Search results for: student outcome

Authors: Paul Lam, Kevin Wong, Chi Him Chan

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Constant practicing and accurate, immediate feedback are the keys to improving students’ speaking skills. However, traditional oral examination often fails to provide such opportunities to students. The traditional, face-to-face oral assessment is often time consuming – attending the oral needs of one student often leads to the negligence of others. Hence, teachers can only provide limited opportunities and feedback to students. Moreover, students’ incentive to practice is also reduced by their anxiety and shyness in speaking the new language. A mobile app was developed to use artificial intelligence (AI) to provide immediate feedback to students’ speaking performance as an attempt to solve the above-mentioned problems. Firstly, it was thought that online exercises would greatly increase the learning opportunities of students as they can now practice more without the needs of teachers’ presence. Secondly, the automatic feedback provided by the AI would enhance students’ motivation to practice as there is an instant evaluation of their performance. Lastly, students should feel less anxious and shy compared to directly practicing oral in front of teachers. Technically, the program made use of speech-to-text functions to generate feedback to students. To be specific, the software analyzes students’ oral input through certain speech-to-text AI engine and then cleans up the results further to the point that can be compared with the targeted text. The mobile app has invited English teachers for the pilot use and asked for their feedback. Preliminary trials indicated that the approach has limitations. Many of the users’ pronunciation were automatically corrected by the speech recognition function as wise guessing is already integrated into many of such systems. Nevertheless, teachers have confidence that the app can be further improved for accuracy. It has the potential to significantly improve oral drilling by giving students more chances to practice. Moreover, they believe that the success of this mobile app confirms the potential to extend the AI-assisted assessment to other language skills, such as writing, reading, and listening.

Keywords: artificial Intelligence, mobile learning, oral assessment, oral practice, speech-to-text function

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Authors: Hanna Gulema, Meaza Demissie, Alemayehu Worku, Tesfaye Assebe Yadeta, Yemane Berhane

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Background: In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA). Method: We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study’s outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the Mixed effect logistic regression model was used to examine the effect of the intervention. Result: The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06–4.09]) after controlling selected covariates, p-value 0.033. Conclusions: The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.

Keywords: family eating practice, social norm intervention, adolescence girls, caregiver

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Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Mohamed Ghoz, Hala Alsabeh

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Context: Macroscopic Nose Macroneedling (MNM) is a new non-surgical procedure for lifting and tightening the nose. It is a tissue-non-invasive technique that uses a needle to create micro-injuries in the skin. These injuries stimulate the production of collagen and elastin, which results in the tightening and lifting of the skin. Research Aim: The research aim of this study was to investigate the efficacy and safety of MNM for the treatment of nasal deformities. Methodology A total of 100 patients with nasal deformities were included in this study. The patients were randomly assigned to either the MNM group or the control group. The MNM group received a single treatment of MNM, while the control group received no treatment. The patients were evaluated at baseline, 6 months, and 12 months after treatment. Findings: The results of this study showed that MNM was effective in improving the appearance of the nose in patients with nasal deformities. At 6 months after treatment, the patients in the MNM group had significantly improved nasal tip projection, nasal bridge height, and nasal width compared to the patients in the control group. The improvements in nasal appearance were maintained at 12 months after treatment. Theoretical Importance: The findings of this study provide support for the use of MNM as a safe and effective treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities. Data Collection: Data was collected from the patients using a variety of methods, including clinical assessments, photographic assessments, and patient-reported outcome measures. Analysis Procedures: The data was analyzed using a variety of statistical methods, including descriptive statistics, inferential statistics, and meta-analysis. Question Addressed: The research question addressed in this study was whether MNM is an effective and safe treatment for nasal deformities. Conclusion: The findings of this study suggest that MNM is an effective and safe treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities.

Keywords: nose, surgery, tie, suture

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Authors: Arburim Iseni, Afrim Aliti, Nagri Rexhepi

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This paper focuses mainly on an important aspect of student-linguistic errors. It aims to explore the nature of Albanian intermediate level or B1 students’ language errors and mistakes and attempts to trace the possible sources or causes by classifying the error samples into both inter lingual and intra lingual errors. The hypothesis that intra lingua errors may be determined or induced somehow by the native language influence seems to be confirmed by the significant number of errors found in Albanian EFL students in the Study Program of the English Language and Literature at the State University of Tetova. Findings of this study have revealed that L1 interference first and then ignorance of the English Language grammar rules constitute the main sources or causes of errors, even though carelessness cannot be ruled out. Although we have conducted our study with 300 students of intermediate or B1 level, we believe that this hypothesis would need to be confirmed by further research, maybe with a larger number of students with different levels in order to draw more steady and accurate conclusions. The analysis of the questionnaires was done according to quantitative and qualitative research methods. This study was also conducted by taking written samples on different topics from our students and then distributing them with comments to the students and University teachers as well. These questionnaires were designed to gather information among 300 students and 48 EFL teachers, all of whom teach in the Study Program of English Language and Literature at the State University of Tetova. From the analyzed written samples of the students and face-to-face interviews, we could get useful insights into some important aspects of students’ error-making and error-correction. These different research methodologies were used in order to comprise a holistic research and the findings of the questionnaires helped us to come up with some more steady solutions in order to minimize the potential gap between students and teachers.

Keywords: L1 & L2, Linguistics, Applied linguistics, SLA, Albanian EFL students and teachers, Errors and Mistakes, Students’ Assessment and Self-Assessment

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Authors: Matthew Cameron, Stephen Yang, Latifa Al Kharusi, Adam Gosselin, Anissa Chirico, Pouya Gholipour Baradari

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Background: Iron supplementation has been evaluated in several randomized controlled trials (RCTs) for the potential to increase baseline hemoglobin and decrease the incidence of red blood cell (RBC) transfusion during cardiac surgery. This study's main objective was to evaluate the evidence for iron administration in cardiac surgery patients for its effect on the incidence of perioperative RBC transfusion. Methods: This systematic review protocol was registered with PROSPERO (CRD42020161927) on Dec. 19th, 2019, and was prepared as per the PRISMA guidelines. MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar were searched for RCTs evaluating perioperative iron administration in adult patients undergoing cardiac surgery. Each abstract was independently reviewed by two reviewers using predefined eligibility criteria. The primary outcome was perioperative RBC transfusion, with secondary outcomes of the number of RBC units transfused, change in ferritin level, reticulocyte count, hemoglobin, and adverse events, after iron administration. The risk of bias was assessed with the Cochrane Collaboration Risk of Bias Tool, and the primary and secondary outcomes were analyzed with a random-effects model. Results: Out of 1556 citations reviewed, five studies (n = 554 patients) met the inclusion criteria. The use of iron demonstrated no difference in transfusion incidence (RR 0.86; 95% CI 0.65 to 1.13). There was a low heterogeneity between studies (I²=0%). The trial sequential analysis suggested an optimal information size of 1132 participants, which the accrued information size did not reach. Conclusion: The current literature does not support the routine use of iron supplementation before cardiac surgery; however, insufficient data is available to draw a definite conclusion. A critical knowledge gap has been identified, and more robust RCTs are required on this topic.

Keywords: cardiac surgery, iron, iron supplementation, perioperative medicine, meta-analysis, systematic review, randomized controlled trial

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Authors: Sophia Ming Lee Wen, Chao-Ching Kuo, Yu-Line Hu, Yu-Lung Ho, Chih-Cheng Huang, Yi-Hwa Lee

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Teaching and learning should involve social issues by which effectiveness and humanity is due consideration as a guideline for sharing and co-creating knowledge. A qualitative method was used after a pioneer study to confirm pre-service teachers’ awareness of open knowledge. There are 17 in-service teacher candidates sampling from 181 schools in Taiwan. Two questions are to resolve: a) How did teachers change their educational ideas, in particular, their attitudes to meet the needs of knowledge sharing and co-creativity; and b) How did they acknowledge the necessity of working out an appropriate way between the educational efficiency and the nature of education for high performance management. This interview investigated teachers’ attitude of sharing and co-creating knowledge. The results show two facts in Taiwan: A) Individuals who must be able to express themselves will be capable of taking part in an open learning environment; and B) Teachers must lead the direction to inspire high performance and improve students’ capacity via knowledge sharing and co-creating knowledge, according to the student-centered philosophy. Collected data from interviewing showed that the teachers were well aware of changing their teaching methods and make some improvements to balance the educational efficiency and the nature of education. Almost all teachers acknowledge that ICT is helpful to motivate learning enthusiasm. Further, teaching integrated with ICT saves teachers’ time and energy on teaching preparation and promoting effectiveness. Teachers are willing to co-create knowledge with students, though using information is not easy due to the lack of operating skills of the website and ICT. Some teachers are against to co-create knowledge in the informational background since they hold that is not feasible for there being a knowledge gap between teachers and students. Technology would easily mislead teachers and students to the goal of instrumental rationality, which makes pedagogy dysfunctional and inhumane; however, any high quality of teaching should take a dialectical balance between effectiveness and humanity.

Keywords: critical thinking, dialectic between effectiveness and humanity, open knowledge, pedagogy

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Authors: Obasa Joshua Ifeoluwa

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Phonetics is the foundation and most important part of language learning. This article, through an acoustic experiment as well as using Praat software, uses Yoruba students’ Chinese consonants, vowels, and tones pronunciation to carry out a visual comparison with that of native Chinese speakers. This article is aimed at Yoruba native speakers learning Chinese phonetics; therefore, Yoruba students are selected. The students surveyed are required to be at an elementary level and have learned Chinese for less than six months. The students selected are all undergraduates majoring in Chinese Studies at the University of Lagos. These students have already learned Chinese Pinyin and are all familiar with the pinyin used in the provided questionnaire. The Chinese students selected are those that have passed the level two Mandarin proficiency examination, which serves as an assurance that their pronunciation is standard. It is discovered in this work that in terms of Mandarin’s consonants pronunciation, Yoruba students cannot distinguish between the voiced and voiceless as well as the aspirated and non-aspirated phonetics features. For instance, while pronouncing [ph] it is clearly shown in the spectrogram that the Voice Onset Time (VOT) of a Chinese speaker is higher than that of a Yoruba native speaker, which means that the Yoruba speaker is pronouncing the unaspirated counterpart [p]. Another difficulty is to pronounce some affricates like [tʂ]、[tʂʰ]、[ʂ]、[ʐ]、 [tɕ]、[tɕʰ]、[ɕ]. This is because these sounds are not in the phonetic system of the Yoruba language. In terms of vowels, some students find it difficult to pronounce some allophonic high vowels such as [ɿ] and [ʅ], therefore pronouncing them as their phoneme [i]; another pronunciation error is pronouncing [y] as [u], also as shown in the spectrogram, a student pronounced [y] as [iu]. In terms of tone, it is most difficult for students to differentiate between the second (rising) and third (falling and rising) tones because these tones’ emphasis is on the rising pitch. This work concludes that the major error made by Yoruba students while pronouncing Chinese sounds is caused by the interference of their first language (LI) and sometimes by their lingua franca.

Keywords: Chinese, Yoruba, error analysis, experimental phonetics, consonant, vowel, tone

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Authors: Migena Mana, Ahmed Khalid Syed, Abdul Malik, Nikhil Cherian

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In recent years, advancements in deep learning enabled researchers to tackle the problem of self-driving cars. Car companies use huge datasets to train their deep learning models to make autonomous cars a reality. However, this approach has certain drawbacks in that the state space of possible actions for a car is so huge that there cannot be a dataset for every possible road scenario. To overcome this problem, the concept of reinforcement learning (RL) is being investigated in this research. Since the problem of autonomous driving can be modeled in a simulation, it lends itself naturally to the domain of reinforcement learning. The advantage of this approach is that we can model different and complex road scenarios in a simulation without having to deploy in the real world. The autonomous agent can learn to drive by finding the optimal policy. This learned model can then be easily deployed in a real-world setting. In this project, we focus on three RL algorithms: Q-learning, Deep Deterministic Policy Gradient (DDPG), and Proximal Policy Optimization (PPO). To model the environment, we have used TORCS (The Open Racing Car Simulator), which provides us with a strong foundation to test our model. The inputs to the algorithms are the sensor data provided by the simulator such as velocity, distance from side pavement, etc. The outcome of this research project is a comparative analysis of these algorithms. Based on the comparison, the PPO algorithm gives the best results. When using PPO algorithm, the reward is greater, and the acceleration, steering angle and braking are more stable compared to the other algorithms, which means that the agent learns to drive in a better and more efficient way in this case. Additionally, we have come up with a dataset taken from the training of the agent with DDPG and PPO algorithms. It contains all the steps of the agent during one full training in the form: (all input values, acceleration, steering angle, break, loss, reward). This study can serve as a base for further complex road scenarios. Furthermore, it can be enlarged in the field of computer vision, using the images to find the best policy.

Keywords: autonomous driving, DDPG (deep deterministic policy gradient), PPO (proximal policy optimization), reinforcement learning

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Authors: Jameelah Omolara Yaqub

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One of the main reasons for the existence of central bank is that it is believed that central banks have some influence on private sector decisions which will enable the Central Bank to achieve some of its objectives especially that of stable price and economic growth. By the assumption of the New Keynesian theory that prices are fully flexible in the short run, the central bank can temporarily influence real interest rate and, therefore, have an effect on real output in addition to nominal prices. There is, therefore, the need for the Central Bank to monitor, respond to, and influence private sector decisions appropriately. This thus shows that the Central Bank and the private sector will both affect and be affected by each other implying considerable interdependence between the sectors. The interdependence may be simultaneous or not depending on the level of information, readily available and how sensitive prices are to agents’ expectations about the future. The aim of this paper is, therefore, to determine whether the interdependence between asset prices and monetary policy are simultaneous or not and how important is this relationship. Studies on the effects of monetary policy have largely used VAR models to identify the interdependence but most have found small effects of interaction. Some earlier studies have ignored the possibility of simultaneous interdependence while those that have allowed for simultaneous interdependence used data from developed economies only. This study, therefore, extends the literature by using data from a developing economy where information might not be readily available to influence agents’ expectation. In this study, the direction of relationship among variables of interest will be tested by carrying out the Granger causality test. Thereafter, the interaction between asset prices and monetary policy in Nigeria will be tested. Asset prices will be represented by the NSE index as well as real estate prices while monetary policy will be represented by money supply and the MPR respectively. The VAR model will be used to analyse the relationship between the variables in order to take account of potential simultaneity of interdependence. The study will cover the period between 1980 and 2014 due to data availability. It is believed that the outcome of the research will guide monetary policymakers especially the CBN to effectively influence the private sector decisions and thereby achieve its objectives of price stability and economic growth.

Keywords: asset prices, granger causality, monetary policy rate, Nigeria

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Authors: Paola Utreras, Yazmina Olmos, Loreto Sanhueza

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This work has the purpose of study and incorporate Problem Based Learning (PBL) for engineering students, through the analysis of several thermal images of dwellings located in different geographical points of the Region de los Ríos, Chile. The students analyze how heat is transferred in and out of the houses and how is the relation between heat transfer and climatic conditions that affect each zone. As a result of this activity students are able to acquire significant learning in the unit of heat and temperature, and manage to reverse previous conceptual errors related with energy, temperature and heat. In addition, student are able to generate prototype solutions to increase thermal efficiency using low cost materials. Students make public their results in a report using scientific writing standards and in a science fair open to the entire university community. The methodology used to measure previous Conceptual Errors has been applying diagnostic tests with everyday questions that involve concepts of heat, temperature, work and energy, before the unit. After the unit the same evaluation is done in order that themselves are able to evidence the evolution in the construction of knowledge. As a result, we found that in the initial test, 90% of the students showed deficiencies in the concepts previously mentioned, and in the subsequent test 47% showed deficiencies, these percent ages differ between students who carry out the course for the first time and those who have performed this course previously in a traditional way. The methodology used to measure Significant Learning has been by comparing results in subsequent courses of thermodynamics among students who have received problem based learning and those who have received traditional training. We have observe that learning becomes meaningful when applied to the daily lives of students promoting internalization of knowledge and understanding through critical thinking.

Keywords: engineering students, heat flow, problem-based learning, thermal images

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Authors: Hong Wu, Naiji Lu

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Improvement of health behavior among people with chronic diseases is vital for increasing longevity and enhancing quality of life. This paper researched the causal effects of informal care on the compliance with doctor’s health advices – smoking control, dietetic regulation, weight control and keep exercising – among older people with chronic diseases in China, which is facing the challenge of aging. We addressed the selection bias by using propensity score matching in the estimation process. We used the 2011-2012 national baseline data of the China Health and Retirement Longitudinal Study. Our results showed informal care can help improve health behavior of older people. First, informal care improved the compliance of smoking controls: whether smoke, frequency of smoking, and the time lag between wake up and the first cigarette was all lower for these older people with informal care; Second, for dietetic regulation, older people with informal care had more meals every day than older people without informal care; Third, three variables: BMI, whether gain weight and whether lose weight were used to measure the outcome of weight control. There were no significant difference between group with informal care and that without for BMI and the possibility of losing weight. Older people with informal care had lower possibility of gain weight than that without; Last, for the advice of keeping exercising, informal care increased the probability of walking exercise, however, the difference between groups for moderate and vigorous exercise were not significant. Our results indicate policy makers who aim to decrease accidents should take informal care to elders into account and provide an appropriate policy to meet the demand of informal care. Our birth policy and postponed retirement policy may decrease the informal caregiving hours, so adjustments of these policies are important and urgent to meet the current situation of aged tendency of population. In addition, government could give more support to develop organizations to provide formal care, such as nursing home. We infer that formal care is also useful for health behavior improvements.

Keywords: chronic diseases, compliance, CHARLS, health advice, informal care, older people, propensity score matching

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Authors: Edward A. Osifodunrin, Jose Manuel Dias Lopes

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In Nigeria, enormous efforts/resources had, over the years, been expended on promoting financial inclusion (FI); however, it is seemingly discouraging that many of its self-declared targets on FI remained unachieved, especially amongst the Rural Dwellers and Actors in the Informal Sectors (RDAIS). Expectedly, many reasons had been earmarked for these failures: low literacy level, huge informal/rural sectors, etc. This study posits that in spite of these truly-debilitating factors, these FI policy failures could have been avoided or mitigated if the principles of active and better-managed citizens’ participation had been strictly followed in the (re)design/implementation of its FI policies. In other words, in a bid to mitigate the prevalent FE in Nigeria, this study hypothesizes the positive impact of increased/active citizens’ participation on FI outcome(s), backed by a preliminary empirical validation. Also, the study introduces the RDAIS-focused participatory financial inclusion policy (PFIP) as a major FI policy regeneration/improvement tool. The three categories of respondents that served as research subjects are FI experts in Nigeria (n = 72), RDAIS from the very rural/remote village of Unguwar Dogo in Northern Nigeria (n = 43), and RDAIS from another rural village of Sekere (n = 56) in the Southern region of Nigeria. Using survey design (5-point Likert scale questionnaires), random/stratified sampling, and descriptive/inferential statistics, the study often recorded independent consensus (amongst these three categories of respondents) that RDAIS’s active participation in iterative FI policy initiation, (re)design, implementation, (re)evaluation could indeed give improved FI outcomes. However, some questionnaire items also recorded divergent opinions and various statistically significant differences in the mean scores of these three categories. The PFIP (or any customized version of it) should then be carefully integrated into the NFIS of Nigeria (and possibly in the NFIS of other developing countries) to truly/fully provide FI policy integration for these excluded RDAIS and arrest the prevalence of FE.

Keywords: citizens’ participation, development, financial inclusion, formal financial services, national financial inclusion strategy, participatory financial inclusion policy, rural dwellers and actors in the informal sectors

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Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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Authors: Mark P. Mayala, Henry Mayala, Khuzeima Khanbhai

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Background: Heart failure has been a rising concern in Tanzania. New drugs have been introduced, including the group of drugs called Angiotensin receptor Neprilysin Inhibitor (ARNI), but due to their high cost, angiotensin-converting enzymes inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) have been mostly used in Tanzania. However, according to our knowledge, the efficacy comparison of the two groups is yet to be studied in Tanzania. The aim of this study was to compare the efficacy of ACEIs and ARBs among patients with heart failure. Methodology: This was a hospital-based prospective cohort study done at Jakaya Kikwete Cardiac Institution (JKCI), Tanzania, from June to December 2020. Consecutive enrollment was done until fulfilling the inclusion criteria. Clinical details were measured at baseline. We assessed the relationship between ARBs and ACEIs users with N-terminal pro-brain natriuretic peptide (NT pro-BNP) levels at admission and at 1-month follow-up using a chi-square test. A Kaplan-Meier curve was used to estimate the survival time of the two groups. Results: 155 HF patients were enrolled, with a mean age of 48 years, whereby 52.3% were male, and their mean left ventricular ejection fraction (LVEF) was 37.3%. 52 (33.5%) heart failure patients were on ACEIs, 57 (36.8%) on ARBs, and 46 (29.7%) were neither using ACEIs nor ARBs. At least half of the patients did not receive a guideline-directed medical therapy (GDMT), with only 82 (52.9%) receiving a GDMT. A drop in NT pro-BNP levels was observed during admission and at 1-month follow-up on both groups, from 6389.2 pg/ml to 4000.1 pg/ml for ARB users and 5877.7 pg/ml to 1328.2 pg/ml for the ACEIs users. There was no statistical difference between the two groups when estimated by the Kaplan-Meier curve, though more deaths were observed in those who were neither on ACEIs nor ARBs, with a calculated P value of 0.01. Conclusion: This study demonstrates that ACEIs have more efficacy and overall better clinical outcome than ARBs, but this should be taken under the patient-based case, considering the side effects of ACEIs and patients’ adherence.

Keywords: angiotensin converting enzymes inhibitors, angiotensin receptor blockers, guideline direct medical therapy, N-terminal pro-brain natriuretic peptide

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Authors: Babatunde Joel Todowede

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It is a public knowledge that lack of quality and qualitative education breeds problems besetting Nigeria as a nation today. This paper entitled “Quality and Qualitative Education for all, panacea for insecurity and political unrest in Nigeria” seeks to explore how quality and qualitative education for all will tends to put an end to insecurity and political unrest in Nigeria as a Nation. It may be pertinent to note at this juncture that the development of any modern society or nation is primarily hinged on the functionality of its educational system. There is no developed nation in the world today, which does not owe its advancement to quality and qualitative education. In other words, Education is a vital instrument in the nation’s economic competitiveness, in its people, and in its communities. Hence, Education is not luxury to be cut in difficult economic times – it is an essential element of growth. In fact, education is the bedrock of any society that hopes to be numbered among the developed economies in the world. Nigeria, as a nation, has made continual efforts to assume its rightful place in education on the African continent, but has not been quite lucky. Interestingly however, Quality and Qualitative Education for all will come about if all stakeholders in the Education Sector perform their roles with skill and efficiency. Education is a very sensitive area, hence, needs to be passionate about education, and focused on building a future for the sector.” Quality and qualitative education instill significant core values in every student, which shape them into mature, caring and independent individuals. These values include commitment, collaboration, integrity, responsibility and respect. By imbibing these values in every aspect of their life, they are able to contribute their skills and talents while supporting each other in attaining their lifelong goals. This paper identified lack of proper education as the bane of insecurity and political unrest in the Country and urged the government to review the policy in a way that there will be quality and standard to check insurgency in the Country. More so, until the fallen standard of education in Nigeria is fixed to engage out of school children, the incessant attack on innocent Nigerians, particularly in the North East may get worse.

Keywords: quality and qualitative education, panacea, insecurity, political unrest

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Authors: Sofiya Rao, Sagnik Dey

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Aerosol-cloud-precipitation interaction continues to be one of the largest sources of uncertainty in quantifying the aerosol climate forcing. The uncertainty is increasing from global to regional scale. This problem remains unresolved due to the large discrepancy in the representation of cloud processes in the climate models. Most of the studies on aerosol-cloud-climate interaction and aerosol-cloud-precipitation over Indian Ocean (like INDOEX, CAIPEEX campaign etc.) are restricted to either particular to one season or particular to one region. Here we developed a theoretical framework to quantify aerosol indirect radiative forcing using Moderate Resolution Imaging Spectroradiometer (MODIS) aerosol and cloud products of 15 years (2000-2015) period over the Indian Ocean. This framework relies on the observationally constrained estimate of the aerosol-induced change in cloud albedo. We partitioned the change in cloud albedo into the change in Liquid Water Path (LWP) and Effective Radius of Clouds (Reff) in response to an aerosol optical depth (AOD). Cloud albedo response to an increase in AOD is most sensitive in the range of LWP between 120-300 gm/m² for a range of Reff varying from 8-24 micrometer, which means aerosols are most sensitive to this range of LWP and Reff. Using this framework, aerosol forcing during a transition from indirect to semi-direct effect is also calculated. The outcome of this analysis shows best results over the Arabian Sea in comparison with the Bay of Bengal and the South Indian Ocean because of heterogeneity in aerosol spices over the Arabian Sea. Over the Arabian Sea during Winter Season the more absorbing aerosols are dominating, during Pre-monsoon dust (coarse mode aerosol particles) are more dominating. In winter and pre-monsoon majorly the aerosol forcing is more dominating while during monsoon and post-monsoon season meteorological forcing is more dominating. Over the South Indian Ocean, more or less same types of aerosol (Sea salt) are present. Over the Arabian Sea the Aerosol Indirect Radiative forcing are varying from -5 ± 4.5 W/m² for winter season while in other seasons it is reducing. The results provide observationally constrained estimates of aerosol indirect forcing in the Indian Ocean which can be helpful in evaluating the climate model performance in the context of such complex interactions.

Keywords: aerosol-cloud-precipitation interaction, aerosol-cloud-climate interaction, indirect radiative forcing, climate model

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Authors: Kathryn Strachan, Sameer Otoom, Amal AL-Gallaf, Ahmed Al Ansari

Abstract:

Introduction: Introducing a reliable method to select graduates for an award in higher education can be challenging but is not impossible. Multisource feedback (MSF) is a popular assessment tool that relies on evaluations of different groups of people, including physicians and non-physicians. It is useful for assessing several domains, including professionalism, communication and collaboration and may be useful for selecting the best interns to receive a University award. Methods: 16 graduates responded to an invitation to participate in the student award, which was conducted by the Royal College of Surgeons of Ireland-Bahrain Medical University of Bahrain (RCSI Bahrain) using the MSF process. Five individuals from the following categories rated each participant: physicians, nurses, and fellow students. RCSI Bahrain graduates were assessed in the following domains; professionalism, communication, and collaboration. Mean and standard deviation were calculated and the award was given to the graduate who scored the highest among his/her colleagues. Cronbach’s coefficient was used to determine the questionnaire’s internal consistency and reliability. Factor analysis was conducted to examine for the construct validity. Results: 16 graduates participated in the RCSI-Bahrain interns’ award based on the MSF process, giving us a 16.5% response rate. The instrument was found to be suitable for factor analysis and showed 3 factor solutions representing 79.3% of the total variance. Reliability analysis using Cronbach’s α reliability of internal consistency indicated that the full scale of the instrument had high internal consistency (Cronbach’s α 0.98). Conclusion: This study found the MSF process to be reliable and valid for selecting the best graduates for the interns’ awards. However, the low response rates may suggest that the process is not feasible for allowing the majority of the students to participate in the selection process. Further research studies may be required to support the feasibility of the MSF process in selecting graduates for the university award.

Keywords: MSF, RCSI, validity, Bahrain

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Authors: Chan Hui-Ya, Ding Shin-Tan

Abstract:

Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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Authors: Juan-Pedro Rica-Peromingo

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The important change taking place with respect to the media and the audiovisual world in Europe needs to benefit all populations, in particular those with special needs, such as the deaf and hard-of-hearing population (SDH) and blind and partially-sighted population (AD). This recent interest in the field of audiovisual translation (AVT) can be observed in the teaching and learning of the different modes of AVT in the degree and post-degree courses at Spanish universities, which expand the interest and practice of AVT linguistic accessibility. We present a research project led at the UCM which consists of the compilation of AVT activities for teaching purposes and tries to analyze the creation and reception of SDH and AD: the AVLA Project (Audiovisual Learning Archive), which includes audiovisual materials carried out by the university students on different AVT modes and evaluations from the blind and deaf informants. In this study, we present the materials created by the students. A group of the deaf and blind population has been in charge of testing the student's SDH and AD corpus of audiovisual materials through some questionnaires used to evaluate the students’ production. These questionnaires include information about the reception of the subtitles and the audio descriptions from linguistic and technical points of view. With all the materials compiled in the research project, a corpus with both the students’ production and the recipients’ evaluations is being compiled: the CALING (Corpus de Accesibilidad Lingüística) corpus. Preliminary results will be presented with respect to those aspects, difficulties, and deficiencies in the SDH and AD included in the corpus, specifically with respect to the length of subtitles, the position of the contextual information on the screen, and the text included in the audio descriptions and tone of voice used. These results may suggest some changes and improvements in the quality of the SDH and AD analyzed. In the end, demand for the teaching and learning of AVT and linguistic accessibility at a university level and some important changes in the norms which regulate SDH and AD nationally and internationally will be suggested.

Keywords: audiovisual translation, corpus linguistics, linguistic accessibility, teaching

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Authors: John Odo Ogah

Abstract:

The study investigated ways of fostering students’ interest in senior secondary two Biology, using prior knowledge of behavioural objectives and assertive questioning strategies in Benue State of Nigeria. A quasi-experimental research design was adopted; the population comprised 8,571 senior Secondary two students. The sample consisted of 265 SSII biology students selected from six government schools in the study area using a multi-staged sampling technique. Data was generated using the Biology Interest Inventory (BII). The instrument was validated and subjected to reliability analysis using Cronbach’s Alpha formula, which yielded a coefficient of 0.73. Three research questions guided the study, while three hypotheses were formulated and tested. Data collected were analyzed using means, bar graphs, and standard deviations to answer the research questions, while analysis of covariance (ANCOVA) was employed in testing the hypotheses at 0.05 level of significance. The finding revealed that there is a significant difference in the mean interest ratings of students taught cellular respiration and excretory system using assertive questioning strategy, prior knowledge of behavioural objectives strategy and lecture method (p=0.000˂0.05). There is no significant difference in the mean interest ratings of male and female students taught cellular respiration and excretory systems using an assertive questioning strategy (p=0.790>0.05). There is significant difference in the mean interest ratings of male and female students taught cellular respiration and execratory system using prior knowledge of behavioural objectives strategy (p=0.028˂0.05). It was recommended, among others, that teachers should endeavor to utilize prior knowledge of behavioral objectives strategy in teaching biology in order to harness its benefits as it enhances students’ interest.

Keywords: interest, assertive, questioning, prior, knowledge

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Authors: Debrah Mtshelwane, Alewyn Nel, Lizelle Brink

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Social desirability is an important topic to study. It may be possible that different cultures experience social desirability in different ways. Different cultural groups exist within South Africa, however the focus of this study is specifically in the Zulu culture. This research aims to explore social desirability from an emic perspective within the social constructivist paradigm among individuals within the Zulu culture. The researcher intended to identify those features Zulu individuals deem as socially desirable and undesirable from their cultural viewpoint. The research was conducted using a qualitative research design and the constructivism paradigm was utilised in this study. Combined purposive and quota non-probability sampling was employed for this study. A sample of 30 employees (N = 30) working in various organisations from the provinces of Gauteng and KwaZulu-Natal formed part of this study and data were collected through semi-structured interviews. Thematic analysis was used to analyse the data. The main findings showed that Zulu people regard certain behaviours and actions as socially desirable and others as undesirable. The following are considered socially desirable: Conscientiousness, dominance, subjective expectations and positive relations, these are the themes that were reported on the most. These are positive features in the Zulu culture, and they reflect on behaviour patterns, attitudes and manners that people display, which are also seen as acceptable and good in the Zulu culture. The following are regarded as socially undesirable features that were identified by people who belong to the Zulu culture, the themes that were identified as undesirable are: non-conscientiousness, non-dominance (male), dominance (females), tradition, negative relations and subjective expectations. This study creates awareness on social desirability in the workplace and provides basic tools to management on how to deal with such behaviours relating to this phenomenon in the workplace. This knowledge informs employees on the concept of socially desirable behaviour, and provide more insight into behaviours and/or emotions Zulu individuals. The outcome of this study provided new indigenous, empirical knowledge on the phenomenon of social desirability within the South African context.

Keywords: cultural diversity, emic perspective, social constructivism paradigm, social desirability, Zulu culture

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Authors: Henriette Jarild-Koblanck, Monica Moro

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The research has been implemented at the Kalmar University now LNU Linnaeus University inside the Design Program (Designprogrammet) for several years. The Work Book tool was created using the framework of the Bologna declaration. The project concerns primarily pedagogy and design methodology, focusing on how we evaluate artistic work processes and projects and on how we can develop the preconditions for cross-disciplinary work. The original idea of the Work Book springs from the steady habit of the Swedish researcher and now retired full professor and dean Henriette Koblanck to put images, things and colours in a notebook, right from her childhood, writing down impressions and reflections. On this preliminary thought of making use of a work book, in a form freely chosen by the user, she began to develop the Design Program (Designprogrammet) that was applied at the Kalmar University now LNU Linnaeus University, where she called a number of professionals to collaborate, among them Monica Moro an Italian designer, researcher, and teacher in the field of colour and shape. The educational intention is that the Work Book should become a tool that is both inspirational for the process of thinking and intuitional creating, and personal support for both rational and technical thinking. The students were to use the Work Book not only to visually and graphically document their results from investigations, experiments and thoughts but also as a tool to present their works to others, -students, tutors and teachers, or to other stakeholders they discussed the proceedings with. To help the students a number of matrixes were developed oriented to evaluate the projects in elaboration, based on the Bologna Declaration. In conclusion, the feedback from the students is excellent; many are still using the Work Book as a professional tool as in their words they consider it a rather accurate representation of their working process, and furthermore of themselves, so much that many of them have used it as a portfolio when applying for jobs.

Keywords: academic program, art, assessment of student’s progress, Bologna Declaration, design, learning, self-assessment

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Authors: Mahnaz Seyedoshohadaee, Azadeh Nematolahi, Parsa Rahimi

Abstract:

Introduction: Rehabilitation training after hip joint surgery is one of the priorities of nursing, which can be helpful in today's world with the advancement of technology. This study was conducted with the aim of the effect of Tele rehabilitation Education on outcomes of hip osteoarthritis. Methods: The present study was a semi-experimental study that was conducted on patients after hip replacement in the first half of 2023. To perform the work, 70 patients who were available were included in the study and were divided into two intervention and control groups by a nonrandom method. Inclusion criteria included: a maximum of 6 months had passed since the hip joint replacement, age between 30-70 years, the ability to follow instructions by the subject, the absence of accompanying orthopedic lesions such as fractures, and having access to the Internet, a smartphone, and the Skype program. Exclusion criteria were severe speech disorder and non-participation in a training session. The research tool included a demographic profile form and Hip disability and osteoarthritis outcome score (HOOS), which were completed by the patients before and after the training. Training for people in the intervention group in 4 sessions, including introduction of the disease, risk factors, symptoms, management of disease symptoms, medication, diet, appropriate exercises and pain relief methods, one session per week for 30 to 45 minutes in the groups 4 to 6 people were offered through Skype software. SPSS version 22 statistical software was used to analyze the data. Results: The average score of osteoarthritis outcomes in the patients before the intervention was 112.74±29.64 in the test group and 110.41±16.34 in the control group, which had no significant difference (P=0.682). After the intervention, it reached 85.25±21.43 and 109.94±15.74, respectively, and this difference was significant (P<0.001). The comparison of the average scores of osteoarthritis results in the test group indicated a significant difference from the pre-test to the post-test time (p<0.001). But in the control group, this difference was not significant (p=0.130). Conclusion: The results showed that Tele rehabilitation Education has a positive effect on reducing the outcomes of hip osteoarthritis, so it is recommended that nurses use Tele rehabilitation Education in their training in order to empower patients.

Keywords: training, rehabilitation, hip osteoarthritides, patient, complications

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Authors: Muhammad Asim

Abstract:

Background: Less than half of women in South Asia (SA) use any modern contraceptive method which leads to a huge burden of unintended pregnancies, unsafe abortions, maternal deaths, and socioeconomic loss. Women empowerment plays a pivotal role in improving various health seeking behaviours, including contraceptive use. The objective of this study to explore the association between women's empowerment and modern contraceptive, among rich and poor segment of population in SA. Methods: We used the most recent, large-scale, demographic health survey data of five South Asian countries, namely Afghanistan, Pakistan, Bangladesh, India, and Nepal. The outcome variable was the current use of modern contraceptive methods. The main exposure variable was a combination (interaction) of socio-economic status (SES) and women’s level of empowerment (low, medium, and high), where SES was bifurcated into poor and rich; and women empowerment was divided into three categories: decision making, attitude to violence and social independence. Moreover, overall women empowerment indicator was also created by using three dimensions of women empowerment. We applied both descriptive statistics and multivariable logistic regression techniques for data analyses. Results: Most of the women possessed ‘medium’ level of empowerment across South Asian Countries. The lowest attitude to violence empowerment was found in Afghanistan, and the lowest social independence empowerment was observed in Bangladesh across SA. However, Pakistani women have the lowest decision-making empowerment in the region. The lowest modern contraceptive use (22.1%) was found in Afghanistan and the highest (53.2%) in Bangladesh. The multivariate results depict that the overall measure of women empowerment does not affect modern contraceptive use among poor and rich women in most of South Asian countries. However, the decision-making empowerment plays a significant role among both poor and rich women to use modern contraceptive methods across South Asian countries. Conclusions: The effect of women’s empowerment on modern contraceptive use is not consistent across countries, and among poor and rich segment of population. Of the three dimensions of women’s empowerment, the autonomy of decision making in household affairs emerged as a stronger determinant of mCPR as compared with social independence and attitude towards violence against women.

Keywords: women empowerment, contraceptive use, South Asia, women autonomy

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Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari

Abstract:

The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.

Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen

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Authors: Michael Lekan-Kehinde, Abimbola Asojo, Bonnie Sanborn

Abstract:

Good acoustic performance has been identified as one of the critical Indoor Environmental Quality (IEQ) factors for student learning and development by the National Research Council. Childhood presents the opportunity for children to develop lifelong skills that will support them throughout their adult lives. Acoustic performance of a space has been identified as a factor that can impact language acquisition, concentration, information retention, and general comfort within the environment. Increasingly, students learn by communication between both teachers and fellow students, making speaking and listening crucial. Neurodiversity - while initially coined to describe individuals with autism spectrum disorder (ASD) - widely describes anyone with a different brain process. As the understanding from cognitive and neurosciences increases, the number of people identified as neurodiversity is nearly 30% of the population. This research looks at guidelines and standard for spaces with good acoustical quality and relates it with the experiences of students with autism spectrum disorder (ASD), their parents, teachers, and educators through a mixed methods approach, including selected case studies interviews, and mixed surveys. The information obtained from these sources is used to determine if selected materials, especially properties relating to sound absorption and reverberation reduction, are equally useful in small, medium sized, and large learning spaces and methodologically approaching. The results describe the potential impact of acoustics on Neurodiverse students, considering factors that determine the complexity of sound in relation to the auditory processing capabilities of ASD students. In conclusion, this research extends the knowledge of how materials selection influences the better development of acoustical environments for autism students.

Keywords: acoustics, autism spectrum disorder (ASD), children, education, learning, learning spaces, materials, neurodiversity, sound

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Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

Abstract:

Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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Authors: Muhammad Asim

Abstract:

Background: Less than half of women in South Asia (SA) use any modern contraceptive method which leads to a huge burden of unintended pregnancies, unsafe abortions, maternal deaths, and socioeconomic loss. Women empowerment plays a pivotal role in improving various health seeking behaviours, including contraceptive use. The objective of this study to explore the association between women's empowerment and modern contraceptive, among rich and poor segment of population in SA. Methods: We used the most recent, large-scale, demographic health survey data of five South Asian countries, namely Afghanistan, Pakistan, Bangladesh, India, and Nepal. The outcome variable was the current use of modern contraceptive methods. The main exposure variable was a combination (interaction) of socio-economic status (SES) and women’s level of empowerment (low, medium, and high), where SES was bifurcated into poor and rich; and women empowerment was divided into three categories: decision making, attitude to violence and social independence. Moreover, overall women empowerment indicator was also created by using three dimensions of women empowerment. We applied both descriptive statistics and multivariable logistic regression techniques for data analyses. Results: Most of the women possessed ‘medium’ level of empowerment across South Asian Countries. The lowest attitude to violence empowerment was found in Afghanistan, and the lowest social independence empowerment was observed in Bangladesh across SA. However, Pakistani women have the lowest decision-making empowerment in the region. The lowest modern contraceptive use (22.1%) was found in Afghanistan and the highest (53.2%) in Bangladesh. The multivariate results depict that the overall measure of women empowerment does not affect modern contraceptive use among poor and rich women in most of South Asian countries. However, the decision-making empowerment plays a significant role among both poor and rich women to use modern contraceptive methods across South Asian countries. Conclusions: The effect of women’s empowerment on modern contraceptive use is not consistent across countries, and among poor and rich segment of population. Of the three dimensions of women’s empowerment, the autonomy of decision making in household affairs emerged as a stronger determinant of mCPR as compared with social independence and attitude towards violence against women.

Keywords: women empowerment, modern contraceptive use, South Asia, women autonomy

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Authors: Theingi Shwe, Riken Homma, Kazuhisa Iki, Juko Ito

Abstract:

The growing cities of the developing country are characterized by rapid growth and poor infrastructure management inviting and accelerating relative environmental problems. Even though the movements of the sustainability had already been developed around the world, it is still increasing in the developing countries to plant sustainable practices. Aligned with the sustainable development actions, many sustainable assessment tools are also developed to rate and evaluate the sustainability performances through the building to community level. Among them, CASBEE is developed by Japanese organizations and is recognized as one of the international well-known assessment tools. The main purpose of the study is to find out the potential of CASBEE tool reflecting sustainability city level performances in developing countries. The research framework was designed with three major phases: Quantitative Approach, Qualitative Approach and Evaluation Reflection. The first two approaches were based on the investigation of tool’s contents and indicators by means of three sustainable dimensions and sustainability categories. To know the reality and reflection on developing country, Pathein City from Myanmar was selected and evaluated by 2012 version of CASBEE for Cities. The evaluation practices went through assigned indicators and the evaluation outcome presents the performances of Pathein city’s environmental efficiency as a very good in current conditions. The results of this study indicate that the indicators of this tool have balance coverage among three dimensions of sustainability but it has not yet counted enough for some indicators like location, infrastructure and institution which are relative to society dimension. In the developing countries’ cities, the most critical issues on development such as affordable housing and heritage preservation which are already planted in Pathein City but the tool does not account for those issues. Moreover, in some of the indicators, the benchmark and the weighting coefficient are strongly linked to the system birth region. By means of this study, it can be stated that CASBEE for Cities would be potential for delivering sustainable city level development in developing country especially in Myanmar along with further inclusion of the indicators.

Keywords: assessment tool, CASBEE, developing country, Myanmar, Pathein city, sustainable development

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