adrenocorticotropic
hormone and thyrotropin, in blood serum. In IAH diagnostics an important place in our
researches is occupied by the family anamnesis collection for establishment of
hereditary predisposition to this disease. The family anamnesis found out by means of
the standard questionnaire Familyanamnesis - the isolated forms of adenoma of a
hypophysis (Familial isolated Pituitary Adenomas - FIPA, WHO - 2005) [14,16]. At the
same time similar effect can cause and environment [20,21] factors. Increase of IAH
cases among relatives can be approved by total action of adverse factors of internal
and environment where as at IAH patients woth sporadic form in most cases by action
of aggressive factors of the environment [8,17,18]. IAH cases registered at relatives of
192
relationship of degree I (parents, brothers and sisters, children). The family anamnesis
considered burdened at existence at the patient of the 2nd struck relatives or more.
Patients were criteria of an exception of IAH inspection is with prolactins,
comatotropins, gonadotropins, syndrome of Itsenko-Kushing, tireotropins, gipogonadism and acromegaliya, patients after beam therapy and accompanying diseases
of endocrine systems, including with diabetes, and also with multiple endocrine
neoplaziya (MENI) and CNC which arise inconnection with a mutation in MENI and
PRKAPIA genes respectively [2,15,23]. Assessment of a clinical picture at IAH patients
carried out by the analysis of the main complaints to the moment of establishment of a
disease. Thus adhered to E.I.Marova's marked out in the monograph offered
scheme questionnaire [5]. At clinical inspection special attention turned on such
violations as visual: decrease in visual acuity, restriction of fields of vision,
doubling in eyes, dacryagogue; disorder of sexual function: at women amenoreya, violation of a menstrual cycle (oligomenoreya, oligopsomenoreya),
galactoreya, superfluous growth of hair, at men - decrease in a libido or
impotence, prostatitis, orchitis. Neurologic violations: headaches, dream violation,
dizziness, violations of sense of smell, decrease in memory, apathy. The
general: thirst, weakness and fatigue, increase in weight of a body, drowsiness,
vegetative crises. It should be noted that at IAH patients symptoms, a clinical picture
which demanded participation of various experts came to light. In this regard for
specification of the IAH diagnosis, except the neuroendocrinologist,
parti-
193
As a result of the analysis of the received data it is established that at IAH patients
seldom meets separate symptoms, more often they are combined and/or more come
to light a disease of many symptoms - on 3-5 symptoms at the same time. The
combination of 2-3 symptoms of a disease in l-group is revealed at 17 (34,0%), a of
many symptoms at 20 (40,0%) and many symptoms at 13 (26,0%). In 2-group the
combination of 2-3 symptoms is revealed at 7 (33,3%), of many symptoms at 13
(61,9%) and of many symptoms at 1 (4,8%). Both in the lst, and in the 2nd group at
IAH patients important clinical manifestations were - sexual violations at 64 and 90,5%,
decrease in sight - at 36 and 76,2%, headaches - at 54 and 80,9%, lack of periods 22,0 and 28,0%, violation of a menstrual cycle - at 18,0 and 23,8% at the age of women
till 50 years, and at men till 55 years - violation of sexual functions - at 24,0 and 38,1%.
At women of 1-group duration of a disease meets till 20 and more than 21 years 28
and 20% more often, the similar picture in this group is noted and at men - at 20 and
12,5%. In 2-group among women till 5, 10 years respectively 14,3 and 28,6%, and
among men also 5 (19,0%), to 10 - 9,5%, till 20 years - at 14,3%. On the size of a
tumor of a hypophysis at patients with inactive adenoma in l-group come to light to 10
and 20 mm, at women - 34 and 16,0%, so at men - 26,0 and 18,0%, where as at
patients of 2-groups both at women, and at men - to 20 and huge 28,6-19,0% and 9,533,3% (table 1).
It should be noted that at patients of 2-group with hereditary IAH signs is more
often than at patients of l-group - without hereditary signs prevail frequency of clinical
signs, such as sexual violations - 26,5%, decrease in sight - for 40,2%, headaches for 26,5%, doubling in eyes - for 15,0%, visual discomfort - for 12,5%, olfactory
violations - for 19,8%, vegetative crises - for 12,3%, on duration of a disease among
women till 5 and 20 years - for 12,3 and 24,6%, but to a lesser extent till 20 and more
than 21 years - for 23,2 and 15,2%, and among men of such difference it is not
revealed. On the size of a tumor to 20 mm and huge women of 2-groups and to a lesser
extent to 10 mm - for 29,2% more often prevailed, and among men in 2-group the sizes
of a tumor to 10 mm - it is less than in 1-group - for 21,2%, and with huge, on the
contrary it is more - for 31,3%. Undoubtedly, on frequency of clinical symptoms of a
IAH disease the sizes of a tumor influenced.
194
Table 1
Symptoms of a disease in the analysis of patient's records at IAH patients
in studied groups in comparative aspect
Symptom
n=50
n=21
abs
abs
,%
2-1
Sexual disorders
32
64.0
19
90.5
+26,5
Decreased vision
18
36,0
16
76,2
+40,2
Headaches
27
54,0
17
80,9
+26,9
2,0
9.5
+7,5
Double vision
4.0
19,0
+15,0
Lacrimation
4,0
9,5
+5,5
Visual discomfort
2,0
14,3
+12,3
Olfactory violation
4,0
23,9
+19,9
Vegetative crises
2,0
14,3
+12,3
4,8
+4,9
Liquorrhea
4,8
+4,8
menstrual cycle
18,0
23,8
+5,8
amenorrhea
11
22,0
28,6
+6,6
12
24,0
38,1
+14,1
- women:
2,0
14,3
+12,3
under 5
4,0
28,6
+24,6
under 10
13
26,0
4,8
-21,2
under 20
10
20,0
4,8
-15,2
- men:
6,0
19,0
+13,0
under 5
10,0
9,5
-0,5
under 10
10
20,0
14,3
-5,7
under 20
12,0
4,8
-7,2
>21
>21
195
17
34,0
4,8
-29,7
under 10
16,0
28,6
+12,6
>24
2,0
19,0
+17,0
- men:
13
26,0
4,8
-21,2
under 10
18,0
9,5
-8,5
>20
4,0
33,3
+29,3
giant
giant
A diplopia
Burnings in eyes
Dacryagogue
10,0
abs
abs
50,0
group n=2
group n=30
The second
The first
Lack of sigth
of vision
Restriction of fields
acuity
Decrease in visual
Disorders
Up to 10 mm
+40,0
2-1
%,
12
abs
5,9
5,9
5,9
70,6
group n=17
The first
abs
12,5
12,5
12,5
12,5
87,5
group n=8
The second
>10 mm
+6,6
+12,5
+6,6
+6,6
+16,9
2-1
%,
abs
33,3
33,3
33,3
100,0
group n=3
The first
abs
9,1
9,1
27,3
9,1
9,1
72,7
group n=11
The second
Giant
-24,2
+9,1
-6,0
+9,1
-24,2
-27,3
2-1
%,
Comparative these frequencies of complaints to visual violations at IAH patients in groups, depending on the size of a tumor
Table 2
196
Cambridge Journal of Education and Science
197
hair
or impotence
Decreased libido 3
Men:
growth
Excessive
Galactorrhea
eya)
oligoopsomenor
(oligomenorrhea
Menstrual
disorders
10,0
16,6
10,0
abs
50,0
50,0
group n=2
group n=30
abs
The second
The first
Amenorrhea
Women:
Disorders
Up to 10 mm
+40.0
+33,4
-10,0
%2-1
abs
47,1
11,8
23,5
35,3
n=17
abs
25,0
37,5
50,0
25,0
group n=8
The second
>10 mm
-22,1
+26,7
+26,5
-10,3
%2-1
abs
33,3
66,7
group n=3
The first
abs
45,5
9,1
36,4
group n=11
The second
Giant
+12,2
+9,1
-30,3
%2-1
Comparative these frequencies of complaints to sexual disorders at IAH patients in groups, depending on the size of a tumor
Table 3
198
Cambridge Journal of Education and Science
199
14
Sleep disorders
Dizziness
Anosmia
Loss of memory
Apathy
46,7
abs
50,0
50,0
group n=2
group n=30
abs
The second
The first
Headaches
Disorders
Up to 10 mm
+50,0
+3,0
%2-1
10
abs
11,8
17,6
58,8
n=17
abs
12,5
12.5
50.0
62,8
62,8
group n=8
The second
>10 mm
+12,5
+12,5
+38,2
+45,2
+4,0
%2-1
abs
100,0
66,7
100,0
group n=3
The first
11
11
11
abs
9,1
9,1
9,1
100,0
100,0
100,0
group n=11
The second
Giant
+9,1
+9,1
9,1
+33,3
%2-1
Comparative these frequencies of complaints to neurologic disorders at IAH patients in groups, depending on the size of a tumor
Table 4
200
Cambridge Journal of Education and Science
Vegetative crises
Decrease AP
Drowsiness
of a body
Decrease in weight
a body
Weakness, fatigue
Increase in weight of
3,33
10,0
23,3
100,0
50,0
100,0
abs
abs
group n=2
group n=30
The second
The first
Thirst
Disorders
Up to 10 mm
+96,7
+40,0
+76,7
2-1
%,
abs
17,6
11,8
11,8
11,8
52,9
5,9
n=17
abs
62,5
12,5
25,0
50,0
37,5
75,0
37,5
group n=8
The second
>10 mm
+44,9
+12,5
+13,2
+38,2
+25,7
+22,1
+31,6
2-1
%,
abs
66,7
33,3
33,3
100,0
33,3
group n=3
The first
11
abs
81,8
45,5
18,2
18,2
18,2
100,0
36,4
group n=11
The second
Giant
+15,1
+12,2
+18,2
+18,2
+18,2
+3,1
2-1
%,
Comparative these frequencies of complaints to all-somatic disorders at IAH patients in groups, depending on the size a tumor
Table 5
201
202
203
204
- visual, sexual, headaches, vegetative crises, a climax come aged till 20-25
years, and time of establishment of the diagnosis - 10-20 years;
- adenomas > 10 mm which progress quicker, in huge adenomas, with the heavy
course of a disease more often come to light, than at patients from the single is IAH;
- the IAH family form and development of clinical symptoms at early age should
be object of diagnostic screening and be considered as one of modifying factors of
emergence of this disease.
References:
1. Wachs V.V. Inactive pituitary adenomas // Neuroendocrinology: Clinical Essays,
ed.prof. EI Marovo. - Yaroslavl: DIA Press, 1999. - P. 276 - 307.
2. Dedov I.I., Zubkov N.A., Arbatskaya N.Y. and other. MODY type 2: clinical and
molecular genetic characteristics of l3 cases. The first description of MODY in
Russia // Problems. Endocrinol. - 2009. 3. - P. 3-7.
3. Dedov I.I., Wachs V.V. Molecular and genetic aspects of the pathogenesis of
pituitary tumors // Actual problems of Neuroendocrinology: Proc. Proceedings of
the 3rd All-Russia. Scientific and practical. Conf. - M., 2003. - P. 3-5.
4. Kadashev B.A. Pituitary adenomas: clinical features, diagnosis, treatment. Moscow-Tver, LLC "Triad X", 2007. - P. 368.
5. Marova E.I. Neuroendocrinology. - Yaroslavl, 1999. - P. 506.
6. Simonenko V.B., Dulin P.A., Makanich M.A. Neuroendocrine tumor management.
- Moscow: GEOTAR - Media. - 2010. - P. 240.
7. Tyulpakov A.N. The role of molecular genetics in the diagnosis and treatment of
endocrine disorders. Brief description of monogenic forms of inherited endocrinopathies diagnosed in the Federal Enz 15-year period (1996-2010) //
Problems. Endocrinol. - 2011. - 1. - P. 26-34.
8. Endocrinology / Henry M. Kronenberg, Shlomo Melmed, Kenneth S. Polonsky, P,
Reed Larsen / Trans. from English. ed. I.I. Dedova, G.A. Melnichenko. - M.: OOO
"Reed Elsevier", 2010. - P. 427.
9. Agha A., Thornton E., O'Kelly P. et al. Posterior pituitary dysfunction after traumatic
brain injury // J. Clin. Endocrinol. Metab. - 2004. - Vol. 89. - P. 5987-5992.
10. Alexandr J.M., Bikkal B.M., Zerwas N.T. Clinical nonfunctioning pituitary tumors
are monoclonal in origin // J.Clin. Invest. - 2009. - Vol. 86, 1. - P. 336-340.
205
11. And the Comparative Risk Assessment Collaborating Group Selected major risk
factorand global and regional burden / M. Ezzati, A. Lopez, A. Rodgers et al. //
Lancet. - 2002. - Vol. 360. - P. 1347-1360.
12. Arafah B.M., Nasrallan M.R. Pituitary tumors: pathophisiology, clinical manifesttations and management // Endocrinol. Relaf. Cancer. - 2001. - Vol. 4. - P. 287305.
13. Beckers A. C.D. Pituitary adenomas // Graph. Med. Ltd. - 2007. - P. 367-481.
14. Beeckers A., Daly A.F. The clinical, pathological, and genetic features of familial
isolated pituitary adenomas // Europ. J. Endocrinol. - 2007. - Vol. 157, 4. P. 371-382.
15. Chahal H.S. Familial isolated pituitary adenomas // Turop. Endocrinol. - 2009. Vol. 1. - P. 2638-2640.
16. Daly A.F., Vanbellinghev J.F., Rhoo S.K. et al. Aryl hydrocarbon receptorinteracting protein gene vutations in familial isolated pituitary adenomas: analysis
in 73 families // J. Clin. Endocrinol. Metab. - 2007. - Vol. 92, 5. P. 1917-1919.
17. Doherty G.M., Thompson N.W. Multiple endocrine neoplasma type 1: duodenopancreatic tumors // J. Surg. Oncol. - 2005. - Vol. 89. - P. 143-150.
18. Krages W., Schaaf L., Dralle H., Bjehm B.O. Clinical and molecular diagnosis of
multiple endocrine neoplasma type 1 // Langenbeck. Arch. Surg. - 2002. - Vol. 386.
P. 547-552.
19. Marini F., Falchetti A., Monte F. Del. et al. Multiple endocrine neoplasma type 1 //
Orphanet. J. Rare. - 2006. - Vol. 2. - P. 1-38.
20. Mekted S. Update in pituitary disease // J. Clin. Endocrinol. Metab. - 2008. Vol. 93,2. - P. 331-338.
206
207
and the age of one year) is 2 per 1000 liveborns in Iceland while in Mozambique it is
120 per 1000 live-births [3]. There are 316 deaths per 1000 liveborns in Sierra Leone
as compared to 5 deaths per 1000 liveborns in Japan and 4 deaths per 1000 liveborns
in Finland [3]. The evidence on the child health and life opportunity inequality
throughout the world is alarming indeed: in Chad, every fifth child dies before they
reach the age of 5, while in the European Region, the under-five mortality rate is 13
out of 1000 [3]. The WHO insists that such an alarming difference in health has no
genetic or biological grounds; hence, this disparity is socially caused.
It is necessary to bear in mind that pronounced health disparities can be easily
found within developed countries as well. The report released by World Vision in 2013,
The Killer Gap: A Global Index of Health Inequality for Children, sheds light on the
problem of child health inequality throughout the world. The report has ranked 176
countries according to the health service gap (including access to health services,
health awareness, life expectancy and other indicators). As a result, France is at the
top of the list, while Chad is at its bottom. The USA takes the 46th place which indicates
that a countrys wealth is not a guarantee of health equality [4].
The definitions of health, suggested by the World Health Organization in 1958
combines the physical, mental, and social spheres of our life, and in such a manner
constitutes the all-embracing formula of human existence: health is not merely the
absence of disease, but a state of complete physical, mental, spiritual and social
wellbeing [qtd. in 5]. It is necessary to observe that health status and socio-economic
conditions are closely associated. That is to say, socio-economic inequalities quite
often trigger numerous health disparities. Childrens health status largely depends to
household income, and in the process of growing-up this relationship becomes even
more distinct. The relatively worse health status of children proceeds into adulthood,
as they are most likely to have poorer work capability and opportunities, as well as loss
of wages due to increased number of sick leaves. In this context, A.Deaton remarks
that in the UK and the US, an additional inch of height comes with 1.5 to 2 percent
higher earnings [6]. That is to say, the correlation between low income and health
becomes steeper throughout the career development. Low family income prevents
children from developing their physical and cognitive potential. As a matter of fact,
children from poorer household arrive at the threshold of adulthood with lower health
status and educational attainment [6] the latter circumstance is partly conditioned
by poor health. Thus, educational status and poor health actually endanger their
208
earning power in adulthood [6]. The cumulative effects of negative conditions, such as
low income, poor housing, nutrition and limited health care aggravate the child health
status in the process of growing up. In addition to discomfort experienced in childhood,
abundant evidence suggests that exposure to inequality may have a detrimental
influence on health and well-being across the life course [7]. Thus, another important
issue that needs investigation is the life course perspective, that is, the effect of poverty
and health inequality on the entire life of a person.
Apart from its impact on physical health, lower socioeconomic status and
inequality can also affect mental health of children. V.Murali extensively discusses the
relationships between low socioeconomic status and increased incidence of mental
illness which recently has become apparent indeed. The scholars argue that children
from the poorest households are three times more susceptible to mental disorders than
children from the well-to-do families [8]. As a matter of fact, poverty and unemployment
can trigger personality disorders, emotional disturbance, as well as inclination to
alcohol and substances misuse, and even suicide [8]. The scholars have investigated
prevalence of psychiatric disorders according to social class (classes I, II, III, IV and
V). It is necessary to observe that the prevalence of psychiatric disorders within the
lowest social class (class V) is striking indeed (depressive disorder: 9 % in class I;
35 % in class V; phobia: 2 % in class I; 13 % in class V; obsessive-compulsive disorder:
6 % in class I; 21 % in class V; panic disorder: 1% in class I; 12 % in class V; functional
psychosis: 4 % in class I; 17 % in class V; alcohol dependence: 33 % in class I; 73 %
in class V; drug dependence: 7 % in class I; 50 % in class V) [8].
In 2013, British Medical Association published a report as to the child health
status in the UK. As the report demonstrates, after the application of numerous tackling
policies, the situation is improving. The report extensively discusses the current
problem of child health inequality as compared to the situation at the end of the 90s.
As a matter of fact, in 1999, the United Kingdom ranked the third in child poverty among
the industrialised countries (behind United States and Russia); it also ranked behind
Germany, France, Japan, Slovenia and Singapore in terms of early childhood deaths
(the UK took the 18th place). Moreover, the rate of infant mortality in class V (the
poorest families) was 70 percent higher than in those from social class I; the average
birth weight in families from class V was 115 grams lighter than in those from class I
and so on [9]. Thus, despite the fact that the UK is one of the richest countries in the
world, the child well-being remains quite a problem. According to the 2013 BMA report,
209
there are quite alarming examples of socioeconomic and health inequalities in the UK.
For instance, the life expectancy of a boy born in Chelsea or Kensington is over 84
years, while it is only 75 years for a boy from Islington which is actually less than five
miles away. Furthermore, the 2003 Childrens Dental Survey demonstrates that in
classes IV and V 13 percent of five year olds never undergone dentists examination,
as compared to 2 percent in classes I, II and III [9]. That is to say, BMA aspires to
reveal the inconsistencies within the NHS system and suggests the ways to eliminate
them.
There is an extended debate as to the potential of policies in addressing health
inequalities. J.Kronenfeld argues that health services (both preventive and therapeutical) are able to improve the health status in disadvantaged groups [5]. For
instance, numerous public health nursing programmes (Equally Well; Healthier,
Wealthier Children; The Family Nurse Partnership and the like) are aimed at
supporting poor families and thus tackling child health inequality. Indeed, elimination
of child health inequalities requires multiple actions on the part of health services. It is
essential to render health services more accessible, to raise their awareness of the
problems which poor families usually face.
Meanwhile, the opposing viewpoint asserts that a much broader context must
be taken into account. For instance, the World Health Organization advocates the
intersectoral approach in overcoming the problem of health inequalities [10]. The WHO
emphasizes the necessity of reducing the inequalities in health in a number of
documents. For instance, Health-for-All Policy for the 21st century explicitly
advocates the intersectoral collaboration, promotion of equal health care opportunities,
community participation and sustainable development. In the UK, the activity of NHS
demonstrates commitment to intersectoral plan of actions. One of its core principles is
based on the acknowledgment that good health largely depends on environmental,
economic and social factors (for instance, housing, nutrition and education). Therefore,
the NHS is committed to work with other public services to intervene not just after but
before ill health occurs [11]. The Child Poverty Strategy, implemented by the UK
government propels a sustainable approach to reducing child health inequality with
due consideration of a wide range of factors (for instance, home environment and
education) [1]. In fact, poor health status of children can be attributed to education
within the family, since more educated people can utilize health information more
210
effectively. Lower socioeconomic status can also be associated with risky behaviours,
such as immoderate drinking, smoking, lack of exercise and obesity [6].
The BMA also stimulates the cross-professional approach to the problem of
child health inequality: their reports are essentially multidisciplinary, involving experts
from different spheres of activity. In recent years, the BMA has produced a number of
effective recommendations and reports, for instance, Getting it Right for Children and
Young People (2010) report which claims that NHS needs greater integration;
Growing up in Scotland (2011); Nurturing Children, Supporting Families childcare
policy statement (2011); The Children and Young Peoples Health Outcomes Forum
(2012) and many others. Moreover, the BMA advocates the so-called life-course
approach to this problem. That is to say, child health needs to be controlled even before
conception, as well as throughout the life. It is common knowledge that low birth weight
is one of the primary causes of infant mortality. Therefore, under-18 mothers from poor
households and other categories of disadvantaged young women need special
education and control. It is essential to provide teenagers with health education as to
their lifestyles and habits (such as harm of smoking during pregnancy). For instance,
such programmes as Governments Teenage Pregnancy Strategy are aimed at
helping teenagers to avoid early pregnancy. Since the launch of this programme in
1999, the rate of under-18 conception has decreased from 46.6 per 1,000 live births
(1998) to 40.5 per 1000 live births (2008) [9].
It is thus obvious that health inequality cannot be addressed by separate and
narrow policies. Instead, government-directed strategies that combine economic
development and active social policies are needed [12]. The integrated approach to
the problem of child health inequality should embrace the structural changes in
economies that will promote employment; stimulation of labour demand and generation
of new workplaces; distribution of tax credits and subsidies; government investments
in skills development, education, extension services and infrastructure. In the context
of multidisciplinary approach to the problem of child health inequality, A.Deaton
emphasizes the benefits of economists participation [6]. From the economists
position, child health inequality can be eliminated through the measures and
mechanisms, related to education, parental earnings and labour force participation, for
instance, discount rates in the sphere of education [6].
Thus, child health inequality is a burning problem of the 21st century which must
be settled with urgent steps and multidisciplinary policies. In fact, these issues demand
discussion and streamlining both at national and international levels. By means of the
211
collaborative approach, strategies of comparison and contrasting, the countries all over
the world will be able to find a reasonable way out of these problems. Currently, there
are numerous policy options as to the reducing health inequalities. Most initiatives do
not focus exclusively on health service, but deal with problems in education,
employment and social security as root causes of child health inequalities. In other
words, numerous social, educational, occupational, environmental and community
service measures are important factors of promoting health and well-being of children.
Thus, the policy options are by no means limited to the measures within the health
care system. Through the application of intersectoral plan of actions, one can achieve
the long-term effects on health status of children.
References:
1. Report on Health Inequalities in the European Union. Brussels, 2013. P. 38-39.
2. World Health Organization. Monitoring Inequality: An Emerging Priority for Health
Post-2015. Geneva, 2015. P. 27.
3. Marmot M. Social determinants of Health Inequalities // The Lancet. 2005. 365.
P. 1104.
4. The Killer Gap: A Global Index of Health Inequality for Children. London, 2013.
P. 14.
5. Kronenfeld J.J. Health Care Policy: Issues and Trends. Westport, 2002. P. 157.
6. Deaton A. What Does the Empirical Evidence Tell Us About the Injustice of Health
Inequalities? // Inequalities in Health: Concepts, Measures and Ethics. Oxford,
2013. P. 270.
7. Emerson E. Relative Child Poverty, Income Inequality, Wealth, and Health // The
Journal of the American Medical Association. 2009. 301(4). P. 425.
8. Murali V. Poverty, Social Inequality and Mental Health // Advances in Psychiatric
Treatment. 2004. 10. P. 224.
9. British Medical Association. Growing Up in Britain: Ensuring a Healthy Future For
Our Children. London, 2013. P. 155.
10. World Health Organization. Social Determinants of Health. Geneva, 2013. P. 12.
11. Gordon D. Wales NHS Resource Allocation Review. Independent Report of the
Research Team. Cardiff, 2001. P. 24.
12. Cook S. Combating Poverty & Inequality: Structural Change, Social Policy and
Politics. New York, 2011. P. 2.
212
213
214
61
80
%
60
39
40
22
11
20
0
89
78
100
under 1 year
girls
215
80
72
70
53
60
% 50
40
47
50 50
57
43
28
30
20
10
0
boys under 1
year
girls under 1
year
manifesting form
boys from 1
to 3 years
girls from 1 to
3 years
asymptomatic form
216
carbapenems
glycopeptides
cephalosporins
100
80
60
40
20
0
217
flourquinolones
aminoglycosides
macrolides
linosamines
penicillins
tetracyclines
Klebsiella pneumoniae
S.aureus
P.mirabilis
S.pyogenes
E.coli
P.vulgaris
P.aeruginosa
218
carbapenems
glycopeptides
macrolides
penicillins
tetracyclines
linosamines
aminoglycosi
flourquinolones
cephalosporins
Klebsiella pneumoniae
S.aureus
P.mirabilis
S.pyogenes
E.coli
P.vulgaris
P.aeruginosa
infection
in
long-term
management. NICE guideline. - London (UK): National Institute for Health and
Clinical Excellence, 2007. - 30 p.
2. Shaikh N., Hoberman A. Acute management, imaging, and prognosis of urinary
tract infections in children // Retrieved. - 2010. - www.uptodate.com/online/
content/topic.do.
3. Gruzina V.D. Communication signals of bacteria / Gruzina V.D. // Antibotics and
Chemotherapy. 2003. 48 (10). P. 32-39.
4. Ilyina T.S. Biofilms as a way of existence of bacteria in the environment and the
host organism: the phenomenon of genetic control and regulation systems for their
development / Ilyina T.S., Romanova Y.M., Ginzburg A.L. / Genetics. 2004.
40 (11). P. 1-12.
219
220
221
for the population normal defense mechanisms of the lungs, leading to the formation
of bronchopulmonary diseases [6].
The prevalence of respiratory diseases among both children and adults, is the
actual problem of modern medicine.
In the recent years there has been observed a steady trend towards the
occurrence and total spread of the systemic diseases of the respiratory organs, in
most cases having become chronic, relapsing course. The questions of timely
supplying patients with necessary medicines resolve the prognosis of disease.
The object of the study. The study used information of the Institute of Health
and Medical Statistics on these diseases. Patients with chronic obstructive pulmonary disease hospitalized in the Republican Specialized Scientific and Practical
Medical Center of Tuberculosis and Pulmonology after S. Alimov. Initial information
included the medical history and hospital records of patients.
Methods of research. In the course of scientific research there have been
used conventional modern methodology and methods: comparative, logical, analytical, correlation, regression, mathematical analysis.
Scientific novelty. The results of prognosis for the growth of respiratory
diseases in Uzbekistan until 2023. Using comparative analysis of outpatients and
medical history assessed the structure and major comorbidities were presented.
Identification of the severity of patients health state, concomitant pathology was
made on the basis of the results of analysis of case records.
The reliability of the results is confirmed by the fact that all comparative
statistics were processed using information and computer technologies.
The purpose of the study. On the basis of statistical data to explore the
prevalence of respiratory diseases and to forecast to 2023. Analyze of the hospital
records and medical history of patients with chronic obstructive pulmonary disease.
Materials
and
methods.
The
epidemiology
of
respiratory
diseases
cannot be considered favorable, since these diseases are quite common among
the population. Increased risk of morbidity in childhood justifies the need for
improved analytical methods for studying the dynamics of respiratory diseases.
One way to improve the effectiveness of anti-epidemiological service of the
population is the scientific validity of the planning of preventive measures. The bases
222
for the development of targeted plans are the results of a retrospective epidemiological analysis and prediction of disease.
For short-term forecasts of annual incidence, rates prompted 2 methodical
approaches. 1. Forecasting using methods of determining "maximum stability". 2.
The regression equation.
Algorithm and analysis of the parametric prognosis are as follows. Under the
parametric prognosis in this case the prognosis of the function is considered, the
argument of which varies as a discrete variable with a constant step rate. When
predicting changes in incidence over the time the elements of this vector must be
numeric values of illness measured at regular intervals, namely a year. A number of
annual incidence rates, showing the change of a phenomenon in time, is a dynamic
series [2, 3].
Through statistical analysis of time series there have been resolved following
tasks:
Identification and description of the characteristic phenomena of trends over
time;
The selection of a statistical model describing these changes;
The search for the missing intermediate values (interpolation) on the basis of
existing indicators;
Prediction based on the available results of future values (extrapolation) of the
analyzed series.
A characteristic feature of time series as an independent variable X the time
factor stands, and the dependent Y changing the dependence relationship between
variables X and Y is one-sided, because the time factor does not depend on the
variability of symptoms.
Graphics of time series are not going smoothly, and the broken lines, as,
together with the main reasons that determine the general pattern of variation in
signs to increase them the numerous secondary causes influence inducing random
fluctuations: natural disasters, changes in diet, environmental degradation, accidental
emissions of harmful substances, epidemics and so on. To identify the main trend of
the conjugate variation of features and to average the influence of random factors it
is necessary to align the values of time series, i.e. the broken lines there should be
replaced by smooth, gradually running line.
One of the most effective approaches is considered the alignment of time
series by the method of least squares. According to this method with an infinite
223
number of lines which could theoretically be drawn between the points representing
the original series only one line is selected, which would have the smallest sum of
squares of the deviations of the datum points from the theoretical straight line:
(x
x ) 2 min
Q ( yi yx ) 2 ( yi f ( x))2 Qmin
Calculating according to the principles of mathematical analysis the minimum
of this expression, transforming it, you can get a system of normal equations in which
the required parameters of the regression equation appeared to be the unknown
values, and the known coefficients are determined by the empirical values of
features, usually by sums of their values and their cross derivatives.
The equation of a straight line or a parabola of the 1 order can be expressed
as deviations of the terms of the series from their average values:
y x y byx ( x x ); x y x bxy ( y y )
y x y byx ( xi x ); x y x bxy ( yi y )
The system of normal equations for the determination of the parameters a and
b will be the following:
an b ( xi x ) y
a ( xi x ) b ( xi x ) 2 y( xi x )
Since
224
y y
y( x x )
(x x)
(1)
(2)
chronic
and
20000
15000
10000
5000
0
2000
2001
2002
2003
2004
2005
2006
2007
Navoiyskaya area
Samapkandskaya area
Supxandapinskaya area
Sypdapinskaya area
2008
2009
225
Year
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
23973
24471
24888
24388
23111
23747
22897
24179
24215
23931
22732
25283
24813
23219
12361
12681
12723
12601
13172
13038
12677
12646
13090
12774
12491
12129
12331
12417
16482
15381
15972
16789
17241
17095
18032
18421
18849
17387
13544
12674
13780
12428
7616
6065
6308
6874
7384
8784
10305
11014
12051
10380
10413
12183
15594
16724
16500
14943
15739
17593
17348
18476
18572
18044
16598
15718
16388
16820
15971
15978
17951
17115
15031
21511
23780
23206
22806
22819
19258
19471
19229
17425
19739
18467
28369
28556
29914
25458
22742
26891
19069
22398
20701
12964
13668
19317
19124
18804
9130
9814
13030
15421
15580
11231
11826
12111
12463
13220
13056
13947
13879
14770
14767
16111
12738
12694
12218
12046
12051
13190
13487
12766
13277
13912
16191
17913
10176
9169
9388
9818
10306
11294
12154
12774
12822
13192
13003
13291
14733
14796
18507
18471
18876
17564
17858
17392
14923
15208
14267
15021
13784
14269
16789
17902
17534
19149
16977
19627
18330
17057
16964
19330
19104
18111
22989
19861
21026
23245
226
Xorezmskaya
area
The Republic of
Karakalpakstan
The Republic of
Uzbekistan
18861
19157
16468
16479
16555
16350
19021
18392
18322
18907
17658
16903
16977
21703
18884
17887
15136
14225
13895
12825
12427
11706
11615
11350
14238
14640
17891
20270
16889
16944
16734
17140
16825
16599
15951
16659
16328
15442
15741
16207
17106
17864
100000
The Republic of
Uzbekistan
80000
Fepganskaya area
60000
Navoiyskaya area
40000
Buxapskaya area
20000
City Tashkent
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
Figure 2. Morbidity due to the respiratory organ diseases per 100 thousand
population (In absolute terms)
The next stage of research was to predict the spread of respiratory diseases in
the Republic of Uzbekistan.
When aligning the dynamic series, we used the statistical data on the
incidence of respiratory population of Tashkent for the years 2000-2013 (Table 1).
In this case, the arithmetic mean value of the independent variable defined by
the time point designated natural numbers:
1 14
7,5
2
227
y 335847
23989,1 (2. 10)
a i
14
n
b
y ( xi x ) 3646
)
x
x
i
y x 23989,1 16,02( xi x )
Table 2
The dynamics of the spread of respiratory diseases among the population
of Tashkent city for the years 2000-2013 (per 100 thousand population)
Year
xi
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
1
2
3
4
5
6
7
8
9
10
11
12
13
14
105
The prevalence of
respiratory diseases, yi
23973
24471
24888
24388
23111
23747
22897
24179
24215
23931
22732
25283
24813
23219
335847
xi-x
y(xi-x)
(xi-x)2
yx
-6,5
-5,5
-4,5
-3,5
-2,5
-1,5
-0,5
0,5
1,5
2,5
3,5
4,5
5,5
6,5
-2E+05
-1E+05
-1E+05
-85358
-57778
-35621
-11449
12090
36323
59828
79562
113774
136472
150924
-3646
42,25
30,25
20,25
12,25
6,25
2,25
0,25
0,25
2,25
6,25
12,25
20,25
30,25
42,25
227,5
24093
24077
24061
24045
24029
24013
23997
23981
23965
23949
23933
23917
23901
23885
0,5
1,6
3,4
1,4
3,8
1,1
4,6
0,8
1,0
0,1
5,0
2,1
2,3
2,3
2,2
y x 23989,1 16,02( xi x )
Calculated according to this equation, the dependent variable is placed in the
last column of Table 2. A visual representation of this gives the figure 3, which shows
the calculated scrap and smoothly running line of this series.
Talk about the reliability of statistical forecasts of dynamics of any phenomena
can only be while maintaining the general trends, i.e. if there is a certain degree of
inertia effects.
This refers to the inertia of the relationships, which maintains the outline of the
mechanism of formation of the phenomenon, and the inertia of the nature of the
dynamics of the process (temperature, direction, stability) for a sufficiently long
period of time.
228
26000
25000
24000
23000
22000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Original Series
Aligned series
Year
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
City Tashkent
24093
24077
24061
24045
24029
24013
23997
23981
23965
23949
23933
23917
23901
23885
Andizhanskaya area
12811
12786
12762
12738
12713
12689
12664
12640
12616
12591
12567
12542
12518
12494
Buxarskaya area
17667
17412
17156
16900
16645
16389
16133
15878
15622
12366
15111
14855
14599
14344
Dzhizakskaya area
5458
6176
6893
7610
8328
9045
9762
10480
11197
11914
12632
13349
14066
14783
16885
16866
16847
16829
16810
16791
16773
16754
16735
16717
16698
16679
16661
16642
19732
19750
19767
19784
19801
19818
19835
19852
19869
19886
19903
19920
19937
19954
29092
28074
27056
26039
25021
24003
22986
21968
20950
19933
18915
17897
16880
15862
11364
11588
11812
12036
12260
12484
12708
12932
13156
13380
13604
13828
14052
14276
12888
13030
13172
13314
13456
13598
13740
13883
14025
14167
14309
14451
14593
14735
Kashkadarinskaya
area
Navoiyskaya area
Namanganskaya
area
Samarkandskaya
area
Surkhandarinskaya
area
Syrdarinskaya area
9089
9525
9961
10397
10833
11269
11705
12141
12576
13012
13448
13884
14320
14756
Tashkentskaya area
18167
17909
17651
17392
17134
16876
16617
16359
16100
15842
15584
15325
15067
14808
Ferganskaya area
17068
17401
17735
18068
18402
18736
19069
19403
19736
20070
20404
20737
21071
21404
Xorezmskaya area
17380
17472
17565
17658
17751
17843
17936
18029
18121
18214
18307
18400
18492
18585
14833
14826
14818
14811
14804
14796
14789
14781
14774
14766
14769
14751
14744
14737
16703
16688
16672
16657
16641
16625
16610
16594
16579
16563
16547
16532
16513
16501
The Republic of
Karakalpakstan
The Republic of
Uzbekistan
229
Table 4
The resulting smooth line can be extended to give a forecast for 2010-2023
Region
Year
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
City Tashkent
23869
23853
23837
23821
23805
23789
23773
23757
23741
23725
Andizhanskaya area
12444
12417
12390
12363
12337
12310
12283
12256
12229
12203
Buxapskaya area
14088
13832
13577
13321
13065
12810
12554
12298
12043
11787
Dzhizakskaya area
15515
16235
16955
17675
18395
19116
19836
20556
21276
21996
Kashkadapinskaya area
16623
16605
16586
16567
16549
16530
16511
16493
16474
16455
Navoiyskaya area
19971
19989
20006
20023
20040
20057
20074
20091
20108
20125
Namanganskaya area
14844
13827
12809
11791
10774
9756
8739
7721
6703
5686
Samapkandskaya area
14500
14724
14948
15172
15396
15620
15844
16068
16292
16516
Supxandapinskaya area
14877
15019
15161
15303
15445
15587
15729
15871
16013
16155
Sypdapinskaya area
15192
15627
16063
16499
16935
17371
17807
18243
18679
19114
Tashkentskaya area
14550
14292
14033
13775
13517
13258
13000
12741
12483
12225
Fepganskaya area
21738
22072
22405
22739
23073
23406
23740
24073
24407
24741
Xopezmskaya area
18678
18770
18863
18956
19048
19141
19234
19327
19419
19512
14729
14722
14714
14707
14699
14692
14684
14677
14670
14662
16485
16469
16454
16438
16423
16407
16391
16376
16360
16345
230
17,60%
31,40%
Mild form
The average form
Severe form
52,00%
231
References:
1. .., .., .., .. . . .
2010. 4. . 4547.
2. . - / . . , 1999.
459 .
3. .., .. - ( ). : - ,
2005. 84 .
4. . .
/ .
, 2013. . 240 .
5. ..
// ,
: .-. . , 2011.
. 200-201.
6. .., .., .., .. . // VII
. . 14 ( 34) 2010. . 130131.
7. .. . O`zbekiston tibbiyot jurnali. . 2006. 4. 26-.
232
233
associated with BMD (=0.086, P=0.01) and BMAD (=0.0075, P=0.002); however,
adjusting for insulin AUC explained this difference. Insulin AUC (=0.0006, P=0.029)
and fasting insulin (=0.0005, P=0.01) were positively associated with BMAD only in
AA adolescents. Insulin AUC and fasting insulin were not significant predictors of
BMD for adults.
Conclusion: The higher insulin concentration among AA adolescents is
associated with increased BMD and higher BMAD.
Keywords: bone mineral density; insulin secretion; ethnic differences; bone
mass.
1. INTRODUCTION
Insulin is considered to be an anabolic agent of bone by many authors [1-5].
However, recent investigations suggest a potential adverse influence of diabetes and
pre-diabetes on the bone [6,7]. It is also widely reported that African Americans (AA)
have a greater degree of insulin resistance compared to European Americans (EA)
[8], and puberty is a developmental state of increased insulin resistance [9].
Adolescence is considered to be the critical period during which the peak bone
mass is achieved [10]. Many studies have confirmed that AA have much higher bone
mineral density (BMD) and bone mineral content (BMC) than EA, beginning during
childhood and adolescence [11]. Hence it is important to understand the relationships
between insulin (especially insulin secretion and sensitivity) on BMC and BMD in
healthy adolescents and adults and to identify if are any ethnic differences in these
relationships. We hypothesized that the higher insulin concentrations will result in
better bone mass and this may be more pronounced in AA adolescents due to their
higher insulin concentrations. We also hypothesized that the effect of insulin will be
mediated in part by the fat mass.
Osteoporosis and related fractures are known to cause considerable morbidity
and financial burden [12]. Yet, even now, determinants of bone mass in adolescents
and young adults are not well known. An estimated 80% of the bone mass is
attributed to genetic factors, however, the remaining 20% of modifiable factors may
have a crucial role in regulation of bone mass and density [13,14]. The known
determinants of BMD and BMC are body weight, height, lean body mass, fat mass,
sex and race [1,15-18]. Dual-energy x-ray absorptiometry (DXA) is the most widely
used method for assessing BMD and is a well studied and verified surrogate
234
235
2.2 Methods
Body composition (fat and lean mass) and bone mass were assessed using
DXA (iDXA, GE-LUNAR Radiation Corp., Madison, WI). Bone mass, as measured by
DXA at whole body, is reported as bone mineral content (BMC) (grams) or areal
BMD (BMC/bone area g/cm2). Whole body bone mineral apparent density (BMAD,
g/cm3), was calculated according to the formula, BMC/[whole body mineral
area2/body height] [22,23]. Bioelectrical impedance analysis (BIA) was used to measure participants lean body mass using Tanita BC-418 segmental body composition
analyzer (Tanita Corporation, Arlington Heights, IL).
For each subject, a mixed meal tolerance test (MMTT) was performed using
Carnation Instant Breakfast prepared with whole milk in a dosage of 11.5 kcal/kg of
lean body mass (LBM) [1.75 gm/kg LBM of carbohydrate], followed by repeated
blood draws at baseline and at 5, 10, 15, 20, 25, 30, 45, 60, 90, 120, 150, and 180
minute after the start of meal ingestion. Plasma samples were stored at 80C until
assay.
2.3 Laboratory Analyses
Glucose was assayed in 10 l sera using a Sirrus analyzer (Stanbio, Boerne,
TX). The mean intra- and inter-assay coefficients of variation (c.v.) for glucose
analysis in the Core Laboratory are 1.28% and 1.53%, respectively. Insulin was
assayed by immunofluorescence on a TOSOH AIA-II analyzer (TOSOH Corp., South
San Francisco, CA); intra-assay CV of 1.5% and inter-assay CV of 4.4%. Wholebody insulin sensitivity was calculated as proposed by Matsuda et al. [24], where
WBISI = 10,000/ (fasting glucose x fasting insulin) x (mean glucose x mean insulin
during OGTT). The homeostatic model assessment of basal insulin resistance
(HOMA-IR) was calculated using the formula: HOMA-IR = [fasting insulin (U/ml)
fasting glucose (mmol/L)] / 22.5 [25,26]. Post-MMTT area under the curve (AUC) and
incremental AUC for insulin and glucose were calculated using the trapezoidal
method. [27]. The serum 25(OH)D assays were obtained commercially (Quest
Diagnostics, Nichols Institute, San Juan Capistrano, California), using Liquid
chromatography-tandem mass spectrometry (LC-MS/MS) methodology which is
considered to be the reference standard for 25(OH)D assay [28]. Serum PTH was
commercially assessed by a two-site immunoradiometric assay that detects intact
236
PTH (1-84) and the amino-terminally truncated PTH (7-84) fragments (normal range
10-65 pg/ml) (Quest Diagnostics Nichols Institute, San Juan Capistrano, California).
2.4 Statistical Analyses
Demographic and body composition characteristics were compared between
adults and adolescents as well as between EA and AA subjects. Chi-square (Fishers
exact when expected cell counts were <5) and Students t-test were used for
categorical and continuous variables, respectively. Spearman correlation coefficients
were used to assess collinearity between serum 25(OH)D with the other independent
variables. General linear models were used to assess the association of clinical
characteristics with BMD and BMAD. Separate multivariable linear regression models
were performed to adjust for potential confounders individually such as height, lean
mass, percent body fat, fasting insulin, insulin AUC. P0.05 was considered
statistically significant. Analyses were performed using SAS software (version 9.2;
SAS Institute, Cary, NC).
3. RESULTS
Table 1 illustrates the characteristics of adult and adolescent female subjects.
Compared to adults, healthy adolescent females had significantly higher insulin AUC
(P=0.0004), lower WBISI (P=0.0005) and higher fasting insulin (P=0.0002). Total fat
mass, percent body fat, serum 25(OH)D and BMD were not significantly different
between adults and adolescents. When both cohorts were stratified by race (Table 2),
there were no statistically significant differences in age, BMI, percent body fat, or Zscore between AA and EA adolescents or AA and EA adults. Serum 25(OH)D was
significantly lower among AA adolescents compared to EA adolescents (P<0.0001)
and among AA adults compared to EA adults (P=0.0003). There was no difference in
BMD Z-score between AA and EA adolescents or adults. The mean BMAD was
statistically higher among AA adolescents compared to EA adolescents (P=0.0024).
Spearman correlation coefficients between the independent variables and
25(OH)D (data not shown) demonstrate that there was a statistically significant
correlation between 25(OH)D with total fat mass (rho=-0.597 and percent body fat
(rho=-0.714) among EA adolescents. There were no significant correlations between
the independent variables and 25(OH)D among AA adolescents, AA adults or EA
adults. There was a moderately significant positive correlation between 25(OH)D with
237
BMD (rho=0.463, P=0.071) and with BMAD (rho=0.539, P=0.031) among AA adults
only. Among adolescents and adults, there were no statistically significant differences in
mean BMD or BMAD between those with serum 25(OH)D concentrations of 20 ng/ml or
30 ng/ml (data not shown).
Table1.1.Descriptive,
Descriptive, metabolic
metabolic and
characteristics
Table
andbone
bonemineral
mineral
characteristics
Variable
Age (yr)
Race: AA/EA
Body weight (kg)
Height (cm)
2
BMI (kg/m )
Region percent body fat
(%)
Lean mass (kg)
25(OH)D (ng/ml)
1,2
PTH (pg/ml)
Bone mineral content (gm)
Bone mineral density
2
(g/cm )
Whole body bone mineral
3
apparent density (g/cm )
Z-score
Insulin AUC (uIU/ml)
WBISI
Fasting insulin (uIU/ml)
Adults (N=29)
Mean SD or n (%)
31.7 8.8
16 (55.2)/ 13 (44.8)
66.9 14.0
165.6 6.5
24.3 4.2
32.4 7.4
Adolescents (N=49)
Mean SD or n (%)
15.7 1.4
33 (67.3)/ 16 (32.7)
62.7 12.2
164.7 7.0
23.1 4.0
29.7 5.9
0.18
0.59
0.22
0.070
41.7 5.3
23.3 10.7
-2543.2 380.3
1.2 0.1
41.03 6.0
19.3 8.6
36.5 14.6
2471.2 349.2
1.2 0.1
0.61
0.079
-0.40
0.15
0.095 0.010
0.091 0.008
0.0467
0.63 1.1
6293.6 2775.5
10.2 5.6
5.4 2.9
0.71.0
11,619.3 6,174.2
5.6 3.1
9.4 5.8
0.89
0.0004
0.0005
0.0002
P
<0.0001
Legend: Reported as mean S.D or n (%). Abbreviations: AA, African American; EA, European
Legend:BMI,
Reported
as mean
S.D or n25-hydroxyvitamin
(%). Abbreviations:
AA,
African hormone;
American;
EA,
American;
body mass
index; 25(OH)D,
D; PTH,
parathyroid
AUC,
European
BMI,
body
mass
index;
25(OH)D,
25-hydroxyvitamin
D;
PTH,
area
under theAmerican;
curve; WBISI,
whole
body
insulin
sensitivity
index.
Methods:
Students
t-test
and
chi1
2
square test were
used to determine
statistical
missing
frombody
adults,
n=16sensitivity
missing
parathyroid
hormone;
AUC, area
undersignificance.
the curve; n=29
WBISI,
whole
insulin
from adolescents
index. Methods: Students t-test and chi-square test were used to determine statistical
significance. 1n=29 missing from adults,
Associations of BMD and BMAD
with variables for adults and adolescents are illustrated in
2
n=16 missing
Table 3. Among adults, body weight,
BMI, andfrom
lean adolescents
mass were significant predictors of BMD.
There were no significant predictors of BMAD among adults. Serum 25(OH)D was not
significantly associated with BMD or BMAD. Among adolescents, body weight, BMI, total fat
Associations
BMD and
BMADbody
withfatvariables
for adults
and adolescents
mass,
lean mass, inofaddition
to percent
were significant
predictors
of BMD and are
BMAD. Similar
to adults,
25(OH)Dadults,
was not body
significantly
associated
with BMD
BMADwere
illustrated
in Table
3. Among
weight,
BMI, and
lean ormass
among adolescents. Among adolescents, AA race was significantly associated with BMD
for percent
body fat;
and BMAD.
The association
BMDwere
persisted
after adjusting
significant
predictors
of BMD.with
There
no significant
predictors
of BMAD
among
however, adjustment for insulin AUC (adjusted =0.012, P=0.76), fasting insulin (adjusted
=0.062,
P=0.067)
and lean
(adjusted =0.046,
p=0.072)with
attenuated
the BMAD.
significance
adults.
Serum
25(OH)D
wasmass
not significantly
associated
BMD or
Among
of race with BMD. The association of AA race with BMAD persisted after adjusting for %
adolescents,
body weight,
BMI,
total fat lean
mass,
lean(adjusted
mass, in
additionP=0.012),
to percent
body fat (adjusted
=0.0076,
P=0.0008),
mass
=0.0059,
andbody
fasting insulin (adjusted =0.0055, P=0.023), but did not persist after adjusting for insulin
fat were
significant
predictors
of BMD
and
BMAD.
Similar
adults, with
25(OH)D
was not
AUC (adjusted
=0.0027,
P=0.41).
Among
adults,
AA race
was to
associated
BMD even
after adjusting for fasting insulin (adjusted =0.097, P=0.034) and insulin AUC (adjusted
significantly
associated with BMD or BMAD among adolescents. Among adolescents,
=0.10, P=0.036). Adjusting for percent body fat (adjusted =0.087, P=0.065) and lean
=0.059, P=0.19)
attenuated
theBMD
significance
of AA race
withassociation
BMD among with
AA mass
race(adjusted
was significantly
associated
with
and BMAD.
The
adults. Fasting insulin and insulin AUC were strongly associated with BMD and BMAD in
adolescents.
for for
percent
body body
fat, the
BMD remained
BMD
persistedAfter
afteradjusting
adjusting
percent
fat;associations
however, with
adjustment
for insulin
statistically significant for fasting insulin, but not for insulin AUC. Among adolescents, BMD
AUC
(adjusted
=0.012,
(adjusted
=0.062,
increased
0.0055
[units] forP=0.76),
every unit fasting
increase insulin
in fasting
insulin after
adjusting P=0.067)
for percent and
body fat. Fasting insulin and insulin AUC were not associated with BMD after adjusting for
lean mass (adjusted =0.046, P=0.072) attenuated the significance of race with
238
BMD. The association of AA race with BMAD persisted after adjusting for % body fat
(adjusted =0.0076, P=0.0008), lean mass (adjusted =0.0059, P=0.012), and
fasting insulin (adjusted =0.0055, P=0.023), but did not persist after adjusting for
insulin AUC (adjusted =0.0027, P=0.41). Among adults, AA race was associated
with BMD even after adjusting for fasting insulin (adjusted =0.097, P=0.034) and
insulin AUC (adjusted =0.10, P=0.036). Adjusting for percent body fat (adjusted
=0.087, P=0.065) and lean mass (adjusted =0.059, P=0.19) attenuated the
significance of AA race with BMD among adults. Fasting insulin and insulin AUC
were strongly
with BMD
and BMAD
in adolescents.
lean mass.associated
The associations
with fasting
insulin and
insulin AUC with
significant after adjusting for percent body fat and lean mass.
BMAD remained
BMI (kg/m )
Height (cm)
Percent body fat (%)
Lean mass (kg)
25(OH)D (ng/ml)
PTH (pg/ml)
Bone mineral content (gm)
Bone mineral density (g/cm)
Whole body bone mineral
3
apparent density (g/cm )
Z-score
Insulin AUC (uIU/ml)
WBISI
Fasting insulin (uIU/ml)
Adults
Mean SD
AA: 32.910.5
EA: 30.26.3
AA: 72.414.6
EA : 60.110.2
AA: 25.34.5
EA : 23.03.5
AA: 168.86.0
EA: 161.64.7
AA: 34.57.5
EA: 29.96.8
AA: 43.75.7
EA: 39.33.8
AA: 16.84.8
EA: 31.310.7
AA
EA -AA: 2718.6334.6
EA: 2327.5325.5
AA: 1.30.1
EA: 1.20.1
AA: 0.0970.011
EA: 0.0920.0006
AA: 0.41.3
EA: 0.90.8
AA: 6958.63124.1
EA: 5475.12111.6
AA: 8.83.3
EA: 11.87.4
AA: 5.62.6
EA: 5.33.4
P
Value
0.43
0.016
0.14
0.0016
0.10
0.026
0.0003
-0.0038
0.031
0.15
0.19
0.16
0.18
0.79
Adolescents
Mean SD
15.51.4
16.21.4
64.313.1
59.59.6
23.83.8
21.63.9
164.07.5
166.25.7
29.65.6
29.86.2
42.16.5
38.94.3
14.95.5
27.96.7
37.013.8
2
35.217.4
2516.9387.5
2382.5247.0
1.20.1
1.10.1
0.0940.008
0.0860.007
0.81.1
0.40.9
14223.96165.9
6988.82320.6
4.11.9
8.42.8
10.76.6
6.62.3
P Value
0.12
0.20
0.077
0.30
0.89
0.076
<0.0001
0.76
0.21
0.011
0.0024
0.30
0.0004
0.0002
0.0027
Legend: Reported as mean S.D or n (%). Abbreviations: BMI, body mass index; 25(OH)D, 25-
Legend:
ReportedD;as
mean
S.D hormone;
or n (%).
Abbreviations:
25(OH)D,
hydroxyvitamin
PTH,
parathyroid
AUC,
area under the BMI,
curve; body
WBISI,mass
whole index;
body insulin
sensitivity index.
Methods:
Students t-testhormone;
and2 chi-square
testarea
wereunder
used to
determine
25-hydroxyvitamin
D;
PTH, parathyroid
AUC,
the
curve; statistical
WBISI, whole
1
significance. n=9 missing from AA adolescents, n=7 missing from EA adolescents
body insulin sensitivity index. Methods: Students t-test and chi-square test were used to
determine statistical significance.
1
n=9 missing from AA adolescents, 2n=7 missing from EAadolescents
After adjusting for percent body fat, the associations with BMD remained
statistically significant for fasting insulin, but not for insulin AUC. Among adolescents,
239
BMD increased 0.0055 [units] for every unit increase in fasting insulin after adjusting
for percent body fat. Fasting insulin and insulin AUC were not associated with BMD
after adjusting for lean mass. The associations with fasting insulin and insulin AUC
with BMAD remained significant after adjusting for percent body fat and lean mass.
Table 3. Associations of BMD and BMAD with outcome variables
Table
3. Associations of BMD and BMAD with outcome variables
Variable
BMD
WB BMAD
Adults
Adolescents
0.097
0.031
0.086
0.011
Body weight
0.0038
0.019
0.0066
<.0001
BMI
0.012
0.029
0.018
<.0001
0.0045
0.068
0.0098
<.0001
0.0040
0.20
0.0084
0.0023
Lean mass
0.011
0.0083
0.013
<.0001
25(OH)D
-0.0022
0.32
-0.0036
0.062
Insulin AUC
0.0000032
0.70
0.0064
0.016
WBISI
-0.0014
0.74
-0.0053
0.36
Fasting insulin
0.00090
0.91
0.0074
0.0065
0.0050
0.17
0.0075
0.0024
Body weight
0.000060
0.65
0.00035
0.0002
BMI
0.00032
0.47
0.0010
0.0005
0.000061
0.77
0.00057
0.0004
0.000032
0.90
0.00054
0.0089
0.00017
0.62
0.00061
0.0019
25(OH)D
-0.000042
0.81
-0.00025
0.081
0.00030
0.66
0.00064
0.0046
WBISI
0.00010
Fasting insulin
-0.00034
0.76
0.60
-0.00075
0.00062
0.13
0.0018
Legend: The crude coefficients (change in BMD/BMAD for every unit change in the select variable)
Legend:
The crude coefficients (change in BMD/BMAD for every unit change in the select
and P-values from the general linear model. Abbreviations: BMI, body mass index; 25(OH)D, 25variable)
and P-values
frommineral
the general
Abbreviations:
BMI, Insulin
body mass
hydroxyvitamin
D; BMD: bone
density,linear
BMAD:model.
bone mineral
apparent density,
AUC: index;
insulin area
under the curve, WBISI:
body
insulin
sensitivity
index BMAD: bone mineral apparent
25(OH)D,
25-hydroxyvitamin
D;whole
BMD:
bone
mineral
density,
Associations between BMAD with variables by race are illustrated in Table 4. Among EA
WBISI: whole body insulin sensitivity index
adults, insulin AUC and fasting insulin were not significant predictors of BMAD. Among AA
adolescents, fasting insulin (= 0.00052, P= 0.011) and insulin AUC (= 0.00061, P= 0.029)
were significant predictors of BMAD; however this association disappeared after adjusting
Associations between BMAD with variables by race are illustrated in Table 4.
for percent fat. Insulin AUC and fasting insulin were not significant predictors of BMAD for
AA adults (fasting insulin, = -0.00052, P=0.66; Insulin AUC, = 0.00011, P= 0.91), EA
Among
EA adults, insulin AUC and fasting insulin were not significant predictors of
adults (fasting insulin, = -0.00028, P=0.63; Insulin AUC, = -0.000096, P= 0.92) or EA
adolescents
(fasting
= -0.00029,
P=0.73;insulin
Insulin AUC,
=-0.00066,P=0.011)
P= 0.53). and insulin
BMAD.
Among
AAinsulin,
adolescents,
fasting
(=0.00052,
240
WB BMAD
Adolescents
WB BMAD
Adults
Variable
European American
Adolescents n=16
Adults n=13
African American
Adolescents n=33
Adults n=16
Body weight
0.00021
0.30
0.00033
0.0006
BMI
0.00030
0.54
0.0011
0.0010
Region percent
body fat
Lean mass (kg)
0.000044
0.89
0.00086
0.0001
0.00059
0.18
0.00046
0.030
25(OH)D
0.000094
0.75
0.00015
0.58
-0.00066
0.53
0.00061
0.029
0.0012
0.13
-0.0016
0.087
Fasting insulin
-0.00029
0.73
0.00052
0.011
Body weight
0.00020
0.28
-0.00011
0.59
BMI
0.00071
0.18
-0.00010
0.88
Region percent
body fat
Lean mass (kg)
0.00018
0.54
-0.00025
0.54
0.00047
0.35
-0.00021
0.70
25(OH)D
0.0000080
0.97
0.0011
0.076
-0.000096
0.92
0.00011
0.91
0.00018
0.49
0.00051
0.59
-0.00028
0.63
-0.00052
0.66
Legend: Abbreviations: BMI, body mass index; 25(OH)D, 25-hydroxyvitamin D; Insulin AUC: insulin
area under the curve, WBISI: whole body insulin sensitivity index; WB BMAD- whole body apparent
Abbreviations:
BMI, body mass index; 25(OH)D, 25-hydroxyvitamin D; Insulin
bone mineral density.
Legend:
AUC:
insulin area under the curve, WBISI: whole body insulin sensitivity index; WB BMAD: whole
4. DISCUSSION
body apparent bone mineral density
To our knowledge, little has been reported about the associations between insulin secretion
sensitivity and BMD and BMAD in healthy adolescents. The beneficial roles of insulin on
4. and
DISCUSSION
skeletal health has been entertained by many authors [1], supported by the observations that
in type 1 diabetes
and reported
higher BMDabout
in subjects
with type 2 diabetes
[4,5]. insulin
Tolower
our BMD
knowledge,
little has[2,3]
been
the associations
between
We found that there are stronger associations of BMAD with fasting insulin and insulin AUC
in
AA adolescents.
exert
direct
effect on
cells as
it promotes osteoblasts
secretion and
sensitivityInsulin
and can
BMD
and
BMAD
inbone
healthy
adolescents.
The beneficial
proliferation and osteoblastogenesis and inhibits apoptosis [1]. Moreover, insulin acts
synergistically
with the health
salutory bone
insulin like growth
factor-1authors
(IGF-1) and
roles of insulin
on skeletal
has effects
been of
entertained
by many
[1],PTH
supported
[1]. Moreover, studies have alluded to a signaling pathway connecting bone and glucose
metabolisms, mainly
interconnected
pathway
that and
involves
leptin,BMD in
by the observations
thatthrough
lower anBMD
in type hormonal
1 diabetes
[2,3]
higher
osteocalcin, and adiponectin [29]. Our study suggests that higher fasting insulin levels and
secretion observed in AA adolescents may be beneficial for their bone health.
subjects insulin
with type
2 diabetes [4,5]. We found that there are stronger associations of
However, in adults, the insulin effect disappears. Therefore, it is possible that the peak bone
mass in AA may be acquired during puberty in conjunction with the higher insulin.
BMAD with fasting insulin and insulin AUC in AA adolescents. Insulin can exert direct
effect on bone cells as it promotes osteoblasts proliferation and osteoblastogenesis
and inhibits apoptosis [1]. Moreover, insulin acts synergistically with the salutory
bone effects of insulin like growth factor-1 (IGF-1) and PTH [1]. Moreover, studies
have alluded to a signaling pathway connecting bone and glucose metabolisms,
mainly through an interconnected hormonal pathway that involves leptin, osteocalcin,
and adiponectin [29]. Our study suggests that higher fasting insulin levels and insulin
secretion observed in AA adolescents may be beneficial for their bone health.
However, in adults, the insulin effect disappears. Therefore, it is possible that the
241
peak bone mass in AA may be acquired during puberty in conjunction with the higher
insulin.
This observation should not be taken out of the context that pre-diabetes and
type 2 diabetes (T2DM) adversely influences the bone health [6,7]. Prepubertal,
obese children with pre-diabetes reportedly have lower bone mass compared to
obese, non-diabetic children [7]. It is not known whether the bone is relatively spared
in obesity despite the cellular resistance to insulin in critical tissues such as fat, liver
and muscles. Pre-diabetes and T2DM are states of both insulin resistance and
impaired insulin secretion, resulting in abnormal glucose regulation; hence, the
increased incidence of poor skeletal health reported in those individuals [4,7] may not
reflect the independent actions of insulin on bone.
Corroborating other studies, we found that body weight, BMI, fat mass, and
lean mass are associated with BMD in adolescents and young adults. The effect of
insulin is mediated in part by fat mass among AA adolescents, which is suggested by
the disappearance of the association between insulin measures and BMAD after
adjusting for percent fat. Although total fat mass has a positive association with total
bone mass, visceral adiposity measures reportedly have negative associations with
bone mass [7]. We did not measure disparate adipose compartments, but found a
strong positive correlation between total bone mass and percent fat in normal weight
AA adolescents. When we adjusted for % fat, the association of BMD with insulin
AUC and fasting insulin disappeared implying that the % fat influences the
associations. We postulate that insulin affects fat deposition which in turn has
beneficial effects on bone by some signaling factors such as leptin [30]. We have not
assessed any mediators for this study. Similarly we have not measured
subcutaneous vs. visceral adiposity to see if the association is influenced
differentially by the type of fat compartment. Larger studies evaluating whether the
insulin directly affects the bone, or if insulin influences fat mass, which in turn
positively affects the bone will be helpful to delineate this speculation.
Strengths of the study were that we included healthy, non-obese, nonsmoking, post menarchal adolescent females and adult females as our research
subjects. Our study is unique in that we evaluated the insulin response to a mixed
meal in a physiological fashion which allowed us to optimally delineate the insulin
response to a meal. To our knowledge, this is the first study to assess relationships
between meal-stimulated insulin and BMD in this particular age group. Moreover, we
242
found that the ethnic differences in insulin secretion in the critical adolescent time
period of life influence BMD and BMAD. This study is also strengthened by the
inclusion of adults in addition to adolescents as it clearly demonstrates the
advantages of enhanced adolescent insulin secretion on BMAD.
Despite strengths, it is not without limitations. We do not have their calcium
intake data. It has been reported that bioavailable vitamin D may be more important
in determining BMD and BMAD [31]. We have not assessed other factors that may
potentially play a role such as free (unbound) vitamin D and IGF-1. We have not
utilized peripheral quantitative computed tomography (pQCT) and hence cannot
ascertain whether the better BMD in AA adolescents translates to better bone quality
and microarchitectural integrity. Our study was limited by the small sample size
particularly among the adult female cohort, which makes our findings less
generalizable.
5. CONCLUSIONS
Our data demonstrate that in non-obese, non-diabetic African American
adolescents, insulin secretion of puberty is associated with greater BMD; however,
the extent to which the greater BMD is beneficial to skeletal health warrants
investigation.
CONSENT
All authors declare that written informed consent and assent was obtained
from the parents and patients.
ETHICAL APPROVAL
The Institutional Review Board of the University of Alabama at Birmingham
(UAB) approved both studies. Written informed consent in all subjects and assent in
those <18 years was obtained before entry to the study.
ACKNOWLEDGEMENTS
This study was funded by UAB Diabetes Research Training Center (P60 DK079626)
and
by
Child
Health
Research
Center
Grant
K12
HD043397
(T0909180013), and was supported by the Center for Clinical and Translational
Science (5UL1 RR025777). JAA was supported by the American Heart Association
243
(Greater Southeast Affiliate). The NORC core lab (P30DK56336) and DRTC core lab
(P60DK079626) for laboratory analyses and body composition analyses are
supported by grants from the National Institutes of Health.
COMPETING INTERESTS
Authors have declared that no competing interests exist.
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246
demonstrated no significant differences between the groups. On the other hand, social
relations domain had higher values in athletes compared to non athletes (P<.05).
Results from VEINES-QOL/Sym questionnaire (the questions 1, 2, 3, 4 (a, b, c),
5 (b, c), 6, 7 and 8 showed no statistically significance between the groups. Analyzing
247
the 4d (leisure activity) and 5a (time spent for daily activities) questions, higher values
were observed for the athletes (P<.05).
Conclusion: Considering the data obtained by WHOQOL/Bref survey, physical
exercise improves the quality of life of wheelchair individuals. However, it has not been
possible to establish the relationship between physical exercise and the improvement of self-perception on venous symptoms in wheelchair individuals.
Keywords: handicapped; exercise; athletes; non athletes; cardiac output;
venous symptoms.
1. INTRODUCTION
Venous return is a hemodynamic mechanism that involves the transport of
venous blood to the right atrium through veins focusing the right atrial pressure
variation in relation to the rate of flow through the peripheral vasculature [1,2]. Elevated
cardiac output (the volume of blood ejected by the heart per minute, which determines
the amount of blood delivered to the exercising muscles) is regulated by the increase
in skeletal muscle blood flow and venous return to the heart [3].
The great majority of cardiac output during exercise is devoted to the
working skeletal muscle [4]. During dynamic exercise, the rhythmic contraction of the
peripheral skeletal muscles results in the compression of the intramuscular veins, and
imparts a considerable amount of kinetic energy to the venous blood and facilitates
its return to the heart. The skeletal muscle pump has been shown to be very effective
at emptying the venous vessels, since more than 40% of the intramuscular blood
volume can be translocated centrally with a single muscular contraction [5].
Furthermore, the vast majority of venous outflow during dynamic muscular exercise
occurs during the concentric phase of contraction, providing further credence to the
notion that increases in intramuscular pressure are important sources of energy for the
blood returning to the heart during exercise [6,7].
Exercise training optimizes the ventilatory oxygen uptake by increasing both
maximum cardiac output and the ability of muscles to extract and use oxygen from
blood. Beneficial changes in hemodynamic, hormonal, metabolic, neurological, and
respiratory functions also occur with increased exercise capacity [8,9].
It is widely established that the practice of physical activities improves the
muscular tonus and the physiologic hypertrophy of skeletal muscles increases the
efficiency of venous return. Long-term moderate exercise training determines a
248
sustained improvement in functional capacity and quality of life in patients with chronic
heart failure [10].
However, the overall life quality must be the most important reason to stimulate
the abilities to practice physical activity [11]. In this way, regular physical exercise
practicing means an improvement in lifestyle and may enhance health in many
aspects besides physical, for example by facilitating and fostering social contact,
i.e., positively impacting the global quality of life [12].
Venous diseases have been extensively studied through clinical [13,14] and
observational studies [15]. The symptoms and clinical signs [16] are important tools to
evaluate venous function. In addition to that, investigative studies based on
biochemical markers [17,18] and inquiries that define the profile of the patients are
also useful to improve the knowledge and to clarify ways to deal with the venous
diseases and their complications [19-21].
Kahn et al. [22] described a comprehensive psychometric evaluation of a
venous-disease-specific quality of life measure questionnaire that was developed and
validated by Abenhaim et al. [23], in an independent sample of patients with acute
deep venous thrombosis. Studies like these, whose subjects are wheelchair users, are
rarely found.
The purpose of the present study is to evaluate the impact of the physical
activity in persons with lower limbs muscular atrophy considering two main aspects:
the quality of life and the self-perception of the venous return symptoms.
Therefore, we have delineated an observational cross sectional study in order
to access the influence of the regular physical activity on those aspects.
2. METHODS
2.1 Subjects/Groups, Inclusion and Exclusion Criteria
At the first contact with the potential subjects, they received an explanation
concerning the objective of the study and then were invited to be part of the research.
Twenty five volunteers attended the study. Inclusion criteria were people aged
between 20-60 years old and wheelchair users of two groups: the ones who regularly
practiced physical exercises and the ones who did not.
Groups:
Group 1: Twelve participants who did not practice regular physical activities
and were being followed up in a universitary physiotherapy clinic-University of
249
250
impaired and also evaluate the impact of this vascular disorder symptoms on their daily
routine [22,24].
Social-demographic questionnaire: consisting of 10 questions (age, home
address, marital status, quantity of children, living arrangements, current occupation,
educational level and family income) that together point epidemiological individuals'
profile [22].
WHOQOL-Bref (version in Portuguese) is a valid questionnaire that consists of
26 questions that assess the quality of life, physical capacity, psychological status,
social and environmental interactions in which the interviewee is inserted. The
responses made possible to identify and quantify the magnitude of daily limitations
due to health problems of individuals included. The results of this tool complement the
results of the first questionnaire (VEINES-QOL/Sym) [25].
2.4 Protocol
2.4.1 WHOQOL-Bref protocol
The WHOQOL-Bref was a WHO [26] questionnaire that was adapted and
validated to Portuguese by Fleck et al. [25].
The WHOQOL-Bref module consists of 26 questions (with question number 1
and 2 on the overall quality of life), the answers follow Likert scale (1 to 5, the higher
the score the better quality of life) [26]. Except for these two questions (1 and 2), the
instrument has 24 facets, which make up 4 domains: Physical health (7 items),
Psychological (6 items), Social relations (3 items) and Environment (8 items) [26].
This instrument will need to recode the value of questions 3, 4, 26. (1=5) (2=4)
(3=3) (4=2) (5=1) [26].
To calculate each facet is just sum the values of interview answers and divide
by the number of participants. After that, the average is made and the results will be
from 1 to 5. The mean scores are then multiplied by 4 in order to make domain scores
comparable with the scores used in the WHOQOL-100 and subsequently transformed
to a 0-100 scale [26].
2.4.2 VEINES-QOL/-Sym analysis
The VEINES-QOL/Sym produces two scores, one is the estimate of the impact
of Venous Chronic Disease on quality of life (the VEINES-QOL) and other
related to symptoms resulting from Venous Chronic Disease (the VEINES-Sym) [24].
251
The items related to the symptoms are: heavy legs, aching legs, swelling, night
cramps, heat or burning sensation, restless legs, throbbing, itching and tingling
sensation [24].
It was not necessary to calculate this questionnaire's scores, because the
purpose of the present study was to compare only the impact of the exercise in
wheelchair individuals.
2.5 Statistical Analysis
For all the questions involving the VEINES-QOL/Sym, except the questions
number 4 and 5, the Likert scale was used. It consists of a psychometric response
scale primarily used in questionnaires to obtain participant's preferences or degree of
agreement with a statement or set of statements. Most commonly seen as a
5-point scale ranging from "Strongly Disagree" on one end to "Strongly Agree".
The statistical analysis of VEINES-QOL/Sym questionnaire considered the
questions 4 and 5 as dichotomic variables.
All the questions/answers were tabulated on Excel before proceeding to
the statistical analysis between athletes and non-athletes.
The results from VEINES-QOL/Sym were analyzed by Chi-square test, which
is used to investigate whether distributions of categorical variables differ from one
another. It compared the tallies or counts of categorical responses between two
independent groups. The test uses only actual numbers and not percentages, mean
and proportions.
The results of the WHOQOL-Bref were analyzed by unpaired Student's t-test.
The data were expressed as MeanSD.
The results of the Social-demographic questionnaire were analyzed by
Student's t-test and proportion test.
Non-parametric G test was suitable applied for analyzing two independent
samples for categorical data [27].
The differences between groups were considered significant at P<.05.
To statistical analysis the following software packages were used: Graph
Prism 5.03 (San Diego, CA-USA); Excel (Microsoft Corporation) and Bio Estat 5.0
(www.mamiraua.org.br).
252
To statistical analysis the following software packages were used: Graph Prism 5.03 (San
Diego, CA-USA); Excel (Microsoft Corporation) and Bio Estat 5.0 (www.mamiraua.org.br).
3. 3.1
RESULTS
ProfileAND DISCUSSION
3.1Basic
Profile
characteristics of the subjects are presented in Table 1.
Basic characteristics of the subjects are presented in Table 1.
were single. The non athletes group consisted in twelve participants (8.33% female,
In terms of each absolute values of age (not ranges of age), it was not found significant
91.67%
male), most of them (58.3%) was aged between 20-40 years and 58.33% was
difference (Student's t-test) between the groups (P>.05); the H0 hypothesis was not
single.
In terms of each absolute values of age (not ranges of age), it was not found
significant difference (Student's t-test) between the groups (P>.05); the H0 hypothesis
was not rejected, thus assuming equal variances. At the same way, comparing the
monthly income between the wheelchair users athletes and non athletes, the H0
hypothesis (P>.05, Student's t-test) was also not rejected.
253
Excluding monthly income and ranges of age parameters, G-test was applied
[27]. The nonparametric G-test was used to compare ranges of age and marital status
between both groups of wheelchair users. When comparing ranges of age (21-30;
31-40; 41-60), the H0 hypothesis of equality was not rejected for athletes and nonathletes groups (P=.0778). The condition of being an athlete or non athlete is not
associated with marital status, since the hypothesis of equality H0 (P>.05) was not
rejected.
Regarding labor condition (occupation), the value of P was .0004 (P<.05),
so the H0 hypothesis was rejected. This result demonstrates dependence between
being an athlete and this condition (working/occupation).
The level of education is also a factor that is related to being an athlete or not,
because the H0 hypothesis of equality was rejected (P=0.0082, i.e., P<.05).
According to the 2010 census conducted by IBGE (Brazilian Institute of Geographic
and Statistic) [28], the vast majority of handicapped individuals had only basic
education. This data also was observed on the non athletes profile (25% had basic
education). On the other hand, the athletes group had an improvement on the
schooling levels (15.3% undergraduate individuals). We may infer from these results
that practicing sports can be a powerful motivation to keep on studying despite their
physical limitations. Analyzing the data on the educational level and occupation, we
were able to establish a positive association between higher educational levels and
higher percentage of persons working. In the group of non athletes no one was
working, and this was also the group that had the lower educational levels.
Concerning living alone or with relatives, most athletes (wheelchair users)
reported living alone. Comparing to the non athletes, the obtained value of P was lower
than 0.5 (P=.0011), the H0 hypothesis of equality was rejected, hence there is
dependence between living alone and practice of sports. Indeed living alone and
working are associated. Working brings financial independence, which provides
stability and self-assurance for the individual to live by himself. Among athletes,
53.85% are employed and as a result of that, a higher percentage (84.61%) of
individuals live alone.
The use of continuous medication among the wheelchair users is also another
factor that is related to the fact of being or not an athlete (P=.0019). The long-term
use of medication is another point. It was more prevalent in the non athletes group
254
Athletes (n=13)
835.14
90.432.26
85.062.33
77.88.09
P
0.315
0.106
0.013
0.605
aHigher scores indicate better outcome. Scores are shown as meanstandard deviation
be
255
explained as not depending on the subjects, since the Brazilian government supplies those variables.
The third domain is related to social relationships, such as personal
relationships and social support. In these aspects, there were significant statistical
difference between the results obtained from athletes and non athletes. Our results
were in accordance as demonstrated by Resnick [12], that regular physical exercises
enhance health, facilitate and foster social contact, and positively affect the quality of
life, thus leading to improved social life and interaction.
3.3 VEINES-QOL/Sym
The results obtained from VEINES-QOL/Sym are presented on the Table 3. It
is possible to observe that only the answers for the 4d and 5a questions are
statistically different between the groups of wheelchair users (P<.05, Chi-square test).
The Table 3 shows the analysis between the athletes and non athletes groups,
when analyzed using the Chi-square test.
The answers related to the question 4d showed that 84.6% of the wheelchair
athletes did not feel limited to have leisure activities due to leg injury, and just 41.6%
of the non athletes answered the same. This fact can be an indication that the
regular physical exercise increases the individual motivation.
Table 3. Statistically significance between the wheelchair users: athletes and non
Table 3. Statistically significance between the wheelchair users:
athletes, in VEINES-QOL/Sym questionnaire
Question
04-d Does your leg problem now limit you in social or
leisure activities in which you are sitting for long
periods?
05-a During the past four weeks, did you cut down
the amount of time you spent on work or other
activities?
Q: question. (**P<.05)
not
The
answers
the question
5athat
showed
that
The
answers
givengiven
to the to
question
5a showed
92.3% of
the92.3%
athletesof
didthe
not athletes
notice anydid
difference on the time spent for daily activities, and 58.3% of the non athletes declared
notice
any difference on the time spent for daily activities, and 58.3% of the non
likewise.
The questionnaire is limited in terms of time, only assessing the past four weeks. Since both
groups
have been using is
wheelchair
long time
(eight years
hypothesize
The questionnaire
limited for
in aterms
of time,
only minimum),
assessingwethe
past four
that the athletes could not realize the real impact of how positively practicing regular physical
theytime
have(eight
only been
exercises
the execution
of daily
activities, because
weeks.
Since can
bothinterfere
groupsin have
been using
wheelchair
for a long
years
playing basketball for two years.
minimum), we hypothesize that the athletes could not realize the real impact of how
The issues analyzed with the other answers did not support statistical differences when
positively
practicing
regular
physical
exercises
can indicates
interferethat
in physical
the execution
daily
comparing
the data
of athletes
and non
athletes. This
exerciseof
does
not reduce
self-perception
of venous
symptoms,
and possibly
does
not reduce the
activities,
because
they have only
been playing
basketball
for two
years.
development of a venous disease. This fact could be explained when considering that both
athletes and non athletes are conditioned to a wheelchair status, i.e., they are limited to
perform only sitting activities, which decrease the work of the lower limbs muscles [30].
Although the literature presents solid data concerning the stimulation of cardiac function and
its beneficial relationship with venous return [1,2], regular physical activity (basketball) of the
superior members, accomplished by wheelchair athletes included in the present research,
256
The issues analyzed with the other answers did not support statistical
differences when comparing the data of athletes and non athletes. This indicates that
physical exercise does not reduce self-perception of venous symptoms, and possibly
does not reduce the development of a venous disease. This fact could be explained
when considering that both athletes and non athletes are conditioned to a wheelchair
status, i.e., they are limited to perform only sitting activities, which decrease the work
of the lower limbs muscles [30].
Although the literature presents solid data concerning the stimulation of cardiac
function and its beneficial relationship with venous return [1,2], regular physical activity
(basketball) of the superior members, accomplished by wheelchair athletes included
in the present research, was not proven enough to improve self-perception of venous
return.
4. STUDY LIMITATIONS
The cross sectional nature and the influence of seasonal variations are some
of the limitations of the study.
The main limitations of the present study are related to the recordatory. To
conduct the study using questionnaires, it is necessary to rely on the memory of the
respondent. Some of the information may be inaccurate due to forgetfulness.
The small number of subjects able to fit in the study is another important
limitation (being a wheelchair user and practicing a group sports). However, all
individuals were assessed using two different validated instruments (VEINES0OL/Sym and WHO0OL-Bref).
5. CONCLUSION
The practice of regular physical activity may be a direct causal factor in the
motivation for individuals who live alone, since sports provide greater self-esteem and
more confidence. In addition to that, physical exercises can be considered activities
of social interaction, which reduce the isolation of the individual and decrease the
family emotional dependence. The financial and emotional independence, which
come from working, are reinforced by the improvement of self-confidence, which is
stimulated when practicing sports in groups, such as basketball. This fact observed in
the athletes highlights the different profile comparing to the non athletes wheelchair
users.
257
258
5. Stewart JM, Medow MS, Montgomery LD, McLeod K. Decreased skeletal muscle
pump activity in patients with postural tachycardia syndrome and low peripheral
blood flow. Am J Physiol Heart Circ Physiol. 2004;286(3):H1216-1222.
6. Folkow B, Gaskell P, Waaler AB. Blood flow through limb muscles during heavy
rhythmic exercise. Acta Physiol Scand. 1970;80(1):61-72. DOI:10. 1111/j.17481716.1970.tb04770.x.
7. Hogan MC, Grassi B, Samaja M, Stary CM, Gladden LB. Effect of contraction
frequency on the contractile and non contractile phases of muscle venous
blood flow. J Appl Physiol. 2003;95(3):1139-44.
8. Sullivan MJ, Higginbotham MB, Cobb FR. Exercise training in patients with
chronic heart failure delays ventilatory anaerobic threshold and improves
submaximal exercise performance. Circulation. 1989;79:324-329. DOI: 10.1161/0.
9. Hambrecht R, Niebauer J, Fiehn E, Kalberer B, Offner B, Hauer K, et al. Physical
training in patients with stable chronic heart failure: effects on cardiorespiratory
fitness and ultra structural abnormalities of leg muscles. J Am Coll Cardiol.
1995;25(6):1239-49. DOI: 10.1016/0735-1097(94)00568-B.
10. Belardinelli R, Georgiou D, Cianci G, Purcaro A. Randomized, controlled trial of
long-term moderate exercise training in chronic heart failure. Circulation.
1999;99:1173-82.
11. Shephard RJ. Independence: A new reason for recommending regular exercise
to your patients. Phys Sportsmed. 2009;37(1):115-8. DOI: 10.3810.
12. Resnick B. A seven-step approach to starting an exercise program for older
adults. Patient Educ Couns. 2000;39(2):243-52.
13. Prandoni P, Villalta S, Bagatella P, et al. The clinical course of deep vein thrombosis. Prospective long term follow up of 528 symptomatic patients. Haematologica. 1997;82:423-8.
14. Miron MJ, Perrier A, Bounameaux H. Clinical assessment of suspected deep vein
thrombosis: comparison between a score and empirical assessment. J Intern
Med. 2000;247:249-54.
15. Fowkes FJ, Price JF, Fowkes FG. Incidence of diagnosed deep vein thrombosis
in the general ppopulation: Systematic review. Eur J Vasc Endovasc Surg.
2003;25:1-5.
16. Perrier A, Desmarais S, Miron MJ, et al. Non-invasive diagnosis of venous
thromboembolism in outpatients. Lancet. 1999;353:190-5.
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260
28. IBGE. General characteristics of the population, religion and people with
disabilities. Brazilian demographic census. 2010;72-89. Portuguese.
29. Chakravarthy MV, Joyner MJ, Booth FW. An obligation for primary care
physicians to prescribe physical activity to sedentary patients to reduce the risk
of chronic health conditions. Mayo Clin Proc. 2002;77(2):165-73.
30. Seki K, Sato M, Handa Y. Increase of muscle activities in hemiplegic lower
extremity during driving a cycling wheelchair. Tohoku J Exp Med. 2009; 219
(2):129-38.
261
Education
Humanities & Social Sciences
Wang Ping,
English Department, College of Foreign Languages, Jiaxing University, China
262
school, and staffing, instructional organization, allocation of human and material resources, and student and staff timetables are a few examples of areas that may be
affected.
Implementing Mandarin Chinese into the UK school timetable is causing a big
challenge and change within the MFL department. According to [2], about 60% of the
teachers claimed they were qualified in teaching Mandarin Chinese. They were either
qualified teachers in China or in the UK but in subjects other than Mandarin Chinese.
Most of those unqualified teachers were qualified English teachers in China. Therefore
it might not take long to train them to be. [3] (p.229) states that linguistic theories are
the backbone of language teaching in the sense that they equip teachers with analytical tools to solve language problems on the job. For instance, an understanding of
the importance of appropriateness in speech would provide a teacher with a sound
base for teaching chi fan le ma? (Have you eaten?) as an opening greeting rather
than the conventional nihao! (hello!). [4] shows his concern on the major challenges
facing by native speakers Mandarin Chinese teachers in Australia:
1. Acculturation: This applied particularly to the educational environment
where behavioural patterns and attitudes of students as well as interpersonal relationships among teaching staff differed greatly from those which a native teacher would
have experienced in a Chinese learning environment.
2. Pronunciation: It seems to be a common phenomenon that native speakers
whose mother tongue is other than the Mandarin dialect speak Mandarin with a pronounced accent, and some have great difficulty in mastering particular Mandarin
sounds. In general, native speakers from Malaysia, Singapore, Hong Kong and to a
lesser degree, Taiwan, fall into this category.
3. Romanisation: Taiwanese, even those whose native tongue is Mandarin,
would have no exposure to the pinyin Romanisation system.
The issues mentioned above also confronted the Mandarin Chinese teachers
surveyed in the UK, especially pedagogical and classroom management problems.
[3] explained that native speakers typically came from an educational environment in
which students expected to be led by teachers to a greater extent than their Western
counterparts. In such an environment, teachers also prefer a more teacher-centred
style of classroom management than Western colleagues. Another common problem
may be language-related. [5] noticed this among non-English native student teachers
in the UK, who found that such teachers often faced challenges in teacher-pupil relationships. These were primarily about understanding what students were saying to
263
each other and to the teacher, knowing when students were serious or trying to take
advantage, understanding humour and sarcasm, and being made to feel foreign by
the students. Procedure-related problems such as understanding hierarchies or disciplinary procedures for students, identified by [5], were also found among the part-time
Mandarin Chinese teachers who responded to the survey.
Moreover, the lack of adequate textbooks and other teaching and learning materials in Mandarin Chinese is a concern for teachers. However, as [6] (p.131) claimed
that there is no such thing as an ideal textbook. Materials are but a starting point,
teachers are the ones who make materials work; they make them work for their students and for themselves in the context in which they teach. Mandarin teachers perhaps should not depend too much on a formally approved textbook, as they once
would in the context of the Chinese education system. Finally, most Mandarin
Chinese teachers in the UK complain that the GCSE and A-level Mandarin Chinese
examinations are intended for British-born Chinese who speak Mandarin at home,
but are too difficult for most British students.
Any change is complex because it is inextricably linked to our emotions: sorrow
at the sense of loss of the old, and anxiety at the uncertainties that the new will bring
[7] (p.16). This paper is going to explore some of the issues related to this new change
within the MFL department. It begins with the initiative and the context of the change.
Then it reviews resistance and its resources to the change. The next part goes through
how these barriers were overcame and the final part of the paper will summarise some
useful suggestions for those who want to implement similar change within a MFL department in the UK. In a word, the paper focuses its on the following questions: what
problems lie ahead for the secondary schools in the UK school context? How is Mandarin Chinese taught in the secondary schools in the UK?
2. BACKGROUND AND CONTEXT
The importance of MFL is said to lie in helping pupils to understand and appreciate different cultures and countries; and to think of themselves as citizens of the
world [8] (p.162) and if education must enable us to respond positively to the opportunities and challenges of the rapidly changing world in which we live and work [9]
(p.3), we would assume that within any MFL department today, what languages to
teach is a question. In addition, what do opportunities mean in terms of foreign languages? When Moon says that the structure of employment in the twenty-first century
264
is likely to have a greater European and international character, the ability to communicate in a second or third language, or even to learn a new one quickly, could
become crucial to many jobs [10] (p.91). What does he mean by international
character? What changes are happening in the UK in terms of international relationship? We will agree that Chinas international importance, relevance and profile are
increasing.
In the UK, the government departments of education in English, Wales
and Scotland, together with the British Council, have agreed on a strategy to support
the learning Mandarin Chinese through direct access to native speakers, school linking and collaborative activities. Qualified and experienced teachers from China are
recruited to act as Chinese language assistants. Confucius classes are established in
the UK secondary schools and fully-trained Mandarin teachers are sent to boost the
classroom teaching.
Statistic shows that it is still not very common for secondary schools in the UK
to include Mandarin Chinese on timetable, though a significant number of schools
have started to offer Mandarin Chinese. So why did the MFL department of my school
decide to do so? Before I answer the question, I will give a very brief description of
the school. It is a catholic girls school in London. The school is a language college.
Traditionally, it only offered French, then Spanish on schools timetable. Today, it offers seven languages in all, 3 in curriculum time, the others in twilight time: French,
Spanish, Russian, Italian, Portuguese, Japanese and Mandarin (which was started
in 2001). 56% of the students are girls whose parents are first or second generation
immigrants from Africa and Caribbean. In the local community, unemployment is high,
and the number of pupils who receive free school meals is an indicator of the socioeconomic background of these families. I agree with Fullan that less-well-educated
communities are not as likely to initiate change or put effective pressure on educators
to initiate change on their behalf [11] (p.62). Therefore the new policy in MFL in my
school is not because of pressure from parents.
According to Fullan, one of the factors affecting initiation of a specific educational change is the access to information [11] (p.57). It is true in my school case.
The Head of MFL department and coordinator of Language College spends large
amounts of time at conferences and in workshops within ongoing professional networks of communication among her peers, which contributes to her identifying the
need for a new direction for the development of the MFL departmentto offer Mandarin
Chinese and to implement it into school timetable.
265
However, that only the Head of MFL department should identify the need for
the change is not enough. Another very important factor affect the initiation is advocacy from central and /or school administrators. As Fullan claims, at the school
level, the principal has always been the gate-keeper of change, often determining
the fate of innovations coming from outside or from inside [11] (p.59). The current
principal in my school was appointed two years ago. As a new Head, she was very
keen to implement something new in the school, and to support the Language College
ethos. Also, she shows how important marketing the school or selling the school [12]
it is for her. Since the establishment of the so-called quasi-market in education, parental choice, open enrolment, age-weighted pupil funding, and a mixture of different
kinds of schools in any locality are all intended to engender a climate of competition
[13,14,15,16]. It is therefore not surprising that she was very supportive for this new
policy. However, will it be easy to implement it?
3. RESISTANCE AND CAUSES
According to [17] (p.172), it is often easy to identify the need for change but
agreeing on the direction of change is another matter, especially when people are
still arguing about the place of MFL in the school curriculum. Even if not everyone is
as extreme as Williams who insisted that allowing young people to give up MFL after
Key Stage 3 is wise and it would be even wiser to take the more radical step of limiting
compulsion to just one year because this knowledge cannot be said to be of utility to
the vast majority of English-speakers. There is a conspicuous lack of hard evidence
that foreign language skills will increase productivity and employment [18] (p.117).
Many educators more or less take his side. My school is not an exception. [19] identified this reason for resisting change as belief that change is unnecessary. Resistance is always a likely response, especially in the early of a change initiative and
most frequently among the more experienced and long-serving members of a teaching community [20]. Other members of staff, including some of the Strategic Leadership Team in my school expressed their doubts when the new plan was raised.
At most of the UK secondary schools, French had always been the accepted
traditional language. All pupils learned French from Year 7 to 11, and all had a year
of Spanish in year 9. The Head of Department said it took her three years to raise the
status of Spanish to the same level as French in the department. Spanish and French
are now taught to all pupils having the same percentage of curriculum time over the
3 years at the cost of one fewer hour on Technology. In fact, one nature of change
266
was identified by [21] as structural and systemic, which means any real change will
affect the whole system, in that change in one part of institution has a knock-on effect
in other parts. As a result, it is understandable that other department might resist the
change due to the possible loss of status and power [19], if another new language is
taken into timetable.
Besides the resistance from the colleagues from other departments, as we all
know, learning foreign language requires substantial investment of resources. Thus it
makes the task even harder that the possible cost of taking a completely different
language into school timetable. Even as early as in 1976, the Prime Minister of the
time, James Callaghan questioned in a speech the value for money of the British
education system [7] (p.1). Is it worth investing in new teachers, buying new textbooks and building up other resources needed for this Mandarin Chinese subject?
Does the school have some other more urgent needs for this money? Thus the second
cause of the resist is due to the relatively high cost [19]. Even the Head and Head of
the Department are very supportive; the resource of Mandarin is still quite limited in
the department compared with French and Spanish. Let along the additional materials, they dont have enough textbooks for each student therefore the Mandarin teacher
needs to do lots of photocopies.
Within the MFL department, the change is likely to be resisted if it threatens the
job security of those affected by it [19]. In the case of my working school, Spanish is
directly threatened by this new policy. Year seven girls used to learn French and
Spanish at the same time. Now, all Year 7 girls are doing two terms of French, one
term of Spanish, and one term of Mandarin, which means fewer hours for Spanish,
of course. That is why one Spanish teacher will have to leave. In addition, even if
it is not that serious to cause the threaten of job security, other language teachers
might still feel what [22] (p.75) described that in some schools where there were already two languages on offer in the lower school, colleagues might be unwilling to see
a third introduced because they would be seen as competing for pupils at the option
stage. In my school all students in Year 8 choose two from French, Mandarin or Spanish. No teachers would be happy to see the students drop her/his subjects and naturally they all hope to keep their talented and well-behaved students so that they could
have better candidates for GCSE and A-level exams. Thus the competition arose from
here: who is to learn what language? In the case of my school, 45 girls chose
to do Mandarin and thirty of them got the chance. The Head had planned to choose
girls who were well behaved and also gifted in Languages to learn Mandarin because
267
it is much more difficult than European languages. However, the final list of the students, which was decided by a French teacher because the Head of the department
was away for a school trip, turned out to be a mixed one with several students who
were very difficult to manage and didnt take the subject seriously. Therefore, we can
sense the resistance from other language teachers, which is quite natural response.
4. STARTING SMALL AND THINK BIG
[23] describes the change process as having three major components: initiation, implementation and institutionalisation. In the case of my school, the change is
still at early implementation stage because it is only in the second year. So what
might be interesting is how the Head of MFL department managed to overcome the
resistance to start the implementing Mandarin into school timetable by distributing the
school kids in the different classes as a lash-up or contingent measure of meeting the
resistance.
[24] suggested that if necessary, implement change initially on a small scale
and Fullan [25] also said starting small and think big. That is exactly what the Head
of MFL department in my school does. Right at the beginning, she knew what her
long-term goal was. But she didnt implement the change suddenly. Instead she
started to offer Mandarin in one of the after school clubs in 2001. In order to help the
students, staff and parents know more about China and Chinese culture so that the
learning of Chinese language becomes more acceptable in the school organised by
British council in 2004, in which the students have opportunities for contact with
speakers of the language, through structured interviews, letters or e-mail messages,
face-to-face meetings, art, music, song and student exchange programs, which also
make learning the target language meaningful. And it turned out to be a big success.
Students and staff came back from China and shared their experienced community,
she started to join the Summer Mandarin Immersion Trip to China with their family
members and peers, which contributed to a Chinese atmosphere in the school and
community. At the same time, with support from the Head and the Governors of the
school, she decided it was time to seriously begin the innovation within the department. First she found a Chinese Language Assistant via British Council who actually
is an experienced teacher in China. In this way it saves her time to train a new teacher
and saves the school money if we bear in mind that relatively high cost was always
one cause of the resistance.
268
In order to avoid resistance from other departments, she kept it within the MFL
department. Chinese was taught in curriculum time by sharing with Spanishs time thus
it didnt affect any other department.
During the process, she knows that telling people about the progress of the
change can help to maintain commitment to the change [24]. Also according to [26],
one of the key factors for success at this stage is early feedback on progress made.
Therefore, she herself first continually showed her commitment to this new change
within the department. For example, she fully supported the new Mandarin teacher
with resource and classroom management. She helped the new Chinese teacher with
the techniques of Information Technology. She encouraged the new teacher to participate in professional development activities and teach her how to arrange and design a variety of interactive learning activities for students. She changed the new
teachers view towards the assessment - either an aid to learning or a process which
enabled students to demonstrate their knowledge and skills in the target language,
based on curricular expectations. She helped this new teacher from China adapt gradually in the education system in the UK by involving the teacher in accessing a variety
of professional development activities in language learning. She used to comment:
Technology can provide greater access real-world problems and authentic
contexts for facilitating Mandarin learning and teaching, and provide alternative methods of representing and communicating knowledge. It fosters innovation, facilitates
dialogue and offers potential for developing new practices in the education and research communities. And education technology can be crucial to the success of any
language learning and teaching program. Professional development, which supports
effective practice, is essential to the successful use of any technology, resource or
application.
And she never forget inform the Head and the Governor of any progress about
the change. For instance, BBC reported the Mandarin Project in Lauriston primary
school run by the Chinese teacher; the Mandarin lesson was filmed by both ITV and
CNN. This was, of course, on News Letters to parents, too. All these send out a
message to both school and community: It is right to implement Mandarin into school
timetable. Even so, the program assessment was held by the school authority to find
the language program was reviewed periodically to ensure quality; and to find the
assessment strategies adopted were valid and reliable measures of program outcomes.
269
At the beginning, some of the Strategic Leadership Team was not happy because she sent the Mandarin teacher to teach Mandarin in local primary school for
free. But later the feedback was that the Mandarin project in the primary school became so famous that more primary schools in the district wanted it. Especially one
primary school, with which the Principal of my school was trying hard to forge link
contacted her asking for help with starting Mandarin lessons. Mandarin now became
the ambassador of the school. Nobody doubts that it is a waste of money to send the
Mandarin teacher to primary schools anymore.
Furthermore, she even made Mandarin earn money for the school. This is also
shown in the research by [1]:
The school authority, school administrators, counsellors and teachers promote
the benefits of language learning. Communication documents and activities include
information packages for parents and students, open houses, information evenings,
brochures, school authority/school Web site, school displays and posters. Student
activities may include student clubs, Internet pen pals, field trips and student exchanges. The language taught is visible in the school through the use of signs, bulletin
boards, displays, school concerts, extracurricular activities and school announcements.
She contacted principals or Heads of MFL department she knew. They might
want to offer Mandarin Chinese but lacked qualified teachers for some reason. She
went to these schools with the Mandarin teachers to deliver taster Mandarin lessons
for free. And in the end, the LEA of Westminster agreed to pay my school to send
teachers to teach Mandarin Chinese at first in two primary schools. And there are more
schools asking for it. Up to now, three schools are paying my school for it. Once again
all these factors prove that it is worth the money to invest in this new subject. In
summary, as the head of the department, what she fulfilled is establishing policies
that support language learning; ensuring that schools implement quality language programs; establishing clear measures of student achievement for target languages;
allocating sufficient funds for language learning; developing, authorizing and
offering locally developed language programs per provincial policy; and providing professional development opportunities [1]. While what I as a leading Mandarin teaching,
reflects, too, what [1] has explored in their research that is encouraging students to
learn the language; stating clearly what students are expected to learn; selecting and
implementing appropriate resources for students; assessing and reporting student
progress in target languages; pursuing individualized professional development that
270
will improve the language learning in students; advising on student program placement; providing advice about provincial standards and curriculum; planning methods
of communicating with parents and with the public; and reporting to, and communicating with, parents about their students progress.
5. DISCUSSION AND IMPLICATION
Though it is still early to say the new change in MFL Department of my formal
school is successful. The implementation of Mandarin Chinese into school timetable,
however, is proved to be a good start. As a reflection I totally agree with [1] the indicators of an effective school language program:
alignment of curriculum, instruction, assessment, resources and reporting of student
progress;
student and parent understanding of learning outcomes and student assessment;
_
staff-initiated language projects and ideas that support and improve language
learning;
targeted professional development to address personal, school and school authority goals;
Then what does this good start imply? It is more than that they have the courage
to take the risk, though there is risk in any change. According to [23], top-down is all
right under certain conditions. The success of my school lies in the fact that they have
a principal and a Head of MFL Department who understand the implementation and
271
fully support it. And this change, which has a clear, well-structured approach, was
also tied to a local need. As the Head of the MFL department puts it many pupils
in my school are already disadvantaged by birth, family background, income and
race. If learning Mandarin means future possible employment opportunity, why should
we hesitate?.
According to [27] and [28], evaluating the change right from the beginning and
a review of the schools current state as regards it are also essential. Before you start
to implement the change, ask yourself Is the proposed change necessary at this
time? Can the proposed change be properly resourced? Are additional resourced required? What will be the benefits of
monitored and evaluated?. And it is also important to think about the potential
resistance and can you overcome them and in what way? The thinking maps provide
some systematic and reliable information that can be used as a basis for action [29].
More importantly, in gauging the success of the implementation process, it is a
good idea to continue to compare the current Chinese teaching program to the characteristics of the so-called successful language program discussed earlier. More and
more of these characteristics should become apparent as the implementation process
proceeds. All new programs are likely to experience some bumps during the implementation stage. Over time, these should resolve themselves and the confidence and
comfort level of all stakeholders should increase. Continued improvement is the result
of a continuous cycle of planning, implementing, monitoring, assessing and revising.
As each goal is reached, an existing goal is expanded or a new goal is established,
and the cycle continues to generate positive change and improvement. Individuals
may incorporate the cycle of continuous improvement into their professional practices
as efficiently as schools incorporate it into the teaching and learning environment [1].
COMPETING INTERESTS
Author has declared that no competing interests exist.
REFERENCES:
1. Alberta education. School Administrators Guide; 2007. Available: http://www. Education.alberta.ca/media/632761/schadm_rev07.pdf.
2. Wang P. The Provision of Mandarin Chinese in the UK Secondary Schools: what's
in the way. European Journal of Education. 2009;44(1).
272
273
274
rd
tially at the end of the 2 , 3 , 4th and 5th (final) medical years. Results indicated
a mean Positive Attitude Score (PAS) of 51.9 (range 13-65) at the beginning of 2nd
year declining to 45.5 at the end of this year. This decline in positivity was statistically
significant with p < 0.035. Results indicated a mean Negative Attitude Score (NAS)
of 29.8 (range 13-65) at the beginning of 2nd year rising to 33.8 at the end of this
year. However, the longitudinal approach taken highlighted that attitudes rose again
by the end of the 3 rd gear-mean PAS 48.7, and 4th - 49.3 and attitudes almost
returned to baseline by the end of the 5th Year - mean PAS 49.3. The NAS score
remained constant at 31.4 at the end of 3rd year, 31.4 at the end of 4th and 29.6 at
the end of the 5th year.
These changes in NAS were not statistically significant. A qualitative study is
indicated to investigate the causation of the fall in positive attitude scores and rise in
negative attitudes at the end of the second year. As communication skills are a
core requirement for practicing in a professional discipline further research into these
findings is warranted.
Keywords: ommunication skills; attitudes; undergraduate medicine.
275
1. INTRODUCTION
A recent area of interest in the European literature is that of medical students
attitudes to communication skills teaching and learning. This has been investigated
previously in medical student cohorts in the UK [1], Norway [2], Scotland [3] and more
recently Korea [4]. It has been largely under investigated in Ireland. Initially, Doherty
[5] investigated medical students attitudes to communication skills training and attitude change following formal teaching. She reported that students confidence improved in areas relating to direct patient encounters. Students reported that they felt
they were better listeners, less nervous around patients and more comfortable in
knowing what to say to patients following formal training. This was a small exploratory
study and pioneered interest in this topic area in Ireland. Subsequently, Rees et al.
[6] published a series of papers in the UK which culminated in the design and validation of a communication skills attitude scale CSAS (Appendix 1). During this process
Rees reported that UK medical students had varying attitudes to communication
skills learning, with some believing good communication skills were essential to be
an effective doctor. However, others believed these skills came naturally and time
spent learning these skills were futile and wasteful. Communication skills were seen
as a soft science as they were not quantifiable and were perceived to be of low
academic credibility. She suggested that student resistance to the integration of the
social sciences into medical training may be owing to a number of factors. These included students uncertainty in the early years of their relevance to clinical practice,
incongruity with the biomedical model, teachers attitudes and poorly defined educational goals.
Subsequently, Tor Anvik et al. [2] re-tested the CSAS following a translation to
Norwegian. They distributed the CSAS by postal survey to 4 Medical Schools and
yielded a 60 % response rate (n=1833). On analysis of the data they concluded that
`attitudes` were more complex than merely positive or and negative. They suggested
there were 3 concepts measured within the tool, namely `attitudes to learning` (Items
7,10,12,18, 21 and 25), attitudes to the relative importance of good communication
skills from the students perspective` (Items 1, 4 positive, and 3, 9, 22 negative) and
thirdly `respecting patients and team members`(Items 5,9,14,16). They postulated that
attitudes may affect cognitive and affective learning and suggested that repeated
measures of the CSAS may assist in curriculum design and evaluation [2]. A limitation
of this study was that it was cross sectional not longitudinal. Cleland [3] then re-tested
276
the CSAS tool in Scotland where similar findings to Rees [1, 6] were observed. Students indicated a positive attitude initially, but this declined over the clinical years. A
limitation of this study was that of cohort effects as three separate cohorts of students
were studied and compared rather than one cohort progressing through the undergraduate years [7].
More recently, Sowon-Ahn [4] utilized the CSAS in Korea to explore potential
differences in attitude of medical students to communication skills learning in a different culture and where English was not the first language. The results again indicated
that students had doubts about the need for communication skills learning in medicine
and concern regarding the facilitation of interpersonal skills. Ambiguity regarding their
motivation to learn these skills and a negative attitude towards assessment ultimately
resulted in a displayed overconfidence in their skills. In summary, despite a variety
of research study settings, the finding of a decline in positive attitude pre and post
an initial training course appears consistent. The aim of this study was therefore
to utilize a longitudinal approach to investigate attitudes and attitude changes in an
Irish Medical School over the entirety of the training programme.
2. METHODS
2.1 Research Sample
A total class of 128 medical students was initially invited to participate on Day
1 of the 2nd Medical Year, pre clinical exposure. Participants were informed of the
research aims and asked to complete a communication skills attitude scale (CSAS)
whilst in a large lecture theatre. All were assured that participation was optional and
anonymous. All data was collected by the first author who was not involved in teaching
or assessing the communication skills programme to reduce potential bias [9]. This
initial dataset formed the baseline attitude scores. All students completed a CSAS,
n=128 , however, one student who was repeating the 2nd year was, following discussion, excluded from this study as previous clinical exposure may have been a confounder. The final sample at the beginning of year 2 was 127 medical students. The
CSAS was distributed again to all participants in a large lecture theatre by the first
author at the end of their 2nd Medical Year (n=127) and then sequentially at the end
of the 3rd (n=96); 4th (n=110) and 5th (n=47) medical years respectively. The entire
original cohort started and finished the programme.
277
3. RESEARCH INSTRUMENT
3.1 Communication Skills Attitude Scale CSAS
The Nottingham Communication Skills Attitude Scale (CSAS) [6] was utilized
in this study (Appendix 1). This previously validated tool consists of a likert scale
consisting of 26 statements, 13 of which are positively worded and 13 are negatively
worded. Positive and negative statements are randomly interspersed throughout the
instrument. Students scores range from 13-65 for positive attitude statements (PAS)
and 13-65 for negative attitude statements (NAS). The validity of the tool is further
enhanced by students having a high positive score (PAS) having a reciprocal low negative score (NAS).
3.2 Analysis of the Data
The CSAS forms were completed anonymously at the start of the programme
and were thus not coded with an identifier that could be used to link each students
survey data over the five measurement points. Furthermore, the number of survey
responses in the five measurement points were disparate (min=47, max=127). Consequently, it was not possible to utilize paired statistical tests or repeated measures
ANOVA in this study [7]. Resampling methods [7,8] were therefore utilized to analyze
the data. The underlying statistical estimator for PAS / NAS was ANOVA, whereas
the Kruskal-Wallis non-parametric test for used for individual questions [9]. Where
significance was determined across the five measurement points, a second level
analysis was conducted. This analysis consisted of removing one measurement point
at a time and repeating the resampling analysis with the remaining four measurement
points [8, 9].
4. RESULTS
4.1 Positive Attitude Score (PAS), Negative Attitude Score (NAS)
Weak statistical significance was determined for a difference across the five
measurement points for the PAS score (90th percentile p=0.075). Second-level analysis determined that the beginning of the second medical year and the end of the second medical year measurement points were the cause of the difference across the
five measurement points. Third-level analysis showed that there was statistical significance (95th percentile p=0.035) for a difference between the PAS scores of the start
and end of the second medical year (Table 1 and Fig. 1).
beginning of the second medical year and the end of the second medical year measurement
points were the cause of the difference across the five measurement points. Third-level
th
analysis showed that there was statistical significance (95 percentile p=0.035) for a
Cambridge
of and
Education
difference between the PAS
scores ofJournal
the start
end ofand
theScience
second medical year (Table 1
and Fig. 1).
278
PAS
NAS
PAS
NAS
Year 2 start
Year
51.9 2 start
29.8
51.9
29.8
Year 4
Year
49.3 4
31.4
49.3
31.4
Year 5
Year
49.3 5
29.6
49.3
29.6
Fig. 1.
1. Box
Box plots
plots of
of 55 measured
measured points
points of
of PAS
PAS
Fig.
No statistical
significance
was determined
when comparing
the comparing
NAS scores across
the scores
five
No statistical
significance
was determined
when
the NAS
measurement points (Table 1 and Fig. 2).
across the five measurement points (Table 1 and Fig. 2).
279
and 21 (90th percentile p=0.069) - Table 2. Second-level analysis revealed that only
the start of the second medical year measurement point was responsible for the
change across the five measurement points in item 7. Similar analysis showed that the
beginning and end of the second medical year measurement points were responsible
for the change across the five measurements in items 9 and 21. Third-level analysis
revealed that there was a statistically significant difference (95th percentile p=0.046)
between the start and end of the second medical year measurement points for item
9. Similarly, a weak statistically significant difference (90 th percentile p=0.038) was
determined between the start and end of the second medical year measurement
points for item 21.
Table 2. Mean values for items having statistically significant changes
Item
2- Neg
3- Neg
7- Pos
9- Pos
11- Neg
21- Pos
22- Neg
Year 2 start
1.35
2.48
3.58
4.22
2.77
4.15
2.82
Year 2 end
2.28
2.9
2.9
3.48
3.33
3.45
3.42
Year 3
1.92
2.7
3.02
3.89
2.94
3.8
3.33
Year 4
1.94
2.35
3.03
3.86
2.74
3.83
2.94
Year 5
1.66
1.91
2.96
3.96
2.55
4.04
2.66
280
surement points were determined to have caused the change across the five measurement points for item 11. Third-level analysis for item 11 revealed a weak statistically significant difference (90 th percentile p=0.041) between the end of the second
medical year and the fifth medical year measurement points.
Second-level analysis of item 22 showed that the end of the second medical
year, the third medical year and the fifth medical year measurement points were responsible for the first-level difference across the five measurement points. Third-level
analysis of item 22 showed a weak statistically significant difference (90 th percentile
p=0.057) between these three measurement points. Fourth-level analysis showed
that the fifth medical year measurement point was responsible for the difference identified in the third-level analysis.
With regard to other items of interest and relevance on the CSAS, 60 % of
participants disagreed with ITEM 19: I dont need good communication skills to be a
good doctor from the beginning to the end of the programme demonstrating a positive
correlating between good communication and good doctoring. Equally of interest was
ITEM 20: I find it hard to admit to having some problems with my communication skills.
It appears the further into the training programme the student progresses the less able
they are to admit to difficulties with communication. This needs to be observed for
and addressed at this crucial point in the training programme pre certification.
5. DISCUSSION
The results identified that students had positive baseline attitudes to communication skills teaching and learning at the beginning of their second medical year.
The findings of a positive attitude at the beginning of the pre-clinical course concurred
with Reess (1) original UK studys findings albeit the power of Rees`s study was
greater with a sample size of 216. The educational methods used by Rees are similar
to those employed in Ireland with small group experiential learning methods, supported by seminars and assessed at a history taking station at OSCE (1).Thus
these findings may be generalisable and be reflective of attitudes of medical students
in other Irish and UK medical schools.
Students in this study were less positive in attitude to communication skills
teaching and learning at the end of the first clinical year (Year 2). With regard to
interest in learning, usefulness of skills set and impact of communication skills on
team working .This concurs with previous UK findings [6]. Tor Anvik also reported
an attitude decline in 3 out of 4 medical schools in Norway over a 6 year programme.
281
He described this attitude change as being more specific to `affective` attitudes [10]
and reported `cognitive` attitudes remained constant. His study suggested students
feelings regarding the teaching of communication changed in the early years perhaps
owing to a dislike of teaching methods such as video-recording and feedback and
poorly delivered feedback. These factors may leave the students uncomfortable
and vulnerable with resultant negativity.
Over 60% of students at every data point disagreed with the statement that that
they don't need good communication skills to be a good doctor. The need for
this skill set is recognized, this has been described previously as a cognitive attitude
[10]. It may be the manner in which it is taught that is affecting the attitude change or
affective attitude [10]. Aspegren [11] previously reported students preferred practical
experience and experiential learning to attain communication skills rather than formal
teaching. As students tend to over-estimate their communication skills abilities [3]
they may feel that their skills are not in need of improvement and be 'unconsciously
incompetent' in this skill set in the earlier years. A decrease in negativity in the later
years may be due to the progression of the students from the unconscious incompetent to the conscious incompetent [12]. The relevance of this skill set may become
more evident as the students near completion of the training programme and begin to
appreciate the realities of joining the clinical workforce. Students did report an increasing inability to report problems with communication as they progressed through the
programme. It could be postulated that by the programme end students become more
aware of their limitations. It is essential that they are supported at this crucial point of
transition from student to health care professional. This self awareness may be owing
to natural ageing and maturing or may be as a result of becoming more self reflective
as they progress through a medical training course. Further qualitative research is indicated to fully explore this area.
A suggested cause of a decline in attitude at the end of year 2 is that
following the theoretical component of the taught course and actual patient contact;
the students may have gained insight into their limitations in this area. They may experience a loss of positivity as they experience difficulty with the application of theoretical classroom taught knowledge in the reality of clinical medicine. It could be that
medical students merely espouse the theories of good communication in the early
years giving the socially desired responses on the CSAS. A further suggestion for
the decline in attitude is the de-emphasis of the importance of communication
282
skills in the clinical years. The culture of medicine to which the students become exposed to in which communication skills were not traditionally considered a priority.
Making communication clinically relevant to junior medical students may address the
decline in attitudes. Educational initiatives may include shadowing of Senior Staff as
positive role model and direct observations of Inter-Disciplinary and Intra-disciplinary
communication interactions in the clinical setting.
Communication skills are often seen as a soft science, not quantifiable and of
low academic credibility. Students decline in attitudes to communication skills learning
may be due to their uncertainty in the early years of their relevance to clinical practice
as they spend little time there. Incongruity with the biomedical model may be a causative factor reflected in students attitudes. Equally teachers attitudes may influence
the students' experiences [10]. Poorly defined educational goals may fail to emphasize the fundamental need for good communication skills for professional practice. It
is accepted that attitudes are difficult to influence but may change when new
knowledge is presented, provided that the knowledge is convincing and the presenter
is credible [11]. Recently there is an increased interest and review of the selection
processes for candidates entering Medical Schools in Ireland. Medical Educators
accept that attitudes will impact on skills and ultimately on behavior [11]. Good communication skills need to be identified early in the selection process to identify personnel truly suited to a career in Clinical Medicine. Tomorrows doctors need to
demonstrate above average intelligence quotients (IQ), emotional intelligence and ultimately positive attitudes to communication skills learning.
6. LIMITATIONS
A potential limitation of this study is the use of a 5 point Likert scale. The use
of a seven or nine point Likert scale [8] is indicated in future studies to yield more
sensitive data that would facilitate exploration of the potential impact clinically of a
change in attitude. Coding of the CSAS forms with confidential individual identifiers
throughout the 5 years would have enabled comparisons to be made with regard
to individuals' changes and allowed for analysis of paired data. Inclusion of aspects
of the curriculum, socio-demographic data and individual differences may explain
some of the outcomes and would have enabled comparisons to be made with findings
from previous studies [1,2,3,4,5,6,10]. Further cluster analysis of the items changing
most significantly on the CSAS to identify any latent factors would have potentially
strengthened the results. These limitations will be addressed in future studies.
283
7. CONCLUSION
In conclusion, undergraduate students in an Irish Medical School have a positive attitude to communication skills teaching and learning at the beginning of the
training programme. By the end of the first clinical year (2nd year), the decline in
attitudes to communication skills teaching and learning was statistically significant.
By the end of the training programme attitudes are almost back to the original baseline attitude scores. The decline in attitudes at the end of the 2nd year is an area for
concern and needs to be addressed with effective teaching interventions. Communication skills are a mandatory and core component of professionalism and a prerequisite to inter-disciplinary clinical work.
ETHICAL APPROVAL
Consent for this study was gained from the Health Sciences Departments'
Research and Ethics Committee.
ACKNOWLEDGEMENTS
Class of 2012 for participating in this research.
Mr. Craig Smoothey for his advice and assistance with the statistical analysis.
PRACTICE POINTS
1. Medical students in Ireland commence their training with a positive attitude to
communication skills teaching and learning.
2. There is a statistically significantly drop in positivity at the end of the first clinical
year (Year 2).
3. Educational initiatives need to address this decline in positive attitude supporting
students through the middle years of training promoting the attainment and
retention of the core skills of good communication required for professional
practice.
COMPETING INTERESTS
The authors report no competing interests or conflict of interest in the
researching and writing of this paper.
284
REFERENCES:
1. Rees CE, Sheard C. Evaluating first-year medical students attitudes to learning communication skills before and after a communication skills course. Medical
Teacher. 2003;25(3):302-7.
2.
com/content/text/index.shtml.
harles M. Grinstead J, Laurie Snell. Introduction to Probability. Available:
http://www.dartmouth.edu/~chance/teaching_aids/books_articles/probability_book
/ ams book.mac.pdf.
285
APPENDIX 1
Communication Skills Attitude Scale- (Rees) 2002
Please read the following statements about communication skills (CS) learning. Indicate
whether you agree or disagree with all of the statements by circling the most appropriate
response:
1=strongly disagree
1
2
3
4
2=disagree
3=neutral
4=agree
5=strongly agree
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
12345
287
viors during the pre-planned school schedule. During key educational experiences
the teachers were deviating from formal instructional schedules and the students
were neither sitting in silence, nor complying with formal directives. Rather, they were
shouting with enthusiasm, rejoicing in their learning, at times ignorant of the fact that
they were actually learning.
Conclusion: This article shows that in Israel learning is equated with noisy and
rather informal modes of instruction, suggesting that "active" methods have long-term
educational effects on students' lives.
Keywords: learning; classroom instruction; key experiences; Israel; culture.
1. INTRODUCTION
"In one of my social studies courses for high school seniors, I conducted a
discussion on possible contradictions between democracy and national security. The
pupils worked in teams, preparing arguments for or against each position. The
discussion between the groups provoked excitement, with pupils fervently shouting
at each other. Suddenly in walks the principal, asking if all was under control. I
answered that it was. After class the principal approached me and asked whether I
had discipline problems in class and whether I had managed to finish teaching the
required material" (reported by a high school teacher).
This incident reflects a common wisdom among educators, pupils, and parents
alike, namely that silent classrooms are conducive to learning [1]. According to this
position, silent classrooms provide conditions for effective learning, where teachers
can cover the required curriculum in predetermined timing and at a predetermined
level [2-4]. It is further assumed that noisy classrooms provide fertile ground for pupil
misbehaviour and disengagement. For example, critiques of open or progressive
schools claim that unorganised debates, open discussions and individualised learning
might provide pupils with an opportunity to use the noise and din during such activities
to disrupt classroom order. The common assumption is that learning in such settings
undermines classroom order and exacerbates discipline problems. Learning and noise
are regarded, then, as oxymoronic.
This assumption is indeed heralded by principals who pride themselves on the
silent learning climate in their schools, regarding it as proof of effective learning.
Teachers, too, consider silent classrooms as a key for learning and are inclined to
288
identify a silent classroom with efficient learning. Even pupils and parents emphasize
the importance of a solemn atmosphere for learning, claiming that pupils cannot study
properly in "noisy" classrooms.
In contrast, a growing body of scholarship has begun to undermine the
sweeping conclusions of this common wisdom. Such criticisms stem from recent
theoretical developments that point out the inability of traditional bureaucratic school
systems (which opt for silent classrooms) to cater for long-term meaningful learning
amongst pupils. Theoretical trends such as "constructivism in education", "active
learning", and "authentic instruction" look for instructional and curricular features that
allow pupils to have meaningful long-term learning experiences [5-8]. Furthermore,
an increasing volume of research showing that there is no simple correlation
between classroom noise and pupils' achievements supports such trends. This
literature further suggests that under certain conditions silent classrooms might even
create alienation and pupil disengagement [9,10].
Moreover, critical scholars claim that silence primarily serves schools as a
control device, thus curtailing significant learning [11]. They claim that many schools
maintain silent atmospheres as a disciplinary means, thus compromising significant
didactic goals [12]. They argue that administrators settle for class attendance,
focusing on the accumulation of required credit points for graduation exams. Many
pupils react to such school policies with opposition, expressing little involvement in
class and a protest of roaring silence. Nevertheless, most of them are well aware of
the importance of a graduation diploma for their future. Consequently, they go
through the motions and pretend to be busy learning, knowing that a facade of
involvement is the real scale by which they are evaluated in school [13]. But behind
their expressed silence, they harbour disengagement, alienation, and hostility
towards school and school learning [14,15].
The debate over the silent classroom has theoretical and practical implications,
and has consequently received much attention. While the academic critics of the silent
classroom have gained momentum, educational policies in the past decades have
pressed more firmly on schools to attain predetermined curricula and standards. For
example, in the US the National Commission on Excellence in Education, and its
repercussions in standards-based reforms two decades later has increased the
emphasis on bureaucratic procedures and control mechanisms. In the UK, the
289
National Curriculum has similarly pressed for standartisation and control of instruction
and curricula. Such reforms have not passed unnoticed in the world, Israel including.
Notwithstanding the importance of this debate over silent, controlled classrooms, most of the extant literature on the topic is polemic in nature and ideologically
driven. This state of affairs precludes any firm conclusion put forth by the protagonists
in the debate. Furthermore, most of the studies on this issue were conducted in
ordinary or traditional classrooms, where learning is focused on transferring "dead
ideas" from teachers to pupils. As a result, they could not examine the extent to which
significant learning takes place in silent classrooms.
To overcome these limitations, the present study assesses the extent to
which silent classrooms enable students to experience meaningful instruction. It does
so by analysing retrospective key educational experiences that have left a long-term
mark on pupils' lives. The study uses the most significant learning experiences that
adults recall from their school days in order to reconstruct the type of instructional
practices that were evident in those classrooms. On this empirical basis it seeks to
reassess the claims about the efficacy of silence in classrooms.
1.1 The Classroom as a Learning Society
Willard Waller (1932) characterised the classroom as a learning society
that imposes contradictory tasks on teachers: namely to teach and to motivate pupils.
On the one hand, teachers are required to transmit the required curriculum in
large heterogeneous classrooms. To that effect, they have to teach the pupils a preplanned and pre-scheduled curriculum and prove to their superiors (as well as to
parents) that their pupils achieve formal requirements. In order to meet this goal
teachers are encouraged to discipline their pupils and safeguard the orderly
environment of the classroom. Hence, they are keen on having a silent classroom,
constantly supervising pupils and organising instruction using pre-prepared lesson
plans [16,17].
On the other hand, the constant supervision and disciplinary control of pupils
contradict the second task of teaching, namely motivating pupils, exciting them, and
arousing their interest in learning. Different studies have shown that significant
learning experiences occur when teachers supply pupils with a free choice of topics,
challenging material, high level of skills, and relevant subject matter [5,9]. Therefore,
290
in order to attain their second task, teachers have to ease their disciplinary supervision
and minimise pupil control. Overall, the more teachers try to supervise and control
pupil behaviour, the less they succeed in arousing motivation in their pupils, and vice
versa.
There is evidence that in facing this dilemma most teachers choose to
supervise classroom learning, thus compromising meaningful learning and inquiry.
Studies have shown that the duality of the classroom as a learning society leads
teachers to perceive silence levels as a central measure for assessing their
professional capacity as teachers [18,19]. Many teachers also know that supervisors,
head teachers, and parents all expect them to maintain a silent classroom in order to
assure amicable learning conditions for the pupils [20]. These conclusions are
supported by findings of leaders in school effectiveness studies, who concur that silent
and focused classrooms are more conducive for learning [21].
The inevitable compromises that teachers make - preferring controlling
rather than motivating their pupils - stem from the organisation of the school [7].
The bureaucratic principles of public schools reward teachers who discipline their
pupils, while obstructing those who seek to motivate the pupils by using informal
strategies [22]. The following analysis suggests that silence in classrooms is indeed
driven by organisational considerations.
First, hierarchical teacher-pupil relationships encourage teachers to maintain
distance from their pupils, avoiding improvisation and flexibility [17]. They prefer to
follow pre-set course outlines while preventing pupils from developing an independent
learning agenda. Second, the bureaucratic requirement to abide by impersonal
rules and regulations leads most teachers to meticulously cover the material in the
curriculum while blocking new initiatives and learning ideas that are not "test material".
To meet these requirements, teachers strictly hush their classroom so that they can
"cover the material" in time. Thus, dictation from the teacher's notebook and reading
out aloud from pre-prepared worksheets create the feeling of serious and silent
learning, especially to external spectators. Third, school inspection rules also pressure
teachers to maintain silence. Inspectors mainly assess external features of classroom
instruction: They check national school timetables, assess the attainment of the
National Curriculum, focus on decreasing dropout rates, and on controlling pupil
misbehaviour. Studies have indeed shown that inspectors focus on symbolic and
291
292
show that many classrooms are noisy and disobedient, with teachers sacrificing
instructional demands in order to attain the facade of a controlled classroom. With
some generality, then, these studies support the claim that silent classrooms are
indeed more effective for learning.
Third, school effectiveness studies - a conceptually independent body of
literature - have a similar view. These studies have attempted to extract basic features
of school organisation and culture, which set some schools ahead of the pack, and
emphasised that silent and controlled school environments yield high achievements
[31-35]. In contrast, in schools that lack leadership and control mechanisms over pupil
achievement, pupils evade learning while settling for the lesser side of the educational
opportunities that schools provide.
Although they differ conceptually and methodologically, these three lines of
study concur that orderly and silent classrooms constitute the grounds for efficient
learning. They also seem to agree that noisy, uncontrolled classrooms harbour
disobedience and pupil disengagement. Notwithstanding this agreement, these
theoretical schools share similar shortcomings, which should preclude a hasty
acceptance of their conclusions about the effectiveness of silent classrooms for
meaningful learning.
There is reason to suspect that what these studies call "learning" is not really
meaningfully experienced as such by pupils. These cumulative models of learning
assume that learning is a slow process that takes time to materialise, with pupils
accumulating knowledge by sitting in classrooms day after day, year after year. There
is reason to believe, however, that meaningful learning experiences cannot be
equated with the outcomes measured by most studies in educational research. School
achievements in mathematics, science, or reading cannot be equated with meaningful
learning experiences. Consequently, these studies have not yet provided sufficient
evidence to decide that silent classrooms are indeed necessary for producing
meaningful learning experiences.
Overall, existing research does not provide us with a resolution to the question
of whether a silent classroom is actually a learning classroom, or more accurately
whether a learning classroom is necessarily a silent one. The aim of the present study
is to fill in the gap in this literature and test the claim that a meaningfully learning
classroom requires silence. Unlike most studies in this field, the present study
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(n = 92) and primary schools (n = 162). Statistical testing did not show any correlation
between respondents' age and the type of institution that most prominently affected
their life. This finding suggests that the results do not reflect memory-related recency
effects. Moreover, it is possible that the design of the study triggered respondents to
tell a story as a "turning point" narrative [39], though the phrasing of the questions
asked respondents to report their best life experiences, or the most significant ones,
without hinting at the fact that the study focuses on critical moments.
2.2 Methodologies
Data gathering was based on in-depth interviews in which the respondents
were asked to report their three most significant learning experiences, whenever and
wherever they occurred. After the interview, respondents were asked to choose the
most significant experience of the three, and to answer a closed questionnaire related
to it. Respondents were taped during the interview and the entire transcripts were
taken from the tapes. Respondents were asked to address three main aspects of
their key experiences:
Organisation - in this part the respondents were asked to describe the organisation of the activity, focusing on teaching practices and methods.
Phenomenology - in this part the respondents were asked to report their
feelings during the activity, while discerning between intellectual, emotional, and
identity-focused phenomenological experiences.
Outcomes - in this part the respondents were asked to report the long-term
effects of their key experiences, while discerning between effects on their values,
behaviours, pragmatic decisions, and personality.
2.3 Data Analysis
The study used a grounded-theory approach, combining deductive and
inductive content analysis of the interviews. The analysis started with a deductive
coding of the narratives using categories derived from the pilot study. Further
categories were inductively gleaned from the data. Each experience was divided into
segments (sentences and paragraphs), and each was assigned a main title. Similar
titles were grouped into theoretical categories, which were developed and refined as
the coding continued.
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lecture-type instruction can remain engraved for life, conditioned on their instructional
characteristics.
3.1 Contents and Activities in Key Educational Experiences
Table 1 presents the frequency distribution of the categories, which were used
to describe instruction during key, highly meaningful learning experiences. Based on
the analysis of the narratives, we distinguish between content and activity characteristics. The reports suggested that many key experiences occur in silent classrooms, but that the content of instruction during these episodes was relevant,
authentic and challenging. However, the results clearly suggest that many key
experiences took place in noisy classrooms, where the activities did not allow teachers
to maintain a silent, orderly environment.
Table 1. Frequency distribution of content and activity feature in key
educational experiences
Teaching Strategy
Authenticity
Relevance
Challenge
Performance in Public
Experimentation
Use of Multiple Skills
Constructing Peaks
Allowing Choice
Using Competitions
Using Surprises
Type
Content
Content
Content
Activity
Activity
Activity
Activity
Activity
Activity
Activity
Frequency (N)
121
63
58
56
34
32
25
21
20
10
The following exegesis of the results uses original transcripts from respondents'
reports in order to exemplify the contents and activities during key educational
experiences, and to characterise the atmosphere during these episodes. We usually
cite one quote for each category, although we could have provided many more. The
numbers appearing at the bottom of the quotes refer to respondents' ID code and
memory number.
3.2 Content Characteristics
The most salient content characteristic appearing during key educational
experiences is authenticity. Authentic instruction is usually defined as teaching reallife topics, or as doing real-life activities [5]. Most respondents considered authentic
instruction as "learning from life and about life" - learning that is neither scholastic
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nor disconnected from real-life and the adult world. Rather, the contents of instruction
extend from real-life topics and connect pupil learning to their surrounding world.
Authentic instruction brings pupils into direct contact with reality, without the mediation
of a formal and emotionless school curriculum, which by its very nature relates to
pupils' "ratio", or cold reason [41]. In contrast, direct contact with real-life situations
allows pupils to feel and think at the same time, thus engraving the educational activity
for a long time.
The analyses suggested that authentic instruction usually took place outside
the ordinary classroom, immersing pupils in real-life situations. These settings were
devised using learning expeditions and by visits to institutions, or by an active
participation in an event [42]. These visits and active participation in authentic settings
can turn routine topics into lifelong, key educational experiences. For example, a 24
year old respondent described an authentic lesson his teacher devised instead of a
routine social studies lesson.
"In our social studies class in the 11th grade, we conducted discussions about
motor vehicle accidents. At one time we went to visit the hospital where many accident
casualties were hospitalised, some in critical condition, some even comatose. It is
rather difficult to admit, but no teacher, no lecturer, nor traffic professional who came
to the classroom to talk to us, no officer or doctor could ever be such a strong and
real education figure as that critically wounded person in that ward. The learning
method was the situation itself... healthy children standing face-to-face with an
accident victim" (44/3).
The second most frequent category was relevance. Understanding, as John
Dewey claimed, happens only through an experience, which is related to pupils'
lives [43]. Learning must stem from past experiences and build up from the local to
the universal. Similarly, many scholars claim that learning has to happen "close" to
the individual (in his "proximal zone of experience", as Vigotsky says), and relies on
pupils' original experimental discoveries. This perspective indeed promotes school
reform in many places, which opt to adopt relevant instruction and curriculum that
connect with pupils' lives. As children differ from each other in their abilities, interests
and past experiences, a relevant curriculum must allow each one to choose his or her
personal topic of interest. Noteworthy in this respect is Theodore Sizer's dictum that
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"Kids Differ" [8,44], a basic principle later developed in his Coalition of Essential
Schools.
Examples for relevance in teaching reappear in respondents' narratives of their
key educational experiences. For example, a 30 year old educational counsellor told
us about the research project she did during the seventh grade.
"Seventh grade was the Bar Mitzvah year in the kibbutz, part of which was
dedicated to a project which examined a topic related to Israel. At that time I was
reading a book by Dvorah Omer, called "Love unto Death", which describes a love
affair between a young girl from the army during 1947-8, and one of the boys there,
who was later killed. As a seventh grader I was touched by the story and decided to
write my project on that. It was a true story and I decided to write my paper on that
topic... My father drove me to Dvorah Omer's house and I talked to her... she let me
read some of the diaries that the girl (Zohara) kept, which were the raw material for the
plot... My father also drove me to see one of Zohara's childhood friends... reading
Zohara's diaries and talking with her friends linked the reality and my imagination (the
book)... the mere connection of something I read with its reality made that experience
that much more unique and fascinating... my decision to study literature and education
rose out of my feelings and interest in studies which could be applied to reality" (279/1).
The third most frequent content characteristic is challenge (n = 58). Many
respondents, some of whom had previously defined themselves as mediocre or poor
pupils, noted that their "great moments of learning" were characterised by the difficult
challenge they faced. Often, those were tough research assignments given to pupils
in or out of school. In other cases, pupils were faced with topics and assignments
that were intellectually and emotionally challenging, and promoted stormy and
lengthy debates in class. All in all, challenging assignments demanded that pupils
make the most of their personal resources (thinking, will-power, self-discipline and
motivation), while requiring high performance levels, concentration and engagement.
One of the most challenging instructional strategies was based on teamwork where
pupils had to solve difficult problems and assignments in a group. A respondent who
reported on his physics class provided an apt example for this category.
"The teacher presented us with a time-limited challenge, namely to build a
device which produces its own energy... the pupils spent the whole weekend trying out
different ideas and methods, using all the material and knowledge they possessed as
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well as their creative imagination... of course we did not make it, but... we did not feel
we were busy learning, but rather that we were dealing with the challenge of proving
to that teacher that we could do it" (200/1).
The challenge in those tasks is often accompanied by a time limit, which
creates a sense of urgency among pupils. In this and other cases we learnt that pupils
dropped all other activities and focused their energy on solving the problem, since it
was important for them to prove to their teacher that they could meet the challenge.
3.3 Characteristics of Informal Activity
Besides content characteristics, the analysis has pointed to seven other
informal features of key educational experiences. The frequency count of these
features appears in Table 1, and the following discussion elaborates on a number of
them.
The most frequent instructional strategy we found (n = 56) is performance
in public. Respondents have a varied perception of an "audience", including peers,
adult guests (e.g., parents), and external evaluators. Performing in front of an
audience puts pupils in a stressful situation and encourages them to attain their best
performance. We have found that public success and immediate feedback arouse
intense feelings and self-fulfillment among respondents. For example, a 44 year old
respondent recounted that at the age of 15 she enjoyed her geography classes
particularly because the teacher appointed her as a "little teacher". At the beginning
of every lesson the respondent conducted a 10-minute rehearsal with her class peers.
"I enjoyed the activity very much. It was lots of fun standing in front of the class,
explaining the issues and discovering that pupils are interested and understand my
explanations. I felt I was in command of the curriculum, that I was a good pupil,
and that I was well able to explain the lesson to my classmates. The presence of
the pupils prompted me to continue and explain and repeat it every time. This made
me highly satisfied" (368/2).
The
second
most
frequent
instructional activity
was
research
and
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data, and prepare a research report. Experimental work in biology class, or writing a
theoretical paper in a social science class, created an almost singular experience
where pupils felt that they are finally responsible for creating, criticising, and validating
knowledge. For example, a respondent reported that as part of his high school
geography lessons he had to choose one elective course out of several options, and
he chose navigation because it interested him. In this informal framework, the
geography teacher taught the pupils to read maps and draw navigation routes.
"Learning was practical. We went out for two- or three-day field trips. At the
beginning of each trip the teacher explained the maps, and then the pupils went out
for a hands-on experience, alone or in pairs... The independent experimentation was
very enjoyable. It gave us a feeling of independence and control, confidence, and a
sense of orientation... In time, this preoccupation with navigation turned from a hobby
into a semi-professional career. I took part in many navigation competitions in Israel
and won first prize in quite a number of them" (384/3).
The third instructional strategy we deciphered was skills. Indeed, supporting a
rich research tradition [46-48], the present study found that instructional activities that
used a variety of pupils' skills tended to leave their mark for many years. Examples
are numerous and varied: artistic skills (acting, dancing, singing, painting), technical
skills (building and dismantling construction) or personal skills (handling time
pressures, organisation management, teamwork). In all the narratives in which this
strategy appeared, the activity demanded that pupils use more than one skill. A good
example is the story of a respondent who today works as a guide in a science museum.
"In the ninth grade biology class, we were asked to write a paper on air pollution.
Later, the teacher asked for volunteers to put up an exhibition on air pollution. I
volunteered and together with a team of five other pupils we were busy for a whole
month preparing the exhibition. It was important for us to put across the message to
all pupils, in a clear and understandable way, so that even those who were not
interested in the subject would support the issue. Our cause was sublime: to arouse
awareness of the risks of air pollution. Unlike our theoretical paper, here we had to
use many skills, working under a pre-set timetable and using creative and original
skills. For example, we drew the globe crying for help: "My hole in the ozone layer was
growing and the icebergs were melting..." On another poster, we pasted all kinds of
sprays ejecting preones, which attack the ozone layer. In order to illustrate acidic rain
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we drew black forests, deserts and wilderness, versus green and fresh grass with
budding flowers. The teacher gave us a free hand in deciding which topics to focus
on, and how to present them... The exhibition, which we built single-handedly, was
positioned at the entrance of the school and was highly successful... we received
praise from other pupils. During the activity I felt self-fulfilled and experienced a sense
of vocation. Constructing the exhibition by ourselves gave me a sense of motivation
to learn and apply myself; it taught me what teamwork and cooperation is all about,
and I felt in control of the subject matter" (451/1).
This report illustrates the importance of using pupils' skills. Firstly, the use of
skills can influence pupils' engagement in class, as they are given the opportunity
to express their skills and capabilities - a very different feat to what is commonly
demanded in silent, orderly classrooms. Secondly, exhibiting their prowess using
different media (painting, writing, putting up exhibitions, theatrical shows) allows
otherwise lesser involved pupils to take part in organising such activities [6].
Furthermore, the multi-media character of such activities promotes the use of many
senses (touch, vision, hearing, smell, and even taste) and touches a variety of
interests, thus allowing almost every pupil to take part in the activity and enjoy learning.
Another strategy that teachers used to challenge and motivate pupils was
evident in their use of competitive situations. Respondents reported that their peak
motivation occurred during the competitions that their teachers conducted in class.
Competitiveness was not the main theme of the activity, but rather a catalyst that the
teacher used to prompt pupils to take an active part in learning. Nevertheless,
competitions can transform a dull lesson into a highly emotional endeavour. As a
result of such arousal in class, pupils retain long-lasting memories of the content of
instruction, or of its moral principle. For example, a young respondent described a
covert though significant competition that her teacher initiated between her pupils.
"As part of my high school curriculum I chose to study Arabic. In my final year
we had to pass an oral graduation test. But most pupils, myself included, had a very
hard time with that. We felt stressed and tense, fearing the test... One day the teacher
invited us over to her house. We watched a short videotape of her last visit to Egypt,
listened to songs in Arabic, and she gave us some refreshments. We talked and
laughed like friends... Then the teacher asked us to tell a story in Hebrew, and she
helped us write it in Arabic. Then she prompted us to have a dialogue in Arabic about
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the meaning of the stories. Thus, we began a sort of invisible, but positive,
competition, as each pupil wanted to express his own opinions and oppose the
others... Finally, we learnt to love Arabic and succeeded nicely" (451/1).
Surprise - although the least prevalent strategy we extracted - represents
another unique means by which teachers arouse intense feelings and motivation.
Surprises in activities create highly emotional excitation and promote pupils' cognitive
insight. Furthermore, such situations create high motivation among pupils, who seek
to discover or solve the mystery that the teacher cast into the activity. Surprising
activities could take form in a variety of ways. According to some reports, key
educational experiences took place when pupils did not know what to make of the
teacher's plotted lesson. For example, one respondent described a surprising
activity that her science teacher created in primary school.
"The teacher, a colorful personality, called for a volunteer and asked him to lie
on her desk (usually covered with test tubes). She blindfolded him and forbade us to
react throughout the experiment. In addition, we were neither told what the subject
matter was, nor about the purpose of the experiment, so we did not know what to
expect. The teacher inserted pieces of paper between the volunteer's toes and lit
them. The pupil began rotating his legs as if he was riding a bicycle and just in time
the teacher removed the burning pieces of paper. This is how I learnt the fascinating
topic of instincts. The surprise caused excitement in class" (51/1).
This story demonstrates that pupils had no clue as to what was about to happen
in class. Then, in what seemed like a scene from a highly charged emotional
gathering, e.g., where the preacher is inspiring his congregation, the respondent had
an insight - the topic of the lesson, which earlier had seemed to be an unfocussed,
chaotic educational activity, became clear to her.
In reviewing the results, it appears that key educational experiences did not
take place in silent classrooms. The analyses have shown that pupils were all but
slumber: they were active, fervent, enthusiastic, and keenly interested in the topic;
they were emotionally aroused, feeling excitement and fulfillment. The content
and activity characteristics described here suggest that for instruction to have longlasting effects on pupils' lives, it cannot be based on simple teacher-centered
strategies. Likewise, teacher-centered, controlled and supervised classrooms left few
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traces in pupils' recollections. Rather, instruction that passed the test of years was
based on "noisy" and seemingly disorderly strategies.
Performance in public was necessarily predated with uncontrolled, cheerful
rehearsals; competitions generated shouts and enthusiastic engagement; relevance
and authenticity made things dear to pupils' lives, thus implicating their selves in
the activity, resulting in highly emotional and fervent involvement. Although we do not
test this hypothesis here, we conjecture that instructional activities that combine
several of the above mentioned content and activity features are more likely to have
long-lasting effects on pupils' lives than those that use only one or none at all. All
in all, the evidence suggests that although key educational experiences did not
necessitate noise or disorder in class, they rarely occurred in silent, highly supervised
classrooms. The next section elaborates on this claim.
3.4 Outward Bound: Learning Outside the Classroom
Dewey and Whitehead, the American pragmatic philosophers, noted at the
beginning of the twentieth century that instruction through the use of experimentation
could translate disconnected scholastic knowledge into the child's own reality, and
thus revive "dead ideas" [43, 49]. According to their position, only experimental
learning, which connects classroom learning with authentic and relevant topics
outside the school, deserves the title of education. The findings of the present
study support this philosophical view, by showing that key educational experiences
occur "in the real world", i.e., outside schools' boundaries [42].
Indeed, many respondents (n = 65 or 13.5% of the experiences) pointed to the
fact that their key educational experiences took place outside the classroom. Learning
through field trips, visits to an orchard, and excavating genuine archaeological
sites combined theoretical content (previously studied in class) with its authentic,
natural setting. Outward-bound activities are enriching, helping pupils gain insight
about the topic and its natural context. For example, a 45 year old respondent spoke
about her high school biology classes, which took place outside the classroom. She
described how enjoyable these field trips were, and why pupils were cooperative the
whole time.
"My high school science teacher was an avowed science lover and an expert
on reptiles and plants of all kinds... Few were the lessons we had indoors. Sometimes
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we were in the lab, and sometimes we strolled in the fields surrounding the school, or
travelled far away on field trips... he used to talk about the topics while picking up
stones and telling us: "look, under this stone I found the reptile which is called so and
so..." We never dared interrupt his lessons, because the experience was so engaging
that we did not want to make trouble in class and be punished and miss the next field
trip" (304/1).
3.5 Silent Engagement in Teacher-Centred Classrooms
Significant learning experiences rarely occurred in silent classrooms. Nevertheless, the evidence suggests that under certain conditions even teacher-centred
instruction can produce key educational experiences. The analysis found that many
respondents reported their significant learning experiences to have occurred in
teacher-centred classes (n = 75), where teachers combined authenticity, relevance,
surprise, or peaks into the curriculum. Integrating these characteristics in teaching
resulted in pupils' cognitive curiosity and emotional involvement with instruction. For
example, one respondent described her high school history teacher as follows:
"The teacher entered the classroom and said she was going to talk about
the Holocaust. This was not surprising, as it was part of the curriculum. We took
out our notebooks and pens but the teacher said, 'there is no need'. I have to admit
that I personally did not like history nor did I like the teacher. I used to disrupt and
disobey from time to time. She started the lesson with a presentation from that period.
She said she was going to speak as a Holocaust survivor. She talked about her
parents, about their life in the community. She didn't ask questions - it was one
continuous lecture... we sat there for two long hours mesmerised. We even gave up
the break. At the end of the lesson she opened the box that stood on her table, and
took out a bar of soap, displaying it as her family members. We were shocked. I can
still remember that lesson in detail" (232/1).
There is reason to believe that the silence in this and in similar classrooms was
due to the pupils' keen interest in what the teachers had to convey. To the extent
that the contents were authentic, challenging and relevant to pupils' lives, they willfully
cooperated with their teacher's agenda. To the extent that such encounters required
pupils to incorporate their personal resources into learning and forced them to think,
to introspect or retrospect; to the extent that they learnt new things about their
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environment and about their own selves - to that extent pupils had immersed
themselves in learning, entering a state of flow [50]. Unlike traditional teachercentered instruction, learning in highly challenging and authentic classrooms does not
allow pupils to remain passive. Silence in these cases resulted from attentive listening
on the part of the pupils, rather than from an enforced discipline by the teacher. In
conclusion, the testimonies that we analysed prove that it is possible to significantly
affect pupils even in teacher-centred classrooms - without the need to use
"firecrackers", charisma, or highly charged rhetoric.
4. DISCUSSION
The present study has provided an initial description of instructional practices
that teachers used in what time proved to be adults' most meaningful educational
encounters. It has demonstrated that certain content and activity characteristics
generated cognitive and emotional involvement among pupils that affected their life
henceforth. The following discussion of these results touches upon four main
conclusions.
First, the study has shown that most key educational experiences occurred in
a "noisy classroom" rather than in a "silent" one. While the literature assumes that
teacher-controlled and silent classrooms constitute arenas conducive to learning, the
present study shows that meaningful, key educational experiences mostly occur
during an active and noisy interaction among class peers, during a public performance
in front of an audience, while working in pairs, through interviewing and arguing, and
by utilizing different skills and capabilities.
Teachers' use of competitions often led to pupils shouting at each other with
excitement. The construction of peaks and surprises in the curriculum generated
involvement and enthusiasm. The requirement to exhibit diverse skills and capabilities often created a carnival-like atmosphere in class.
Thus, in contrast to pupils' usual silent attendance in school, the instructional
strategies described here necessitated pupils to attend to relevant and authentic
issues, which demanded their utmost cognitive effort. During these key educational
episodes, learning did not require silence. On the contrary, silence in class would have
annihilated learning and dulled the emotions that surfaced during the activity, replacing
them with a cold, meticulous scholastic activity. One respondent summed up her
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experiences poignantly: "That was not a silent classroom, there was a lot of noise, but
such a healthy noise, where everyone called out to the other: 'I found, I discovered,
come see what I've got'. That was extremely interesting, the noise, the sounds,
the voices. These are things I remember until today" (200104622).
Second, some of the experiences mentioned here did not involve stormy verbal
interactions. Nevertheless, the pupils were far from being passive. Instruction in such
contexts impelled pupils to use their capabilities in an active and motivated manner.
For example, the paper that the respondent wrote on the protagonist in Dvora Omer's
story (relevance), or the preparation of drawings and presentations for the air pollution
exhibition (skills), did not require that the respondents work in a noisy setting.
Indeed, pupils can perform such assignments without talking, some without need for
interaction whatsoever. Nevertheless, these tasks definitely demanded respondents
to use their cognitive ability, skills and capabilities, while exhibiting enthusiasm and
learning derived from inner motivation. All in all, it seems that a passive engagement,
which characterises silent classrooms (where teachers talk and pupils listen), is rarely
mentioned in the context of significant, key learning experiences.
Third, admittedly, in about 10 percent of the experiences the activity took place
in the context of a teacher-centred classroom, which could be externally described as
a silent classroom. Nevertheless, the results have indicated that the key experiences
that occurred in these settings were not like any other silent, teacher-centred lesson
in school. In almost all cases we found the lesson to be authentic, relevant and
challenging, and the topics were mostly connected to pupils' lives, or to burning issues
that had to do with the community, the school, or their country. Thus, although the
teacher controlled the classroom and instructed in a structured method, pupils in
these settings participated enthusiastically, with overt excitement or covert emotional involvement. This implies that teachers can maintain conservative instructional
activities, yet modify the contents of the curriculum in creative ways, connecting with
and reaching to the life-world of their pupils. Such curricular modifications can
promote exciting debates that would set them apart from the tradition of neutral,
insignificant and routine school learning.
Fourth, the current study suggests that the alleged contradiction between noise
and meaningful learning has little empirical support. It has shown that "positive
noise" was evident during key educational experiences, yet it did not harm order in
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the classroom. In fact, quite the reverse: respondents remembered many teachers
because they promoted noise in their classroom, without losing control over instruction
or discipline. Actually, the reports have indicated that some teachers (n = 25)
considered noise as a positive factor that improves learning and discipline in the
classroom. This contrasts with the common belief held by most teachers that such
noise harms the pupils' ability to learn. Moreover, 40 respondents explicitly referred
to active learning and noise as beneficial, because these features formed a positive
learning atmosphere, aroused interest in the topic, and caused enjoyment and,
paradoxically, even order and discipline in class. The following quotes attest to this
statement: "The classes were conducted as a debate, the theoretical material which
we were all familiar with was taught in the most interesting way possible, and this I
believe is the reason there was no need for disciplinary measures. The pupils came
to learn, because of the lesson" (178/1). "The experiment related to the topic... we
worked in teams and the teacher passed between us and talked with us... The noise
of talking did not bother us. It was almost like a "free hour" which nobody wanted to
miss" (215/1).
Finally, this study supports the thesis by Waller (1932), Bidwell (1965), and Yair
(1997), who claimed that instruction is undertaken in a sociologically ambivalent
setting [51], with teachers torn between the need to motivate pupils and to discipline
them at the same time. The results suggest that teachers who preferred to inspire their
pupils and excite them through learning have been remembered in the long term. In
contrast, the efforts to discipline pupils result in boring them. Thus, the bureaucratic
emphasis that compels most teachers to emphasise discipline, social order and
silence in class results in pupils remembering very few teachers and meaningful
learning experiences. An emphasis on order, discipline and silence curtails the
potential influence of teachers on pupils, and neutralises the basic goal of schooling:
developing interest and love for learning, and influencing pupils' lives.
Nevertheless, the contradiction between discipline and motivation is not
inherent in classroom instruction [9]. The present study suggests that by creating high
motivation for learning, teachers can neutralise the need to discipline pupils since
learning results from pupils' inner interest. The study has indeed shown that when
instruction was authentic, relevant and challenging, when it was built on suspense,
surprise, peak moments and competitions - pupils participated energetically, without
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causing discipline problems. The noise - and there was much noise during these key
experiences - was the noise of learning, of enthusiasm, of the enjoyment involved in
acts of creation. There is evidence that the insistence on disciplining pupils results in
boredom and - as a consequence of that - in noise, discipline problems, and
alienation from instruction [52]. Upon reflection, it seems that teachers fear discipline
problems in their classroom because they understand that what they do in their silent
classroom actually bores their pupils.
5. CONCLUSION
To conclude, it seems that the question is not whether noise is conducive to
learning, but rather what type of noise. The current study has shown that high noise
levels that derive from enthusiasm and interest in learning do not contradict school
goals. Therefore, if schools wish to affect pupils, they need to find ways to allow more
teachers to be authentic, relevant and challenging. They need to expand the use
of surprises, peaks, competitions, and independent research. The present study has
shown that silent classrooms conceal what time will prove to be meaningless
instruction. In contrast, it has shown that what externally seems to be a disorderly,
chaotic classroom may actually constitute an arena that is educative and will be
meaningful for a lifetime. In concluding this paper we suggest that there might be
some Israeli uniqueness to our results, as culture always plays a part in learning and
instruction [40]. The Israeli national habitus fits the features we identified here [53],
and it is possible that students in other countries might be shocked by some of the
outstanding activities we described here. Comparative studies need to ascertain this
conjecture.
ACKNOWLEDGEMENTS
This paper is based on data collected by the first author in a large study of key
educational experiences and on the doctoral dissertation of the second author. The
study was supported by small grants from the Shaine and Eshkol foundations at the
Department of Sociology & Anthropology, and the NCJW Research Institute for
Innovation in Education, Hebrew University of Jerusalem.
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COMPETING INTERESTS
Authors have declared that no competing interests exist.
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analyze what ideal teacherhood consists of in vocational education in the first place
according to VETs perceptions. This viewpoint was chosen because VETs own
conceptions have not been profoundly analyzed thus far.
3. VOCATIONAL EDUCATION TEACHERS IDENTITY
Ideal teacherhood in vocational education is connected with a teachers
identity. Our previous study analyzed VETs identity [38] revealing that it consists of
four areas:
(1) Substance knowledge, including the know-how of VETs professional field,
professional expertise, and work-specific skills.
Teachers are traditionally perceived as subject matter experts. Knowledge of
subject matter has always been the core feature of a good teacher [39]. However,
instead of distribution of information, todays teachers are merely expected to handle
transmission of knowledge. Moreover, evaluation of information and skills is
important in these days. In addition, professional expertise has to be updated
constantly, and the readiness to professional change and development has to be
provided already in vocational basic education.
(2) Pedagogical expertise, including the ability to lead teaching, learning, and
study processes, organize and analyze teaching situations, and encounter and guide
students.
Although technology and teaching methods develop all the time, teachers
personal inputs still matter. It is especially apparent in the pedagogical, ethical, and
moral dimensions of teaching. Pedagogical expertise is a combination of many
knowledge and skills related to student interaction and how they are applied in the
practical complexity of teaching situations [2].
(3) Work-life skills, including co-operation skills, willingness to create networks,
ability to work in various teams, and economic and administration skills.
VETs work in collaboration with colleagues in the college and with employers
and other representatives of the professional field. VETs function as mediators
between vocational education students and work-life professionals.
(4) Developmental abilities, ability and will to develop ones mastery over the
knowledge and skills in ones vocational field, participate in the development of ones
field and work life, and trust in the progress of vocational development through
teaching and learning processes.
317
Due to the professional change and variation, VETs are required to possess
such knowledge and teaching skills that helps vocational education students adjust
to the days professional expectations. VETs are expected to work for and influence
the appreciation of their vocational field.
The classification of professional identity in many ways reminds earlier
illustrations of a teachers professional identity [40,41,42,43,44]. Our research was
focused on less studied teachers: VETs perceptions have not been studied much
compared to, for example, elementary school teachers. However, their work differs
greatly from other teachers work.
In this study, we continue our analysis of VETs perceptions of their work. The
focus is especially on their ideas about ideal teacherhood and its connection with
professional identity.
4. METHODS
The purpose of this study is to describe VETs understanding about ideal
teacherhood in vocational education. At the same time, the goal is to analyze how
VETs try to develop professionally and how ideal teacherhood is connected with
professional identity. The following research questions were set for this study:
(1) How does ideal teacherhood in vocational education appear according to
VETs descriptions?
(2) How is ideal teacherhood in vocational education connected to
professional identity according to VETs perceptions?
In this study, twelve Finnish VETs were recruited from one vocational
education college with multiple fields. The request to participate in the study were
sent to all 28 VETs in this college. The teachers had the following questions to help
them to create their narratives: (1) How long you have worked as a VET and how
old are you now?; (2) How did you end up in a VETs profession?; (3) How did you
develop as a VET of this kind that you are today?; (4) What were you like at the
beginning of your career and how are you today as a teacher?; (5) What kind of a
teacher would you like to become?; and (6) What would yo like to achieve in your
teachers career?
The teachers were asked to either write their narratives or record them with a
digital recorder that the researcher would transcribe afterwards. The data obtained
included oral (N=5) and written (N=7) narratives. The narrative research approach
318
319
320
Following ones own path is not easy nor can any teacher avoid new
challenges and learning or new goals. The uncertain future of professions fester
many VETs minds, but still they want to do teaching well.
I am more like a coach, expert, educator, and some guide who shows
various opportunities that are reasonable for the youth (6).
My dream is to work with balanced and nice youngsters who are highly
motivated to learn a profession for themselves (9).
The heterogeneous student material sets pressure for the pursuit of ideal
teacherhood in vocational education. Many VETs learned to understand that not all
students aim at the top in their field but students goals and readiness are extremely
variable.
The fact that you have more and more difficult students and their life
situations are hard. So, you always have a feeling that, in addition to being
able to provide them with right kind of teaching for work life, I should be able to
give them good guidelines in life (4).
5.2 The Features of Ideal Teacherhood in Vocational Education
The conception of ideal teacherhood turned into a more realistic one as the
VETs work experience increased. The idealistic ideas from the beginning of their
careers became more practice-based and turned into fields of expertise guiding
their work and illustrating their core know-how. Ideal teacherhood in vocational
education occurred in the VETs descriptions through six features.
5.2.1 Mastery of ones professional field and ability to act as a reformer
VETs own experiences and learning about the profession can function
as students support, especially when it comes to the acquisition of good professional skills and knowledge. Mastery of ones professional field means that
the VET knows the nodes and critical points as well as the phases of professional
development.
You have to keep updated all the time, and that is hard for sure. In our field,
the technology develops so fast, that you really have to work hard to keep in the
picture (7).
The purpose is to widen my own expertise. Then I will have more information
to distribute to students and more opportunities to realize practical teaching (11).
321
Along with their profound mastery of the profession and teaching it to students,
VETs influence the renewal of professions and enhance students readiness for lifelong learning.
And I think that I will never be ready as a person, and therefore, I cannot
become ready as teacher either. As I grow as a person, I also develop as a teacher.
- You always have to keep up the profession by developing the professional side.
And you cannot become a master in that either. You mature as a human being (4).
5.2.2 All-round pedagogical expertise
Ideal VETs know different teaching methods, are able to plan and be flexible in
teaching situations according to students needs, and give room to individuals and
various students learning abilities. Evaluation at its best can also enhance students
learning motivation.
I would like to develop and know more all the time. I do follow my
profession a lot and I like this field and these subjects I teach. And I would like to
study, too, in the future (5).
I would like to develop into a better expert, for example, of learning difficulties
and to encounter the youth with problems (9).
5.2.3 Networking and collaboration
Ideal VETs can develop professional expertise and students careers by
creating connections with work life. Networks and multi-professionalism necessitate
cooperation, and so does the updating of vocational education. Electronic communication, real-time flow of information, and internationalization also demand new forms
of cooperation.
independent and autonomous teachers work has more and more changed
into cooperation and team work. Teachers have to be able to adjust their teaching
and especially evaluations within predetermined dates mastery over ICT and various
registers and follow-up systems, as well as cooperation and interaction skills (12).
5.2.4 Encouragement and support for students
With even the smallest gestures, VETs can help students
to achieve the
322
323
324
325
326
7. CONCLUSION
Meaningful work is the source of human well-being [65]. This study showed
that identity reflection makes a salient part of VETs perceived well-being at work
[66,67]. The development toward ideal teacherhood in vocational education happens
through each teachers personal reflection including the shift from the dominating
professional self to the flourish of personal self and, finally, toward the balance
between them. Perhaps, ideal teacherhood in vocational education lies not so much
in teachers outer performances but intrinsic reflection and balance. This does not
mean that they would need excellent work-life skills, knowledge, and networks in
their special fields, but, when acquired, they make a salient part of their wellconstructed professional identity [68]. Eventually, teachers, who are in the first name
terms with their vocational education teacher identity, can act as bellwethers and
true developers of their fields. They are inspiring and motivating teachers who, due
to their expertise, enhance students learning and are able to educate future experts
for the needs of work life.
Therefore, VETs work includes a distinct ethical dimension. This study
showed how VETs perceptions of the realities of the profession and ideal
teacherhood emphasize the ethical side of the work. Teachers work in general is
focused on significant phases and situations in peoples lives [69,70,71]. According
to Elena Seghedin [72], teachers ethical action in teaching develops alongside the
development of professional expertise and vice versa: professional expertise
develops also through ethical action. In Finland, Emmi Enlund, Mari Luokkanen, and
Taru Feldt [73] studied teachers ethical burden and ethical dilemma, and ended up
recommending that education institutions should utilize the ethical guidelines
composed by trade unions. They would support teachers work. Common models to
help teachers action in problematic situations could be created based on the
guidelines, which would provide teachers with collective certainty in ethical
considerations. Williamson McDiarmid and Mary Clevenger-Bright [74] point out that
teachers work and professional development are closely tied in the wider society.
According to Kirsi Tirri [75], expertise in teachers work develops through education
and experience and includes freedom and, first and foremost, responsibility to act in
the profession.
Indeed, a well-balanced teacher identity and core values are the sources of
stability and sense of purpose for teachers [76]. This viewpoint contributes also to
327
the current discussion of stress and coping as well as the sense of self-efficacy
in teachers [77,78,79,80]. For example, studies about perceived level of self-efficacy
have proven to be the core dimension of preventing and treating teachers stress
[81]. When considering the findings from the point of view of ideal teacherhood, it
seems relevant to suggest that a successful identity development and a positive
conception of oneself as a VET contributes to the sense of self-efficacy at work and
respectively to ones well-being at work as well. These kind of perspectives appear
of increasing importance in todays rapidly changing work in all occupational fields,
including that of VETs.
COMPETING INTERESTS
Authors have declared that no competing interests exist.
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H.S. Skovoroda Kharkiv National Pedagogical University,
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Poltava V.G. Korolenko National Pedagogical University,
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362
Natalia Chebotareva,
Moscow University of Economics and Liberal Arts,
Associate Professor, Ph.D. in Pedagogics, Faculty of Humanities,
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Moseychuk Ann,
Odessa Regional Basic Medical School
373
Along with this the acquisition of new educational standards of the general secondary education involves the active introduction of research and design activities in
school.
Analysis of current research. Bases of the organization of research activities
are described in the works of L.S. Vygotsky, V.V. Kraievsky, V.A. Krutetsky, I.Ia. Lerner, S.Ia. Rubinshtein, Iu.A. Saurov, V.A. Slastenin.
The process of formation of research abilities of students is examined in the
studies of: O.A. Abdullina, S.I. Arkhangelsky, N.V. Kuzmina, etc.
The problem of revitalization of research activities of students is represented in
the works of: D.V. Vilkeiev, M.A. Danilov, M.I. Makhmutov, A.M. Matiushkin, R.I. Malofeiev, P.I. Pidkasisty.
The goal of research is to consider the totality and composition of actions that
characterize the main aspects of operational structure of research activities, based on
which to analyze the results of the diagnostics of research competence of medical
school freshmen, to determine the conditions of formation of research competence in
the training of future middle ranking medical workers.
Results of the research and their discussion. In light of the economic and
administrative reforms in recent years, vocational school adaptation to modern conditions, the role of the research component of the educational institution along with the
traditional academic and educational segments has significantly increased.
Today, the society is interested in personnel, ready and able to the introduction
of modern technologies. In this regard, the importance of the primary function of professional educational institutions training of highly qualified professionals takes on
a new meaning. Today a professional educational institution not only needs to provide
the graduates with strong, systemic, deep theoretical knowledge and practical abilities
and skills, but also to train personnel capable of independent scientific, research and
innovative activities, who have organizational skills.
The solution of the set tasks requires a high level of productive human activity,
the ability to generate information, which is new compared to the information contained
in the training materials, to solve problems arising in the course of educational activities
(Iu.G. Tatur) [6].
Accordingly, the development of research skills, the implementation of research
activities becomes a relevant direction of modern education.
374
In our view, this trend is a key link in the complex chain of competitive training
of a modern specialist. In this connection, we consider it necessary to define the essence of the concepts of research activities, research skills, to consider the totality
and composition of actions that characterize the basic aspects (sides) of the operational structure of research activities.
In the general context of the activity theory, A.N. Leontiev and S.L. Rubinshtein
define research activities as a specific human activity on the subject, means, methods,
products and results, as well as requirements to the very subject of this activity, which
is regulated by consciousness and activity of a person, which aims to meet the cognitive needs [5]. The result of this activity is to obtain new knowledge in accordance with
the intended purpose, objective laws and available circumstances defining reality and
achievability of goals through specific ways and means of action, through the formulation of the problem of isolating the object of research, conducting experiments, description and explanation of the facts obtained in experiment, creating a hypothesis (theory),
prediction and verification of acquired knowledge.
Mastering of ways (informational, logical, methodological, technological, etc.)
and techniques (methods) of research activities by students becomes of particular significance, as research skills are formed on this basis (I.A. Zimniaia) [3].
V.A. Andreev understands research skills as ... the ability to apply an appropriate technique of the scientific method in solving a problem, performing a research
task [1].
V.V. Uspensky considers research skills as ... the ability of independent observations, tests, searches, acquired in the process of solving research tasks [7].
E.A. Shashenkova considers sides of research activities as sides of a multipleaspect, multi-stage process, defined by a nomenclature actions included in it, where
the first side intellectual and research includes the actual intellectual operations
and the actual research activities (choice of research methods: comparison, analysis,
synthesis, abstraction, substantiation, generalization, systematization, classification,
modeling; critical assessment, planning of work, setting goals, objectives, determining
object and subject of research, hypothesizing), the second informational and receptive actions with information permanent work with the scientific literature, derivation
from texts and understanding of required information, bibliographic search, study
(reading) of a text, its analysis, fixing, work with a computer (sensing of information,
understanding and interpretation of information, mastering reading strategies: viewing,
375
analytical, searching, sampling), and the third the productive side of research activities includes a study, processing of the obtained data, facts (carrying out research,
processing of research data: quantitative and qualitative data analysis, statistical analysis of the results, their interpretation, planning, thesising, preparation of graphic
schemes, referencing, bibliographical activities, their textual fixation, selection of facts,
formulation of provisions, concepts, annotating, note-taking; conclusions on the work)
[8]. The third side of research activities reflects the results of research conduct in such
forms of literary products as a library-research paper, scientific paper, research report,
report, theses, term paper, graduation paper, monograph, dissertation.
Mastering the methods and techniques of research activities by a student determines the level of research competence of this student.
As part of a thesis research, a questioning Research activities of students of
medical school was held in the Odessa Regional Medical School in the 2014-2015
academic year.
The research involved 208 students of the 1st year in the specialty Nursing,
Paramedic work. The following results were obtained during the research. At the initial stage of training, 156 students (75% of the total number of respondents who participated in the experiment) showed a low level of research competence, which is characterized by a complete lack of interest in carrying out research work, inability to work
with the scientific literature, unwillingness and inability to analyze and systematize it.
Students do not want to raise their own level of scientific activity and they do not have
any scientific interest.
42 students (about 20% of the total number of research participants) are assigned to the base level of research competence. They have some knowledge of scientific research, understanding of specific areas of scientific knowledge, primary skills
of research work. This group of students does not have a desire to implement it.
10 freshmen, which accounted for 5% of the total number of participants of the
experiment, have a sufficient level. These students demonstrated scientific interests,
ideas about scientific research and personal experience of its implementation, the ability to analyze and systematize scientific data, to allocate the most important facts, to
define the goals and objectives of the research, to determine a hypothesis of the scientific research, to confirm or deny it, to select and implement a primary diagnosis, to
make scientific conclusions based on the scientific data received and to exhibit the
376
results of their research before the public in the form of public speaking, defense and
(or) presentations.
The results obtained evidence that the secondary school still does not pay
enough attention to the formation of research competence of students.
In the formative stage of our experiment, the learning of basic educational programs is aimed at increasing the level of research competence due to: the contents of
the working education programs and disciplines, where the disciplines of biological
cycle play the determining role; training and methodological support of independent
and individual scientific work of students; organization and development of various
types of practices; organization of scientific groups of interest; scientific-themed competitions, conferences, implementation of the state certification of future middle ranking
medical specialists, writing and defense of graduation qualifying papers, taking into
account the interests and needs of medical institutions.
It should be noted that today the traditional system of education and training in
a vocational educational institution does not provide the full formation and development
of research competence. In our formative experiment, it is compensated by a research
and education club (modified system of scientific groups of interest). The club is
needed for the development of skills, improving personal position, and ultimately for
the development of activities (including research) or in the production [2], or in an educational institution.
The work in the club is carried out in parallel with the educational process of
medical school by students and teachers as members of the scientific and educational
club.
Conclusions. Thus, even at a low level of formation of research competence
of freshmen, the conditions that enhance its formation in the course of training, prepare
future middle ranking medical workers to solve research problems in the structure of
their professional activities, were created in the Odessa Regional Basic Medical
School.
References:
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377
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Valentina Bilan,
Pavlo Tychyna Uman State Pedagogical University, Ph.D.,
Associate Professor, the Department of Special Education and Psychology
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Sholom-Aleichem Priamursky State University,
Associate Professor, Candidate f Pedagogical Sciences,
Faculty f European nd Eastern Languages,
Natalia Shklyar,
Sholom-Aleichem Priamursky State University,
Associate Professor, Candidate f Psychological Sciences,
Faculty f Education
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424
425
the All-Russian competition of the national event tourism Russian Events Award.
The participants from Vietnam, Australia, China, Korea, Russia made a lot of suggestions for use mechanisms of decorative art for laboring adaptation disabilities [1]. Authors of this article are active participants of the public processes for development of
Civil Society in own countries. A number of these proposals were discussed at the
Cultural Forum in Moscow and in Yakutsk in September 2015 with initiative by Galina
Alekseeva, as a member of Public Chamber of the Primorsky Kray [2]. The experience
of Vietnam, which many years struggling with the effects of dioxin Wars, is very important also.
According to statistics, in the 2015 there are about 0,65 billion of people with
disabilities around the world, which constitute about 15% of the human population.
Russia has about 10 million of people with disabilities, 4 million of whom are the people
of an active working age [3].
Now we can see so-called cumulative disability, which develops with increased
life expectance and natural aging population. At the same time the challenge of adaptation to the social environment and living conditions to the disabled people and to their
special needs require the use of new methods and forms. It becomes important to
make changes in legislative approaches and the development of forms of employment.
On social protection of people with disabilities in the Russian Federation this law
was approved in Russia in 1995. After this date introduced significant amendments to
this law. Today a new policy of rehabilitation of people with disabilities develops in
Russia. In 2011 An accessible environment program was adapted to address the
needs of people with disabilities through year 2019. In the context of this program, the
conditions for the comforts of life and movements of persons with disabilities are created today in Russia. However, laws and programs have to get adjusted. Folk art in
these programs may take a much bigger role than we see now.
Purpose of article: to explore the practice of public and scientific discussion of
legislative initiatives for the formation of a new cultural policy for people with disabilities.
Object of study: the practice of public and scientific discussion in the International scientific Conference and within the framework of scientific research for adaptation of disabilities with support artistic methods.
426
427
using the statistical software package for the social sciences SPSS using frequency,
correlation, regression analysis of distributions.
The experience of Vietnam, which is represented by Dang Chuynh Mai, the
president of the Association of people with disabilities in Vietnam and MSc. Huynh
Ngoc Hong Nhung, Vice President of Can Tho Association of People with Disabilities.
Results:
Monitoring of the culture state in the 30 municipalities of the Primorye territory
in 2014 year, which were prepared with support of the Primorsky Krai Public Chamber
showed, that people with disabilities have a little possibilities for development their
decorative-applied activity. They can get help from Primorye territory grants program,
but they dont know about these program usually. Only 30 percent of Young people
are working in the Primorye Department of Culture now. According to data for 2013 in
the region 6805 is left of cultural workers (in accordance with the presidential decree
of 07.05.2012 597 "On measures for realization of the state social policy" has been
a significant part of the employees dismissed or transferred to part-time). Of these
employees higher education has 1950 people (in relation to the key personnel of
52.5%). As you can see, the percentage of workers with higher education culture varies
to the same parameters - about 30-50 per cent of the authorized strength [5].
A questionnaire survey of the population (N = 400), consumers of culture and
a questionnaire of culture workers (N = 150) conducted in 2014 in the Primorsky Krai,
shows, that It should be on quantitative culture jump to quality - in a program of cultural
development of Primorsky Territory for 2013-2017 prevail quantitative indicators.
A questionnaire survey of persons with disabilities (N = 200) in order to analyze the level of accessibility of institutions of social and cultural sphere within the
framework of the international project "People decorative work of Russia and Vietnam
as a labor resource for the adaptation of people with disabilities", supported by Science
Foundation FEFU, shows several proposals for laws in Russia and Primorye territory,
contributing to the advancement of persons with disabilities in Russia and Primorsky
Kray through the Traditional Art.
Offers are the following (included in the resolution of the conference):
1. The proposed changes to the Law 181 "On social support to persons with
disabilities" of paragraph 7 of Article 5: "The participation of the state authorities of the
Russian Federation in the provision of social protection and social support to persons
with disabilities" to create conditions for social adaptation of people with disabilities
428
authors of this article are proposing to include among the targets of the Law the idea
of stimulating the development of jobs masters - manufacturers of decorative and gift
items with a view to ensuring the country's territories with branded products of arts and
crafts.
2. Proposed to include to the state program of the Primorsky Territory "Social
support of the population of Primorye Territory on 2013 - 2017 years" as target indicators of the program:
A) The proportion of employed persons with disabilities.
B) The number of newly established workshops of arts and crafts.
3. To strengthen the control over the observance in the Primorsky Kray of Article 21 of the Federal Law "On social support to persons with disabilities", in accordance
with the approved amended on November 22, 2012, which provides the expansion of
powers of public authorities of subjects of the Russian Federation in the implementation of job quotas for the employment of people with disabilities.
4. Convert the draft Program of development of culture on Primorsky Territory
for 2013-2017 "On the distribution of subsidies from the budget of the Primorsky Territory nonprofit organizations for reimbursement of expenses related to the organization and carrying out of the projects ..." to the Resolution of the Primorsky Territory.
5. It is important to use the experience of Vietnam, his Association to support
people with disabilities, and other Pacific Rim countries (Australia, Korea, China) for
the development of programs to support people with disabilities in the Primorsky Territory.
Experience of Vietnam shows several results.
According to statistics, in Vietnam there are 5 million people with disabilities ,
representing 6.3% of the total population. In order to help improve the quality and efficiency of external action to support the people with disabilities, the Vietnam Association of People with Disabilities (the VFD) was established in October 2010 with the
permission of the Ministry of Internal Affairs; VFD First Congress was held in March
2011; VFD Charter was approved on August 2, 2011, which marked the beginning of
activities of the Association. VFD - a public organization, which is a national organization people with disabilities in Vietnam. At the first Congress of VFD (2010) was attended by all 19 member societies, including the central level 7 Societies: Society of
the Blind, Agent Orange, the Red Cross Society to support people with disabilities and
429
orphans ...; 12 provincial Societies of Hanoi, Da Nang, Quang Binh, Lam Dong, Hai
Duong, Lang Son .., now 17 Societies provincial and city levels and 7 Central level.
The character of the activity Vietnamese associations for people with disabilities
we can see on the example Nhip Cau Foundation. Vice President of this Foundation
Huynh Ngoc Hong Nhung of Can Tho Association of People with Disabilities has took
part in our conference.
Nhip Cau Foundation is belongs to Can Tho Association of People with Disabilities. It was established formally after the winning project in the program "Innovation
Day" in 2003 which was launched by the World Bank. It was sponsored by Canada
Fund in the first stage and Ford Foundation in the second stage 2009 to 2011.
From June 2009 to 2011 Nhip Cau Foundation was manager of the project
Enhancing Production Skill for the Coconut Handicraft Products Made by the Disabled
in Can Tho, Viet Nam, sponsored by Ford Foundation (FF) in during 2 years 2009 2011.
In December 2009 Nhip Cau Foundation was coordinator of the project Training
for Community Development and preparing writing proposal for 26 representative of
Associations of People with Disabilities in the South of Viet Nam, sponsored by Center
for Educational Exchange with Vietnam (CEEVN).
It is clear, that Nhip Cau Foundation has unique vision of own development,
which suggests encouraging and empowering people with disabilities (PWDs) their involvement in the labour market, hence contributing towards a reduction in poverty, thus
enabling PWDs to be valued as equal members of society. Values of the Nhip Cau
Foundation activity include the following: an integrated citizen valued society for all, he
has employment opportunities, independence, financial security, public participation.
Main activities the Nhip Cau Foundation activity includes: providing vocational
training for PWDs, creatation of paid employment, production of craft products, participation in marketing and selling of handicraft products made by PWDs, participation in
peer group exchange programs, accession to the competitive sports/recreational, direction to the practice for social work students, service provision for tourists.
The results of Nhip Cau Fund expressed successes in social adaptation, in the
aspects of education, economy and other aspects. Nhip Cau Foundation is one of the
success stories in Vietnam, which develops the integrated approach of community development [6].
430
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A kto by na ojca swego rk witokradcz, ten zbrodnie tak okropn, tak
niewymown. Tak, ach piekieln, diabelsk, nieludzk, e z pokolenia w pokolenie w
krzyku strasznemu, w jku, we wstydzie, w udrczeniu od Boga i Ntury wyklenty,
przeklenty, wyrzucony, pozostawiony, opuszczony...
Henryk
Ten stary boi si, ebym go nie nabi...
Ojciec
Dobra zupa.
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. : . , 48,
. 1, . , 2010. - P. 373384.
461
Kislov Denis,
Ph.D. in Political Sciences,
Associate Professor of the Department of Marketing nd Advertising,
Kiev National University of Trade and Economics (KNTEU),
Founder of the Limited Liability Company
Corporate Research and Consulting International Bureau (LLC CRC IB)
462
conditions of their use and application. One needs to objectively evaluate proportional,
ethical, socially relevant and many other parameters that would reflect the efficiency
and legitimacy of including the myth-making elements in the structure of marketing
communications tailored for the target audiences, individual groups of population or
society as a whole.
Analysis of previous publications and theoretical research. The role and meaning of myth in social and political activities were subject to fundamental research by
many recognized scientists and thinkers. This area became promising in view of the
fact that mythology and myth-making were studied by such authors as Aristotle,
K. Abraham, A. Anisimov, L. Anninsky, S. Antonenko, H. Arendt, R. Barth, M. Berdyaev, M. Weber, W. Wundt, K. Gadzhiev, G.W.F. Hegel, A. Gede, E. Husserl,
A. Donini, M. Eliade, E. Cassirer, Z. Kosidowski, L. Levy-Bruhl, K. Lvi-Strauss,
S. Moscovici, V. Nechaev, J. Ortega y Gasset, O. Panarin, K. Popper, G. Pocheptsov,
Jean Sartre, G. Tarde, S. Tokarev, Z. Freud, E. Fromm, V. Khalipov, K. Hbner,
G. Schiller, K. Jung, K. Jaspers, and many other researchers.
Among the modern Ukrainian scientists, one should mention those writing about
political mythology: V. Bebik, M. Golovatyi, D. Dutsik, M. Karmazin, I. Kresina, N. Mikhalchenko, Yu. Romanenko, Yu. Shaygorodskyi and other authors.
However, myth-making approaches in the theory and practice of developing the
state systems of marketing communications in the conditions of contemporary transformational trends, post-modern influences, sharp competitive contradictions, escalation of political struggle for power, quick socio-economic changes as well as external
challenges and threats have so far been addressed inadequately and without sufficient
attention paid to the mental and psychological consequences caused by the influence
of such myth-making experiments on the population.
Goal of the publication to evaluate the state and conditions of functioning of
the mythological component in the structure of non-commercial state marketing communications, and to characterize the trends of development of these processes.
Principal points. Historically, myth was and still is a significant element of private, public and state life. It has played and will continue to play the role of a regulating
mechanism and a lever used to influence the public and individual consciousness. In
the conditions of dominating market paradigm, the mythological component of marketing communications plays a special role in the systems of relations between the state
463
authorities and society, which can significantly influence the nature of social and political confrontations complicating them to the level of sharp protests.
Counterbalancing the rational and mythological components in the state management sphere, in particular, for the development of a balanced and sustainable perception by the countrys population of inevitable social and political transformations,
should be a mandatory form of interaction between the state management bodies and
civil society. Otherwise, if this requirement is ignored for a long time, a severe imbalance emerges between the declaration of policies by the government and realization
of the meaning of social and political activities by the citizens. The experience of
Ukrainian realities in the second half of 2013 and the first half of 2014 demonstrated
this vividly and tragically.
Mythology used in the techniques of managing the social consciousness of
Ukrainian population balanced between the irrational in terms of its natural essence
and the rational in terms of marketing activities. For instance, the long-term and gradual European integration ideas that were declared for the population in a non-transparent and abstract manner were implemented at a diplomatic and foreign policy level of
governance and reflected in the mass consciousness as fluctuations within the statistic
and partisan error as a classic correlation of 40 to 60, i.e. approximately 40 % of the
respondents were for the EU association, and 60 % were against it. Later on, the correlation between these figures achieved the 50-50 level. The turning point in the consciousness of the surveyed groups of the population was achieved through intensification of the coverage of respective activities in the mass media and through concentration of the mythological component of the EU integration prospects based on the principles of the EU associate membership. At the same time, the mythological component
of marketing means of influence on the popular consciousness began to prevail over
the understanding of the reality of Ukraines relations with the EU.
The impact of the mythologem involved subconscious implantation in the thinking processes of the populace of an automatic transfer of the level and quality of life in
the leading EU member states to the Ukrainian realities immediately after signing the
respective international agreements. Consequently, the expectation of a very distant
bright future was projected for the nearest time, so to speak, which totally contradicted the reality. Yet, this mythologem was able to completely reverse the rating correlation making it 60 to 40 (In other words, according to the results of special sociolo-
464
gical surveys, the majority now support the EU association of their country due to certain youth audiences from central and western parts of Ukraine). The fact that the authorities flatly turned down the association agreement tore the mythologem out of the
consciousness of those (mostly younger citizens of the country) whose preferences
were already formed. It was like depriving them of their dream and hope, however
irrational they might have been, which immediately turned into quite real protests. At
the same time, the authorities were not aiming at eliminating, dampening or suppressing such protests. Furthermore, the government did not even have the mechanisms
corresponding to these goals of state marketing communications that could quickly and
efficiently remove this conflict from the civil society agenda.
Hence, the entirely ungrounded myth of the close and careless European prosperity after its sharp formal collapse served as a trigger for rather ordinary peaceful
protects. Yet, they were immediately used by both internal and external political forces
to invigorate the struggle for power among the oppositional groups as well as to promote the interests of competing oligarch clans and implement certain geo-political aspirations. The absence of a clear and viable marketing communications concept that
could deliver rational and understandable ideas to the populace concerning the principles of Ukraines development made it possible for the myth of the omnipotent maidan as a form of expression of some popular will directly on the streets and squares
of the capital to emerge and become dominating within a short period of time.
The myths of the popular assembly and the revels of maidans and Euromaidans, which in their essence are a bright manifestation of controlled ochlocracy
processes but are widely advertised by the mass media concentrated in the private
hands of national mediacrats, relatively quickly resulted in pseudo-revolutionary ideas
engrossing the masses. This, in its turn, was a result of the controlled chaos and the
violent change of power in the country accompanied by tragic deaths of hundreds of
people and thousands of injuries. The bright, eternal, and seemingly innocent myth of
the better life again was painted with the blood of real victims.
Consequently, the problem of a correlation between the rational and the mythological in contemporary social and political processes of social development plays a
key role from the viewpoint of efficiency and effectiveness, the necessity and sufficiency of the use of technological myth-making means in the systems of marketing
communications of the governmental bodies. Such managerial tasks can only be resolved if they are viewed comprehensively in inter-disciplinary terms from the points of
465
view of political science, psychology, sociology, law as well as the theory of information, marketing and communication sciences.
Pragmatism as well as various post-modernism movements do not provide answers to the questions asked by the nations, peoples and governments of many countries about the directions of their search, about finding adequate methods and means
to successfully confront the challenges of modern civilization, or about development of
efficient models of overcoming possible negative outcomes. For instance, in the opinion of a number of leading Ukrainian researchers of correlations between politics, state
and law, the reason is that it is nearly impossible to identify any definite trend of their
development, not to mention a single paradigm of research and political discourse with
regard to the current transformational processes [1]. At the same time, all national and
foreign researchers refer to the ambiguity and vagueness of the changes, and even to
the fact that the humanity tests itself with the unknown [2, p. 85].
Under such conditions, old political myths and mythologems are combined with
the contemporary myth-making processes both spontaneously by the populace, and
intentionally by the mass media communicators in order to close the embrasures,
from which more and more new salvos are fired at the humanity in the form of the
most complicated social and economic problems, challenges and threats.
Consequently, the specific marketing forms that were introduced as new tools
to the state management systems to replace the non-marketing forms of influencing
(campaigning and propaganda) the consciousness of citizen consumers should also
actively use all the already known forms of myth-making as well as their combinations,
transformations, and interpretations represented in the disguise of fashionable philosophical, populist, post-modernist and other trends. Such solutions should in the first
place take into consideration the basic principles of creation purposefulness and effectiveness of their use as offensive governance mechanisms.
Since the myth is a tool for assimilation of ideas by the collective consciousness,
it can become as demonstrated above an effective manipulation and political double-edged sword in the confrontation of governmental and protest marketing communications. At the same time, the myth performs the function of re-targeting human mental reactions from the casual to the permanent, and stabilizes human thinking, selfesteem and self-determination in the given existence circumstances [3, p. 93]. Hence,
the prevalence of the myth-making influence will mark the victory of some of the opposing political forces.
466
J. Ortega y Gasset in his book, The Revolt of the Masses, wrote that modernity
is characterized by the emergence of a new type of culture mosaic. It differs from
humanitarian culture, which is characterized by order and hierarchy of ideas and
knowledge, in what this new culture represents some semi-structured fragmentation of
random loosely connected notions [4]. Such mosaic culture leads to the appearance
of mass human, an ideal subject for manipulation with his consciousness [5]. At the
same time, the myth becomes an operative tool fulfilling tasks and objectives set to the
myth-making communicators by political players and mediacrats for the sake of their
own, often egoistic and narrow, interests.
Some of the main features of the modern social and political myth are its archetypal and universal nature, symbolism and synchronicity, universality and integrity [3,
p. 358]. G. Pocheptsov described the reflection of these features and characteristics
of the myth in the image, marketing, governmental and party performance [6, p. 150].
He maintained that the myth is unfolded in the mass media as a scenario that immediately identifies the roles of friends and enemies of the protagonist. The latter in practice
is intentionally highlighted and endowed with symbolic virtues by a specific media outlet, for instance, a popular TV channel. Such a protagonist on a TV channel may be,
for instance, a candidate for presidency in the country during the respective election
campaign, who is at the same time the owner or a co-owner of this TV channel. Consequently, the rating of such TV channel becomes the rating of the respective protagonist.
G. Pocheptsov also mentioned that the myth is a special form of communication
because it has a listener but there is no author; and for this reason the myth becomes
irrefutable, since there is no one to argue with; moreover, the myth is an integral construction. Therefore, such myths are presented axiomatically and are not subject to
examination with regard to their compliance with the reality [6, p. 151]. This is the factor
that dominates in the country engrossed in turmoil and emotions, which however lead
to completely opposite behavioral manifestations: from neutral pacifist to extremely
aggressive. That is why almost at the same time and in same place one can observe
purely peaceful protests and bitter military confrontations.
Using the entire vast arsenal of the mechanisms and tools of informational and
psychological operations, mass media being guided by the will of private mediacratic
groups set the mythologems, the meaning and contents of which are delivered to the
subjects the masses, audiences, groups of population, military formations to ensure
467
the most efficient impact on their consciousness and further behavior [7, p. 182]. These
are rather typical forms and methods used both in marketing communications and in
large-scale information wars.
Conclusions and areas for further research
1. Research of contemporary myth-making used in state and political marketing
communications should be carried out comprehensively in the context of a synthesized
multidisciplinary approach.
2. The myth in marketing communications is like a universal operator appealing
to the level of generality through the notions of the mass, overwhelming majority, core
values, etc.
3. The myth in modern marketing communications acquires increasingly blurred,
discourse-oriented, post-modernist forms, but in the conditions of the state and protest
communications it returns again to the more specific and more precise forms.
4. The myth in marketing communications today also acts as a realizer of specific tasks related to the struggle for power both by political and by violent means in the
conditions of severe confrontations between the existing management structures and
representatives of the social protest forces.
5. The myth generally represents some way of interpreting the worldview, modelling the world and national development trends, specific social life activity of the
masses. It can act as a double-edged information weapon that can be used to destabilize the socio-political situation in the country.
References:
1. Rymarenko Yu.I., Vivcharuk M.., Kartunov A.V., Kresina I.A., Rymarenko S.Yu.,
Teleshun S.O., Shkliar L.E. Nacia. Derzava: Ukraina v konteksti svitovogo
etnoderzavnyckogo dosvidu: monografia. - Kiev: Inst.derzavy I prava NAN
Ukrainy, 2000. 516 s. [Rymarenko Y.I., Vivcharuk M.., Kartunov A.V., Kresina I.A., Rymarenko S.Y., Teleshun S.O., L.E. Shkliar. Ethnicity. Nation. Country:
Ukraine in the context of international experience etnoderzhavnytskoho: monograph. - K.: Institute of State and Law of Ukraine, 2000 516 p.].
2. Foreigners V.L. (1999). Raskolota civilizacia. Moskva: Academia. Science [Foreigners V.L. (1999). Broken civilization. Moskow: Academia. Science].
468
469
Yelena Kuvarova,
Oles Honchar Dnipropetrovsk National University,
Candidate in Philological Sciences, Associate Professor,
the Faculty of Ukrainian and Foreign Philology and Art Criticism
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477
Osmina Elena,
Kalashnikov Izhevsk State Technical University,
Doctor of Psychological Science,
Professor of Department of Sociology, Psychology and Culturology,
Ponomarenko Ekaterina,
Kalashnikov Izhevsk State Technical University,
Senior Teacher of Department of English Language
478
the status of subject (in the strict sense a responsible and scrupulous actor by
S.L. Rubinstein) [7].
It should be noted that in Russian psychology and pedagogy the issue of professionally important qualities of a teacher has a long-standing research tradition since
the works of N.V. Kuzmina who introduced the notion of pedagogic competence and
presented its content analysis as a personality trait [3]. Over the past several decades
the designated functional components of competence subject-specific, methodical,
psychological-pedagogical, differential-psychological, auto-psychological have been
further investigated and operationalized due to a great number of practical and theoretical works [2]. A final stage of the professional and personal development of a
teacher is professionalism which is an integrated characteristic of a subject of labour.
Among integrated characteristics of teacher personality A.K. Markova defined: professional consciousness, individual style of activity and communication, creativity [5].
The psychological source of professional and personal behavioral patterns in
real-life situations is mans subjective image or mental model of these situations. A
mental model is the key notion in psychology it is developed in an activity and belongs
to a subject of reflection [4]. Psychic reflection is active by its nature subjective images mediate an activity of a man determining his control and regulatory actions towards the outside world, his own activity and other people. From these considerations
it was supposed that subjective images of teachers about peculiarities of educational
interaction in audiences having different foreign language programs determine the possible forms of this interaction.
Objective. The objective was to study English teachers subjective image of
educational interaction, which is developed during their work with students having different training programs at technical university.
Materials and methods. The teachers of English language department at technical university participated in the research. The respondents (n=39) had different
teaching service and experience of professional interaction with students from different
academic majors. In our research the targets of reflective analysis of the teachers were
two groups of students - bachelors of engineering having a standard language program
and students receiving an additional qualification "Translator in the Field of Professional Communication". Interviewing was in written form. In interviewing there were
common questions (teaching service; educational technologies used in the teaching
process; preferred teaching methods; professional and teaching objectives; evaluation
479
of knowledge and cultural level of students). And there were questions focused on
reflection, such as about benefits and challenges of teaching students receiving an
additional qualification; personality qualities providing successful foreign language
learning; external and internal reasons for ineffective language teaching; personal difficulties in work with students from different academic majors; support expected from
colleagues.
Results and Discussion. The participants of interviewing were divided into
three groups in accordance with the stated teaching objectives. In this case subjectively meaningful objectives of professional activity were meant. The achievement of
these objectives requires not only personal and time resources but the implementation
of meaning-making function of individual activity (as opposed to the strategic objectives
of educational institutions and educational standards).
The first group included the teachers focused on the development of student
personality. These respondents prioritize a learner-centered approach and individualcentered teaching strategies. It is of great importance for them to involve students
emotionally and personally in educational interaction. The involvement is perceived by
them as a necessary condition for successful language learning, professional development for a student and a teacher as well. According to the teachers factors that
prevent the effective educational interaction are external constrains and circumstances
having, most likely, technical character. A categorial analysis of answers of the participants allowed us to make a generalized social-psychological portrait of a teacher focused on students personal development in the process of foreign language learning.
The distinctive features of the first group of respondents are an ability to build up pedagogically appropriate relationships with students and apply in work results of psychological-pedagogical diagnostics; focus on abilities, ambitions and resources of a student that provides a productive learning process in which an academic subject becomes a means of developing creativity in learners, intropunitive reactions to failures,
psychological-pedagogical and auto-psychological competences (Kuzmina N.V.).
The second group was made up of the teachers whose objective of professional
activity is the development of certain language skills. The respondents prefer a didactics-centered approach which provides an accomplishment of teachers mission to
teach translating and speaking on the specific technical subjects and eliminates interpersonal relationships in educational interaction. In the psychological context a teacher
reflects the outcomes of didactic activity rather than a student who is evaluated in terms
480
of know does not know. Such an evaluative attitude towards another person demonstrates indifference and a fixed opinion [1]. As a consequence of this, the teachers
agree on the reasons for ineffective language learning - personal weaknesses of students (poor knowledge, poor communication skills, lack of efforts). A generalized social-psychological portrait of a teacher from the second group includes such characteristics as extrapunitiveness in difficult pedagogical situations, subject-specific and
methodical competences (Kuzmina N.V.), neglecting a duty of personal interaction in
a group.
The third group comprises the teachers who were not able to formulate the subjectively meaningful objectives of language teaching at technical university. Unfortunately, the analysis of respondents answers confirmed their indifferent attitude towards their own professional activity, which was clearly exposed in the negative position to the invitation to participate in the psychological investigation.
The analysis of the obtained results allowed us to establish that a subjective
image of educational interaction contains three structural components an image of
an academic discipline, an image of a learner and a self-image. A subjective image of
Foreign Language as an academic discipline is presented by three variations: foreign
language as a set of teaching (didactics) units, foreign language as a tool of professional interaction, and foreign language as a subject of professional activity. A subjective image of a learner in the context of his attitude to foreign language (from teachers
angle) also has three components: social-pragmatic attitude, professional-pragmatic
attitude, and potentially subjective attitude. Finally, a self-image in the context of subjective preference of teaching methods and strategies provides an opportunity to distinguish three types of teaching activity - standard-oriented, learner-oriented, and subject-oriented. A social-psychological model of educational interaction of foreign language learning at technical university was developed on the basis of the defined constructs [5]. Within the frame of the model three possible forms of educational interaction
- social-role; personal-professional; subject-and-professional - were defined in a triad
of teacher-foreign language-student. It was shown that there are different forms of
educational interaction in the process of foreign language learning at technical university, and the adequate application of the forms is determined by goals and aims of a
certain lesson. Social-role interaction is feasible in the learning situations when a
teacher performs guiding and control functions. Personal-professional interaction contributes to creating a favorable atmosphere, eliminating excess stress and sparking
481
cognitive creativity in learners. Subject-and-professional interaction provides the optimal conditions for building subject-subjective relations.
Conclusions. Social-psychological peculiarities of professional activity of foreign language teachers at technical university are primarily determined by a subjectively meaningful objective. Further, teaching activity is directed towards the accomplishment of this objective. Two overarching objectives were defined personality development by means of language learning and language knowledge itself. Subjective
image of educational interaction has a complex structure including an image of a
learner, an image of an academic discipline and a self-image. A variation of the images
gives an idea of three forms of educational interaction - social-role; personal-professional; subject-and-professional - functionally equivalent in the aspect of achieving final
results.
References:
1. Batishev G.S. Introduction into dialectics of creativity. Saint-Petersburg: Russian
Christian Humanitarian Institute Publ., 1997. P. 464.
2. Kozyreva O.A. The phenomenology of teachers professional pedagogical competence / Educational Technology & Society.11(2). 2008 // http://ifets.ieee.org/russian/depository/v11_i2/html/3.htm.
3. Kuzmina N.V. Professionalism of the personality of the teacher and the master of
industrial training. M.: Higher School, 1990. P. 119.
4. Leontiev A.N. Lectures of general psychology. M.: Smisl, 2001. P. 511.
5. Markova A.K. Psychology of professionalism. M.: Znanie, 1996. P. 312.
6. Osmina E.V., Ponomarenko E.P. A social-psychological model of effective development of foreign competences of technical university students // Kazan Pedagogical Journal. 2015. 2 (109). P. 34-40.
7. Rubinstein S.L. The man and the world // Problemy obshchei psikhologii. M.: Pedagogika, 1973. P. 255382.
8. Symaniuk E.E., Sinyakova M.G. Psychology of vocational educational space of a
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482
Astrakhantseva Irina,
FGBOU VPO "Ulyanovsk State Pedagogical University
named after I.N. Ulyanov", The First Vice-Rector - Vice-Rector for Financial
nd Legal Activities nd Personnel Management,
Kuznetsova Zinaida,
FGBOU VPO "Naberezhnochelninsky Institute
of Socio-Pedagogical Technologies and Resources",
Doctor of Education, Professor,
Nazarenko Aleksandr,
FGBOU VPO "Ulyanovsk State Pedagogical University
named after I.N. Ulyanov",
Doctor of Pedagogical Sciences, Associate Professor
483
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491
I. Parfanovich
492
norms, that describes girls social or antisocial responsibility. Also it requires learning
differences between manifestations of deviations in behaviour of individuals of different
sex and age-specific manifestation of normative and deviant behaviour among girls of
primary school age, teen and young girls. So that we could soundly speak about gender socialization and identification of girls, must be analyzed characteristics of deviant
behaviour, determinants of its forming, mechanisms of deformation of personal development and degree of social and educational neglect.
Literature review. O. Kikinezhdi [O. Kikinezhdi, 2003] and B. Yavir-Iskra
[B. Yavir-Iskra, 2005]. points out that masculinity becoming a characteristic feature not
only of men but also of woman. There is weakening of stereotypes and displacement
of gender roles happening in society [Kon, 2003]. On the other side, increase of strictness level from mens side towards girls and woman could mean increase of feminity
level among men.
Girls are becoming more active, enterprising, aggressive and independent.
However, manifestation of social activity does not always have a positive direction.
Mens psyche is more rational and able to switch from one person or event to another
faster [Kornienko M.V., Romanyuk B.V., Melkin I.M., 2001]. Girls owe complex forms
of self-consciousness earlier then boys [Kuznecova L.,1995]; girls reaction to frustration is more brutal and directed at reaching goal [Petrova T.V., 2007]. It is hard to
understand inner world of woman within logic, it is too much tangled, capricious, complex; woman gives more advantage to ideas then concepts [Yavir I., 2005].
There are different approaches to the prevention of various types of behavioral
deviations in foreign countries. Also there are approaches to improve the prevention
of deviations by: 1) by amplifying a differentiated approach to girls based on their sociopsychological characteristics and the degree of socio-pedagogical neglect [Farrington D.P., 1994]; 2) the complex organization of prevention (with a help of families, law
enforcement, social services, strengthening the interaction of various social institutions) [Melton G., 1995]; 3) consideration of social, socio-pedagogical conditions of
prevention and the correlation of theory and practice [Bulter I., Gwenda R., 2007];
4) taking into account the type of behavioural deviations and state of psychological
health; 5) the organization of the positive impact of the informal environment [Donnell S.O., 2007]; 6) the realization of group work; 7) amplification of the preventive
work in the formal team [llomki E., 2012].
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The study of foreign experience of educational work with girls with normative
and deviant behavior is an urgent problem while forming the system of social work in
Ukraine. The situation is intensified with the change for the worse of criminal background in the youth surrounding. It prearranges the necessity of the search of ways
and methods of juvenile delinquents upbringing in conformity with social-economic
and spiritual development of the society on the whole.
To reach the aim of article were used theoretical (analysis, summarizing, systematization) and empirical (observation, analysis of papers, questioning) methods.
The aim of the study and research methods. The article aims to provide a
comparative analysis of girls behavioural manifestations of various phases of social
and educational neglect.
Results. Girls behaviour deviations are often caused by hypertrophy of social
demands in their consciousness and by ignoring gender stereotypes. Inability to adapt
to social realities, to determinate positive ideals of gender and gender roles leads to
deformation of gender identity. Behaviour can be identified as deviant when gender
identity is misshapen. Regulation of gender behaviour is particularly tense in adolescence. Analysis of behavioural deviations made it possible to identify the distinctive
features of such deviant manifestations among girls: lack of clear standards and attitudes of behaviour according to demands of gender socialization and identifications;
irresponsible attitude to herself as a future women, mother; aggressiveness, hardheartedness, cruelty in relation to surroundings; illogicality in actions; psycho-emotional instability as individual quality; contradiction of world-view and attitudes; unawareness of their self-condition and well-being; breach of positive relationships with
parents; deformation of relationships with surroundings and emotional estrangement;
duration of the latent period of formation deviations.
There are several characteristics that distinguishing girls from boys on normative and deviant behaviour levels. For this purpose we have analyzed the scientific
papers on this issue, written both by Ukrainian [3; 5; 6] and foreign scholars [7; 8;
9; 11].
1. Special features of girls normative behaviour, reasons of deviations in
behaviour. Girls are more impulsive, they are characterized by active searching for
new solutions, methods and ways. Also they are more ingenious. All of this makes
girls deviations more various, sudden and unexpected. It is observed that girls are
more emotional in perception of facts, events and occurrences. Sometimes it leads to
494
fussiness, ambiguity, unreliability, frequent change of solutions and hesitations in making decisions. In extreme conditions girls are less adaptive.
Girls often characterized by subjective inner experience. They have more critical
attitudes to realities of life, future and independent life. But girls are less confident in
psychoemotional aspect, despite the fact girls want to look strong and independent.
Searching for support they are sometimes becoming a victim of negative addiction.
Attitude to own appearance is one of the most important features of gender differences.
The range of behavioural deviations in this aspect is really wide: refusal from food
(anorexia), brutal deviations, criminal actions.
Having compared Ukrainian research files to the similar done abroad, we found
out that foreign researches put more emphasis on social work with children [Bultera I.,
Roberts G., 2007], individual work with families [Melton G., 2007], and the development
of theoretical models of prevention [Donnell S., 2007].
2. Features of the manifestations of deviant behavior of the girls. Under
purely female specific features girls are more capable of flexibility, variability, polymodality in behavior. Modern society creates conditions for increased activity, aggressiveness, independence women, it provokes if not masculinity, then androgenetic in
behavioral manifestations.
Also gender personality differentiation implies taking into account the fact that
in the basis of deviant behavior of girls very often lies resentment, guilt. In many cases
their deviant behavior based on unpleased feelings of security. The manifestation of
aggression, anger, bullying, cynicism, cruelty takes place in cases when girls can't express a positive feminine trait. Girls with deviant behavior are characterized by the fact
that they are mostly impatient, stubborn, self-centered, always strive to be the center
of attention, but consider themselves as independent and communicative personalities. To achieve their goals they are using any means and are often the initiators of
aggressive showdown. Offences are very often associated with immoral lifestyles; desires are focused on a beautiful life.
Deviations in girls behaviour are presented by prevalence of spite, aggression,
cruelty, willfulness in their nature. There is a tendency among girl to gain clearly male
deviation subcultures that displayed in low cognitive activity, cynicism, apathy, hardheartedness in relationships with others.
495
For most girls with obvious negative behavioural deviations is usual: primitiveness of life goals; poverty of interest and hobbies; removal from the educational process; smoking, amoral lifestyle, criminal behaviour, alcoholism; focus on immediate
pleasure; receiving desired items in acceptable and unacceptable forms. Responsibility, shyness, temperance, delicacy, empathy, aspiration for beauty and high spiritual
ideals are absent.
In connection with the manifestations of clearly feminine qualities girls are more
labile and can easily adopt rules of social environment in which she is living. Gender
approach analyses behavioural deviations of person from particular social environment. Girls have more hidden character of deviations and extreme manifestation of
deviations. The result of the negative behaviour of girls is their approach to masculinity.
Due to the comparison of manifestations of girls behavioral deviations in our
country and abroad, the following peculiarities of the deviations were found out: the
dynamics of deviations manifestation in puberty [Donnell S., 2007], polymorphism of
deviations types among the minors [Kuznecova L., 1995], the impact of the variety of
communication links in the young age [Petrova T., 2007], the role of prevention in the
lives of girls with deviant behavior [Farrington D., 1994].
Conclusions. Thus, the age differentiations of pedagogical and psychological
characteristics of girls with behavioural manifestations of deviance are characterized
by a number of attributes. Highlighted are some of them: primary school age lack of
discipline, anger and aggression, reticence, stubbornness, resistance to positive influences; adolescence conflict behavior, frequent symptoms, inadequate behavioral reactions, due to dissatisfaction with their appearance, uncertainty of self-esteem, presence of the complexes, extremes in behavior for exposure to emotional and psychological influence of various factors; youth age disharmony of personality development
through understating or overstating of self-esteem, deformation or absence of positive
life values, low behavioral self-regulation as a consequence of the excessive desire of
self-realization and to please the opposite sex.
Thus, the problem of formation of behavioral deviancy in ontogenetically personal development was investigated. This gave the opportunity to identify specific
characteristics that distinguish younger girls, teenage, and young girls from the boys,
especially normative behaviour, preconditions and specificity of the manifestations of
deviant behavior.
496
In the characterization of deviant behavior attracted the attention of explicit behavioral manifestations of deviant behavior and the invisible girls at risk, the characteristics of the manifestation among children of different age categories.
References:
1. Kikinedgy O. (2003). Gender identity of youth as psychological and pedagogical
problem, p. 711.
2. Kon I. (2003). Sexual culture of XXI century. Pedagogies, No 4, p. 315.
3. Kuznecova L. (1995). The education of girls, Education of schoolchildren, No 1,
p. 2728.
4. Kornienko M.V., Romanyuk B.V., Melkin I.M. (2001). The criminology course,
Ukraine: Kyiv, p. 480.
5. Petrova T.V. (2007). The differential approach in the education of boys and girls of
primary school age, Elementary school, No 8, p. 78.
6. Yavir I. (2005). Features of gender behavior of boys and girls depending on the
way of socialization, Osvityanin, No 5, p. 1821.
7. Donnell S.O. Development of conduct problems in girls: Testing the oretical models and examining the role of puberty. A Dissertation Submitted to the Graduate
Faculty of the University of New Orleansin partial fulfillment of the requirements for
the degree of/ S. ODonnell. M.S. Acadia University, 2007 312 .
8. Farrington D.P. Changes in Crime and Crime Prevention, Annual Review
/ D.P. Farrington, P.H. Wikstrom. Oslo; Stockholm: Seandinavian University
Press, 1994. 197 p.
9. llomki E. Conduct disorder among girls: violent behaviour, suicidality and comorbidity: study of adolescent inpatientsin northern Finland / Essi llomki. University of Oulu, 2012. 98 .
10. Melton G. The Individual the Famile and Social Good: Persona Fuilfment in Times
of Change. Current, Theory and Research in Motivation / G. Melton. Nebraska:
University of Nebraska, 1995. 112 p.
11. Social Work with Children & Familys. Getsng into Practice. Ian Bulter and Gwenda
Roberts. London and Briston, Pennsylvania: Jessica Kingsley Publishers, 2007.
287 p.
497
Inna Boyko,
Odessa National Maritime Academy,
Associate Professor, Candidate of Political Sciences,
the Faculty of Maritime LAW & Management
498
Research results. The term sources implies many different, sometimes conflicting meanings. For example, Herbert Briggs was pointing out that the confusion of
the term sources describes it as the methods or procedures, by which international
law is created [2, p. 44]. George Schwarzenberger proposed the term law creating
process for primary sources i.e. treaties, customs and general principles of law; and
law determining agencies for subsidiary means for determination of law, i.e. judicial
practice and doctrines [3, p. 79]. Lassa Oppenheim was discussing its various meanings differentiates between formal and material sources: formal being the source from
which the legal rule derived its legal validity; and material providing the substantive
content of that rule, e.g. the formal source of custom might had its material source
found in a treaty concluded [4]. J.W. Salmond also holded the same opinion [5]. Therefore, it can be said that there are, in the context of International law, recognized and
accepted methods, by which legal rules come into existence (formal sources), as well
as several ways, in which the precise content of legal
(material sources) [5, p. 555]. According to Salmond, a formal source is that from
which a rule of law derives its force and validity. The material sources, on the other
hand, are those from which is derived the matter and not the validity of the law. The
material source supplies the substance of the rule to which the formal source gives
the nature and the law [Ibid].
An unavoidable degree of flexibility and overlap in the use of the terms with
various meanings such as cause, basis and evidence are observed. Discussing the
difference between basis of law (common consent of international community), causes
of law (particular circumstances in the development of communities suggesting need
for a rule of conduct), and sources of rules of law (the process, by which it first becomes
identifiable as a rule of conduct with legal force and from which it derives its legal validity), Robert Jennings concludes that sources of the rules of law as distinct from the
basis of law are as a whole related to the basis of the legal system [6, p. 23].
Article 59 of the Statute of the International Court of Justice provides that decisions of the courts have no binding force, except for the parties and in respect of the
case concerned [7]. Contrary to the Common Law the doctrine of precedence does not
exist in the international law, still we find that the Court itself in its decisions, the states
in their disputes and legal writers in their scholarly works quote judgments of PCIJ and
ICJ as those of an authority. Thus, even as a subsidiary source, judicial decisions are
499
important in the determination of the existence of legal rules and their content. A unanimous, or almost unanimous, decision plays an important role in the progressive development of law, e.g. the decisions and advisory opinions in the Reparation, Genocide, Fisheries cases have had decisive influence on general international law [8].
In national legal systems precedent constitutes the starting-point of judges' reasoning. Most of the time judges hew closely to the precedent for the purposes of legal
certainty and for fear that their decisions might be challenged before higher instances.
This practice translates into the stare decisis rule in Common Law, and into the concept
of jurisprudence constante in Roman-German Law. In international law the stare decisis rule has been excluded since 1922, but permanent jurisdictions constantly refer to
their previous decisions. Nonetheless, the former are still led to reassess their jurisprudence by various methods in order to take into consideration the evolutions of the law
and of international society. Regional jurisdictions are more inclined to do so than the
global ones. As for arbitral tribunals, they have recourse to legal precedents in a very
variable manner according to the area: interstate relationships, international trade, investment or sport. Furthermore, the increase in the number of courts and arbitral institutions introduces the question whether precedents from one dispute settlement institution are relevant to the others. The question arises when two courts or tribunals apply
the same national law or treaty and when they apply general international law. The
challenge is to navigate between two risks: that of jurisprudential incoherence and that
of government by judges. Legal precedent in international dispute settlement is neither
to be worshipped nor ignored [9, pp. 21-23].
One of the dominant positions in the traditional version of international law is as
follows: the International Court of Justice and other international courts are not entitled
"to form customary law" [10, p. 183]. Mathias Herdegen supports this position and believes that it can be complemented by the statement that "... international courts
only apply the existing law, but they should not shape it". At the same time Herdegen
admits that "decisions of international courts can be attributed to the parties to the
dispute that have contractually subordinated themselves to a corresponding jurisdiction" [Ibid]. It should be noted that for Herdegen "... if the decisions of the International
Court of Justice receive approval of the majority of states", then "a new norm of customary law can be formed" [Ibid]. By using this authoritative opinion as an example we
stress the availability of the position of the international law specialists concerning the
500
role of international judicial institutions in the formation of common, and not of case
law.
In the legal literature of the post-Soviet space the content of Article 38 of the
Statute of the International Court of Justice is often defined as an exhaustive list of
sources of international law [see for example,11].
The situation today is quite different because of the proliferation of international
courts and increasing institutionalization of arbitration. Globally, the International Court
of Justice has found new life. Then came the International Tribunal for the Law of the
Sea, international criminal courts, the Appellate Body of the World Trade Organization
and many international administrative tribunals. At the regional level, the European
Court of Justice and the European, Inter-American and African Human Rights Courts
were created. The traditional forms of arbitration prospered, but new forms have
emerged, with the Iran-US Claims Tribunal, the Court of Arbitration for Sport and the
International Centre for Settlement of Investment Disputes (ICSID).
This development has led to increased attention to the issue of precedent in
both public and private international law. It became obvious that in these areas the use
of precedent poses two problems:
- as in domestic law, we must consider the methods followed by each of the
judicial and arbitration bodies in the use of its own precedents; and
- further, due to the proliferation of autonomous jurisdictions, it is also necessary
to investigate the extent, to which each court or tribunal makes use of the precedent
that other courts or tribunals create. A similar problem arises for arbitration institutions.
In the first case, the legal certainty in a given field is in question. In the second, it is the
coherence of international law in its entirety.
We might associate positivism with the view that sources discourse could supplant other doctrines by mapping the interests of state authority. Maintaining the supplemental position of sources discourse (its dependence upon an authority apparatus
articulated elsewhere) seems similar to avoiding the pitfalls of extreme positivism,
which postulates an authority that it cannot ground. We might associate naturalism
with the view that sources discourse could be consumed by doctrines of substance
and process. Maintaining the independent position of sources discourse (its ability to
validate other norms) seems similar to the dilemma of extreme naturalism that posits
an order, to which it cannot give content. In this view, we would equate the struggle to
501
blend hard and soft rhetorics with the dilemma confronting a theory of international law,
which is to be neither naturalist nor positivist [12, p. 82].
Judicial decisions are confronted in two different ways: they are either considered as subsidiary means for the determination of rules of law, an argument based
on the ICJ Statute itself, or as having the potential to be elevated at the sphere of
formal sources. This controversy is highly interconnected with and affected by both the
force of precedent and the role of international judges as law-makers. It is claimed, on
the one hand, that precedent does not exist in the international legal order, since judgments are binding only upon the parties to dispute; on the other hand, practice has
shown that past cases are highly cited by both the Courts themselves and the international community, and they can have a multiple role to play. Consequently, it is thought,
on the one hand, that judges only apply law and, on the other end of the scale, that
they contribute to the promotion of law in generating or crystallizing custom, jus cogens
norms and general principles. It is incontestable that International Courts have long
contributed to the evolution of the international legal order and it is expected that they
will continue to do so, a fact that foretells that controversy on the place judicial decisions should have is about to be continued and reinforced [13].
For a more precise clarification of the essence of the norms created by international judicial bodies, such norms need to be clearly separated from other rules of international law. Opponents of the recognition of the international judicial precedent as
the source of law often distort its legal nature. Without denying the fact that the court
in its decisions fixes new legal provisions, they either believe them to be customary
norms, or associate with the doctrine. Indeed, Court has the right to apply customary
norm in their proceedings and, therefore, they are reflected in its decisions. However,
we cannot agree with the assertion that any norms of extra-contractual nature contained in the judicial decisions have the nature of customary law. This approach is not
consistent with the concept of "custom", which is current in the international law. Acts
constituting the practice that leads to the formation of customary law, according to
Members of the International Court of Justice "should be such or be carried out in such
a way as to serve as proof of the belief that the practice has become mandatory due
to the existence of the rule of law. The need for such a belief, i.e. the existence of a
subjective element, is defined by the concept of opinion juris sive necessitatis. States
that are parties to the dispute should understand that they perform a legal duty. The
frequency or even the customary nature of actions is insufficient by itself" [14]. The
502
Courts influence on the custom formation process is that by using the custom in the
dispute resolution the Court is only authoritatively confirms the fact of its existence
while the judgment does not act as a source of customary law. Court cannot create a
custom due to the peculiarities of its legal nature. This rule of conduct consists in the
process of relationships between States and is recognized by them as legally binding.
Court may not act as the discoverer of rules either as they have been created not by
Court, but by other entities of law. On the contrary, the collective decision of judges
and not the practice of states is the primary basis of an international judicial precedent.
Therefore, the definition of custom stipulated in Article 38 of the Statute of the UN
International Court of Justice cannot be applied to judicial decisions that contain provisions specifying a particular rule of international law or narrowing a gap in the law.
Conclusion. Thus, some authors attribute the decisions passed by the international court to sources of law insofar as it derives from the provisions of the Statute.
Other researchers representing the Soviet school of international law state that judicial
decisions are not recognized as a source of law, i.e. such decisions are no more than
the reference ones, general guidelines, and so they are called "evidence of customary
rules existence", or "subsidiary means for the interpretation of rules".
Supporters of the independent role of judicial decisions as source of international law with special legal nature argue that the analysis of rules fixed in the decisions
of international judicial bodies enables highlighting the features of case documents.
Rules of law in the international law are always used in the development of any of
existing rules: contractual, conventional or peremptory norms. This implies that rules
of precedence in relation to the above-mentioned international legal rules act as derivatives. This feature is reflected in the fact that their action is directly connected with the
action of "primary" rules. Therefore, any change or cancellation of, for example, certain
provisions of an agreement, based on which a precedent has been established, entails
the termination of such rule of precedence. The precedent may only be applied to the
states, which are bound by the "basic" rule. The court that has created the precedent
can cancel it or change as "outdated", i.e. inconsistent with the new life conditions of
society.
References:
1. Brownlie I. Principles of Public International Law / Ian Brownlie. 7th ed. Oxford;
New York: Oxford University Press, 2008. 784 p.; Cassese A. International Law
503
/ Antonio Cassese. 2nd ed. Oxford; New York: Oxford University Press, 2005.
558 p.; Degan V. D. Sources of international law / V. D. Degan. The Hague:
Kluwer Law International, 1997. 564 p.; Lauterpacht H. International Law. Collected Papers / Hersch Lauterpacht; systematically arranged and edited by E. Lauterpacht, Q.C. Cambridge: Cambridge University Press, 1970 [The digital print
version of 2009]. 539 p.; Mendelson M. The International Court of Justice and
the sources of international law / Maurice Mendelson // Fifty years of the International Court of Justice: essays in honour of Sir Robert Jennings / ed. by Vaughan
Lowe and Malgosia Fitzmaurice. Cambrige: Cambridge University Press, 1996
[Digital printed version 2008]. P. 63-89.
2. The Law of Nations: Cases, Documents, and Notes [ Second Edition ]. Briggs,
Herbert W. [Ed.] Published by Appleton-Century-Crofts, Inc, New York, 1952.
1108 p.
3. George Schwarzenberger. The dynamics of international law. Paperback: Professional Books, 1976. 139 p.
4. Oppenheim L. Lectures on Diplomacy as Part of International Law. Lecture 3. Electronic resource // http://www.slideshare.net/Kingnabalu./lecture-3-sources-of-international-law.
5. Salmond J. W. Jurisprudence.Appendix VIi Salmond J. W. Jurisprudence, 7th ed.,
1924) // Frame A. Salmond: Southern Jurist. Victoria University Press, 1995.
287 p.
6. Sir Robert Jennings, Sir Watts Arthur. Oppenheims International Law. Longman, 1996. 1333 p.
7. Statute of the International Court of Justice // Electronic resource: http:
//www.icj-cij.org/; The Statute of the International Court of Justice. A Commentary
[Zimmermann A., Tomuschat C., Oellers-Frahm K. other] / ed. by A. Zimmermann,
C. Tomuschat, K. Oellers-Frahm. Oxford; New York: Oxford University Press,
2006. 1664 p.
8. Malcolm N. Shaw. International Law. 6-th edition, 2008. 1710 p. (P. 110); Reparations for Injuries Suffered in the Service of the United Nations Case, (1949) ICJ
Rep. 174, cited by Hamid A.G. Sources of International Law: A Re-Evaluation.
P. 18; Reservations to the Genocide Convention Case, (1951) ICJ Rep. 15, cited
by Hamid A.G. Sources of International Law: A Re-Evaluation; Anglo-Norwegian
Fisheries Case, (1951) ICJ Rep. 116, cited by Hamid, Sources Of International
504
505
506
N. Protasova) has researched an issue of conceptualization of the economic mechanism of public administration of education, particularly, development of education. Due
to challenges, which threat modern Ukraine under conditions of the protracted social
and economic crisis, a matter of innovative fulfillment of education is of considerable
importance. Solution of this matter consists in search of methodology for determination, usage, and diversification of sources of financing educational changes. To attain
this goal, there is a need to understand specificity and tendencies of functioning of the
economic mechanism for public administration of educational changes.
A purpose and aims of the article. A purpose of the article is to analyze the
economic mechanism of public administration of educational changes. To achieve this
purpose, the author will solve the following problems: consideration of instrumental
peculiarities; examine the Ukrainian context of functionality of the economic mechanism for administration of changes in education.
Presentation of the main material and substantiation of received research results. A public administration mechanism is a functional sub-system of public administration supplemented by specific methods and organizational functionality in each
particular case of solution of social life problems. The economic mechanism of public
administration influences factors and creates conditions, under which actions of economic entities will cost more expensively or cheaply. Except the economic one, there
are administrative and information and psychological mechanisms within the system
of public administration of education. L. Pashchenko points out that economic and information and psychological mechanisms are applied covertly because of centralization of administration and absence of communications between levels of the system
[1, . 255].
Educational changes are non-linear processes of transformations, which express dynamics of progressive transformations in education being distinct in the scale,
the sense, quality, and durability of progressive transformations in the world. Educational changes include concepts of an educational novelty, an innovation, a reform,
development, and various combinations of them. Public administration of educational
changes is an independent part of a general process of public administration, which
encompasses purposeful producing, approval, and implementation of organizational,
regulative, coordinative, controlling, and motivating influences aimed at renovation, innovative fulfillment, and modernization or large-scale reformation of education. Public
authorities for administration of educational changes in Ukraine comprise the following
507
entities: the Verkhovna Rada, the President, the Cabinet of Ministers of Ukraine (a
higher level); the Ministry of Education and Science of Ukraine, other authorities participating in formation of a governmental educational policy (a central level); local authorities, local self-government bodies (a local level). The educational field activity, including a process of its development, is regulated by the Constitution of Ukraine
(1996), the Law of Ukraine On Education (1991), On Professional and Technical
Education (1998), On General Secondary Education (1999), On Preschool Education (2001), and On Higher Education (2014). The lawmaking activity concerning
development of a new progressive frame law On Education has been occurring in
Ukraine since the end of 2013. This activity should initiate renovation of state norms of
the interaction at different levels of education. The main novelty of a project of the Law
On Education is implementation of professional high school through transformation
of 11-year education into 12-year education (5 years (elementary school) + 4 years
(middle school) + 3 years (high school) in order to unburden an educational program
and to put into practice certification of teachers aimed at encouragement of their professional self-improvement. The institution of teacher certification proposed by legislators hardly differs from the previous post-soviet procedure of pedagogue attestation
and does not fix a right of a teacher to an individual educational trajectory. On account
of absence of an appropriate information and explaining campaign and regular communications with a society on the part of the Ministry of Education and Science, only
30% of parents has understood advantages of 12-year school and supported this
change. Analyzing the current situation in the field, the author may predict that producing a consensus solution regarding the final project of the frame educational law will
take considerable time. In addition, all the stakeholders should be oriented towards
achievement of this consensus. Thus, the author should analyze norms of the current
law.
An economic mechanism of education is, primarily, a set of rules regarding division of societys resources in favor of education. A financial mechanism of public
administration is aimed at improvement of a system of financing and material and
equipment support of education [1, . 281]. A financial mechanism of public administration of educational changes is a functional component of the former. A function of
providing quality of education initiates specific mechanisms of public administration (for
instance, public attestation). A function of development and providing competitiveness
508
hardly possesses mechanisms of public administration. Thus, to manage tasks of innovative fulfillment of education, the government frequently uses mechanisms for administration of a regime of functioning of an educational system. These mechanisms
are not able to create conditions for implementation of full-fledged progressive educational changes.
Ukraine provides accessible and free education at public and local educational
institutions and development of all the levels of education (Article 53 of the Constitution
of Ukraine). According to the Law of Ukraine On Education, a government provides
budget assignations for education, which account for at least 10% of the national income (approximately equals 8% of the GDP). However, since 1991 the government
has not been adhering to this norm, even in a period of economic stability (the greatest
figure in 2010 accounted for 7.4%). It is worth mentioning that the Final Provisions of
the current Budget Code of Ukraine enables the government to exercise a good few of
norms of the educational legislation in a case of a sufficient amount of resources. Thus,
the author agrees with L. Parashchenko concerning urgency of solution of a problem
related to determination of a degree of responsibility of the state authorities for observance of amounts of financing education.
The main problems of economic support of the Ukrainian educational field are:
a) significant unbalance of financing different levels of education (a too large share of
assignations for the higher education (31%) and insufficient financing the secondary
education (41.5%, at an average world rate of 75%); b) a small amount of pupils in a
class (18 pupils, at an average rate in the G-20 countries of 27 pupils); c) a low index
of a number of pupils per teacher (8 pupils, at an average rate in Europe of 17 pupils).
During the independence years, a number of pupils in Ukraine reduced nearly twice
and a number of teachers reduced only by 13%. Such a situation leads to disproportion: the government allocates 7 thousands of hryvna per pupil in densely populated
cities (a class contains 35 pupils) and 19 thousands of hryvna per pupil in rural areas
(a class contains 5 pupils). Recently, the government and the society has reached
consensus regarding necessity of functioning of the elementary school in rural territories regardless of figures of a number of pupils in a class. In a case of an insufficient
number of pupils in a class, a problem of teaching pupils of the middle and high school
should be solved in accordance to capacities of local budgets (by amalgamation of
schools and the solution of a problem related to transportation of pupils or distance
education).
509
For a long period, Ukrainian schools as subjects of local ownership were financed by local budgets. Factually, not every local budget, which was pumped up owing to the individual income tax, had a sufficient amount of funds for financing schools
at its disposal. At the same time, governmental assignments were not received on time.
In order to provide equal financing schools regardless of a region, since 01.01.2015
the government has been subsidizing current expenditures of schools by central
budget funds. Nevertheless, there are no guarantees of an amount of this subsidy in
the legislation now [2]. Responsibility for coverage of capital expenses of schools was
handed over to local authorities.
The Ukrainian legislation determines that a cost estimate of an educational institution must include expenditures for educational institution development. Factually,
an absolute majority of school cost estimates is deficient and these estimates finance
only so-called protected items, i.e. staff salary, payments for local utilities. Funds for
school development or for current needs (medicines, payments for communication services, expendables, etc.) are not usually allocated. Under conditions of resource scarcity, education authorities significantly edit cost estimate projects in accordance to
available recourses. As a result, principals should not only look for sponsorships, but
also form underground economy of institutions.
Since 2000, the government has been including the special funds of school cost
estimates in the single state treasury system. Not a school, but a district education
authority is an administrator of these funds. Since a school is not de facto a legal entity,
a direction of usage of earned funds depends on a will of a governmental official. Such
a situation does not motivate innovations at schools. A functional component of the
economic mechanism of public administration of educational changes at the secondary
school level consists in state support of development of innovators among pedagogues, performing the experimental activity at schools, and extension of opportunities
for self-education of teachers.
In the nearest future, the normative and cost-based financing education according to an allowance principle will persist. In a case of enacting the progressive law
On Education, there can be gradual transition to allocation and usage of funds, which
are oriented towards educational goals and expected results. Stabilization of the educational policy, determination of priorities for medium-term prospects, formulation of
an expenditure strategy, taking notice of real financial needs, and decentralization of
administration will foster the mentioned process.
510
511
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Ph.D., Principal Lecturer
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Iryna Pogorska,
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Doctor of Political Sciences, Senior Researcher,
the Institute of International Relations
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Zaporizhzhya National University,
Associate Professor, Doctor of Law,
Head of the Department of History and Theory
of State and Law, Faculty of Law
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Lesya Petrenko,
Poltava V.G. Korolenko National
Pedagogical University, Doctoral Student f the Department
f General Pedagogics nd Andragogics, Physics and Mathematics Faculty
.
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, . (1878-1967).
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541
Liudmyla Bakhmat,
Municipal Establishment Kharkiv Humanitarian-Pedagogical Academy
of Kharkiv Regional Council, Tutor of Foreign Philology Department
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Pastushenko Ludmila,
National University of Dnipropetrovsk,
Doctor Sc. of Philological Sciences,
the Faculty of Philological Sciences
XVII
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: Constantia, ,
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. - ,
- -
-
549
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, . constantia ,
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Unbestndigkeit der Welt [2]. ,
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,
, ,
, , . ,
..
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-
551
552
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553
554
Savchenko Lyudmila,
Kharkiv Humanitarian Pedagogical Academy, Senior Lecturer,
Faculty f Preschool nd Special Education
, -
, ,
-
:
.
: , , , , .
555
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562
Filimonyuk Lyudmila,
North Caucasian Federal University,
Professor f Department f Pedagogics nd Psychology
f Professional Education, Doctor f Pedagogical Sciences,
Nevinnomisska State Humanitarian
Technical Institute, Professor,
Burljaeva Viktoria,
Nevinnomisska State Humanitarian Technical Institute,
Head of the Department of Professional Training,
Doctor f Social Sciences Professor,
Chebanov Konstantin,
Nevinnomisska State Humanitarian Technical Institute,
Candidate f Pedagogic Sciences, Associate Professor
563
cesses of centuries-old interaction and mutually comprehension with the Russian national character, the Russian world view, the Russian national consciousness in the
conditions of uniform geopolitical interests [2].
Ethnopedagogics studies process of social interaction and public and national
influence during which the personality acquiring social norms, values, experience is
brought up, develops collects and systematizes national knowledge of education and
training of children, all popular wisdom reflected in religious doctrines, fairy tales, legends, bylinas, parables, songs, riddles, proverbs, games, toys and other in family and
communal tenor of life, life, traditions, and also philosophical and ethical, actually pedagogical thoughts and views, that is all pedagogical potential, cumulative experience
of historical and cultural formation of the personality [3]. A teacher, providing national
education, forms national consciousness of the child by training in the native language,
by acquaintance with customs, traditions, valuable orientations of the people. However, putting in structure of the personality national into the forefront, it is necessary to
consider two possible extremes: the nihilistic the denying and not recognizing its
nationality and culture; and nationalistic and chauvinistic the role preaching only the
national priorities and installations and belittling and value of other nationalities. Therefore parallel work on acquaintance with other ethnic collectives is very important not to
miss the sensitive period of assimilation of other languages and cultures, not to limit
the world of social contacts of children [4].
National consciousness or ethnic identity as understanding of the belonging to
a certain ethnos, is formed at the person in the first years of his life, this period is
defining in formation of bases of character and development of the standards of behavior in many respects depending on a social environment. One of the major factors
defining process of formation of ethnic identity are safety and full value of existence of
ethnic traditions in surrounding society [5].
Recognition and acceptance of distinctions of ethnic collectives can be considered norm of cross-cultural interaction at the present stage of development of humanity [6]. At the same time it is also a standard of behavior for the modern polycultural
educated person. Polycultural (international) training is understood as development in
the person of ability validly to perceive an ethnic variety and cultural identity of various
human groups. Absence of due consideration to polycultural education of the individual
leads to social-cultural intolerance and hostility manifestation to other ethnic origin surrounding people.
564
565
growing-up person is brought up only by the identity of the teacher, and no textbooks
can replace it, it and is the fundamental principle of national pedagogics.
For intensification of cognitive activity of trainees on problems of national and
polycultural training the following forms of work are used: conversations, debates on
pedagogical views of the different people, an ideal of the perfect person, to methods
of training; creative evenings with speeches of representatives of the national intellectuals (composers, artists, writers, etc.); carrying out KVN on folklore materials, "days
of ethnopedagogics" with the comparative analysis of educational traditions of the different people; preparation of papers about traditions of education of children, standards of behavior of the different people (following the results of independent search
activity); viewing of video movies about the best pedagogical practices on national and
polycultural education [9].
It is very important that problems of education were harmoniously combined
with problems of training and were fixed in behavior of trainees. In the solution of informative tasks expediently use of dialogue form of education. Such form of carrying
out occupations recovers pedagogical process and promotes deeper and conscious
digestion of material. Intensification of the gained knowledge is promoted by "cross
poll": each team prepares a package of questions on the studied problem for team of
rivals and then watches alternation of their collective and individual answers.
The differentiated approach in education is carried out by drawing up tasks for
drawing up stereotypes and autostereotypes of the different people, a scale of values
in national programs of training, etc. Use of nonconventional forms of education not
only makes active and "recovers" pedagogical process, but also allows to involve pupils in the unique world of national creativity, national pedagogics, influencing their
emotional and strong-willed sphere.
Results of education have to find the reflection first of all in behavior of pupils,
in particular, in personal observance of the basic principles of culture of international
communication by them:
the principle of "ethnic indifference", that is abstraction from a national factor
in interpersonal communication, it should be noted that today the opposite behavior
not only among adults, but also among children even more often meets, and the attention of teachers isn't always focused on these cases of immoral behavior of their wards,
becoming isolated only within a didactic educational cycle;
566
567
568
:
: . ,
, ,
.
.
569
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, , .
. 46 .
,
. , - . .
,
, [1].
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, , . . 18
. ,
, ,
.
;
, . 3 . 56
.
.. , , , , , , . ,
.. : , , ,
, ,
570
(. 1 . 46),
. 46 , [2].
,
, . , ,
, , , . , . 1 . 46 ,
, . . 1 . 46
:
, , . . , ,
, , . . . ,
,
. ,
[3].
- . , . 8
,
571
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, , , . - ,
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. 59 ,
.
, , . . . 1 . 55 , ,
.
. (
, , ), .
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, ,
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572
- , . ,
(. 1 . 1), ,
,
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. (. 2 . 45),
() ,
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,
(. 3 . 46). ,
,
.
,
, ,
,
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, , ,
,
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, .. , , , , [1].
573
, . , ,
, .. [2]. ,
.
.
.
. 8 , . 25.2. , , , . ,
, , .
, , , , ,
. , , , , , . , , , ..
, , , , , ,
.
574
, , , ,
, , [3].
, .. , , ,
[4].
, [5].
. - ,
. . .,
, 1992 .
, .
. 5 .
. . . . .
, 29
201 10/22 ,
,
[6]. , . 2 , , .
, ,
, ..
575
, , .
19 2012. 13 , [7] ,
, . 11.1 ,
. 221- , . , ?
,
, , , , .
,
,
1
1 20 1952 .
. 7
19 2003 23
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, , , . ,
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576
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2004 . N 8-
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11. 19 2003 23 //
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578
579
2008, 20 p.). Thus the term dialect is modified, refined and differentiated, but does
not disappear.
We know that the solution of some important problems of the Kazakh dialectology requires the description of the Kazakh language dialects separately, definition of
their characteristics, similarities and differences. In this regard, an objective of the
study, conducted by dialectologists, is to collect and investigate local characteristics in
the language of Kazakhs, settled outside Kazakhstan in the second half of the XX
century. The peculiarities of the language of Kazakhs in China are divided into three
areas: Ile, Altai and Tarbagatai. They divide the dialects among themselves, without
taking into account Kazakhstan. We think that the Kazakh language in Kazakhstan
should be the basis for the North-East and South-Western dialects, as the literary language is in Kazakhstan (Bazylkhan B. Language of the Kazakhs in Mongolia,
Ulaanbaatar, 1991, p. 67).
In the article the language of the Kazakhs in China is studied in the framework
of the Eastern dialects. Apart from these dialects, this group includes Oskemen and
Ayagoz dialects, located on both sides of the Irtysh River, the language of the Kazakhs
in Mongolia (Bayolgey dialect) and the language of the Kazakhs of Koshagash in
Gorno-Altai area in Russia. The main reasons for bringing together the eastern group
of dialects are the facts of close language relations, the territory and the ethnic connection with each other (Bazylkhan . Language of the Kazakhs in Mongolia,
Ulaanbaatar, 1991, p. 84).
The language of the Kazakhs in China appears only in the form of separate
articles. Sh. Sarybaev, Zh. Bolatov and B.A. Bafin noted about it in their articles. Chinese linguists also could not ignore this issue. The study of this issue began in dialectology of Kazakh Linguistics in the 50s of the XX century, after the formation of the new
PRC.
In these works phonetic features, lexical and grammatical problems of the dialects are covered only in the form of description, not as an object of special study.
Historical, cultural, ethnological reasons and lexical peculiarities of the language of the
Kazakhs in China, alienated from the main group of the Kazakh people and living in
the socio-linguistic environment, deserves to be the object of study from historicalcomparative, as well as linguistic-geographical directions. On the socio-linguistic side
it is important to consider the lexical system of the language of the people, in close
relations with the Chinese people for many years, taking into account the influence of
580
other languages. Our article is interested in studying the changes in the language of
the diaspora, moved from China to Kazakhstan, as a result of relationships with other
people and the influence of other languages (Zh. Mamyrkhanova. Problems of the language of the Kazakhs in China. Beijing, 2013. International Conference Problems of
Philology Article).
At first dialectologists began to study the language features of the people living
in different districts of Kazakhstan, and at the same time exploring the language of the
Kazakhs living in the neighboring republics. Peculiarities of the Kazakh language of
the Kazakhs remained on their own land that has been passed to the other neighboring
Soviet republics such as Russia, Uzbekistan, Turkmenistan, Karakalpakstan and Tajikistan, as a result of historical and political changes, interest the scientists. The expeditions to the places, inhabited by the Kazakhs in former Soviet republics like Uzbekistan, Turkmenistan, Karakalpakstan, Tajikistan and Russian Federation (Orenburg region, in the area of Koshagash and Turaty in Gorno-Altaisk autonomy, Western
Siberia, Kalmyk autonomy) were organized with the aim of collecting data about
the peculiarities of the local language. After some time, the opportunity to explore the
Kazakh language in distant foreign countries as Mongolia and China appeared. The
Kazakh language in other countries is generally described as a transitional dialect
(Zhadi Shakenuly. The Kazakhs in China. Almaty: Kazakh community worldwide,
2007, 34). Evidence of this is the works of many scholars like A. Nurmagambetov
(Language of the Kazakhs in Turkmenistan), T. Aydarov (Language of the Kazakhs in
Uzbekistan), B. Beketov, N. Zhunisov (Language of the Kazakhs in Karakalpak),
A. Tasymov, K. Kurmanaliev (Language of the Kazakhs in Russia), B. Bazylkhan (Language of the Kazakhs in Mongolia) who considered the subject.
Having researched the separate dialects, scientists began to study the dialects
of large areas in recent years. That is, some dialects have been grouped and classified
according to their features, their similarity and differences and also in relation to the
literary language (B. Bamishuly Condition of the language of the Kazakhs in Mongolia.
A. 2004).
One of the dialect groups, which differs from the literary language and other
dialect groups, is the eastern dialect group of the Kazakh language (Zh. Bolatov Eastern dialect group of the Kazakh language and its relation to the literary language. Doctoral dissertation manuscript: 10.02.02. Frunze, 1970).
581
Zh. Bolatov who explored the language of this region for many years, divides
the eastern dialect group into five dialects: Bayan-Olgii (Language of the Kazakhs in
Mongolia), Xinjiang (Language of the Kazakhs in China), Koshagash (Language of the
Kazakhs of Koshagash and Turaty), Oskemen and Ayagoz. The language of the Kazakhs in Mongolia, China, Koshagash and Turaty in the Russian Federation, we are
talking about, is considered a part of the Eastern dialects. Also, in the rest of these
regions the Kazakh language belongs to different groups of dialects. For example the
language of the Kazakhs of Turkmenistan and Karakalpakstan is in the western group
of dialects, and the language of the Kazakhs of Uzbekistan and Tajikistan is in the
southern group of the Kazakh language dialects (Eskekbaev D. - Kazakh Diaspora:
today and in the future. - Turkestan, 2002, 75).
The study of dialectical features of the Kazakh language came out of the scope
of the Republic, and covered the language of Kazakh diaspora abroad. In the first years
of independence the opportunity to explore the language of the Kazakhs living in foreign countries was associated with many factors. Now, when Kazakhstan is a full member of the world community, the issue of relations and communications of Kazakhstan
and the countries, where our compatriots live, has been put at the international level.
Therefore in the last 15-20 years the opportunity to investigate the situations
and changes in the Kazakh language in another language environment appeared. The
peculiarities of language of the Kazakhs living in different countries differ from each
other. This is due to the influence of other people and other languages.
Diasporology as a field of social sciences studies historical, demographic,
ethno-psychological, socio-political, and cultural development of a particular nation located in other countries far from the homeland. In dialectological studies, together with
the study of traditional linguistic phenomenon, there are problems as a state of the
language, language situation, linguistic influence, and the emphasis was placed to the
social and public function of the language of the Kazakh diaspora and irredenta.
Though there are Kazakh people settled in Europe, Pakistan, Libya and other countries, the language of the Kazakhs in Mongolia, China, Afghanistan and recently in
Turkey has become the object of scientists research and there are some scientific
thesis, many articles and monographs on its characteristics (Mustafauly S. Local features in stable combinations: on the material of the language of the Kazakhs in China.
Almaty, 2003, 102).
582
Studying the language of the Kazakh diaspora, which is one-third of the Kazakh
people, living outside Kazakhstan, is one of the important points of Kazakh dialectology. Studying the language of the Kazakhs in China has been conducted recently.
When Kazakhstan was still a part of the Soviet Union in the 1960s.
Zh. Bolatov first conducted his study based on the language of the Kazakhs
moved from China to Semey region in Kazakhstan. Here B. Bafins research also
should be noted (D.Eskekbaev - Kazakh Diaspora: today and in the future. - Turkestan,
2002).
The features of the language of about half a million Kazakhs in China are distinguished with a variety of territorial characteristics and diversity. Firstly, the number
of the Kazakhs in Xinjiang is very big (two million according to some sources). Secondly, the Kazakhs in Xinjiang had the opportunity to develop their language freely.
Here Kazakh schools have been opened, newspapers, magazines, books and textbooks were published, and radio and television have been working in the Kazakh language. The Kazakh language in this area is systematically investigated. They had the
opportunity to develop the Kazakh language as compared to the language of other
Kazakh diaspora living in other countries. Third, the Kazakhs in Xinjiang have reserved
a rich fund of Kazakh folk literature, and these values have been published in about 80
volumes in Xinjiang. Fourth, the language of the Kazakhs in Xinjiang is distinguished
by its rich dialectic, regional phenomena and its diversity (Zhadi Shakenuly. The Kazakhs in China. Almaty: Kazakh community worldwide, 2007).
In the study of Kazakh dialectology the features of language of the Kazakhs in
Xinjiang occupies a special place. Studying the language of the Kazakhs in Xinjiang is
undeniably connected with thousands of separate words of literary language, phraseological units, proverbs and sayings, tales and scientific terms in various fields. We
noticed that two factors affect the language of the Kazakhs in Xinjiang. One of them is
an external factor, i.e. the impact of the Chinese, Uighur and Mongolian languages
with which they have close contact; second, the development of the language according to the internal development of the Kazakh language is based on national language. Until today the internal development of the Kazakh language has played an
important role in changing the language in Xinjiang (Masimkhanuly D. - My freedom is
my Kazakh. - Astana, 2014.- p. 400).
We used comparative-historical description in his article to show the data of the
Kazakh language dialects, Turkic speaking and other neighboring countries.
583
In comparing the language of Kazakhs in Xinjiang with the national Kazakh language we define phonetic, grammatical, lexical and phraseological differences. For
example, the Chinese have translated all the words that we consider the international
terms. The peculiarity of their writing (hieroglyph) also affects it.
The word context is translated from Chinese into Kazakh as soz orta (word
surrounding), as well as many household words and words, associated with the traditions, are different from literary language. For example, in the meanings these everyday words we do not see correspondence:
in literary language
correspondence
in China
to choose
Taldau
separate
Aiyrym
Coat
Shapan
sport shoes
Shaqai
Chopsticks
Sapqy
05.05.15 From the lessons of the Chinese language course for foreigners.
Examples:
nomirin tartu to reduce points
zhotketu to send
telefon beru to make a phone call
korim boldy pretty good, very well
engbek korsetu to deserve
sary qapshyq (liter. a yellow sack)- network folder (in computer), Professor
Zhang Zhingjing explains that the folder is translated from Chinese as sack.
boldy - used as the equivalent of the expressions no need, do not worry, its
enough, well (From the lessons of the Chinese language course for foreigners,
21.03.14).
06.11.2014 From Xinjiang television:
zhauapkershilikti quzastyru to check
bas zhora type of authoritys (bosses) work
nekelenu to get married
kurdelesu to become complicated
584
585
586
587
588
zhiyrly successful.
tarik to wipe out, to destroy: malyn tarik etti - destroyed his fortune
nartyng the best, favourite, somebodys loved
asmar etu to give, to entrust: Ol balasyna mal-mulkin asmar etti. - He gave
his son all his fortune.
tebir mischievous, prankster,
shunangdau ataiy real, true: Ataiy zhigit A real man.
abadan experienced, skilled: Toptyng ishinde abadany sol zhigit. - That guy
is the strongest among the crowd.
ozden ahead of all, strongest
emseu to be keen, to thirst for, to miss: Alysta zhurip ata-anasyn emseu. Missing parents while being away.
qaraq gluttonous, insatiable
bultsaty mountain road covered with clouds
tengiz kuni the sun coming up from the sea
alaman mass of the people
zhady idler, chairwarmer
soi genealogical origin
gazap anger, rage, fury
agash kushiktedi tree buds, blossoms
soz lazy, stubborn person
The words connected with
589
baqyr metal pot with a handle for frying wheat (baqyr - In western Kazakhstan
bucket, ozhau - in the language of the Kazakhs in China).
shorke a log for chopping wood, (from Russian tchurka).
tese a tool like a hoe, less than a hoe
lapas indoor barnyard. In the south it is called as kurke.
aq kerish lime, chalk. In the south of the republic it is called as aq balshyq.
bagar woven sack for wheat
boqsha bag, briefcase
dodege a synonym of cornice
shot door hook
shapashot hoe
shapqy backsword
turpi large rasp (the phrase turpidei tiu means to act rudely)
mostemir tripod (for cooking)
bedre bucket
shattauyq metal clip, pliers
les quadrangular pan for baking bread
karlen kasse porcelain cup
akpish, kuyente yoke, shoulder-yoke to bring water
bukteme pocketbook, wallet
sebet, koridor an entrance hall
tiek hook on the door
dalba hut, shack; hut to rest in the seed field
meskei bowl, from Russian word miska
tegesh half liter enameled ware
katel bucket, perhaps from Russian word kotel
das a large bowl (for food). In many places of Kazakhstan used as metal
basin for hand washing
qama gates, large door for cars
shishaqpaq a match. In other places: keuirt, shyrpy, shaqpaq, shagar
myq (in Kyrgyz lang. nail) a small nail: Ozi myq shegedei He is like a small
nail (strong).
yin agash yoke, shoulder-yoke
tartpa scythe, sickle
590
aiyragash pitchfork
pershil doctor, from the word feldsher (medical assistant)
qulaqshyn a mug
quima water for washing
baki shaver
sharshaq - pitchfork
zhozy a low round table
qoyan qulaq sham light without lamp
Most of the dialects in the language of the Kazakhs in China have appeared in
connection with political events in China. These dialects tell us about the ancient history of the Kazakh people in China. For example the phrase shyganga shyqqan is
currently used as very clever, experienced, and the combination of shygannan
shyqqan means stand out from everyone. These combinations shows that although
the ancient Xinjiang was subordinate to Chinese rule, these expressions were formed
according to the ancient Kazakh, rules (Zh.Samituly. The Kazakhs in China. - Almaty:
Kazakh community worldwide, 2000. - p. 27).
According to the ancient Kazakh law the accused was fined by the degree of
severity of the crime. If a thief cannot pay the fine, his relatives or clan should pay for
him. If that person commits a crime again, his family announces that they will not pay
a fee for him, and if he dies, they will not charge a fee for his murder or injury. People
called such a person as shygannan shyqqan. And the expressions like perde artynda
tutru (to give concealed indication), esik ashu (to establish a connection with other
countries) give us information about important events in the history of the Chinese
people.
Research works in the Kazakh dialectology were associated with diasporology
and lexicography (dialect, regional dictionaries). We need to mention Regional Dictionary of the Kazakh language edited by Sh.Sh. Sarybaev, who collected all the materials of research, scientific papers and dictionaries of the Kazakh dialectology. The
basic material of the dictionary includes lexical, phonetic and grammatical peculiarities
of the language of the Kazakh diaspora in Uzbekistan, Karakalpakstan, Turkmenistan,
Tajikistan, the Russian Federation and far-abroad countries like Mongolia, China, Afghanistan and Iran (B. Otebekov. Language of the Kazakh Diaspora: (based on materials collected from the language of the Kazakhs in Afghanistan and Iran). Almaty,
2000).
591
These selected and analyzed language features can become the rich source for
the identification of some controversial issues, as well as some of the problems concerning the history of the Turkic and other languages. Many researches have been
conducted and scientific essays have been written on the Kazakh language of these
above mentioned regions. Studying vocabulary of Kazakhs abroad and creating the
regional dictionaries contributes greatly to the development of our state language and
stabilization of its norms. From this point, to create a large regional dictionary that covers one of the large sections of our vocabulary - regional words combining them into
one direction is one of the current urgent problems of the Kazakh Linguistics. Such
scholars like Sh.Sh. Sarybaev, A. Nurmaganbetov, S. Omarbekov, Zh. Bolatov, G. Kaliev and O. Nakysbekov participated in creating dictionary and conducting the study,
and they are the members of the dialectological expeditions.
However, we cannot say that the materials of the Kazakh language in foreign
countries, texts, poems, folklore, phraseological units, paremeologisms and regional
language units, appeared as a result of a relationship with the local languages, have
been completely collected. Now we need to carry out an investigation of the Kazakh
language and the language situation of the Kazakhs in China, Turkey, Mongolia, Afghanistan and Iran in the socio-dialectological aspect. Their Kazakh language (in
China and Mongolia) may be subjected to changes after some time due to various
political and social factors, language situations and influence of other language environment.
In order to show the condition, changes and use of the Kazakh language in
these countries, we must take into account the fact that the language of these Kazakhs
is not only used as a dialect, but also as a written and oral language with a literary
norm, with its established vocabulary and terminology. Language status of the Kazakh
language there must be determined, because the periodical publications, political literature, fictions and textbooks are available as well as radio and TV programs, transmitted in the Kazakh language in China, Turkey and Mongolia. There is some non-compliance of written literature in the Kazakh language in foreign countries with the literary
language in Kazakhstan, not saying already about spoken language (N. Mukametkanuly. The socio-cultural image of the Kazakhs in China at the beginning of the
XXI century // Eurasian integration and the Kazakh diaspora. Astana: Elorda 2007).
At the same time there is no systematic character of terms used in the areas of
management, technology, economy, science, politics, etc. Each region uses lexical
592
units borrowed from other languages and their own terms. Along with the borrowed
items there are original terms, which are used successfully in the language of the Kazakhs in China, Turkey and Mongolia. To identify the similarities in terminology, gathering these facts and use these terms for the benefit of the literary language in Kazakhstan is a priority issue, as these language units are a source of enrichment of
terminological fund of our language.
We conclude that the language of the Kazakhs in China remained as a literary
language. Studying the lexical features of returnees we noticed that their language has
a bilingual character as a result of a close relationship with the people of the country
where they have settled. The reason for such phenomenon is the internal and external
linguistic factors. Lexical differences appeared due to the impact of the translations in
Chinese (S. Mustafauly. Local features in stable combinations in the language of the
Kazakhs in China. The thesis of the candidate of philological sciences. Almaty. p. 2002
- 117).
Language is a dynamic phenomenon and constantly evolving process. Changing the vocabulary is changing the meaning of the word. Changing the meanings of
words enhances the quality level of the language (Mustafauly S. Local features in stable combinations: (on the material of the language of the Kazakhs in China). Almaty,
2003). According to scientists, the meaning is completely updated and its frame sometimes expanded and sometimes reduced. Along with the changes of epochs, the concept of mankind is also changing and evolving. Borrowing words from other languages,
word formation, and expansion of meanings and functions of these words will lead to
new concepts. When talking about the returnees language, we must take into account
the different historical, political and socio-economic circumstances that they have experienced. First, the limitation of relations with the Motherland as a result of politicalsocial opposition during the Soviet Union; second, the lack of schools and kindergartens, cultural centers, the press, TV programs in the Kazakh language; third, the difficulty of Russian Cyrillic, as they used Arabic and Latin script; fourth, the function of the
Kazakh language was only in the oral household level; fifth, the impact of the language
environment with whom they have close relationship and where they live, etc. But despite such difficulties and the opposition, our compatriots were able to strictly comply
with the order of use of the native language. Lexical characteristic of the Kazakh returnees language is a lot of loan words. Due to a variety of differences between the
language of the Kazakhs in China and in the literary language, the problem still needs
593
investigation (Kazakh language and returnee // from the reference of scientific conference participants. Almaty: Olke, 2006).
Not only the language, but also the writing of the Kazakhs in these countries is
different. In one country (Mongolia), they use the Cyrillic alphabet, in the second one
(Turkey) Latin and in the third one (China) Arabic writing. This problem should also be
the object of investigation. We believe that our transition to the Latin alphabet in future
will promote the study of the problem of writing of the Kazakhs in those countries.
References:
1. Dittmar. The bases of sociolinguistic, the notebook with tasks. 1997. S. 185.
2. Gorshkova N.E. Urban languages (urbanolekty) in the forms of existence of the
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Berlin) Abstract. dis .. PhD. Philol. Sciences: 10.02.04 N.E. Gorshkova. SPb.,
2008, 20 p.
3. Bazylkhan B. Language of the Kazakhs in Mongolia, Ulaanbaatar, 1991.
4. Mamyrkhanova Zh. Problems of the language of the Kazakhs in China. Beijing,
2013. International Conference Problems of Philology. Article.
5. Zhadi Shakenuly. The Kazakhs in China. Almaty: Kazakh community worldwide,
2007.
6. Bamishuly B. Condition of the language of the Kazakhs in Mongolia. A. 2004.
7. Bolatov Zh. Eastern dialect group of the Kazakh language and its relation to the
literary language. Doctoral dissertation manuscript: 10.02.02. Frunze, 1970.
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10. Mustafauly S. Local features in stable combinations: (on the material of the language of the Kazakhs in China). Almaty, 2003.
11. Prof. Zhang Zhingjing. The lessons of the Chinese language course for foreigners,
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12. Xinjiang TV, 06.11.2014.
13. Bidollakyzy B. Lets learn the Kazakh language. Urumqi, 2007.
14. Newspaper Xinjiang, 1.01.2015, #1.
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the language of the Kazakhs in Afghanistan and Iran). Almaty, 2000.
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beginning of the XXI century // Eurasian integration and the Kazakh diaspora.
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604
Mehriban Tagirova,
Ph.D. in History of Art
605
acting painters, is the connection, intertwining on the time canvas as Azerbaijani carpets, describes epoch, history, several characters of his/her nation-thought, character,
love, diligence, artistic unpredictability. This is pleiad-new colour of painters` wave,
sinking to the depth of the epoch, as if to the waters of Caspian sea, it is not definite
with which force, strength express secrets of its vast bottom to the world and universe.
Let`s approach to the facts in order not to be baseless. Presently, it is not possible to
astonish modern viewer with trends of conceptual art, however, only few decades
early, when post soviet world opens truths of century for itself, grinding, rejecting
transferring canons, applied by obtrusive ideology, pursuing to its immanency, Azerbaijani easel painting represents new artistic world already. Creativity of best painters
is
the
evidence
of
it
K.
Ahmadova,
F.
Khalilova,
A.
Ibrahimova,
D. Mirjavadov, F. Aghayeva, A. Babayeva, M. Abbasova, N. Rahmanova, G. Yunusova, M. Zeynalova, Sh. Alakbarova, F. Hashimova, A. Mehdiyeva, E. Gurbanov,
M.T. Khalilova, A. Mehdiyeva and other respectful painters made their names eternal
in the history of visual arts of independent, flourishing country, approving conceptions
like innovation, individuality, priority, with which tone is provided to world outlook, world
perception and embodiment of modern easel painting of Azerbaijan. For example, lets
appeal to the creativity of F. Aghayev-painter-pictorial specialist, who after completion
of education at Azerbaijan State Art School named after Azim Azimzade, Moscow
Academy of Art named after V.I. Surikov, Faculty of Art, he was awarded with the title
of honoured painter of Azerbaijan for the picture Fishermans family. It seems that it
is actual topic, close topic, not calling painter to seek the answers to the questions in
1980s, which have not ground and occupying thought of intelligent people of the end
of XX century. By this way painter begins to open for himself reality and apparent truth
of near future, going far from realistic trend, approving new term World of theater in
the world of Azerbaijani Art Science with his own creativity, where traditional realistic
images are absent, they are substituted with elements of surrounding world (dishes,
domestic things and so on), which bear summarizing image, subject, as if coined,
multiple word world, talking in whisper about great power, will of the universe (figure 1,
2, 3, 4). F. Aghayev`s creativity is free from letters, not only expanding understanding
of gestures, as well as, imagination of reality, approving concept-birth of gesture from
the reality every time. Namely, this meaning will be developed in the creativity of
M. Zeynalov: In some works, I came to sign system of gesture. I do not know where
art will take me, but I know that I would work with big scale poems and algorithms.
606
Post Soviet fine art will talk about conceptual art and outgoing directions at the
beginning of new millennium, where installation will be means for self-expression of
internal world and reflection of outer world. However, Azerbaijani easel painting already reflected object of image with its hieroglyphs, selecting own method: things or
means for expression of gesture world, reflecting every direction-canon, semiotics, tradition, colour, line, relativity of thought and descriptive thing and so on.
Critic E.M. Langi, preferring abstract expressionism in comparison to the other
formal flows, wrote: No modern artistic flow does not go further in exotism, so, it rises
up to the childhood of human race. With what does regard vast world of eternally
modern D. Mirjavadov, N. Rahmanova, E. Gurbanov and others? They achieved to
create conceptual art through fine art which does not only open way for painters of new
era: Labyrinth Group, Sabina Shikhlinskaya, HeybatBabayev, TairIsrafilov, MuseyibAmirov and other painters, as well as, they joined two concepts Paintings and
Artistic creativity. Odour of gum, used by D.Mirjavadov in his creativity, existing up to
date, not only rises figures from subject of the image, as well as, it is understanding of
talent`s possibility which made eternal memory, colors and contours of the modern age
through means of past ancestors, applying individualism in the frame of conceptual art
(figure 5, 6, 7, 8, 9).
It seems that, really, according to Didro`s statement in poems we are admired
from images which were not impossible in fine art. Our imagination is less punctiliousness in comparison with eyes, our own internal vision of infinity. What if the painter
achieves to admire viewer through any unknown force of talent and tractates of Omar
Khayyam will alive in your mind, glancing to the images.
..with kind woman face and land grass
I will relax until I am alive
If there are painters who can take viewers to time periods with some magic
brush, in this case, Rashad Mehdiyev is one of them. Creativity of painter-window to
the past and future, being at wave of modernity.
To say that he/she is painter-symbolist, who virtuously combines in his/her creativity theme of middle century miniature and European understanding of symbolism,
expressing spirit and psychologic condition through colour, line and form, using mythological, mystic fantastic subjects it means not to say something. It is difficult to apply
607
608
very far, and today discover secrets of these ways with his invisible eyes. And this way
only passes heart, source of love, without it people can not feel happiness and flourishing, so, only in love he acquires simple truths life, forgive, create and to rise to the
following stairs of his growth. However, are these fruits in the bucket of Eva, flying in
the sky and does she bring them for the mankind in her bucket? It is very terrible, but
not tasting them-seeds of faults, loss, temptation, it is hard to understand truth with that
feeling that man with wisdom and love approaches to Almighty. Going through world,
being in euphoria, she sings the very life (figure 11), where there is no en With what
subjects of Rashad`s works are interesting? With very life. Darvish sings about it, embracing tambourine in the picture Circle (figure 12). He removing dozen of sandals in
the way, is in love with absolute Almighty, to His idea about world life, which is expressed with this circle, where no evil can not hide, there is eternal motion, allowing to
seek himself. There is no attempt to the end, it means that it is endless in search of
their man, in other words perfectness out of this circle. Images of birds dont leave
thought and canvas of painter. It is obvious. R.Efendiyev wrote: There are frequent
use of bird images in national art-cock, peacock, crow and so on. N. Ganjavi wrote
about sacral spirit of peacock in Isgandarnama. This bird does not lose its sanctity,
but, passing a time, it is expressed in the form of buta. Peacock symbolizes Sun and
Month God. Birds never lose their symbolism, however, we observe that how birds
transform to the miraculous symbols in modern fine art. Sometimes, they are not symbols of anything, they should be searched in the subjects, however, it is not expressed
through title and letter meaning.
This phenomena, allegoric character in the subjects apparently observes in
Rashad`s composition. For example: Euphoria (figure 13) and so on. This is not signs
of oriental miniature, closely, it is Mugham about endless beauty of two indices soul
and world, which is lovely expressed by Sufis (figure 14). This is very world bird-Tamashaburan, singing song about love, beauty and woman without which world destructs.
Leyla Picture (figure 15) approves truthfulness of these words-look of beautiful
woman with velvety, deep eyes in front of which world became congeal. Internal vast
power, durability, combining with thin, decorative nature of woman, directed to mankind
with clear, interesting, deep look where there is some power which is durable, wise
and honourable. That is Rashad`s vision about Universe Leyla. She-her bird Tamashaburan. This silent image in the very sense expresses whisper: If I will open wings-
609
World will get calm and power. They are in everyone. Understand yourself. Next generation will express to Rashad Mehtiyev their gratitude. Once I.Kheizing said about art
of middle century: Thinking became very dependable from expression in images, vision side, which is important for the last times of middle century, made almighty. All
understandable changed to plastic imagination. This is genetic memory. Combining
realities of civilization, Azerbaijani painters arise extraordinary beauty, providing respect to the epoch, self-expressing with language with means of this time-new century.
This is close, familiar, readable, relative to modern art of Azerbaijani painters.
I take great attention to the title of the work and want that titles live with their
life, but not combining with picture- said M. Zeynalov. This is elusiveness, paradoxicality, naturalness, essence of talent of Azerbaijani painters. Vorringer`s theory on
availability of two main tendencies in art to the abstraction and feeling, as well as, about
advantages and dominancy of tendencies to the abstraction, do not randomly take to
the set with modern apologets. Even, style conception, closely regards with this tendency, confronting with this understanding of naturalism, flowing from effort to expression. However, abstraction it is not conception of separate, unique subject, phenomena. Human begins to separate their differences starting with familiarity with similar
subjects in the frame of abstraction, this is peculiar to all, reaching to the essence.
Feeling and abstraction relates with eachother in human conscious as to two opposite
side, mutually completing and transferring to eachother to the moments. Human can
not create conception, abstraction from null. In this direction, Gegel states that painter
shall call help for himself/herself, on one hand, attentive discretion, on the other hand,
deep mental feelings, deep annoyance. Even, instantaneous look to Sanan`s composition (figure 16) is the approval of the expressed opinion. Same we can say about
Yalchin Efendiyev`s compositions (1971-2000). Submitting complete freedom to the
art, Yalchin calls viewer to the understanding of the hidden phenomena, things, in detail, life. Complex facture, tension colour strongly discovers emotional subtext of his
visions, stating emotionality as if strengthening miraculous game of
subconscious-
ness - writes H. Yusif in his article He burns life for enflaming artabout art of Y.
Efendiyev. Yalchin`s world-confession, warning, notification, prose and poetry, expressing in colours, lines. Painters ideas passed through epochs, collecting wisdom
of times and pouring to the canvas, Yalchin`s island, where he invites his interlocutorviewer with dervishs wisdom. Here, intellectual men become more subtle, lost ones
acquire power, arrogant ones acquire secrets of humility. This young man finds means
610
for communication with which people live long, interesting and meaningful life. Presentiment is strong side of Yalchin. In his every composition he states that calm condition
prevails on multicolority, passing from one condition to other, he knows about it earlier
from his birth. This dedication makes alert, teaches and calms, Yalchin states that this
is not scaring, if we will chose right colours in life (figure 17,18).
We can talk about Azerbaijani art endless. Absheron scenery takes special
place which passes border of pure genre and shows formation of national type of philosophy of scenery. Soul of Azerbaijani painters is rich with sounds which come from
nature. This is separate language which is peculiar to the lovers of nature. This reality
is contemplated by viewer in the works of the painters: S. Bahlulzade, A. Babayeva,
D. Mirjavadova, A. Ibrahimova, F. Khalilova, T. Salahova. K. Ahmadova, T. Narimanbekov, A. Aliyeva, M. Abdullayeva, M. Zeynalova, F. Hashimova, G. Yunus and
others who are ready to listen to the whisper of Absheron wind, angry of Caspian
sea, clearness of sky, zones of streets, protecting traditions of nation in the walls and
maturity of Absheron sand, opening way to the persons who love their motherland.
Possessing these characteristics these spectacular painters expresses warm,
frames, love and so on, open the gates for next generation. Azerbaijan Republic can
be proud of their talents. What is searched by our modern painters of Azerbaijan in
this unsteady world I and wide universe? May be everyone seeks his/her
Shambala - place where they acquire their perfectness, perception and universe life
for sharing it with us who stand in the foot of this miraculous world, who will hear
enchanting answers to the infinite answers of existence.
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Saint Petersburg State University of Information Technologies,
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Oles Honchar Dnipropetrovsk National University,
Postgraduate Student, Faculty of Ukrainian and Foreign Philology
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Federal State Budget Educational Institution of Higher Professional
Education Sholom-Aleichem Priamursky State University,
Birobidjan, Jewish Autonomous Region, Russia
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666
In the legend "Feast of Belshazzar. Mysterious inscription" tells the story of king
Belshazzar feast, where is famous idols and drank the wine of gold and silver vessel,
which his father Nebuchadhezzar had passed out of the temple of Jerusaleem.
In the same hour came "fingers hands human" and started writing over against
the candlestick upon the plaster the walls the royal palaces.
Frightened king invited all the Babylonian astrologers, chaldeans and soothsayers, that they have read the written.
But none of them was able to do this on a proposal from the king was invited by
a protege of the magicians, astrologers and soothsayers Daniel.
Daniel rebuked the king of idolatry and to glorify the God in whose hand is
the breathe of the king and all his ways.
And then follows the scripture read his wrist and interpret "And this is what is
inscribed: Mene, Mene, Tekel, Uparsin.
That is the meaning of the words: Mene - God hath numbered the kingdom and
finished it, Tekel - Thou art weighed in balances and found wanting, Peres-your kingdom is divided between Medes and Persians [3].
Bible scholar theologian comments the text writing on the wall consisted of only
four words, but in each of them containing at least a double meaning Daniel was able
to comprehend that thanks to the inspiration of the Holy Spirit
Of course, it was pagan soges not available. That is the meaning of words: Mene
- God hath numbered the kingdom and finished it.
How can one word contain as many as meaning? The fact that army word
"mene" is related to the Hebrew word "mana" means not only the "count" and "doom"
define". In the following two meanings this verb was used in Isaiahs book: I will
destine you for the sword (Is. 65:12). Consequently, it is a matter of Gods definition
about Belshazzars kingdom, and of that the days of kingdom are numbered and it is
doomed to destruction, at the same time. But how did Daniel know that the end of the
kingdom will come so soon (hashlmh [God] completed it)? Thats where.
The word mn , being read from the end, forms amen, amen, solid,
authentically, verily So, first mene indicates the sentence to numbered days of
kingdom, and second mene (amen) indicates that the time of kingdom is completed.
You have been weighed on the scales and found wanting (Dan. 5:27). This short
word contains wide information. Aramaic verb tekel means to weigh. Both numbered and to weigh are the terms, that were used in the ancient East in relation to the
667
destiny of man above-ground and after death. On the ancient Egyptian illustrations for
the Book of Dead depicted the judgment of Osiris who was weighing the hearts on the
scales. The wanting of the heart was seen as a sign of its lack of wisdom and good
deeds and that doomed her to suffering. But how did the conclusion appeared: found
wanting? According to Hebrew tekel means you will be wanting. A combination of these two meanings aramaic to weigh and hebraic to be wanting gives
interpretation driven by Daniel. Finally, the last part of inscription: ...Peres: Your kingdom is devided and given to the Medes and Persians... (Dan. 5:28). And there one
word also contains two meanings. A verb peres in Aramaic language means to
devide, but the related verb paras in Hebraic language means to refract, dualize. Hence the Prophet concluded that kingdom would be divided into two parts
would be given to two nations, that actually constituted the unified Medo-Persian Empire. One of these nations was directly called upharsin. Pharsin means persians in Aramaic language and their ethnonym is accordant to the verb peres.
As this word is preceded by conjunction u that meant one more nation, and, in a
current political situation, it could be only allied to Persians Medes [1]. Let us turn to
some provisions of Shchedrovitsky: "The notes of ancient events", "written in Mesopotamia two and a half thousand years ago, and subsequently included in the Bible".
"Vividly narrating about the dramatic battles of Light and Darkness, on the completion
of the history and the Last Judgment"; author of the book, the prophet Daniel (6-5
century BC. e.), as evidenced repeatedly used authors speech in the first person: "I,
am Daniel" (Chapters 7-10)".
From the first provision ensue, that the book, reflecting ancient events was written in Mesopotamia and was later included into the Bible. The second provision for the
fighting of Light and Darkness, the completion of the history and the Last Judgment in
this thesis, form reveals the spiritual essence of the religion of Zoroastrianism, the
Medes and his book Avesta.
The third provision indicates that in the first 6 chapters written by the author
apparently earlier the speech is in the first person observed in the 7-10 chapters are
missing. The same provision is developed further with assertion and proof of "fidelity
of the prophecies Daniel, whose prophetic gaze penetrated much further than biblical
criticism expected" [1], launched with an intention to defend belief that "the book could
not be written by Daniel" [1].
668
But let us return to the second provision of the scientist. Probably experience of
the meticulous analysis of sacred texts did not fail the scientist who is in the sixth lecture, "The pious lions, Judaism and Zoroastrianism", come to the conclusion about
cohesion between Judaism and Zoroastrianism, pointing out "that these ideas Zoroastrianism, largely coincide with the teachings of the Torah and the Prophets, and that
was one of the the main reasons for the favor of the Persian kings to the Jewish faith
and their contribution to the restoration of the Temple in Jerusalem (and Par.36, 2223; Ezra. 1: 1-4; Isa. 44, 28; 45: 1-6)" [1]. Furthermore, the scholar referring to fragments of Avesta mentions about the relations between inspiration of Holy Spirit
(Spanta Manu) and pious mans thinking, speech and activities, who is integral in his
good intentions and is devoted to Ahura Mazda the supreme luminous deity; and he
thinks that tsar Dariuss desire to put Daniel over whole kingdom (i.e. to make him the
first minister) is quite grounded. The mentioned qualities of prophet corresponded to
Zoroastrian ideal of piety [1]. Earlier talking about Nebuchadnezzars intention to prepare an exemplary administration from the number of talented and physically hardy
teenagers from conquered nations, to bring them in Babylon way and to make them
speak Chaldaic, Shchedrovitsky writes that the lads, among whom was Daniel, were
chosen only from royal family. Belonging to this estate was expressed by word partemym leading from Old Persian. By scholars assumption this word could enter the
international use after the conquest of Babylon by Medo-Persians in 539 BC (ESF. 1,
3 this word with regard to Persian commanders was translated as main commanders)
[1]. Then is more interesting: The use of given word while describing the conquest of
Jerusalem by Babylonians (it is half century earlier than conquest of Babylon by Persians), perhaps, was due to the fact that Daniel composed his book in old age when
Persian administrative terminology was strengthened firmly in newly formed empire
[1]. The scholars arguments to our opinion are unconvincing. His first assumption does
not match to the second one: old age could not be an obstacle for prophet in using
this word that is convincingly proved by the scholar. In support of our opinions, there
are the arguments of the famous historian-orientalist R.Z.Rogozina, who worked for a
well-known historical material, traces the evolutionary path, past by Chaldeans: Purebred Sumerian-Akkads is almost gone, and the Semites were not kept separately, and
composition with a touch of Kassites and, perhaps, and few Elamites remaining in the
669
region for his release, nationality, which can be called exactly multibreeding, extremely unique and gifted, like all mixed nationalities, consisting, as quite rightly says
Berosus, from a lot of people of different tribes.
This nationality later became known under the name Chaldean, - unoriginal, as
explained earlier, from the small tribe of Kaldi, that lived in the marshy lowlands near
the river mouth - and Western nations concerned to their religion with honor for its
exorbitant antiquity, whereas in fact it relatively was, as we have seen, a posterior
benefit of adunation of two endlessly ancient religions.
However, the classical writers call the land of the old Sumerian-akkads Babylonia more often than the Chaldeans, and the religion the Babylonian, or the Chaldean,
or as Chaldeans Babylonian [2].
The position of Rogozina convinces us that the Chaldeans, initially originating
from the name of an ancient tribe, mingling with others, local or alien people, formed a
new community and organized a new religion.
The most interesting is the indication of the scientist that there were also the
Medes among nationalities, mixed with the Chaldeans.
That is, even before the Persian conquest of Mesopotamia, the Medes ruled
and lived not only in the capital, but also in other major cities, and it is possible that
they brought their religion Zoroastrianism into the local beliefs, which, of course, being
more systematic, influenced on all others.
Another important circumstance, that promoted rapprochement and intimate fellowship with the Sumerians, in our view, was the language unity: the Sumerians and
the Medes spoke using Rogozina lexicon, in the Turan, that is Turkish language. As
Turan, Turkish language was common to the Sumerians and Medes then it would be
truer precisely through the Turkish language, not the Aramaic find the key to the interpretation to deciphering the mysterious inscription. In that case, as we shall verify below, it will seem superfluous to make searches in the content of the words of double
meaning or a set of values in one word.
So, repetitive words "mene" in Turkish means "me", Tekel - the name of God,
which literally means "Right Hand of God". The last part of the "Upharsin inscription"
is transferred as I will punish. By the way, words "written by the hand" of the God were
interpreted by Schedrovitskyin the following way". The verb " resham" denotes "to
write", but also "to impose a sentence" [1]. Thus, without mediated, figurative meanings
each word has its own direct meaning. This direct meaning is fully consistent with the
670
biblical translation, in which there is given God's definition that the days of Belshazzar's
kingdom "are numbered" and "doomed to destruction" [1].
References:
1. .. . .: , 2010. C. 4; 9899; 6; 105; 105-106; 13; 14; 97, 98.
2. .. , / .. . : .. , 1903.
C. 537 .
3. . . ., 1990. C. 859.
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Koniukhov Sergii,
Lviv Polytechnic National University, Teaching Assistant,
Institute of Humanities and Social Sciences, History of Ukraine
and Ethnic Communication Department
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its addition to the OUN propaganda // Vyzvolny shlyah. London, 1982. - 5. 1246 p.
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684
Tatyana Vlasova,
Dnipropetrovsk National University
of Railway Transport named after Academician V. Lazaryan,
Professor, Doctor of Philosophic Sciences,
Philology and Translation Department,
Natalya Bilan,
Dnipropetrovsk National University
of Railway Transport named after Academician V. Lazaryan, Docent,
Associate Professor, Candidate of Philology,
Philology and Translation Department
685
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692
eating of the forbidden fruit), in the narration He purposefully provokes the human
son (the boy Misha) to the cognition of the surrounding world in the form of the
imposition of a ban on something interesting. It is indicative that Misha was not punished by his father for touching the spring; moreover, his father stated with approval
that Misha really is about to realize why the music in the snuff-box plays [3, p. 402].
The fathers closing advice to study mechanics transmits the readers attention to an
even higher level of fabulous allegorical symbolism; then the snuff-box is represented
as a complicated universe, where everything is regulated and built in the form of a
hierarchical pyramid; however, without the spring that is invisibly present behind all
the complex relationships (i. e. without God), everything is dead and lifeless. That is
why the father recommends the study of the divine music of the cosmos with the help
of mechanics celestial mechanics is sure to be capable of conveying a conception
of the universe to human beings and at the same time, interpreting the global plan of
its builder Heavenly Mechanic / Creator / God.
The content of the second fairy tale Moroz Ivanovich is as follows: two sisters
(Needlewoman and Sluggard) live with their nanny; one day Needlewoman drops the
pail into a well, goes down into it, meets with the wells host Moroz Ivanovich, and
comes back home bearing rich gifts from the host; then her sister tries to do the same,
but she does not get any presents at all. At first glance, this fairy tale teaches an
object-lesson about good and bad things in life. However, the same work has a
hidden context which is concealed underneath the didactic description of the external
actions of two heroines. Needlewoman (her name is entirely accordant with her behavior) can do a lot of useful and helpful kinds of work, and Sluggard (her name is not in
need of supplementary interpretation) does not have any practical experience in
housekeeping. Suddenly, in the life of Needlewoman something unexpected occurs,
when her pail falls into the well. Nothing in the world happens by pure accident, therefore this episode in the life of the heroine must be defined as a natural situation
arising in accordance with the laws of destiny. By the way, for some reasons the
nanny conducts herself with unreasonable cruelty she does not feel sorry for the
girl, but sends her to retrieve the sunken pail on her own, without assistance (it is quite
evident that from the commonsense point of view this must surely result in the death
of the heroine).
It should be remarked that the symbolism of the pail along with the deep waters
from the well are unambiguously connected with cosmic waters, the female accepting
693
/ delivering / adopting principle and associative line of images of the Tree of Life, which
is turned upside-down; altogether it entitles one to indicate the beginning of the
initiation in the fairy tale. Consequently, the nanny is the strict supervisor watching the
rigorous execution of the fixed ritual, and the episode of descent into the well must
be considered as a key event because it is this scene that the unfolding of the magical
and fabulous actions begins. Then, Needlewoman descends into the well (direct
movement vertically downwards), comes into contact with Moroz Ivanovich, works for
three days at the old mans place, receives her reward, returns home along the same
route (direct movement vertically upwards). Thus, the main components of the procedure of the initiation are presented, and this confirms our initial theory about the mystery included into the fairy tale (descent into the other world and ascent back, fulfillment of certain tasks fixed beforehand, receipt of the promised reward). Most likely,
Moroz Ivanovich represents the ancient god Veles because in the myths he was portrayed as the old man-host of the beyond and, correspondingly, he was distinguished
as the patron of magicians and wizards; therefore, the procedures of initiation were
conducted under his direct guidance. It is not accidental that in his depiction the features of a man of advanced age are drawn and, hence, the traces of archaism.
The additional testimony of the development of the procedure of initiation in the
fairy tale is ritually grounded in the appearance of the episodical but very important
symbolical feathered personage the cockerel. The functions of the cockerel as the
conductor of the souls from the human world into the other world and vice versa are
well-known, as well as his being the zoomorphic personification of the god Hermes,
who also represents the god-conductor in the ceremonials of initiation. Therefore, the
appearance of the cockerel in the analyzed fairy tale is natural and not accidental. Not
without reason, the writer finds it necessary and important to introduce the obligatory
sound code of the cockerels appeal (cock-a-doodle-doo!) as an essential component
of the mystery (the same element is duplicated in Fairy Tale of the Cock by
A.S. Pushkin, Black Hen by A. Pogorelsky, Viy by N.V. Gogol), because it is the
compulsory ingredient of the initiation. Just as it is not accidental that clever Needlewoman personally feeds the cockerel (this important detail is mentioned at the very
beginning of the fairy tale as one of the main tasks which must be performed by the
heroine each morning).
The second half of the fairy tale is connected with the same mystery procedure
for Sluggard, and this becomes predictably unsuccessful for the heroine as everything
694
that she does is the reflection (as in a distorting mirror) of the successful actions of
Needlewoman. There is a considerable difference, though the writer especially underlines the motivation of the actions of Sluggard: she is incapable of working but at
the same time she is completely sure in advance that the old man is very kind,
which is why he will reward her in any case, just because she comes to his place.
On one hand, it highlights the negative aspect of her parasitic attitude and parasitic
smugness as social phenomena; on the other hand, it shows that the ritual of initiation
in itself does not play the decisive role in the spiritual development and evolution of
the human soul, if only this soul could prepare itself for the initiation in a corresponding
way. So, even though Sluggard returns home safely, her rich gifts brought from
Moroz Ivanovich a glittering diamond and silver bar turn out to be simple pieces
of ice melting away at home. The author, orientating the reader exactly towards the
esoteric underlying theme, finishes the fairy tale with the call to think well what is
truth here and what is untruth; <> what is a joke and what is a lesson [3,
p. 413] the significant dots indicate the hidden meaning of the fairy tale, concealed
behind the image-symbols of a little diamond, given as a keepsake by the aged
man Moroz Ivanovich to Needlewoman, and the false brilliance of a huge silver bar
and a large diamond, which were presented by the wise old man to Sluggard with
the following words: your work is worth your reward [3, p. 413].
Next, we will outline briefly the content of the third tale Fairy Tale of Four Deaf
Men (which is Indian in origin): four men address each other in turn, discuss their
everyday problems and, being absolutely deaf, are offended at the lack of attention
on the part of the other participants of the events. Undoubtedly, the first level of the
fairy tales meaning is the ability to listen to somebody else and come to an agreement
about common affairs. However, these various people from the fairy tale are the representatives of the four castes of Indian society: shepherd (Shudra), thief (Vaishya),
watchman (Kshatriya), churchman (Brahmin). Therefore, the next level of the fairy
tales meaning is the skill to communicate and agree with the representatives from
diverse classes, offer an object of common interest and in this way gain advantages in
satisfying their personal requirements. In this case, the fairy tale represents a bright
illustration of the barest necessity of development of the skills of social orientation:
presumably, it means knowledge of the social hierarchy and some stimulating incentives for the representatives of various social classes.
695
The fourth (Jamaican) fairy tale Broken Jug is about a girl-orphan Masha
brought up by a wicked aunt who treats the girl badly but treats her own daughter
well. The girl breaks a jug by chance and, being afraid of the severe aunts punishment, leaves home, twice meets an old woman without a head and once the same
woman with a head; the girl successfully performs all the tasks set by the old lady and
is rewarded with a new jug, a cane field and a carriage in order to go around her
estate. Her sister follows the same route, but she does not manage to please the old
lady and receives nothing.
The superficial didactic message of this fairy tale contains the idea of respect
/ esteem for ones elder and stimulation of diligence. Yet, the same content might also
be ascribed to the fairy tale Moroz Ivanovich: both literary works coincide in their
main points and represent almost an exact copy of one another; the difference lies
only in the national colouring and some other specific details. It would seem to be
strange that the writer duplicated the same plot. However, thorough analysis of all the
fairy tales details and nuances allows one to highlight the different context, hidden
underneath the simple external plot, in particular an ability to discern the voice of
intuition and follow its directions, easily obtaining the desired rewards. Let us consider the first plotline in the fairy tale: Masha breaks the jug (a necessary object in a
household but not very valuable and quite exchangeable for another one). In desperation the heroine wanders around aimlessly; while meeting the old woman without a
head, she tries not to touch her even with her glance (because the old lady without a
head represents the image-symbol of intuition, which can be put into operation when
mind and intellect are switched off). That is why the girl follows the old womans
directions precisely and continues the route in accordance with the recommendations
she receives. Finally, Masha meets the same heroine with a head it is the direct
indication that this time she must act sensibly and without self-will in order to perform
successfully the tasks set by the old woman. Masha is praised by the old lady (i. e.
the image-symbol of intuition) for being efficient, exact and accurate, is rewarded with
a new jug (the image-symbol of the recovered physical health of the body), as well as
valuable material property (field, house, carriage) which make the young heroine very
rich (the image-symbol of sovereignty and independence of her body, soul and spirit
from the burdens and severities of the material, transitory world, which, at the same
time, is directly associated with the successfully accomplished procedure of enlightenment). That is why Masha abandons the wicked aunt (the image-symbol of the same
696
material world that severely oppresses the girl and is a heavy burden for her) and
happily lives in prosperity.
The second fabulous plotline displays the same itinerary performed by the
aunts daughter (in this image there is the associative symbolism of the non-enlightened soul that is physically tied to the material world). One should point out that the
intuition of the second girl is blocked and does not reveal itself in any form; consequently, this girl does not listen to the old womans advice and does everything
wrongly / incorrectly, following the voice of her own mind; consequently she is scolded
by the old woman and receives a broken egg-shell instead of a reward (the imagesymbol of the failed procedure of initiation). Therefore, the fairy tales moral is too
obvious to miss: one should not ignore the advice and prompting of intuition as it
sometimes contains more value (for those who are able to hear its voice) than the
arguments of the rational human ego.
Thus, the artistic originality of the literary master V.F. Odoyevsky is embodied
in the creation of four fairy tales in which the writer displays a sophisticated beauty in
offering solutions to philosophical problems, emphasizing the process of the spiritual
search. The authors interest is focused on certain mysteries of the human psyche,
the foundations of which are laid in childhood. It may well be that the analysed fairy
tales are addressed to a childrens readership with the purpose of awakening the mind
of an inquiring child and making possible his/her spiritual evolution. The considered
fairy tales by V.F. Odoyevsky represent literary works with a certain philosophical conception hidden under the mask of didacticism and they are orientated towards the
creation in the readers of a particular world outlook which will direct them towards an
esoteric system of knowledge.
References:
1. . .. / .. .
, 1988. . 382.
2. . .. / .. . , 1982. C. 223.
3. XVIII-XIX . , 2010. . 1120.
4. . . , 1991. . 398.
697
Gera Tatiana,
Ivan Frankos Drogobych State Pedagogical University,
Senior Lecturer, Department of Psychology
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2. Harvard Business Publishers for educators / . . 12.12.2015: https://cb.hbsp.harvard.
edu/cbmp/pages/home.
703
3. .., .. -
/ , // 2014. 5. . 113 114.
4. -. . 10.12.2015:
http://www.slideboom.com/presentations /661274/%D0%9A%D0%B5%D0% B9%
D1%81-%D1%82%D0%B5%D1%85%D0%BD%D0%BE%D0%BB%D0%BE%
D0% B3%D0%B8%D0%B8.
5. .. - /
// . 2011. 6. 60. . 711.
6. .. // Pedagogy and Psychology, III (26), Issue: 50,
2015. Scientific and Professional a New Dimension. Budapest: Society for
Cultural and Scientific Progress in Central and Eastern Europe, 2015 118 .
. 87-93.
7. Gera Tatiana. Psychological support of problem solving by future teachers // Massachusetts Review of Science and Technologies, MIT Press, 2015, 2(12),
(July-December). Volume VI. MIT Press, 2015. 607 . P. 488-497.
8. .. - // .
: . 1. 1. :
, 2014. 282 . . 149154.
9. .. // :
. . . / . . . (. .), . (.
) . : , 2015. 35. 338 . . 101-117.
10. .. //
. 2015. - 2 (60). . 137148.
704
V'iacheslav Zhdan,
HSEE of Ukraine Ukrainian Medical Stomatological Academy,
Doctor of Medical Sciences, Professor,
Viktor Bobyriov,
HSEE of Ukraine Ukrainian Medical Stomatological Academy,
Doctor of Medical Sciences, Professor,
Serhii Bilash,
HSEE of Ukraine Ukrainian Medical Stomatological Academy,
Doctor of Biological Sciences, Professor,
Tetiana Klymach,
HSEE of Ukraine Ukrainian Medical Stomatological Academy,
Practicing Psychologist
705
on students motivation to study. In psychology, motivation means the collection of internal and external reasons that induce a subject to activity [6].
The problem of motivation and motives of activities has been examined in a
large number of papers and monographs by V.G. Asieiev, V.K. Viliunas, I.A. Dzhydar'ian, V.A. Ivannikov, E.P. Ilyin, E.A. Klymov, O.M. Leontiev, P.M. Jacobson,
S.O. Mykytniuk, and by foreign authors as well: H. Heckhausen, R. Frenkin, R. Emmons, A.H. Maslow [1-12].
The aim of the study was to identify the attitude of today's youth to study, determination of the main motives for training, formation of students' positive learning
motivation, increase of self-esteem in perception of themselves and others.
Subject of the study: motivational complex of personality. By this we mean
the value of internal, external positive motivation in the structure of educational and
pro-fessional activities. Research objectives: an experimental study of the
characteristics in academic motivation sphere of medical students.
Methods of research: at the end of 2014-2015 academic year, we conducted
psychodiagnostical stage of collecting empirical data on features of motivational
sphere among the first-year students at Ukrainian Medical Stomatological Academy:
Medical Faculty No1, Dental Faculty and Faculty for Foreign Students Training. 468
students have been polled. Age of students was 17-22. Medical Faculty No1 was represented by 171 students; Dental Faculty by 180 students, Faculty for Foreign Students Training by 117 students.
Diagnostics of motivational sphere was conducted by methodology of T.I. Ilyina
Motivation of training at universities, which consists of 50 questions. Differentiation
of responses was carried out in three scales: acquisition of knowledge (the desire
to gain knowledge, intellectual curiosity); mastering the profession (the desire to
master professional knowledge and form important professional features); obtaining
a diploma (the desire to receive a diploma at a formal learning, to find workarounds
for exams) [5]. The practical significance of research consists in the fact that it reveals
the content of psychological characteristics in educational motivation of medical students, and displays its significant components.
Results and discussion. The following results on features of motivational
sphere of students in different areas of training have been obtained. The overall indicators of leading motives among the surveyed domestic students 351 persons at
Ukrainian Medical Stomatological Academy are as follows:
706
707
Dental Faculty.
The leading motives for students to study are:
acquisition of knowledge 69 students (38%);
mastering the profession 54 students (30%);
obtaining a diploma 57 students (32%).
Young people are enrolled at the Academy after a school or lyceum; there are
students who have graduated from a medical college. Almost all respondents pointed
out that further study of certain subjects is secondary for them. The students value
such traits as perseverance, hard work, straightforwardness, sociability, cheerfulness,
honesty, commitment, restraint. They would like to get rid of laziness, inattention,
drowsiness, uncertainty. Students noted that the training process is impeded by such
traits as inconstancy, rapid mood swings, and irritability. The training process of future
dentists is promoted by ingenuity, endurance, perseverance, stubbornness, the desire
to help people in the future [13].
Faculty for Foreign Students Training.
Foreign students from countries of the former Soviet Union are easily adapted
to study in Ukraine; they have almost no problems in learning of the Russian language.
Most of students are enrolled at the Academy after school 18 students (55%), some
graduated from lyceum 6 students (18%), medical college 6 students (18%), gymnasium 3 students (9%). Students value such traits of character as diligence, honesty, patience, kindness. They believe that education is impeded by laziness and
wrong time planning.
The leading motives to study at Ukrainian Medical Stomatological Academy
for students from the post-Soviet countries are:
acquisition of knowledge 18 students (55%);
mastering the profession 12 students (36%);
obtaining a diploma 3 students (9%).
Students from countries of the Middle East have the following prior education:
school 18 students (46%), medical college 18 students (46%), lyceum 3 students
(8%). These students have problems with learning of the Russian language which
complicates their stay in Ukraine. They value such traits as compassion, kindness,
attention to people. Students would like to get rid of irritation and resentfulness.
The leading motives to study at Ukrainian Medical Stomatological Academy
for students from the Middle East are:
708
709
3. .. //
. . ., 1988.
. 2630.
4. .. // . 1985. 3. . 113123.
5. .. . . .: ., 2006. 512 .
6. ..
. . 1985. 4. . 46.
7. .. , . .: , 2002. . 5279.
8. . / . . - .: , 2006. 352 .
9. ..
/ :
: . . . . (14-15 2015 .
. ). : , 2015. 192 .
10. . . , . .: , 2003. 651 .
11. X. : 2 . . 1 / . .. . ., 1986. 408 .
12. . . . .: , 2004. 416 .
13. .., .., .., .., .. //
. 2015. 3 (52). . 169 171.
14. .., .., .., .., ..
/ The International
Scientific Associaton SCiENCE & GENESIS: The International Multidisciplinary
Congress Knowledge is power, power is knowledge (27 July, 2015 Vienna
(Austria). 255 .
710
Olga Vlasova,
Dnipropetrovsk National University
of Railway Transport named after Academician V. Lazaryan,
Associate Professor, Candidate of Philosophic Sciences,
Philosophy and Sociology Department,
Tatyana Kuptsova,
Dnipropetrovsk National University
of Railway Transport named after Academician V. Lazaryan,
Associate Professor, Candidate of Philosophic Sciences,
Foreign Languages Department
711
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:
1. Hutcheon L. A Poetics of Postmodernism. History. - Theory, Fiction. - New York
and London: Routledge, 2002. 268 p.
2. . S/Z. - . , 209. 373 .
3. . . : - /
. : , 2000. 185 .
4. .. // . North Charleston,
2015. . 156-159.
5. . . .: , 2007. 495 .
6. . . .:
, 2011. - 464 .
7. . . // . .
. : -, , 2009. . 31-60.
716
Tatiana Mineeva,
Volga State University of Water Transport,
Professor, Doctor of Law Sciences, the Faculty of Law,
Tatiana Migunova,
Professor, Doctor of Law Sciences, the Faculty of Law
717
precedent and the decisions made by other courts, only the principle of justice. Therefore, its official name - Court of Equity. In the Russian Empire in the second half of the
XVIII century, while the judicial reform was start off, also appeared unusual judiciary conscientious courts.
Discussion: In one of his lectures V.O. Klyuchevskii urged his listeners that
before the reforms of Catherine II in the old Russian legal proceedings, as well as in
other countries of the proceedings, it was not the court of conscience" [1]. That same
opinion was supported A.D. Gradovsky: "As regards conscientious trial, his position is
very original, at least in the form in which it wanted to create" The Code of the provinces" [2]. He unsuccessfully objected to G.M. Baratz [3]. A.N. Savin showed a rich field
of social conflicts began to develop Chancery Court of Justice [4]. In England, the rise
of the court of justice has caused debate. A striking example from the Chancery Court
imprinted William Roper, the husband of the daughter of Thomas More. More took the
petitioners every afternoon at his home in London (Chelsea area) and took all without
any restrictions. Often here, after hearing the petitioner (without the written statements), immediately decided (for example, he acted with the request of a poor widow,
according to his close relatives) [5]. Thus, More demonstrated the public the benefits
of natural-legal justice to procedural formalism of medieval English courts. It should be
noted that the jurisprudence of the Chancellor More has a direct relationship with its
theoretical and legal reflections and innovative solutions in the field of legal policy.
At that time when More was Chancellor, a discussion between Christopher Saint
Germain, a doctor of law, and anonymous Serjeant at the Laws of England was
opened. The first of the disputants stood for expanding the scope of activities of the
courts of justice and the prerogatives of the Court of Chancery. The second opponent,
repeating the ideas of the petitioners House of Commons of the XIV - XV centuries,
accused the Court of Chancery in the destruction of the entire legal system, based on
common law (common law), and threat to social stability [6].
It seems that the debate was a certain attempt to probe public opinion on the
subject to mitigate the harsh laws of England. Based on the study of texts of Saint
Germain and "Serjeant" suggest that they are both written by the same hand. It is perfectly acceptable suggestion that the dispute was inspired by the Chancellor Mohr, who
has repeatedly raised the issue before the king the right to control the actions of the
chancellor of judges and especially the sentences of other courts of England to alleviate the fate of the accused (or already charged). Humane ideals of St. Paul and other
718
supporters of the natural right of the ideological leaders of the early Christians Moor
sought to attach to the contemporary reality. Activities of the great English humanist in
his native country allows to speak about him as a defender of natural rights.
In the modern historical-legal science nobody have doubt in the use of the
courts of justice but discuss a variety of aspects of their work, as did Margaret Avery
[7], Joseph Byankalana [8], P. Tucker [9]. And we believe that in the XV-XVI centuries
the courts of justice softened the harsh laws of the common law.
This opinion is well with the concept of G.L. Hart that unfair or cruel laws cant
always serve the people [10].
Argumentation: Speaking about the nature of Chancery, usually recall in the
famous case of the petition in 1422 Walter v. Reginald, in which the parties were asked
to solve their case to the "Royal Chancellery, which is the court of conscience" to get
an answer here on the case in accordance with reason and conscience. The comments
we find the following statement - the voice of conscience is true, then we are talking
about based on the conscience of justice.
Tradition of Chancery Court without procedural rules and regulatory standards
of the old judiciary continued Star Chamber and the Court of the Poor Mens Causes,
which were founded by Henry VII Tudor. Star Chamber, composed of bishops, secular
lords, the court "King's Bench" and "common law" and looked into the case, the parties
to which were the representatives of different social classes [11]. If we consider only
39 cases published by J.S. Leadem [12], it is only a small fraction of cases that dealt
in the reality, we can see that the jurisdiction of the Star Chamber was boundless. Here
obeyed litigations between the different groups of the urban population (three lawsuits
between the members of the tailors and Exeter City Council), between the cities (City
council of Exeter against City Council of London), complaints of merchants at fairs or
illegal duties. Cases of unlawful conduct of the elections, the abduction of women and
forced marriage, an insulting word and action, of the disregard for the subpoena, the
abuse of power or of a wrong balance were the subject of the jurisdiction of the Star
Chamber.
Citizens of Worcester and Gloucester were busy in front of Star Chamber about
commutation statute of the Parliament in 1504, forbidding them to collect fees from the
River Severn transported goods [12, p. 129], the holder of the Malmesburys monastery Robert Porter tried to get confirmation of their free status [12, . 211]. One of the
cases concerned the transaction usurious. Acute social conflict arose between the ci-
719
tizens of Exeter (three similar cases between versed in the Star Chamber) [12, p. 578].
Most of these cases were the jurisdiction of the courts of common law, the Statute of
1485 did not give the right to the Star Chamber for their consideration. Many defendants pointed out to this fact, seeking to postpone the hearing in the common law
courts with their routine, delays and corruption.
The breadth and ambiguity of jurisdiction were distinguishing features of the Star
Chamber, and this uncertainty is its strength. The Chamber strongly intrude into the
sphere of other judicial authorities. Cases of Common Courts were removed for analysis at the meetings of the Star Chamber. The Star Chamber received complaints
from different regions of the country: Gloucester, Shropshire, Malmesbury, Cumberland, Yorkshire, Kent, Winchester, Oxfordshire, etc.
One of the statutes of Parliament 1495 allowed to persons who were poor, to
institute lawsuits for forma pauperis. Lawmakers declared that the king wants to equal
justice for all people, so poor were allowed not to pay the usual legal fees. So, the
Court of the Poor Men's Causes or the Court of Request was appeared [13], there
were some special clerks and attorneys for working with papers. According to the jurisdiction of the Court of Request had differed from the Star Chamber, it obeyed only
civil litigations. By its nature, the Court of Request, like the Star Chamber was a court
of justice or conscience, even though procedural matters largely followed traditional
forms of common law. Among the typical case, for example, concerns Laisy against
Saville in 1569, the petty feudal war [13, p. 1-3]. Squire Thomas Laisy with a detachment of fifty men attacked the knight manor John Saville, broke the fence and stole
bulls, cows and horses. In the case of Hyde v. Gatsby servant made a complaint to
landlord for nonpayment of wages [13, p. 13].
Many cases were similar to those heard in the Star Chamber. Leadem directly
pointed to the transfer of certain cases of petitions in the Court of Request of the Star
Chamber [13, p. 140]. He emphasized the democratic nature of the petitions of the
Court, seeing it as a blessing of Henry VII to the poor people of England. A.N. Savin
denied this democracy, seeing in the Court only branch of the Star Chamber [4,
p. 130]. Star Chamber and the Court of Request entered numerous conflicts between
landowners and holders of land in the legal framework, have split the ranks of the
discontented.
The randomness of the old, traditional courts, the desire to strengthen the central power, ensuring justice for the various social groups - of these goals, and we see
720
in the ideas of Catherine II in Russia in the XVIII century. Courts ashamed by her order,
had to serve not only justice, but to natural law [. 89].
Consider the composition of the conscientious trial. The judge of conscientious
court could become a person capable, conscientious, thoughtful, just and blameless
[14, 89 .]. The judge had the sixth class of the Table of Ranks. It should be noted that
in the sixth rank were the advisers of government of province, counselors civil and
criminal chambers, counsellor of the Exchequer, prosecutor of province , the first and
second chairmen of the High Provincial Court [14, . 89]. This is indicative of the importance that was being sold at the provincial level to conscientious judges of the court
and the court itself.
The composition of conscientious court as defined in Article 396, except for
judges, were six judges: two members from each social class, so its composition we
can see merchants and burghers, free rural inhabitants. Conscientious court relied in
its activities to the natural principles of the protection of "personal" or "private" "human
security". The principles of his work: "humanity in general"; "respect for the person",
"turning away from oppression and the oppression of humanity".
Results: Were revealed similarities in the circumstances of occurrence of the
courts of justice in medieval England and Russia, the era of Catherine II, much of the
functions, jurisdiction of Russian courts conscientious reminiscent of their English predecessors.
Competing interests: Authors have declared that no competing interests
exist.
References:
1. .., 1989. . . V. .: . . 124.
2. .., 2001. . . 9. .: . . 9. . 115.
3. .., 1983.
/ .
4. .. 1903. . . . 27, 121, 127.
5. Roper W., 1626. Mirrour of Vertue in Worldly Greatness or the Life of syr Thomas
More, L.
721
6. Plucknett T.F.T., Barton J.L., 1974. Cristopher St Germans Doctor and student /
T.F.T. Plucknett, J.L. Barton. London; Guy J.A. (ed.), 1985. Cristopher St German on Chancery and Statute / J.A. Guy (ed). London.
7. Avery M., 1969. The History of the Equitable Jurisdiction of Chancery before 1460
// Bulletin of the Institute of Historical Research (Vol. XLII. P. 129144).
8. Biancalana Joseph. 2001. The Free Fail and the Common Recovery in Medieval
England, 1176 1502 / Biancalana J. Cambridge: Cambridge Univ. Press, 2001. 498 p.
9. Tucker P., 2000. The Early History of the Court of Chancery A Comparative Study
/ P. Tucker // EHR. IX P. 791.
10. Hart H.L.A., 1963. Liberty, Law and Morality. Stanford University Press. 96 pp.
11. Statutes of the Realm. V. II. P. 509-510.
12. The Select Cases before the Kings Council of the Star Chamber,1487-1509. Ed.
J.S. Leadem. 1903, Selden Society. L. V. 16.
13. The Select Cases of the Court of Request, 1497-1509. Ed. J.S. Leadem, 1898,
Selden Society, L.
14.
1775 1817 , 1818. , . . 278.
722
723
Carola M. Kaplan notes that the title of E.M. Forsters novel, as well as Shelleys
poem proclaims the central problem of the text: love to one person and the exclusion
of others. The researcher agrees, that name can be interpreted as Forsters criticizing
of marriage, including marriage of his autobiographical hero Rickie because this marriage denies and betrays a deep, hidden Rickies homosexuality [1, p. 52]. The problem that confronts Rickie the knowledge of his own nature, "reality". One of the realities of his nature W. Stone calls the latent homosexuality [2, p. 192-193]. Rickys marriage breaks up because he renounces his own nature.
A.S. Hennings thinks the poem is a keynote, leading to some fundamental issues in the novel, such as whether to seek unity in marriage at any cost? Forster described the marriage of Agnes and Rickie unhappy. So, the answer is obvious: marriage is not always the right decision and does not always meet the emotional expectations [3, p. 40].
In W. Stones opinion, the motive of Agnes and Rickies marriage is designed
specifically to give a lesson to people of both sexes [4, p. 202]. According to B.B. Finkelstein, Forster describes a marriage as a prison for a woman in his first novel "Where
Angels Fear to Tread"; and in "The Longest Journey" it is a prison for both sexes,
especially for men, because it separates marriage from fraternity and friendship, particularly from friendship with homosexual overtones that occurs in the first novel between Philip and Gino [2, p. 35].
Taking into consideration the fact that the phrase "the longest journey" is synonymous with "marriage" in P.B. Shelleys poem, N. Royle suggests a reader to note
that Forsters novel could be named "Marriage". Then some moments considered as
poignant misogyny in the text are clear. But both the poem "Epipsychidion" by Shelley,
and "The Longest Journey" by Forster bring to the condemnation not only marriage,
but love only to one person, more precisely, to one woman. The dedication of the novel
"Fratribus" ("To Brothers") makes clear that the book is addressed to men. This appeal
is part of the reference to a group of young people in Cambridge to which Forster joined
in his final student year in 1901. But more generally, this indicates the deeper level in
the novel is philosophical and polemical about relations between men and importance
of male friendship [5, p. 22-23]. According to P.K. Bakshi, Forster emphasizes the intensity of friendship and brotherhood, testing them against heterosexual love and marriage [6, p. 103]. The structure of the novel develops the contrast between true unity,
724
represented by Rickie and Ansells friendship and between fake union represented by
the marriage of Agnes and Rickie.
The expression the longest journey means marriage in Shelleys poem:
it is in the code
Of modern morals, and the beaten road
Which those poor slaves with weary footsteps tread,
Who travel to their home among the dead
By the broad highway of the world, and so
With one chained friend, perhaps a jealous foe,
The dreariest and the longest journey go [7, 246].
The translation of E.M. Forsters novel should take this fact into account. Thus,
Konstantin Balmont translates the poem into Russian as:
... ,
-
,
- ,
,
,
[8, 148].
The longest journey is translated as and . So
one should translate the name of Forsters novel into Russian and Ukrainian keeping
at least a hint of poetry. The Russian version is not
appropriate, it does not keep in touch with Shelley. It would be possible to translate it
into Russian as and into Ukrainian as . But one should keep in mind first translating Shelley.
Dedication to brothers is a reference to Forsters close connection with the philosophical brotherhood in Cambridge. A.S. Hennings believes such dedication to be a
subtle hint of homosexuality or male relationships and friendships that can be an alternative for some people. Recognizing the fact that repressed homosexuality is significant in the semantics of the novel, the researcher at the same time warns of interpreting it as the basic idea (message) of the novel [9, p. 40-42].
725
The beginning of the novel responds to Forsters manner to initiate a story: the
author represents almost all the main characters in the first chapter during a dispute
between the Cambridge students. The most important of them is Stewart Ansell, a
friend of Rickie Elliot, the main character. His speech begins novel.
Stewart Ansell is immersed in philosophy, he has a habit to draw a circle inside
a square: Ansell was sitting alone with a piece of paper in front of him. On it was a
diagram a circle inside a square, inside which was again a square) [9, p. 135]. This
symbol is repeated throughout the book, and, as C. Summers notes, indicates Ansells
interest of disclosuring reality [10, p. 61].
The most critics agree that Ansell is a Rickies potential lover. When Rickie represents Agnes, with whom he married later, Ansell refuses to acknowledge her existence. The fact that Agnes does not exist for Ansell, according to N. Page, is a way to
point out the lack of her "individual moral nature" [11, p. 56-57].
By this rejection of Agnes Ansell declares war to women, demonstrating a kind
of "homosexual jealousy" [2, p. 41]. In a letter to Rickie he calls him "a person who has
not to marry", because he is not suitable for this, he was created in order to love many
people ("You are not a person who ought to marry at all. You are unfitted in body: that
we once discussed. You are also unfitted in soul: you want and you need to like many
people, and a man of that sort ought not to marry") [9, p. 191]. Rickie gives the answer:
"You've written to me, "I hate the woman who will be your wife", and I write back, "Hate
her. Can not I love you both?") [9, pp. 192]. Rickies question "Can not I love you both?"
reveals to the reader his high spirit: no one can divide real friends, and his future wife
did not even want to separate them.
W. Stone sees in Ansells war announcement a kind of sexual jealousy, partly
hate to female, and in his denial of the marriage relationship the critic finds a connection with the play "Man and Superman" (1905) by Bernard Shaw [4, pp. 199].
The protagonist of the novel, Frederick Elliot, a student at Cambridge, a lame
young man, called Rickie. His father gave him this nickname because of his inherited
lameness, Rickies name means "rickety", "unsustainable".
A certain autobiographical element is present in Rickies stories about "intimacy
with nature", which are almost identical to Forsters early stories, Rickies story reminds
Forsters famous work "Other Kingdom". This type of character is quite traditional. He
has something of Stephen Dedalus by James Joyce, and lameness and poor taste for
women closers him to Philip Carey ("Of Human Bondage" by William Somerset
726
Maugham). He hates memories about his father and loves memories of his mother,
has a certain literary talent, a great love to beauty and fear of practical life. He is an
average sensitive young man from novels.
B.B. Finkelstein believes Rickies situation is similar to the situation of many
modern heroes: he is out of a sense of reality and gripped by forces he does not understand. Because of this, the researcher calls Rickie a main character, but not a hero
[2, p. 37].
Unexpected twist of the plot happens in the first part, it is the death of Gerald,
Agness fiance, which occurred just before the marriage. Many critics have expressed
dissatisfaction in a way which Forster disbands this character, reporting at the beginning of the chapter: "Gerald died that afternoon" [9, p. 163]. The announcement of the
death in the sentence of four words at the beginning of the fifth chapter was considered
by the researchers as unnatural treatment of the characters. We think it again connects
the novel with Shelleys poem, hinting that marriage is a failure, nevertheless it happened or not, its always a tragedy.
Since Geralds death Agnes and Rickie entering into new relationships. It was
Gerald's death that has made them interdependent.
Rickies love to Agnes was interpreted by the critics as "disguised love to the
deceased mother" (C. Kaplan), or as his passion for Gerald (J. Bristow, P.K. Bakshi,
C. Summers), or as passion to Geralds love to Agnes (R. Stall).
P.K. Bakshi gives the example that in any sexual association between Rickie
and Agnes Rickie recalls her together with Gerald [6, p. 117].
In the tenth chapter one more leading protagonist appears, Stephen, a mixture
of a pagan god and a modern hooligan.
This "famous pagan" is called the most interesting character in the book after
Rickie. He is Rickies the brother, though his addition. Stephen is Forsters attempt to
describe "a child of nature", as Gino in Where Angels Fear to Tread. Both, Stephen
and Gino are full of life and violent brutality.
P.K. Bakshi calls such manifestations of rudeness a sign of homoerotic desire,
as in Gino; it hints at the mans sexual energy. Stephen is a mixture of Greek, pagan
and rough qualities and embodies a homoerotic ideal for Rickie [6, p. 107].
Thus, the novel can be regarded as the embodiment of modernist content completely new and "forbidden" in Victorian literature; but it is the embodiment happens in
traditional, classical novelistic form. So we can talk about a new modernist poetics.
727
However, ultimately, more generally consider about modernism one can only after further study of Forsters creative work.
We emphasize on E.M. Forsters connection with classical literature and as it is
seen in our research the translation of his novels should be done taking it into account.
References:
1. Kaplan Carola M. Absent father, Passive Son: The Dilemma of Rickie Elliot in The
Longest Journey // Tambling, Jeremy. E.M. Forster. London: Macmillan Press Ltd,
1995. 236 p.
2. Finkelstein Bonnie Blumenthal. Forsters Women: Eternal Differences. New York
and London: Columbia University Press, 1975. 183 p.
3. Hennings Anne Sofie. The Essence of E.M. Forster on the basis of the novels &
selected short stories. Copenhagen: Copenhagen University, 2001. 118 p.
4. Stone Wilfred. The Cave and the Mountain. A Study of E.M. Forster. Stanford:
Stanford University Press, 1966. 436 .
5. Royle Nicholas. E.M. Forster. Plymouth: Northcote, 1999. 99 p.
6. Bakshi Parminder Kaur. Distant Desire: Homoerotic Codes and the Subversion of
the English Novel in E.M. Forster's Fiction. New York: Peter Lang Publishing, Inc.,
1996. 250 .
7. The Complete Poetical Work of Percy Bisshe Shelley. Cambridge: Cambridge University Press, 1982. 356 p.
8. , . . . .
. . .: " ", 1998. 384 c.
9. Forster E.M. The Longest Journey // Great Novels of E. M. Forster: Where Angels
Fear to Tread, The Longest Journey, A Room with a View, Howards End. New
York, 1992. . 125-374.
10. Summers Claude J. E.M. Forster. New York: Frederick Ungar, 1983. 406 .
11. Page Norman. E.M. Forster. London: Macmillan, 1987. 133 .
728
Hursand Mahmudov,
Senior Lecturer, Tashkent Institute of Irrigation and Melioration (Uzbekistan),
Umida Parpieva,
Teacher of English, Tashkent Institute of Irrigation
and Melioration (Uzbekistan),
Feruza Jumanazarova,
Head of the Department of Foreign Languages,
Tashkent State Technical University (Uzbekistan)
729
awareness of human world events through the prism of personal thinking, the ability to
draw the right conclusions should be the criterion for modern personality, capable of
healthy and free thinking.
Developed by us on the basis of this and offered for teachers of the college and
employees involved in training and methodological issues of, this course is designed
for 20 hours, the content of which is displayed in the following matters:
- Processes of global intellectual development and freedom of the human mind
in the process of globalization;
- The concept of freedom mindset, its essence and role in the outlook of the
person, the relationship with other concepts, and unlike them. Free thinking - quality of
harmoniously developed personality;
- ccurring in the world struggle of opinions and issues of healthy thinking;
- Why do we need freedom mindset? The responsibility and Ethics freedom
of of expression thinking;
- Issues of education at pupils of culture of free thinking in the teaching of
social and human sciences;
- The impact of an intensive an information stream in the human consciousness;
- Free thinking - the imperative of our time. Freedom is not the territory without
borders.
This program not only acquaints the heads of educational institutions and
teachers with the essence and the content of free thinking, however, is undoubtedly
useful to them in practical activity, serves as a pledge success in the implementation
of the task with a deep understanding of its essence. Apart from the fact, this program
can and should be used on refresher courses, constantly operating in the educational
institution workshops.
In the solving the problems in the teaching of general subjects teaching staff of
educational institutions need to solve the following problem, which plays an important
role in the development of at pupils of of properties and qualities of a harmoniously
developed personality:
- onsistent study employees of educational institutions works of our Head of
State Islam Karimov about the ability to think freely of our citizens during execution
their duty;
- Based on the study of the problem and related topics of scientific and
educational literature, published in the periodical press materials, the development
of their knowledge and skills;
730
- Based on the explanation of the students carried out int he community update
the formation of their citizenship and the expansion outlook;
- Promotion of high pedagogical requirements for conducting subject
teachers of lessons;
- Creation of conditions for effective and efficient use of funds and factors of
formation of at pupils of culture of free thinking;
- Providing a high professional training of subject teachers, attracting specialists
with higher education, with experience;
- Identify areas of general education courses, their content, methods aimed at
developing culture of free thinking in each teacher and students;
- Systematically introduce students to the international by the Convention on
Child Rights, the Constitution of the Republic of Uzbekistan and other laws relating to
the protection the rights of the child [1, p. 24];
- ontinuing support and stimulate of gifted youth participation in competitions;
- The introduction of specific examples in the minds of the youth the value
exhibited by our country cares about youth and future generations;
- Familiarizing pupils to popular wisdom, the advice and instructions of our great
ancestors of the education of man, the formation of their inherent in our people such
qualities as patience, prudence, the desire for knowledge, respect for national values;
- Ensuring that the educational institution on its territory to become resident in
the territory of the population not only in the center of education, but also at the center
of free thought. In the process of teaching in professional colleges items "The idea of
national independence: the basic concepts and principles", "Study of the Constitution
of the Republic of Uzbekistan" History of Uzbekistan, "Fundamentals of spirituality",
"Native language and literature" are embodied didactic possibilities of formation of of
free thinking at pupils.
It is known that the formation and development of students' culture of free
thinking can not be provided a period of one or more classes. It can be achieved on a
scheduled basis, using a set of activities and lessons, or by using the possibilities of
each subject.
In the process of familiarization of pupils with Article 29 of the Constitution it is
explained that the article is one of the major success after reaching our republic
independence and legislative strengthening displayed in her freedom of thinking - on
the basis of recognition of it as a fundamental individual human rights is embedded in
their minds the idea that it is devoid of any ideological pressure [2, p. 40].
731
Students explained that everyone has the right to choose any system of values.
Freedom of thinking covers all areas of intellectual and spiritual life. Freedom of
thought is an absolute human right, and in accordance with Article 29 of the
Constitution, everyone has the right to freedom of thought, speech and opinion.
Everyone has the right to seek, receive and impart any information, except against the
existing constitutional system and other restrictions stipulated by the law as explained
to students during lessons [3, p. 160].
In the socio-economic College Urtachirchik district of Tashkent region,
technological and economic college town Yangiyul, engineering college Mirzo-Ulugbek
district of Tashkent city and Uchtepa college of national craftsmanship, Tashkent
technological professional college has been carried out a series lessons, and
extracurricular activities devoted to training and development of free thinking at pupils,
in during which accumulated and generalized an interesting experience.
All three colleges on the basis of a plan developed by under the motto "think
freely, freely read, freely live" to carry out educational and educational work. In
particular, organized in socio-economic College Urtachirchik district nonacademic
activities has been created "Club of free-thinkers", which students of the college
participate in the direction "Economic activity", "International Business", "Exchange
activity" and others.
In the foyer of the college installed a box of "Free thought", and any pupil can
leave him a letter with his exciting ideas, where appropriate - criticism and proposals
to correct deficiencies. These letters of free thinking pupils analyzed once a quarter at
a general meeting of the college students via teachers and then published, addresses
the identified deficiencies and corrective measures. As a result, based on developing
free thinking college students have increased self-confidence, their ability. The college
is developing an atmosphere of mutual trust, healthy friendly Wednesday.
On the lessons of "Study of the Constitution of Uzbekistan" in Urta Chirchik
socio-economic College of Tashkent region with the elements developed by the author
of the game "Member of Parliament" students are given the opportunity to evaluate
themselves, and in an open and collective discussion assess their knowledge which
turns reality and justice this evaluation.
In these lessons, aimed at creating a of free thinking, the teacher perform its
function as a function of experts. During a visit to lessons and learning form and
develop skills of free creativity and psychological freedom. It is noted that "the rejection
of pedagogy based on subordination, obedience and a transition to a system of
732
733
elements of lessons, the second based on the development of lessons using classic
methods. Non-traditional elements of lessons, including the author of the game
developed by "Member Parliaments were mutually evaluated" and "Field of Miracles"
are used only in the first group. Topics include the same in the two groups, and in the
first and second hour of lessons in the first group is very high level of achievement of
this goal.
It is known that during the teaching lessons in the native language and literature
attention is paid to full absorption of the material students learned, learn new words
and phrases, pronunciations correction, a full understanding of the content of the text,
the assimilation of grammatical categories, and at the same time, the development of
spelling skills.
In studying the writing of new words and spelling rules of the teacher requires a
systematic approach.
With this purpose in the first group in the teaching of subjects "Native language
and literature" and "Foreign Language", we used non-traditional development for the
lessons of "Field of Miracles" that to achieve its objectives.
Analysis of the results obtained from teachers, watching classes and students,
as well as written survey shows that: firstly, an active presence in the classroom of
students has increased by one hundred percent; Second, the motivation has risen
sharply in the classroom of students; Third, the students increased self-confidence,
and that can get in-depth knowledge; fourthly, the lessons students are not showing
signs of boredom and fatigue; Fifth, Anectus students wrote that they would like to
always lessons were organized in such a way; in the sixth, the students pointed out
that they have risen confidence, they can look, think independently and express their
thoughts; in the seventh, before slow learners we do not notice how deeply involved in
the training process, and noted that regulyarngo participate in the performance of
tasks, and they have improved academic performance; in the eighth, in the
assessment of students' knowledge achieved justice and masshabny coverage of all
students.
This type of lesson is interactive, and aims to develop at pupils activity,
independent research, independent thinking, and constantly creates opportunities to
consolidate the students' skills of correct letters. At the lesson "Field of Miracles",
based on the subjects employment, the study of writing compound words or phrases
on the blackboard draw a large square, which, in turn, divided into smaller squares.
The teacher calls a synonym of the studied words. Before pupils it should be
put the task: to guess the word in sound and spelling. Pupils randomly talk and fill the
734
cells. Despite the game form, students serious approach about this process. Those of
them, who is very active in finding letters encouraged the teacher, they are awarded
extra points.
The teacher during class moves to the role of the expert: analyzes the results
and announce them. Thus developing search skills and of free thinking. However, the
present time requires students to have the ability to consider the situation with
comparative, critical, logical point of view, to give them an objective assessment, to
analyze, in other words, to be able to think independently.
From many years of pedagogical observations follows such conclusions that
compared the current is still the traditional methods of teaching are more productive
non-traditional teaching methods. Thus, they provide tasks for special education of
pupils of high professional colleges young citizens with high qualifications, separate
and independent thinking, resistant to life's challenges, has its own analytical view.
Summing up, we can say, education of young people, based on free thinking,
resistant to the difficulties of life, have immunity against various undesirable trends the imperative of our time.
References:
1. . .:
. 2005. 24 .
2. . .: , 2008. 40 .
3. ., ., . ( ),
.: , 2001. 160 .
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- // - . . 2002,
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/ .. // . - 2006. - 4 (52). - . 10-12.
735
Guro-Frolova Yulya,
736
(yet) unknown perpetrator" (B. Ainsworth) [1]; educated attempt to provide investigative agencies with specific information as to the type of the individual who may have
committed a certain crime (J. Geberth) [2]; information gathered at a crime scene,
including reports of an offenders behaviour, used both to infer motivation of an
offence and to produce a description of the type of the person likely to be
responsible (D. Grubin) [3]; collection of leads (D. Rossi) [4]; biological sketch
of behavioural patterns, trends, and tendencies (R.E. Vorpagel) [5].
Summarizing existing points of view, offender profiling can be determined as a
special technique, a method of crime investigation by interpreting the information from
the crime scene in order to construct a profile of a person who might have committed
the crime. The information might come from the witness/victim testimony, forensic autopsy, etc.
Foreign researchers believe that this technique is not able to identify the perpetrator accurately, as it is based on the principle of probability of committing a crime.
Offender profiling serves as a subsidiary element of investigation. The method is usually applied in case of the absence of physical traces left at the crime scene.
The first official attempt of profiling dates back to 1876, when Italian criminologist and psychiatrist Cesaro Lombroso (06.11.1835 - 19.10.1909) published the work
"Criminal Man" (LUomo Delinquente) based on the ideas of Charles Darwin's theory
of evolution [6]. The researcher came up with the theory of physical characteristics
typical of born criminals.
Hans Gross, an Austrian judge and criminologist, contributed to the scientific
attempts of explaining the nature of the crime and its forecasting. H. Gross put forward
the idea that criminals are better interpreted during the study of their crimes. The scientist believed that almost in every case the offender left the traces of his presence at
the crime scene [7].
In 1888, a British forensic expert Thomas Bond participated in the investigation
of the series of brutal murders of prostitutes in London (the case of "Jack the Ripper").
His professional activity influenced the process of foreign offender profiling genesis.
The researcher is recognized as one of the founders of the offender profiling theoretical
and practical bases development.
A scientifically based attempt of offender profiling was also taken by Walter
Langer, an American psychologist and psychoanalyst. In 1943 he came up with the
profile of Adolf Hitler.
737
738
739
740
741
Makyeshyna Yuliya,
Dnepropetrovsk State Institute
of Physical Culture and Sports,
Doctor of Philosophy,
Social-Humanities Department
-
: . - -
.
.
: , , , , .
, , ,
742
, . , . , .-. , . , . , . ..
, .
70-
(. , . , . , . ), 80- (. ,
. , . , . , . , . ,
. ). ., , ,
, (. , . ,
. , . , . , . , . ). , , , ,
, .
, , , , .
, . . , , .
; ,
( ) , [1].
.
, .
, , . , , ,
.
, ,
,
743
-, .
-
: - ,
-;
, .
, , (male
gaze) , - .
, ,
/, , ,
: . ,
, . , . , , .
- ;
. ,
. ,
, , .
,
, , , , . , , ,
. , , . , , :
, . , -, , (
), . . . , , ,
, , . , , ,
744
; ,
, , , ,
, , . ,
-, .
- , ,
, , , , . , , -, ,
,
, ( ) ,
. .
, , , ,
, -. - , ,
( !) . , , . .,
, . ,
; , , , , , , .
, , , , : , , . . ,
, , : 100 %
, , . , ,
, .
, , [2, c. 260].
:
- .
745
, , .
? , , , , , , . . , , , , .
(1989) , , , - , , ., ,
[5, c. 2].
, , , . , ,
(, , . .) ,
. ,
, -,
, , , . ,
, ,
,
, .
. -
,
, , ,
.
746
, . , , .
, ,
. -,
, , .
, ,
,
.
, .
,
,
. .
[4].
, , . - .
, ,
, .
-, : ,
-, - [3]. , , : (. . ) (. ). , , , ,
,
- .
747
, , ,
, , . - .
, - - , .
, ,
. , ,
, .
:
1. Alexander J. C. Social Science as Reading and Performance: A Cultural Sociological Understanding of Epistemology // European Journal of Social Theory. 2009.
12(1). P. 2141.
2. Freedman E. No Turning Back. New York: Ballantaine Books, 2003. 446 p.
3. Greer G. The Whole Woman / Germaine Greer. London: Black Swan, 2007.
452 p.
4. Kaplan T. Crazy for Democracy: Women in Grassroots Movements. New York and
London: Routledge, 1997. 243 p.
5. Lintott S. Philosophical Inquiries into Pregnancy, Childbirth, and Pregnancy: maternal subjects. London, NewYork: Routledge, 2012. 268 p.
748
Yakov Lensu,
Belarusian State Academy of Arts,
Ph.D. in History of Arts, Associate Professor,
Head of the Department of Theory and History of Design
:
. . ,
, , , .
: , , , ,
.
, , .
749
, , . . , . .
, . , , .
, . , [1, . 84]. , ,
. , , , .
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,
. . , , -
.
, , , , . ,
,
. , ,
, .
, .
, , ,
. ,
, . .
,
().
750
, 20 . , , , . 1 , .
.
. , , .
, , . .
. : ,
, , : , .
,
,
[2, . 213].
, . , , . . , ,
.
. , , . , , , ( ).
, . .
. , 1,5
. ,
, .
, .
751
40 .
, , , , .. ,
, , ,
, .
[3, . 192].
, ,
, - . ,
,
. ,
.
, .
, , , , . , ,
.
, , , ,
. , ,
, , -,
, -, , .
, . , ,
- .
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,
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752
. , [4, . 9]. . , ,
. .
, (4035 ..),
, . ( , 2512
..)
. , , () - ().
. .
,
, .
, -- 20
. ,
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.
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, : , . .
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,
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, ,
. , , , . , ,
, , , ,
. ,
, , , , , , .
. : , .
:
1. . : / . .
.: , 1995. 272 .
2. Jelinek J. Wielki atlas prahistorii czowieka / J. Jelinek. Warszawa: Pastwowe
Wydawnictwo Rolnicze i Lene, 1977. 557 st.
3. .. / .. .
.: , 1980. 240 .
4. .. / .. . .:
, 1985. 299 .
754
NC, USA,
3School
School of
of Sport
Sport and
and Exercise, Massey
Massey University,
University, Wellington, New
4Institute
Institute of Food
Zealand,
755
option for many undergraduate students, there is a growing need to document whether
courses can
canpromote
promotehigher-order
higher-orderoutcomes
outcomes
and,
so under
short-term courses
and,
if soif under
what what
conditions.
conditions.
Keywords: critical reflection; transformative learning; experiential education;
internationalization; globalization.
1. INTRODUCTION
Institutions of higher education arguably have a responsibility to develop
curricula that foster "global citizens", either as a consequence of their educational
mission, in response to political calls for enhanced national security and global
awareness, or in strengthening the employability of their graduates within an everglobalizing context. To fulfil this strategy, four constructs must be addressed: (1) what
is global citizenship? (2) why is global citizenship important? (3) how do we measure
global citizenship?,
citizenship? and
and (4)
(4) how
how is
is global citizenship fostered?
fostered? In
In addition to
discussing these questions, commentary will focus on the pivotal role short-term
study abroad programs can play in fostering global citizenship.
2. WHAT IS GLOBAL CITIZENSHIP?
Although global citizenship is a highly contested and multifaceted term [1,2],
three key dimensions, at least within the study abroad literature, are now commonly
accepted [3,4]: (1) social responsibility (concern for others, for society at large, and
for the environment), (2) global awareness (understanding and appreciation of one's
self in the world and of world issues), and (3) civic engagement (active engagement
with local, regional, national and global community issues). In one of the most
thorough reviews of the global citizenship concept in the study abroad scholarly field,
Schattle [4] proposes that it "entails being aware of responsibilities beyond one's
immediate communities and making decisions to change habits and behavior patterns
accordingly" (p.12).
Outside the study abroad literature, there is consensus that the natural and built
environment is the context in which global citizenship can be best understood [5-8],
since environmental concern not only benefits others beyond the individual, but also
invokes a sense of obligation toward others. According to Dobson [7], the environment
constitutes a community of obligation in which social responsibilities and behaviors
756
extend,
extend, in
in the
the form
form of
of an
an ecological
ecological footprint.
footprint. In
In distinguishing
distinguishing between
between a
a Good
Good
Samaritan (i.e., based on charity) and a Good (Earth) Citizen (i.e., based on
Samaritan (i.e., based on charity) and a Good (Earth) Citizen (i.e., based on obobligations),
Dobson
argues
"the ofidea
the ecological
relaligations),
Dobson
argues
"the idea
the ofecological
footprintfootprint
convertsconverts
rela-tionships
concern for global citizens, as well as the territory where global obligations most
for global citizens, as well as the territory where global obligations most clearly
clearly(p.191).
arise" (p.191).
In avein,
similar
Winn [8]the
considers
concept
of global
arise"
In a similar
Winnvein,
[8] considers
concept the
of global
citizenship
to
757
758
where a student's
preconceived
andplaces,
established
notions
beliefsenvironments
are tested, may
act as
the
catalyst
cultures,
andand
learning
where
a astudent's
exposure
to new
where
student's
or impetus to and
bring
forth a transformative
Of particular
importance
is the
preconceived
established
notions and experience.
beliefs are tested,
may act
as the catalyst
creation
critical reflection
and discussion.
these types
of
or
impetusofto moments
bring forth of
a transformative
experience.
Of particularInimportance
is the
environments,
exposedofto critical
realties reflection
that are outside
their previous
or
creation
of moments
and discussion.
In understanding
these types of
comfort zones,exposed
the learner
may discover
a need
to acquire
new perspectives
in order
environments,
to realties
that are
outside
their previous
understanding
or
to gainzones,
a more
anddiscover
complex
understanding.
A deeper,
more insincere
comfort
thecomplete
learner may
a need
to acquire new
perspectives
order
understanding
reality and
their understanding.
perception of reality
is framed
their
to
gain a moreofcomplete
and how
complex
A deeper,
more by
sincere
worldview, is the
combining
experiences
with of
critical
analysis,
reflection,
and
understanding
of value
realityin and
how their
perception
reality
is framed
by their
abstract conceptualization
[34].
worldview,
the value
in combining
experiences
critical
analysis,
reflection, and
in otherislearning
environments
where
experientiallywith
based
pedagogy
(service-learning,
problem-based learning) has been utilized and experienced for the first-time [31,32].
abstract
conceptualization
[34].
Valuable
to the student experience,
their engagement, and the likelihood of a shift in
worldview
are IS
theGLOBAL
following: faculty-student
engagement,
experiential learning opportunities,
5. HOW
CITIZENSHIP
MEASURED?
Tarrant
two components
based
on (1) an awareness/belief
that In
specific
5. HOW
IS GLOBAL
CITIZENSHIP
MEASURED?
posited
aidentifies
frame
based
on Stern's [35]
Values-Beliefs-Norm
theory (VBN).
this,
environmental
conditions
threaten orbased
have adverse
consequences
for the
the
Tarrant
identifies
two components
on (1) an
awareness/belief
thatthings
specific
There is a consensus that the natural and built environment is the context in which global
Valuecitizenship
canand
be best
this context,
Tarrant
[30] developed acan
learner
values
(2) understood.
an
awareness/belief
that consequences
the
individual/learner
actthe
to
environmental
conditions
threaten
orUtilizing
have adverse
for the things
Belief-Norm model to assess global citizenship and the "added value" of study abroad (Fig.
reduce
the
specific
[30,35].ofThese
components
andthethe
extent
tocan
which
an
1). Invalues
Tarrant's
[30]threat(s)
conceptualization
a framework
role
of studies
abroad
learner
and
(2)
an awareness/belief
thatfor exploring
the individual/learner
act to
education and global citizenship development, he posited a frame based on Stern's [35]
individual
with
these
twoTarrant
beliefs
are critical
toextent
the based
conceptual
Values-Beliefs-Norm
theory
(VBN).
In These
this,
identifies
two
on (1) frareduce
the learner
specificaligns
threat(s)
[30,35].
components
andcomponents
the
to which
an
an awareness/belief that specific environmental conditions threaten or have adverse
mework
Tarrant
forth.
individual
learnerputs
aligns
with the
these
two beliefs
are(2)critical
to the conceptual
consequences
for
the things
learner
values and
an awareness/belief
that the fraindividual/learner can act to reduce the specific threat(s) [30,35]. These components and the
mework
puts
extentTarrant
to which
anforth.
individual learner aligns with these two beliefs are critical to the
conceptual framework Tarrant puts forth.
Personal
Values
Awareness of
Concern
Altruistic
Biospheric
Egoistic
Beliefs about:
Awareness of
Consequences
Awareness of
Responsibility
Personal
Norms
AC (Altruistic)
NEP
AC (Biospheric)
AC (Egoistic)
AR
PN
Pro-environmental
Behavior (or intentions)
Citizen Type
Environmental
Justice-oriented
Policy Support
Participatory
Ecological
Consumer
Personally
Responsible
759
760
norms about such actions and that these are activated in individuals who believe
that environmental conditions pose threats to other people, other species, or the
biosphere and that actions they initiate could avert those consequences" [37]. One
salient, empirical study measured the values associated with social movements
particularly in context of pro-environmental actions. In the Stern et al. [37] study, which
was designed to measure two variables from Shwartz's norm-activation theory
(personal norms and awareness of consequences), resulted in findings that were
strongly consistent with the VBN theory. Essentially, it was determined that personal
norms were strongly associated with the behaviors of all three types of nonactivist
environmentalism, provided the strongest predictor of consumer behavior and
willingness to sacrifice, and was the only variable in their study to have a direct effect
on all three types of movement support.
A limitation of Tarrant's model is that it directly focuses on environmental
awareness and does not directly address the concepts of social justice or civic
engagement, i.e., the key dimensions of global citizenship [3,4]. Although, it should
be noted that in Tarrant's conceptual framework, there is indirect or ancillary inclusion
of personal values and awareness of responsibility (civic engagement) and the
citizen type (social justice orientation) an individual could align. Even though Tarrant
clearly is addressing the conceptualization of "pro-environmental behavior" from an
environmental perspective, it is inextricably connected to other important elements to
be considered when attempting to understanding global citizenship. In addition, the
use of Shwartz's norm-activation theory to operationalize and measure global
citizenship is an important avenue to consider.
6. WHAT ROLE CAN SHORT-TERM STUDY ABROAD PROGRAMS PLAY?
The past 25 years have witnessed growing numbers of students, particularly in
the United States (U.S.), participating in study abroad programs of varying durations,
locations, and academic foci. These growing numbers, contextualized and sourced
from the U.S. higher education student body, have led to the literature being skewed
in context of the U.S. This particular growth and respective body of literature ultimately
reflects a U.S. centric perspective on research into the influence of short-term study
abroad. This is due to the limited number of empirical studies investigating nonU.S. students studying abroad Curthoys [38]. With this, Europe and Australasia
761
762
it" analogy [46] holds true for study abroad (i.e., relative to home campus) remains
relatively unsubstantiated [29,47]. Meaning, whether studying abroad for a short,
moderate, or long-term period, there needs to be some level of consideration for
appropriate measures to be implemented that will help students make connections
from and sense of their new experiences.
Short-term study abroad, when coupled with an adequate pedagogical
framework, could serve as an educative opportunity for fostering transformative
learning environments where new experiences and perspective may be developed.
It is that critical moment where learners have engaged with something novel, whether
it is physical or psychological, that is when reflection and critical reflection become
imperative to the learning process. The shift from physical experience to meaning
making can be different, but it is imperative for perspective transformation and
ultimately behavior adaptation to occur. Though it should be noted that prior to the
exposure to something novel, abstract conceptualization can have occurred.
Meaning, preparation and study for future experiences related to a student's
involvement in a course is also valuable to their learning. These connections
between experience and reflection, content and experience, and reflection and
content are ones that have long been theoretically [14,34,48] and practically [31]
established.
7. DISCUSSION AND DIRECTION
Over the past decade there have been increasing calls to develop the capacity
of higher education students, particularly in the U.S., to think and act globally [11].
One method of encouraging the civic of global citizenship is through study abroad
[30]. To date, the academic response to calls for greater global learning has focused
primarily on increasing quantity (i.e., "just do it"). The number of students participating
in education abroad is often the primary indicator of an institution's success in
achieving globalization aims [44, 49]. Clearly, a major driver of such efforts should
also address quality - the added value and outcomes of studying abroad as indexed
by measures more informative than traditional course evaluation responses. As
resources become available for study abroad development, funds should be targeted
toward programs that promote demonstrable and specific learning outcomes.
763
764
value" of study abroad. A number of nations, including the U.S., have witnessed
growing political pressure to utilize international education as an en masse
mechanism for nurturing global citizenship. However, the extent to which the "just
do it" analogy holds true for study abroad remains relatively unsubstantiated.
Education abroad can effectively prepare students as responsible global citizens, but
only if coupled with action-oriented experiences that encourage reflection, critical
analysis, and synthesis. Since short-term programs are likely to remain the only
realistic option for many undergraduate students, there is a growing requisite
to document whether short duration programs can promote higher-order outcomes
(such as global citizenship) and, if so, under what conditions. In particular, there is a
lack of demonstrable evidence of the transformational change attributable to
participation in field-based/experiential study abroad programs, relative to (a) other
study abroad programs lacking a structured experiential component and/or (b) home
campus (i.e., traditional classroom) courses and/or (c) comparisons of the experiences and learning outcomes of students from different countries and cultures.
Although global citizenship is a highly contested and multifaceted term,
three key dimensions are commonly accepted: social responsibility, global awareness,
and civic engagement. This particular observation lends itself well to the perspective that global citizenship, at its core, is focused on connections - a person's
connections with the products they choose to use, the environment they believe they
influence, and the groups of people who they directly and indirectly associate with.
Whether or not those connections (with products, environments, and people) are
recognized and reflected upon is what fundamentally separates those who
consciously assume their role as a global citizen from those who do not.
ACKNOWLEDGEMENTS
No sources of funded are reported.
COMPETING INTERESTS
Authors have declared that no competing interests exist.
765
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in Kenya
1. INTRODUCTION
Cambridge
Journal
of Education
and Sciencethey do have control over
771
Teachers do not choose
their
classrooms.
However,
the kind
of classroom climate they construct with their students and the kinds of in1. INTRODUCTION
structional
practices
they
utilize.their
Theclassrooms.
classroom However,
environment
shapes
teachers
relaTeachers
do not
choose
they
do have
control over
tionships
their students,
and students
with each
other
andofwith
the
kind ofwith
classroom
climate they
construct relationships
with their students
and the
kinds
inclassroom practices
concepts. they
Teachers
of a classrooms
tone, ethos
structional
utilize.often
Thespeak
classroom
environmentatmosphere,
shapes teachers
relaor ambience
importance
student learning
[1, 2,with
3, 4].
Typically,
teachers
tionships
withand
theiritsstudents,
andforstudents
relationships
each
other and
with
concentrateconcepts.
almost exclusively
on thespeak
assessment
of academic
achievement,
and
declassroom
Teachers often
of a classrooms
atmosphere,
tone,
ethos
vote
little attention
factors which
might be
related[1,to2,their
patterns
of
or
ambience
and itstoimportance
for student
learning
3, 4].students
Typically,
teachers
adaptive learning
performance.
is research
evidenceachievement,
indicating classroom
of academic
and deconcentrate
almostand
exclusively
on theThere
assessment
climate
to attention
be a factortoinfactors
the types
of goals
establish
[5, students
3, 6].
vote
little
which
mightstudents
be related
to their
patterns of
adaptive learning and performance. There is research evidence indicating classroom
Classroom
climate1.1
to be
a factor inClimate
the types of goals students establish [5, 3, 6].
Although classroom environment is a somewhat subtle concept, remarkable
progress
been made
over the last three decades in conceptualizing, assessing
1.1has
Classroom
Climate
and researching
it [7, 8, 9]. This
researchishas
attempted to
answer
many questions
of
Although classroom
environment
a somewhat
subtle
concept,
remarkable
interest tohas
suchover
as does
a classrooms
environment
affect goal
orientaeducators,
progress
been made
the last
three decades
in conceptualizing,
assessing
tion?researching
Can teachers
assess the
of their
own classrooms?
Quesand
it [7,conveniently
8, 9]. This research
hasclimates
attempted
to answer
many questions
of
tions such
as these represent
the thrust
of the workenvironment
on classroomaffect
environments
over
interest
to educators,
such as does
a classrooms
goal orientathe past
decades.
tion?
Canthree
teachers
conveniently assess the climates of their own classrooms? QuesTeachers
playrepresent
a vital role
the of
conceptualization
of the classroom
climate.
tions such
as these
the in
thrust
the work on classroom
environments
over
They
create
the social and physical environments for learning. The very nature
the
past
threeboth
decades.
of classes,
teaching,
students
makes
a positive classroom
climate
a critical
ingreTeachers
play and
a vital
role in
the conceptualization
of the
classroom
climate.
dient create
of student
[10].
are successful
in establishing
They
bothsuccess
the social
andTeachers
physical who
environments
for learning.
The veryeffective
nature
classroom
climates create
more time
foralearning,
involve more
students,
andingrehelp
of
classes, teaching,
and students
makes
positive classroom
climate
a critical
students
to become
self-managing
[11, 12].
positive
learning
environment effective
must be
dient
of student
success
[10]. Teachers
whoAare
successful
in establishing
establishedclimates
and maintained
throughout
thelearning,
year. One
of themore
beststudents,
ways teachers
acclassroom
create more
time for
involve
and help
complish to
this
goal is self-managing
by having a good
management
plan which must
includes
students
become
[11, classroom
12]. A positive
learning environment
be
ways to prevent
problems throughout
from occurring,
having
and procedures,
established
and maintained
the year.
One clear
of therules
best ways
teachers ac-a
physical environment
that
is wella organized,
ways in
which to communicate
complish
this goal is by
having
good classroom
management
plan whicheffectively
includes
with students,
and problems
how students
otherrules
[10]. According
to Doyle
interact with
eachclear
ways
to prevent
fromcan
occurring,
having
and procedures,
a
[10] classrooms
are particular
of environments.
They
distinctive
features
physical
environment
that is wellkinds
organized,
ways in which
to have
communicate
effectively
that students,
influence and
theirhow
inhabitants
how
students
or the
desks are
orgawith
studentsno
canmatter
interact
withthe
each
other [10].
According
to Doyle
nizedclassrooms
or what the
believes
about
education.They
Furthermore,
classrooms
are
[10]
areteacher
particular
kinds of
environments.
have distinctive
features
that influence their inhabitants no matter how the students or the desks are organized or what the teacher believes about education. Furthermore, classrooms are
772
multidimensional, they are crowded with people, tasks, and time pressures, have people with differing goals, preferences and abilities, inhabitants must share resources,
and actions can have multiple effects and influence student participation [10].
The social and physical environment of a classroom can support or interfere
with student learning and well-being. Therefore, teachers carefully plan and create
appropriate and effective classroom climates. There is empirical evidence that shows
teachers perceptions of classroom climate differ based on subject matter [1,7,13].
Teachers perceptions of science classrooms have produced mixed results in terms
of classroom climate, with some studies finding teachers perceptions of science
classrooms to be high in competition and low in affiliation [14,8], whereas other studies show teachers perceptions of science classrooms to be low in cooperation and
cohesion [15,2]. However, recent research has revealed a wide variety of science
thethe
teachers
teaching
style
[16,
4,
classroom climates,
climates, with
with this
thisdiversity
diversitybased
basedonon
teachers
teaching
style
[16,
17].
4,
17].
1.2 Goal Orientation
Does a subject-specific climate influence the learning goals that teachers structure in their classrooms? Recent research on classroom climate has focused on the
classroom instructional goals that teachers establish. Teachers perceptions of the
fit between their classroom environment and their goal orientation are important for
the learning outcomes. A goal is an outcome or attainment an individual is striving to
accomplish [18]. Goal orientation refers to a pattern of beliefs about goals related to
achievement in school. Goal orientations include the reasons teachers pursue goals
and the standards they use to evaluate progress toward those goals. There are four
main goal orientations: mastery (learning), performance, work-avoidance, and social
[19]. For the purposes of this research, only three goal orientations will be utilized.
Mastery-approach goal orientation refers to the need to improve and focuses on learning, understanding, and developing competence in academic situations [20, 21, 22,
19]. Students with a mastery goal are concerned about the task itself instead of their
self-presentation compared to others. Their evaluation for goal progress is intrapersonal in that their success is based on the improvement of competence and the
mastery of the material. For these students setbacks or even failures are not threatening [22].
773
Performance-approach
Performanceapproachgoal
goal orientation
orientation refers
refers to
to both
both the need for improvement and a fear of failure, and a focus on demonstrating and validating ones competence [23, 24]. Performance approach goal orientated individuals, are mainly concerned about their
their selfself-presentation
presentation compared
compared to
to others.
others. They use interpersonal
standard to evaluate their performance in that their success is determined with other
people as referents. Demonstrating competence, outperforming others and garnering
favorable judgments are signs of success and meeting goals. For these students, their
ability is constantly on the line. Setbacks and especially failures are threatening and
suggest a lack of ability [25]. Performance approach goals may sound quite negative.
Earlier research indicated performance goals generally were detrimental to learning,
but current research suggests that a performance goal orientation may not be all negative. In fact some research indicates that both mastery and performance goals are
using active
active learning
learning strategies
strategies and
and high
high self-efficacy
self-efficacy [20,
[20, 26, 25].
associated with using
Performance- avoidancegoal
goal orientation
orientation refers
refers to
to aa fear
fear of
of failure
failure and
and a focus on
Performance-avoidance
masking incompetence; in other words, performance-avoidance oriented students
try to avoid being seen as incompetent [24, 27]. Students with performance avoidance
goals are typically characterized as having a high fear of failure and low competence
expectancies [24]. Thus, they are likely to orient themselves towards the possibility of failure and are highly sensitive to information suggesting anticipated failure
[24,19].
1.3 Classroom Climate and Goal Orientation
Goal theory researchers have found a relationship between teachers goal orientation and their classroom climate [28,29,17]. Furthermore, goal theory leads us to
expect that instructional practices and the nature of educational tasks and assignments that teachers design can pull for either mastery or helpless motivational
patterns that have profound influence on student achievement. In other words, the
goal orientation of classrooms influences whether students will pursue learning goals
(mastery orientation) or performance goals (ego orientation). Mastery goals, in the
United States, are associated with achievement, better academic coping, and positive affect towards school while performance goals are associated with deterioration
of performance, impaired academic coping, negative affect and disaffection from
school [30, 31, 14, 5, 32, 33, 34, 35]. However, recent research indicates that performance goals may not be bad all the time. This research indicates that both performance and mastery goals are associated with high achievement and efficacy [20,25].
774
Dweck and Leggett [36] defined two major kinds of goal orientations: performance goals and learning goals. Individuals with a performance goal orientation seek
to maximize favorable evaluations of their ability and minimize negative evaluations of
ability. Questions like, Will I look smart? and Can I beat others? reflect performance
goals. In contrast, with a learning goal orientation, individuals focus on mastering tasks
and increasing competence at different tasks. Questions such as How can I do this
task? and What will I learn? reflect learning goals. Nicholls and his colleagues [37]
described two similar achievement goal orientations; they used the terms ego-involved goals and task-involved goals, e.g. [37]. Classroom environments that were
high on task involvement and innovation had students with mastery goal orientations,
whereas classroom environments that were high on competition had students with
performance goal orientations [38]. Teachers who embrace mastery goals are more
likely to maintain positive learning environments [39, 40, 17].
Researchers studying goal orientation have focused primarily on academic outcomes. Recently, however, scholars have become interested in ethno racial differences. In their study of eighth grade African American and White students, Freedman,
Gutman and Midgley [41] found that African American students espoused personal
mastery goals and extrinsic goals significantly more than did White students, suggesting cultural differences in student goal orientation. Similar studies have established
an interaction between performance- approach goals and race in predicting the use
of self-handicapping [42,43,21], and the role of academic self-efficacy in mediating
the relations between performance-approach outcomes [17, 44]. These studies indicate the importance of conducting studies in other cultures before reaching concrete
conclusions.
Whereas a vast research literature exists on the influence of classroom climate
on goal orientation and learning outcomes, these studies have been largely conducted
in the United States and Europe. Indeed few studies have investigated the nature
and influence of classroom climate and goal orientation in African cultures [45,46].
Research in the United States and Europe has established that teachers perceptions
of classroom climates and students patterns of adaptive learning vary between urban
and rural schools [47, 48, 49, 35, 50, 51]. Gender and ethnic differences have also
been established, suggesting a possibility of cultural differences in classroom environments and goal orientation [32,40]. However, these findings cannot be generalized
to other cultures.
775
Teacher practices most likely reflect the values and beliefs of the larger culture
they live in. Glover and Law [52] found a strong link between school culture, teacher
practices, and the learning experiences of students. As revealed in the macrosystem,
the uttermost level of Bronfenbrenners model, societys cultural values, laws, customs
and resources significantly affect the activities and interactions of its members [53].
For example, studies on child rearing practices reveal that even though authoritative
child rearing has advantages across cultures, ethnic groups often have distinct childrearing beliefs and practices. Some involve variations in warmth and making demands
that are adaptive when viewed in light of cultural values and family circumstances [54].
These cultural variations remind us that just like parenting practices, teacher practices such as the conceptualization of their classroom environments and goal
orientation can be fully understood only in their larger ecological context.
This study investigated teachers and observers perceptions of the nature of
classroom climates and goal orientation in biology high school classrooms in Kenya.
The following research questions were addressed: How do teachers perceive the
classroom climate in their biology classes? Are there school and gender differences
in the teachers perceptions of the classroom climate and goal orientation? Do teachers and observers perceive the classroom climate and goal orientation in biology classes similarly?
2. METHODOLOGY
2.1 Participants
Participants included 12 teachers who taught tenth- and eleventh-grade biology
classes of two boarding high schools in Kenya. Five of the teachers were from a
boys school (2 females and 3 males) and 7 from a girls school (3 females and 4
males). Professional experience ranged from 2 to 12 years. Both schools are national
schools, admit only high ranking students -those who score 350+ out of 500 points on
the eighth grade national examination [55]. Teachers in both schools are all graduates
from either one of the two main teacher-training national universities in the country.
(Note: Except for few cases, majority of the high schools in Kenya that admit students
who pass the eighth grade national examination are same sex boarding schools.
This is typical of the Kenyan education system). The average class size for both
schools was 45. The size of the schools ranged from 980 to 1,120 students. Biology
was chosen for this study because it is a required course for all high school students.
776
2.2 Procedures
Participation in this study was voluntary; research information and purpose was
sent to all biology teachers in both schools requesting their participation prior to data
collection. Data was collected from multiple sources using self-report and direct
observation measures during the second term (MayJuly) of the school year.
2.2.1 Construct validity
Prior to the visit, the Classroom Climate Questionnaire (CCQ; [9,56] and
Patterns of Adaptive Learning Scales (PALS; [43,42] were sent to two volunteer
teachers from each of the schools where the project was conducted. The teachers (4)
were asked to examine the validity of the items by pointing out any terms that might
be confusing or misunderstood. The volunteer teachers were recruited via e-mail and
personal phone calls. All four teachers identified two terms that may mean something
different in the Kenyan context on the PALS and gave suggestions for changes. In
their view, smart meant dressed up, and dumb meant hard of hearing. Therefore,
smart was replaced with bright and dumb was replaced with stupid. To
control for possible bias, these four teachers did not participate in the final study.
2.3 Measures
2.3.1 Teacher surveys
All of the teachers completed the two surveys (CCQ and PALS). The surveys
were administered in English. (Note: English is the main language of instruction in the
grade.)
The
teachers
responded
to the
in their
Kenyan schools,
schools, starting
startingininthird
third
grade).
The
teachers
responded
to surveys
the surveys
in
their
freeand
time
and returned
them
to the upon
researcher
upon Itcompletion.
It took
free time
returned
them to the
researcher
completion.
took approximately
approximately
minutes
to complete
1015 minutes1015
to complete
each
survey. each survey.
2.3.2 The classroom climate questionnaire (CCQ)
This 54-item instrument adapted from the student survey [57] was developed
by Trickett and Moos [9,56] to assess three underlying sets of classroom dimensions
in junior high school classrooms: Relationship, Personal Growth, and System Maintenance and Change. The Relationship dimension identifies the nature and intensity of
personal relationships within the environment and assesses the extent to which teachers and students are involved in the environment and support and help each other.
The Personal Growth dimension assesses basic directions along which personal
growth and self-enhancement tend to occur. The System Maintenance and Change
777
dimension assesses the extent to which the environment is orderly, clear in expectations, maintains control, and is responsive to change.
Under these three dimensions are nine specific subscales (the original alphas
from Trickett and Moos study of [9] appear here): (a) Involvement (e.g., Students put
a lot of energy into what they do in this class, = .60); (b) Affiliation (e.g., Students
enjoy helping each other with homework in this class, = .59); (c) Teacher Support
(e.g., I take a personal interest in students in this class, = .72); (d) Task Orientation
(e.g., Students sometimes spent extra time on activities in this class, = .36); (e)
Competition (e.g., Some students try to see who can answer the questions first, =
.65); (f) Order and Organization (e.g., Activities in this class are clearly and carefully
planned, = .54); (g) Rule Clarity (e.g., There is a clear set of rules for students to
follow, = .49); (h) Rule Strictness (e.g., I make it a point of sticking to the rules I
make, = .45); and (i) Innovation (e.g., I like for students to try new projects, =
.39). All items are presented in a four-step Likert continuum (e.g., never happens to
often happens), with higher scores representing the high end of the scale. This survey
has been used in classroom climate studies [57,3,9,56,58] and has proven to be reliable and valid. A test-retest reliability of individual scores on scales, when administered twice with a 6-week interval between occasions, ranged from .83 for Rule Clarity
to .95 for Innovation [56].
Traditionally, this survey has been used to assess learning environments
mostly in the United States. Therefore, there was a need to determine if the internal
consistency reliabilities of the scales in the present study were comparable to the original survey. To this end, the Cronbachs alpha values were calculated for the nine
subscales. Reliabilities are presented in Table 1. As seen in Table 1, most of the
current study scales reliabilities were comparable to the original survey. Rule Clarity,
Rule Strictness, and Innovation had relatively high reliabilities compared to the original
subscales. However, Competition ( =.36) and Order and Organization ( = .34) had
low reliabilities. Teachers had several
several questions
questions regarding
regarding these
these subscales that could
attributedtotocultural
cultural
differences.
For examples,
most teachers
put question
be attributed
differences.
For examples,
most teachers
put question
marks
or
asked
the researcher
to explain
the the
meaning
of ofthe
(a) A
marks
or asked
the researcher
to explain
meaning
thefollowing
following items:
items: (a)
students grade is lowered if he/she gets homework in late (Note: Because the
schools are boarding schools, homework is usually completed during class time.);
(b) Students have to work hard for a good grade in this class; (c) I hardly ever have
in in
their
seats;
andand
(d) Students
dontdont
interrupt
whenwhen
I am
to tell
tell students
studentstotoget
getback
back
their
seats;
(d) Students
interrupt
I am talking.
As several
teachers
commented,
that common
sense.
talking.
As several
teachers
commented,
Isnt Isnt
that common
sense.
778
Table 1. Reliabilities for the original and the current study classroom climate
subscales
Subscale
Involvement
Affiliation
Teacher support
Task focus
Competition
Order & organization
Rule clarity
Rule strictness
Innovation
Original
.60
.59
.72
.36
.65
.54
.49
.45
.39
Current
.86
.58
.63
.49
.36
.34
.79
.80
.60
779
# of Items
Original
Current
7
6
.81
.70
.53
.51
4
5
.69
.69
.61
.60
780
Females
Mean
3.17
3.43
3.17
3.57
3.03
3.17
3.30
2.70
2.60
SD
.66
.32
.24
.25
.14
.39
.96
.83
.56
Males
Mean
3.45
3.69
3.64
3.59
3.31
3.31
3.59
3.29
3.36
SD
.52
.35
.20
.36
.42
.24
.33
.38
.49
Sig.
n.s
n.s
.01
n.s
n.s
n.s
n.s
n.s
.05
3.1.2 What are teachers perceptions of their school and classroom goal
orientation?
Descriptive statistics were conducted to determine what types of goals teachers report on the PALS subscales. Overall, teachers reported greater school and
classroom structured performance-approach goals. Tests of means revealed a significant difference between male and female teachers perceptions of their school performance goals, t(10) =2.98, p =.05, d =1.874 and classroom performance goals, t(10)
=3.12, p =.05, d = 1.964. Compared to female teachers, male teachers perceived their
school to be encouraging performance approach goals. Similarly, they perceived their
classrooms to be encouraging performance approach goals. See Table 4 for all
means and standard deviations. Tests of means revealed no statistical difference
781
between the two schools. In addition, there was no significant interaction between
school and gender on goal orientation.
Table 4. Overall means and standard deviations for goal orientation
based on gender
Scales
Females
Mean
4.13
4.26
3.64
3.45
SD
.36
.27
.26
.62
Males
Mean
4.82
4.29
4.46
3.62
SD
.37
.61
.70
.72
Note.
7, Females:
Note. Mean
Mean range:
range: Low=1.0,
Low=1.0, High=5.0;
High=5.0; Males:
Males: N=
N= 7,
Females: N=5
N=5
Sig.
.05
n.s
.05
n.s
Task Focus
Teacher Support
Rule Strictness
Overall
Mean
3.63
3.45
2.50
SD
.27
.32
.00
Boys School
Mean
SD
3.55
.27
3.60
.31
2.50
.00
Girls School
Mean SD
.24
3.70
3.30
.25
2.50
.00
Sig.
n.s
.05
n.s
782
Rule Clarity
Innovation
Student Involvement
Affiliation
Order and Organization
2.50
2.22
2.01
1.85
1.55
.00
.52
.29
.73
.53
2.50
1.83
1.90
1.50
1.25
.00
.18
.16
.40
.42
2.50
2.60
2.21
2.20
1.85
.00
.31
.35
.82
.47
n.s
.01
n.s
.05
.01
Note. Mean range: Low=1.0, High=4.0; boys school: N=5, girls school: N=7. Values are based on 6
observations per teachers (total = 72 observations)
Tests of means were conducted to examine whether observers reported significant differences in the classroom climate between the schools and the teachers
gender.
climate on Innovation, t(10) = 5.10, p =.01, d = 2.125 with the boys school teachers
classrooms being perceived as more innovative; Order and Organization, t(10) = 3.10,
p =.01, d = 2.200 with the girls school teachers classrooms being reported as more
organized; Teacher Support, t(10) =2.32, p = .03, d = 1.988 with the boys school
teachers being perceived by observers as more supportive of their students; Affiliation, t(10) = 2.41, p = .02, d = 1.809 with the girls school classrooms being perceived
as more friendly compared to the boys schools classrooms. No significant gender
differences were found.
3.2.2 What are observers perceptions of goal orientation in biology classrooms?
Descriptive statistics conducted on the patterns of adaptive learning classroom
observations showed class activities to be carefully planned. Observers noted that
teachers stayed on task and covered the amount of material intended to be covered
during class time, and they (teachers) also checked to see if students understood the
material being covered. Rarely did observers see students being recognized for their
work or emphasis being placed on trying hard and making learning fun. Observers
reported few incidences where students worked in collaborative groups. All observers
marked N/O-Not Observed against the items examining the teachers authority. The
items were (a) The teacher is consistent in dealing with students who break
rules, and (b) The teacher explains what the rules are and enforces them if necessary. Table 6 reports all means and standard deviations.
783
Overall
Overall
Mean SD
3.21
.33
2.50
.14
2.16
.43
1.71
.26
1.67
.23
1.60
.56
1.38
.31
1.25
.39
1.00
.00
Boys
BoysSchool
School
Mean SD
2.78
.35
2.50
.00
2.11
.27
1.50
.22
1.00
.34
1.61
.57
1.61
.22
1.22
.45
1.00
.00
Girls
GirlsSchool
School
Mean
SD
3.60
.24
2.50
.19
2.20
.50
1.85
.27
1.05
.25
1.60
.58
1.65
.38
1.20
.39
1.00
.00
Sig.
Sig.
.01
n.s
n.s
.05
n.s
n.s
n.s
n.s
n.s
Note. Mean range: Low=1.0, High=4.0; boys school: N=5, girls school: N=7. Values are based on 6
observations per teachers (total = 72 observations)
784
However, when the classroom climate was assessed by the teachers gender,
a significant difference emerged. The male teachers from both schools saw themselves as being more supportive of their students compared to the female teachers.
This finding was surprising. Since the two schools are boarding, students are away
from their parents for nine months per year and teachers act as surrogate parents
we expected no significant difference in the teachers perceptions of their support for
their students. More research is needed to further explain and understand this finding.
Male teachers also perceived their classroom climate to be high in innovation.
Results on goal orientation revealed all teachers perceive their schools and
classrooms practices as more performance focused. However, male teachers reported significantly high school and classroom performance-focused practices. The
fact that male teachers perceived their classrooms to be high in teacher support
and innovation and also reported high performance-focused practices is contrary to
the findings from [36] and [38] studies which found that classroom climates that were
high in task involvement and innovation led only to mastery-focused practices and
goals. It is likely that teachers perceptions of environmental goal structures are partially influenced by their existing goal orientations. As Pintrich [33] study in the United
States found, if teachers believe that there is an emphasis on competition and demonstrating ability, these beliefs should affect their own motivation and classroom practices.
The other possible reason for these teachers inclination to performance-focused practices could be the nature of the education system in the country. The Kenyan education system is examination oriented. The centralized national examinations
for twelfth graders are quite intense. Eleventh-grade students start preparing for the
national examination in January, the beginning of the year. Eleventh-grade teachers
spent a considerable amount of time reviewing past examination questions with their
students. Bear in mind that all but two of the teachers participating in this study taught
at least one eleventh grade class. Teachers whose students perform well are publicly
recognized by the school and sometimes given awards. In addition, the government,
through the Ministry of Education, publicly announces and publishes the top ten
schools. Plus, this national examination is the single determinant to college or university [55]. It is therefore safe to say that the academic practices that these teachers
report are emphasized within the societal context and also relate to their own perceptions of the academic goal orientation emphasized in the school context. As Ames
[30] and Midgley et al. [29] reported, practices such as public honor rolls or special
785
786
small group-based experiments [1, 8]. It appears as though the teachers in this
study emphasize mastery of content more than critical thinking skills and inquiry
learning that is usually embedded in active student-student interactions or small
groups activities.
The teachers authority was apparent. Students sat in rows facing the teacher,
did not get out of their seats nor talk without the teachers permission. All classrooms
appeared to be well-managed with clear rules and the greatest emphasis placed on
covering the material intended to be covered during class time. The overriding element
was task focus regardless of the grade, gender, class, or school. It was no wonder
that observers consistently checked N/O-Not Observed on items inquiring about the
teachers authority.
This study had some limitations. The sample of teachers included in this study
was limited to 12 teachers and thus restricted higher level statistical analyses. This
calls for caution in interpreting the findings. In addition, these teachers were in samesex boarding schools, therefore, the results may not generalize to all high school biology teachers. Furthermore, this study did not collect data on the students in these
teachers classrooms to examine their perceptions of classroom climate and goal
orientation. In addition, the reliabilities, particularly those of the classroom climate
scale, were generally low. This could be attributed to the cultural differences where
some of the items might have been interpreted differently.
5. CONCLUSION
In conclusion, the study findings from teachers and observers reveal positive
classroom environments that are high on task focus and high performance-focused
practices at both the classroom and school level. Previous research in the United
States examining classroom climates and goal orientations has reported a positive
correlation between positive classroom climates and mastery goals [30,31,38,17].
Kaplan and Maehr [32] for example, found mastery-focused practices to be associated with positive outcomes, whereas performance-focused practices were associated with negative outcomes. Importantly, these studies do not explicitly include aspects of culture or perhaps the interpretation of goal orientations by different cultures.
Given that the definition of a mastery goal centers on learning, understanding, and
improvement, it is likely that culturally valued activities that reflect this goal are
necessary, if not sufficient, for the creation of a meaningful goal orientation. The
two schools in the present study are among the top national schools in the country
787
788
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