Search results for: teaching hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5364

Search results for: teaching hospital

1224 Care and Support for Infants and Toddlers with Special Needs

Authors: Florence A. Undiyaundeye, Aniashie Akpanke

Abstract:

Early identification of developmental disorders in infants and toddlers is critical for the well being of children. It is also an integral function of the primary care medical provider and the early care given in the home or crèche. This paper is focused at providing information on special need infants and toddlers and strategies to support them in developmental concern to cope with the challenges in and out of the classroom and to interact with their peers without stigmatization and inferiority complex. The target children are from birth through three years of age. There is a strong recommendation for developmental surveillance to be incorporated at every well child preventive care program in training and practical stage of formal school settings. The paper posits that any concerns raised during surveillance should be promptly addressed with standardized developmental screening by appropriate health service providers. In addition screening tests should be administered regularly at age 9+, 19+ and 30 months of these infants. The paper also establishes that the early identification of these developmental challenges of the infants and toddlers should lead to further developmental and medical evaluation, diagnosis and treatment, including early developmental school intervention, control and teaching and learning integration and inclusion for proper career build up. Children diagnosed with developmental disorders should be identified as children with special needs so that management is initiated and its underlying etiology may also drive a range of treatment of the child, to parents. Conselling and school integration as applicable to the child’s specific need and care for sustenance in societal functioning.

Keywords: care, special need, support, infants and toddlers, management and developmental disorders

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1223 Bilateral Thalamic Hypodense Lesions in Computing Tomography

Authors: Angelis P. Barlampas

Abstract:

Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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1222 Contents for the Maintenance and Troubleshooting of Anti-lock Braking System for Automobile Craftsmen in Nigeria

Authors: Arah Abubakar Saidu, Audu Rufai, Abdulkadir Mohammed, Ibrahim Yakubu Umar, Idris Abubakar Mohammed

Abstract:

The study determined the contents for the maintenance and troubleshooting of an anti-lock braking system for automobile craftsmen in Nigeria. Two research questions were raised and answered and two null hypotheses were formulated and tested at a .05 level of significance. The study adopted a descriptive survey research design. The study was conducted in Federal Capital Territory (FCT), Abuja, Kaduna, Kano, Lagos and Plateau States, Nigeria. The targeted population for the study was 99 consisting of all 43 non-teaching Subject Matter Experts (SMEs). The study utilized the whole population of the study. The instruments used for data collection were Anti-lock Braking System Maintenance and Troubleshooting Contents Questionnaire (ABSMTQ). Mean was used to analyze data that answered research questions and Z-test was used in testing the null hypotheses. Findings revealed, among others, that 81 items as content for the maintenance of ABS and 61 items as content for troubleshooting ABS for automobile craftsmen in Nigeria. Based on the findings of the study, the recommended, among others, that the National Board for Technical Education should include the contents for the maintenance and troubleshooting ABS in Motor Vehicle Mechanic Works curriculum used for training automobile craftsmen through the process of curriculum review in order to equip them with the competencies in troubleshooting and maintenance of ABS.

Keywords: anti-lock braking system, maintenance, troubleshooting, automobile craftsmen

Procedia PDF Downloads 89
1221 Trends, Attitude, and Knowledge about the Methods of Labour Pain Management among Polish Women

Authors: Kinga Zebrowska, Maria Falis, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Olga Plaza, Katarzyna Kwiatkowska

Abstract:

Introduction: According to the ministerial decree of 16 August 2018, each woman in Poland during childbirth has the right to the pharmacological and non-pharmacological labour pain management (LPM). Aim: The aim of the study was to assess the knowledge of Polish mothers about pharmacological and non-pharmacological LPM, to investigate which methods they chose and their satisfaction with chosen ones. Material And Methods: A prospective cross-sectional study was performed among women who gave birth between 2015 and 2018. The self-composed questionnaire was distributed via the Internet in October 2018. Results: 13.727 women participated in the study. 75% have learned about LPM from the Internet. 68% of them did not gain any information on LPM from doctors during their prenatal appointments Safety of the newborn (46%), midwife’s advice (40%) and the chance of the immediate pain relief (39%) were the most important issues while choosing LPM. Respondents used a wide range of non-pharmacological methods, such as the assistance of partner during labour (81%), physical activity (58%), immersion in water (37%), relaxation techniques (15%) and others. 11% of mothers did not use any of the LPM methods. 52% of women declared that they wanted to use the pharmacological anaesthesia, while 49% had it performed (28% epidural, 16% inhaled anaesthesia, 5% parenteral opioids). Pharmacological methods were unavailable due to lack of anaesthesiologist in the maternity ward (41%) or inaccessibility of the chosen methods in the hospital (31%) and too advanced labour (43%). 48% of respondents did not decide to use pharmacological methods, because the pain was bearable (29%), anxiety of child’s health (17%), or belief that the pain is natural and it should not be avoided (16%). 83% of respondents believed that epidural analgesia has no influence on the time needed to gain a full cervix dilatation and 81% of them claimed that serious spinal cord injury is a common side effect of epidural. 51% believed that epidural increases the risk of caesarean section. Conclusions: The knowledge about the methods of LPM is not satisfactory. We should focus on well- maintained education guided by doctors, midwives, and media.

Keywords: childbirth, labour pain management, maternity experiences, obstetrics

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1220 Relationship of Epidermal Growth Factor Receptor Gene Mutations Andserum Levels of Ligands in Non-Small Cell Lung Carcinoma Patients

Authors: Abdolamir Allameh, Seyyed Mortaza Haghgoo, Adnan Khosravi, Esmaeil Mortaz, Mihan Pourabdollah-Toutkaboni, Sharareh Seifi

Abstract:

Non-Small Cell Lung Carcinoma (NSCLC) is associated with a number of gene mutations in epidermal growth factor receptor (EGFR). The prognostic significance of mutations in exons 19 and 21, together with serum levels of EGFR, amphiregulin (AR), and Transforming Growth Factor-alpha (TGF-α) are implicated in diagnosis and treatment. The aim of this study was to examine the relationship of EGFR mutations in selected exons with the expression of relevant ligands in sera samples of NSCLC patients. For this, a group of NSCLC patients (n=98) referred to the hospital for lung surgery with a mean age of 59±10.5 were enrolled (M/F: 75/23). Blood specimen was collected from each patient. Besides, formalin fixed paraffin embedded tissues were processed for DNA extraction. Gene mutations in exons 19 and 21 were detected by direct sequencing, following DNA amplification which was done by PCR (Polymerase Chain Reaction). Also, serum levels of EGFR, AR, and TGF-α were measured by ELISA. The results of our study show that EGFR mutations were present in 37% of Iranian NSCLC patients. The most frequently identified mutations were deletions in exon 19 (72.2%) and substitutions in exon 21 (27.8%). The most frequently identified alteration, which is considered as a rare mutation, was the E872K mutation in exon 21, which was found in 90% (9 out of 10) cases. EGFR mutation detected in exon 21 was significantly (P<0.05) correlated with the levels of its ligands, EGFR and TGF-α in serum samples. Furthermore, it was found that increased serum AR (>3pg/ml) and TGF-α (>10.5 pg/ml) were associated with shorter overall survival (P<0.05). The results clearly showed a close relationship between EGFR mutations and serum EGFR and serum TGF-α. Increased serum EGFR was associated with TGF-α and AR and linked to poor prognosis of NSCLC. These findings are implicated in clinical decision-making related to EGFR-Tyrosine kinase inhibitors (TKIs).

Keywords: lung cancer, Iranian patients, epidermal growth factor, mutation, prognosis

Procedia PDF Downloads 80
1219 Exploring Key Elements of Successful Distance Learning Programs: A Case Study in Palau

Authors: Maiya Smith, Tyler Thorne

Abstract:

Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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1218 A Study of NT-ProBNP and ETCO2 in Patients Presenting with Acute Dyspnoea

Authors: Dipti Chand, Riya Saboo

Abstract:

OBJECTIVES: Early and correct diagnosis may present a significant clinical challenge in diagnosis of patients presenting to Emergency Department with Acute Dyspnoea. The common cause of acute dyspnoea and respiratory distress in Emergency Department are Decompensated Heart Failure (HF), Chronic Obstructive Pulmonary Disease (COPD), Asthma, Pneumonia, Acute Respiratory Distress Syndrome (ARDS), Pulmonary Embolism (PE), and other causes like anaemia. The aim of the study was to measure NT-pro Brain Natriuretic Peptide (BNP) and exhaled End-Tidal Carbon dioxide (ETCO2) in patients presenting with dyspnoea. MATERIAL AND METHODS: This prospective, cross-sectional and observational study was performed at the Government Medical College and Hospital, Nagpur, between October 2019 and October 2021 in patients admitted to the Medicine Intensive Care Unit. Three groups of patients were compared: (1) HFrelated acute dyspnoea group (n = 52), (2) pulmonary (COPD/PE)-related acute dyspnoea group (n = 31) and (3) sepsis with ARDS-related dyspnoea group (n = 13). All patients underwent initial clinical examination with a recording of initial vital parameters along with on-admission ETCO2 measurement, NT-proBNP testing, arterial blood gas analysis, lung ultrasound examination, 2D echocardiography, chest X-rays, and other relevant diagnostic laboratory testing. RESULTS: 96 patients were included in the study. Median NT-proBNP was found to be high for the Heart Failure group (11,480 pg/ml), followed by the sepsis group (780 pg/ml), and pulmonary group had an Nt ProBNP of 231 pg/ml. The mean ETCO2 value was maximum in the pulmonary group (48.610 mmHg) followed by Heart Failure (31.51 mmHg) and the sepsis group (19.46 mmHg). The results were found to be statistically significant (P < 0.05). CONCLUSION: NT-proBNP has high diagnostic accuracy in differentiating acute HF-related dyspnoea from pulmonary (COPD and ARDS)-related acute dyspnoea. The higher levels of ETCO2 help in diagnosing patients with COPD.

Keywords: NT PRO BNP, ETCO2, dyspnoea, lung USG

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1217 Online Dietary Management System

Authors: Kyle Yatich Terik, Collins Oduor

Abstract:

The current healthcare system has made healthcare more accessible and efficient by the use of information technology through the implementation of computer algorithms that generate menus based on the diagnosis. While many systems just like these have been created over the years, their main objective is to help healthy individuals calculate their calorie intake and assist them by providing food selections based on a pre-specified calorie. That application has been proven to be useful in some ways, and they are not suitable for monitoring, planning, and managing hospital patients, especially that critical condition their dietary needs. The system also addresses a number of objectives, such as; the main objective is to be able to design, develop and implement an efficient, user-friendly as well as and interactive dietary management system. The specific design development objectives include developing a system that will facilitate a monitoring feature for users using graphs, developing a system that will provide system-generated reports to the users, dietitians, and system admins, design a system that allows users to measure their BMI (Body Mass Index), the system will also provide food template feature that will guide the user on a balanced diet plan. In order to develop the system, further research was carried out in Kenya, Nairobi County, using online questionnaires being the preferred research design approach. From the 44 respondents, one could create discussions such as the major challenges encountered from the manual dietary system, which include no easily accessible information of the calorie intake for food products, expensive to physically visit a dietitian to create a tailored diet plan. Conclusively, the system has the potential of improving the quality of life of people as a whole by providing a standard for healthy living and allowing individuals to have readily available knowledge through food templates that will guide people and allow users to create their own diet plans that consist of a balanced diet.

Keywords: DMS, dietitian, patient, administrator

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1216 The Development of an Integrity Cultivating Module in School-Based Assessment among Malaysian Teachers: A Research Methodology

Authors: Eftah Bte. Moh Hj Abdullah, Abd Aziz Bin Abd Shukor, Norazilawati Binti Abdullah, Rahimah Adam, Othman Bin Lebar

Abstract:

The competency and integrity required for better understanding and practice of School-based Assessment (PBS) comes not only from the process, but also in providing the support or ‘scaffolding’ for teachers to recognize the student as a learner, improve their self-assessment skills, understanding of the daily teaching plan and its constructive alignment of the curriculum, pedagogy and assessment. The cultivation of integrity in PBS among the teachers is geared towards encouraging them to become committed and dedicated in implementing assessments in a serious, efficient manner, thus moving away from the usual teacher-focused approach to the student-focused approach. The teachers show their integrity via their professional commitment, responsibility and actions. The module based on the cultivation of integrity in PBS among Malaysian teachers aims to broaden the guidance support for teachers (embedded in the training), which consists of various domains to enable better evaluation of complex assessment tasks and the construction of suitable instrument for measuring the relevant cognitive, affective and psychomotor domains to describe the students’ achievement. The instrument for integrity cultivation in PBS has been developed and validated for measuring the effectiveness of the module constructed. This module is targeted towards assisting the staff in the Education Ministry, especially the principal trainers, teachers, headmasters and education officers to acquire effective intervention for improving the PBS assessors’ integrity and competency.

Keywords: school-based assessment, assessment competency integrity cultivation, professional commitment, module

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1215 Bronchoscopy and Genexpert in the Diagnosis of Pulmonary Tuberculosis in the Indian Private Health Sector: A Short Case Series

Authors: J. J. Mathew

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Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert

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1214 Exchanging Radiology Reporting System with Electronic Health Record: Designing a Conceptual Model

Authors: Azadeh Bashiri

Abstract:

Introduction: In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. Background: This study, provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. Methods: This is a cross-sectional study that was conducted in 2013. The student community was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also, Visual Paradigm software was used to design a conceptual model. Result: Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. Conclusion: According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, provide the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

Keywords: structured radiology report, information needs, minimum data set, electronic health record system in Iran

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1213 A Socio-Cultural Approach to Implementing Inclusive Education in South Africa

Authors: Louis Botha

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Since the presentation of South Africa’s inclusive education strategy in Education White Paper 6 in 2001, very little has been accomplished in terms of its implementation. The failure to achieve the goals set by this policy document is related to teachers lacking confidence and knowledge about how to enact inclusive education, as well as challenges of inflexible curricula, limited resources in overcrowded classrooms, and so forth. This paper presents a socio-cultural approach to addressing these challenges of implementing inclusive education in the South African context. It takes its departure from the view that inclusive education has been adequately theorized and conceptualized in terms of its philosophical and ethical principles, especially in South African policy and debates. What is missing, however, are carefully theorized, practically implementable research interventions which can address the concerns mentioned above. Drawing on socio-cultural principles of learning and development and on cultural-historical activity theory (CHAT) in particular, this paper argues for the use of formative interventions which introduce appropriately constructed mediational artifacts that have the potential to initiate inclusive practices and pedagogies within South African schools and classrooms. It makes use of Vygotsky’s concept of double stimulation to show how the proposed artifacts could instigate forms of transformative agency which promote the adoption of inclusive cultures of learning and teaching.

Keywords: cultural-historical activity theory, double stimulation, formative interventions, transformative agency

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1212 The Electrophysiology Study Results in Patients with Guillain Barre Syndrome (GBS): A Retrospective Study in a TertiaryHospital in Cebu City, Philippines

Authors: Dyna Ann C. Sevilles, Noel J. Belonguel, Jarungchai Anton S. Vatanagul, Mary Jeanne O. Flordelis, Grace G. Anota

Abstract:

Guillain Barre syndrome is an acute inflammatory polyradiculoneuropathy causing progressive symmetrical weakness which can be debilitating to the patient. Early diagnosis is important especially in the acute phase when treatment favors good outcome and reduces the incidence of the need for mechanical ventilation. Electrodiagnostic studies aid in the evaluation of patients suspected with GBS. However, the characteristic electrical changes may not be evident until after several weeks. Thus, studies performed early in the course may give unclear results. The aim of this study is to associate the symptom onset of patients diagnosed with Guillain Barre syndrome with the EMG NCV results and determine the earliest time when there is evident findings supporting the diagnosis. This is a retrospective descriptive chart review study involving patients of >/= 18 years of age with GBS written on their charts in a Tertiaty hospital in Cebu City, Philippines from January 2000 to July 2014. Twenty patients showed electrodiagnostic findings suggestive of GBS. The mean day of illness when EMG NCV was carried out was 7 days. The earliest with suggestive findings was done on day 2 (10%) of illness. Moreover, the highest frequency with positive results was done on day 3 (20%) of illness. Based on the Dutch Guillain Barre Study group criteria, the most frequent variables noted were: prolonged distal motor latency in both median and ulnar nerves(65%) and both peroneal and tibial nerves (71%); and reduced CMAP in both median and ulnar nerves (65%) and both tibial and peroneal nerves (71%). The EMG NCV findings showed majority of demyelinating type (59%). Electrodiagnostic studies are helpful in aiding the physician in the diagnosis and treatment of the disease in the early stage. Based on this study, neurophysiologic evidence of GBS can be seen in as early as day 2 of clinical illness.

Keywords: Acute Inflammatory Demyelinating Polyneuropathy, electrophysiologic study, EMG NCV, Guillain Barre Syndrome

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1211 Maker-Based Learning in Secondary Mathematics: Investigating Students’ Proportional Reasoning Understanding through Digital Making

Authors: Juan Torralba

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Student digital artifacts were investigated, utilizing a qualitative exploratory research design to understand the ways in which students represented their knowledge of seventh-grade proportionality concepts as they participated in maker-based activities that culminated in the creation of digital 3-dimensional models of their dream homes. Representations of the geometric and numeric dimensions of proportionality were analyzed in the written, verbal, and visual data collected from the students. A directed content analysis approach was utilized in the data analysis, as this work aimed to build upon existing research in the field of maker-based STEAM Education. The results from this work show that students can represent their understanding of proportional reasoning through open-ended written responses more accurately than through verbal descriptions or digital artifacts. The geometric and numeric dimensions of proportionality and their respective components of attributes of similarity representation and percents, rates, and ratios representations were the most represented by the students than any other across the data, suggesting a maker-based instructional approach to teaching proportionality in the middle grades may be promising in helping students gain a solid foundation in those components. Recommendations for practice and research are discussed.

Keywords: learning through making, maker-based education, maker education in the middle grades, making in mathematics, the maker movement

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1210 Identifying Teachers’ Perception of Integrity in School-Based Assessment Practice: A Case Study

Authors: Abd Aziz Bin Abd Shukor, Eftah Binti Moh Hj Abdullah

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This case study aims to identify teachers’ perception as regards integrity in School-Ba sed Assessment (PBS) practice. This descriptive study involved 9 teachers from 4 secondary schools in 3 districts in the state of Perak. The respondents had undergone an integrity in PBS Practice interview using a focused group discussion method. The overall findings showed that the teachers believed that integrity in PBS practice could be achieved by adjusting the teaching methods align with learning objectives and the students’ characteristics. Many teachers, parents and student did not understand the best practice of PBS. This would affect the integrity in PBS practice. Teachers did not emphasis the principles and ethics. Their integrity as an innovative public servant may also be affected with the frequently changing assessment system, lack of training and no prior action research. The analysis of findings showed that the teachers viewed that organizational integrity involving the integrity of PBS was difficult to be implemented based on the expectations determined by Malaysia Ministry of Education (KPM). A few elements which assisted in the achievement of PBS integrity were the training, students’ understanding, the parents’ understanding of PBS, environment (involving human resources such as support and appreciation and non-human resources such as technology infrastructure readiness and media). The implications of this study show that teachers, as the PBS implementers, have a strong influence on the integrity of PBS. However, the transformation of behavior involving PBS integrity among teachers requires the stabilisation of support and infrastructure in order to enable the teachers to implement PBS in an ethical manner.

Keywords: assessment integrity, integrity, perception, school-based assessment

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1209 Impact of Team-Based Learning Approach in English Language Learning Process: A Case Study of Universidad Federico Santa Maria

Authors: Yessica A. Aguilera

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English is currently the only foreign language included in the national educational curriculum in Chile. The English curriculum establishes that once completed secondary education, students are expected to reach B1 level according to the Common European Reference Framework (CEFR) scale. However, the objective has not been achieved, and to the author’s best knowledge, there is still a severe lack of English language skills among students who have completed their secondary education studies. In order to deal with the fact that students do not manage English as expected, team-based learning (TBL) was introduced in English language lessons at the Universidad Federico Santa María (USM). TBL is a collaborative teaching-learning method which enhances active learning by combining individual and team work. This approach seeks to help students achieve course objectives while learning how to function in teams. The purpose of the research was to assess the implementation and effectiveness of TBL in English language classes at USM technical training education. Quantitative and qualitative data were collected from teachers and students about their experience through TBL. Research findings show that both teachers and students are satisfied with the method and that students’ engagement and participation in class is higher. Additionally, students score higher on examinations improving academic outcomes. The findings of the research have the potential to guide how TBL could be included in future English language courses.

Keywords: collaborative learning, college education, English language learning, team-based learning

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1208 Expression of DNMT Enzymes-Regulated miRNAs Involving in Epigenetic Event of Tumor and Margin Tissues in Patients with Breast Cancer

Authors: Fatemeh Zeinali Sehrig

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Background: miRNAs play an important role in the post-transcriptional regulation of genes, including genes involved in DNA methylation (DNMTs), and are also important regulators of oncogenic pathways. The study of microRNAs and DNMTs in breast cancer allows the development of targeted treatments and early detection of this cancer. Methods and Materials: Clinical Patients and Samples: Institutional guidelines, including ethical approval and informed consent, were followed by the Ethics Committee (Ethics code: IR.IAU.TABRIZ.REC.1401.063) of Tabriz Azad University, Tabriz, Iran. In this study, tissues of 100 patients with breast cancer and tissues of 100 healthy women were collected from Noor Nejat Hospital in Tabriz. The basic characteristics of the patients with breast cancer included: 1)Tumor grade(Grade 3 = 5%, Grade 2 = 87.5%, Grade 1 = 7.5%), 2)Lymph node(Yes = 87.5%, No = 12.5%), 3)Family cancer history(Yes = 47.5%, No = 41.3%, Unknown = 11.2%), 4) Abortion history(Yes = 36.2%).In silico methods (data gathering, process, and build networks): Gene Expression Omnibus (GEO), a high-throughput genomic database, was queried for miRNAs expression profiles in breast cancer. For Experimental protocol Tissue Processing, Total RNA isolation, complementary DNA(cDNA) synthesis, and quantitative real time PCR (QRT-PCR) analysis were performed. Results: In the present study, we found significant (p.value<0.05) changes in the expression level of miRNAs and DNMTs in patients with breast cancer. In bioinformatics studies, the GEO microarray data set, similar to qPCR results, showed a decreased expression of miRNAs and increased expression of DNMTs in breast cancer. Conclusion: According to the results of the present study, which showed a decrease in the expression of miRNAs and DNMTs in breast cancer, it can be said that these genes can be used as important diagnostic and therapeutic biomarkers in breast cancer.

Keywords: gene expression omnibus, microarray dataset, breast cancer, miRNA, DNMT (DNA methyltransferases)

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1207 Duration Patterns of English by Native British Speakers and Mandarin ESL Speakers

Authors: Chen Bingru

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This study is intended to describe and analyze the effects of polysyllabic shortening and word or phrase boundary on the duration patterns of spoken utterances by Mandarin learners of English in comparison with native speakers of English. To investigate the relative contribution of these effects, two production experiments were conducted. The study included 11 native British English speakers and 20 Mandarin learners of English who were asked to produce four sets of tokens consisting of a mono-syllabic base form, disyllabic, and trisyllabic words derived from the base by the addition of suffixes, and a set of short sentences with a particular combination of phrase size, stress pattern, and boundary location. The duration of words and segments was measured, and results from the data analysis suggest that the amount of polysyllabic shortening and the effect of word or phrase position are likely to affect a Chinese accent for Mandarin ESL speakers. This study sheds light on research on the duration patterns of language by demonstrating the effect of duration-related factors on the foreign accent of Mandarin ESL speakers. It can also benefit both L2 learners and language teachers by increasing their sensitivity to the duration differences and difficulties experienced by L2 learners of English. An understanding of the amount of polysyllabic shortening and the effect of position in words and phrase on syllable duration can also facilitate L2 teachers to establish priorities for teaching pronunciation to ESL learners.

Keywords: duration patterns, Chinese accent, Mandarin ESL speakers, polysyllabic shortening

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1206 Efficacy and Safety of Inhaled Nebulized Chemotherapy in Treatment of Patients with Newly Diagnosed Pulmonary Tuberculosis in Comparison to Standard Antimycobacterial Therapy

Authors: M. Kuzhko, M. Gumeniuk, D. Butov, T. Tlustova, O. Denysov, T. Sprynsian

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Abstract: The objective of this work was to study the efficacy and safety of inhaled nebulized chemotherapy in the treatment of patients with newly diagnosed pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 68 patients aged between 20 and 70 years with newly diagnosed pulmonary tuberculosis. Patients were allocated to two groups. The first (main, n=21) group of patients received standard chemotherapy and further 0.15 g of isoniazid and rifampicin 0.15 g inhaled through a nebulizer, also they received salmeterol 50 mcg + fluticasone propionate 250 mcg at 2 breaths twice a day for 2 months. The second (control, n=47) group of patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g) with a dose reduction after the intensive phase of the therapy. The anti-TB drugs were procured through the Ukraine’s centralized national supply system. Results: Intoxication symptoms in the first group reduced following 1.39±0.18 months, whereas in the second group, intoxication symptoms reduced following 2.7±0.1 months, p<.001. Moreover, respiratory symptoms regression in the first group was observed following 1.6±0.2 months, whereas in the second group – following 2.5±0.2 months, p<0.05. Bacillary excretion period evaluated within 1 month was reduced, as it was shown by 66.6±10.5% in the main group compared to 27.6±6.5%, p<0.05, in the control group. In addition, period of cavities healing was reduced to 2.9±0.2 months in the main group compared to 3.7±0.1 months, p<0.05, in the control group. Residual radiological lung damage findings (large residual changes) were observed in 22 (23.8±9.5 %) patients of the main group versus 24 (51.0±7.2 %) patients in the control group, p<0.05. After completion of treatment scar stenosis of the bronchi II-III art. diagnosed in 3 (14.2±7.8%) patients in main group and 17 (68.0±6.8%) - control group, p<0.05. The duration of hospital treatment was 2.4±0.4 months in main group and 4.1±0.4 months in control group, p<0.05. Conclusion: Administration of of inhaled nebulized chemotherapy in patients with newly diagnosed pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.

Keywords: inhaled nebulized chemotherapy, pulmonary tuberculosis, tuberculosis, treatment of tuberculosis

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1205 A Comparative Analysis of Vocabulary Learning Strategies among EFL Freshmen and Senior Medical Sciences Students across Different Fields of Study

Authors: M. Hadavi, Z. Hashemi

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Learning strategies play an important role in the development of language skills. Vocabulary learning strategies as the backbone of these strategies have become a major part of English language teaching. This study is a comparative analysis of Vocabulary Learning Strategies (VLS) use and preference among freshmen and senior EFL medical sciences students with different fields of study. 449 students (236 freshman and 213 seniors) participated in the study. 64.6% were female and 35.4% were male. The instrument utilized in this research was a questionnaire consisting of 41 items related to the students’ approach to vocabulary learning. The items were classified under eight sections as dictionary strategies, guessing strategies, study preferences, memory strategies, autonomy, note- taking strategies, selective attention, and social strategies. The participants were asked to answer each item with a 5-point Likert-style frequency scale as follows:1) I never or almost never do this, 2) I don’t usually do this, 3) I sometimes do this, 4) I usually do this, and 5)I always or almost always do this. The results indicated that freshmen students and particularly surgical technology students used more strategies compared to the seniors. Overall guessing and dictionary strategies were the most frequently used strategies among all the learners (p=0/000). The mean and standard deviation of using VLS in the students who had no previous history of participating in the private English language classes was less than the students who had attended these type of classes (p=0/000). Female students tended to use social and study preference strategies whereas male students used mostly guessing and dictionary strategies. It can be concluded that the senior students under instruction from the university have learned to rely on themselves and choose the autonomous strategies more, while freshmen students use more strategies that are related to the study preferences.

Keywords: vocabulary leaning strategies, medical sciences, students, linguistics

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1204 Perception of Secondary Schools’ Students on Computer Education in Federal Capital Territory (FCT-Abuja), Nigeria

Authors: Salako Emmanuel Adekunle

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Computer education is referred to as the knowledge and ability to use computers and related technology efficiently, with a range of skills covering levels from basic use to advance. Computer continues to make an ever-increasing impact on all aspect of human endeavours such as education. With numerous benefits of computer education, what are the insights of students on computer education? This study investigated the perception of senior secondary school students on computer education in Federal Capital Territory (FCT), Abuja, Nigeria. A sample of 7500 senior secondary schools students was involved in the study, one hundred (100) private and fifty (50) public schools within FCT. They were selected by using simple random sampling technique. A questionnaire [PSSSCEQ] was developed and validated through expert judgement and reliability co-efficient of 0.84 was obtained. It was used to gather relevant data on computer education. Findings confirmed that the students in the FCT had positive perception on computer education. Some factors were identified that affect students’ perception on computer education. The null hypotheses were tested using t-test and ANOVA statistical analyses at 0.05 level of significance. Based on these findings, some recommendations were made which include competent teachers should be employed into all secondary schools; this will help students to acquire relevant knowledge in computer education, technological supports should be provided to all secondary schools; this will help the users (students) to solve specific problems in computer education and financial supports should be provided to procure computer facilities that will enhance the teaching and the learning of computer education.

Keywords: computer education, perception, secondary school, students

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1203 Buddhism and Society: The History and Contribution of Buddhist Education in Taiwan

Authors: Meilee Shen

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Buddhist monks and nuns have changed within the dynamic culture of Taiwan that they find themselves in. The diverse cultures, economic development, and advanced educational levels of the island are all part of this. Buddhist education has become an interesting aspect in the history of Taiwanese Buddhism. In recent years, Buddhists in Taiwan have made significant contributions to both academic and religious studies. This paper will focus on the following questions: What is Buddhist education? How does a Buddhist education change monastic role in Taiwanese Buddhism? Finally, how has Buddhist education benefited Taiwanese society? Research indicates that Buddhist education in Taiwan possesses four features: 1. Master teaching disciple: Buddhist masters teach monastic rules to monastic disciples only. 2. Monastic education: It is mainly focused on Buddhist doctrines and sangha rules. 3. From Buddhist education to secular education: Buddhist studies were introduced into secular educational environments that were the beginning for outsiders to study Buddhism. It also opened a door to recruit young college students to enter the monastery. 4. Academic Buddhist training: Buddhist monks and nuns have begun to study at secular colleges in various programs besides Buddhist studies. In recent years, Buddhist colleges and secular universities’ religious studies programs have begun to admit overseas students due to the low birth-rate in Taiwan. Therefore, the relationship between Buddhism and Taiwanese society is dynamic.

Keywords: Buddhist college and university in Taiwan, Buddhist education, institutionalization in Taiwanese Buddhism, monastic and secular education, Taiwanese Buddhist monks and nuns

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1202 Evaluation of the Impact of Neuropathic Pain on the Quality of Life of Patients

Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

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Introduction: Neuropathic pain (NP) is chronic pain; it can be observed in a large number of clinical situations. This pain results from a lesion of the peripheral or central nervous system. It is a frequent reason for consultations in rheumatology. This pain being chronic, can become disabling for the patient, thereby altering his quality of life. Objective: The objective of this study was to evaluate the impact of neuropathic pain on the quality of life of patients followed-up for chronic neuropathic pain. Material and Method: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the hospital anxiety, and depression scale (HAD) score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. Results: A total of 1528 patient data were collected; the average age of the patients was 57 years (standard deviation: 13 years) with extremes ranging from 17 years to 94 years, 91% were women and 9% men with a sex ratio man/woman equal to 0.10. 67% of our patients were married, and 63% of our patients were housewives. 43% of patients were followed-up for degenerative pathology. The NP was cervical radiculopathy in 26%, lumbosacral radiculopathy in 51%, and carpal tunnel syndrome in 20%. 23% of our patients had poor sleep quality, and 54% had average sleep quality. The pain was very intense in 5% of patients; 33% had severe pain, and 58% had moderate pain. The function was limited in 55% of patients. The average HAD score for anxiety and depression was 4.39 (standard deviation: 2.77) and 3.21 (standard deviation: 2.89), respectively. Conclusion: Our data clearly illustrate that neuropathic pain has a negative impact on the quality of sleep and function, as well as the mood of patients, thus influencing their quality of life.

Keywords: neuropathic pain, sleep, quality of life, chronic pain

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1201 Tobephobia: Fear of Failure in Education Caused by School Violence and Drug Abuse

Authors: Prakash Singh

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Schools throughout the world are facing increasing challenges in dealing with school violence and drug abuse by pupils. Therefore, the question of the fear of failure to meet the aims and objectives of education inevitably surfaces as it places increasing and challenging demands on educators and all other stakeholders to address this malaise. Multiple studies on the construct tobephobia (TBP) simply define TBP as the fear of failure in education. This study is a continuation of the exploratory studies on the manifestation of fear in education. The primary purpose of this study was to establish how TBP, caused by school violence and drug abuse affects teaching and learning in our schools. The qualitative research method was used for this study. Teachers admitted that they fear for their safety at school. Working in a fearful situation places a high rate of stress and anxiety on them. Tobephobic educators spend most of their time worrying about their fear of violence and drug abuse by pupils and are too frightened to carry out their normal duties. They prefer to stay in familiar surroundings for fear of being attacked by inebriated learners. This study, therefore, contributes to our understanding of the effects of TBP in our schools caused by school violence and drug abuse. Also, this study supplements the evidence accumulated over the past fifteen years that TBP is not a figment of someone’s imagination; it is a gruesome reality affecting the very foundation of our educational system globally to provide quality and equal education to all our learners in a harmonious, collegial school environment.

Keywords: tobephobia, tobephobic educators, fear of failure in education, school violence, drug abuse

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1200 What Constitutes Pre-School Mathematics and How It Look Like in the Classroom?

Authors: Chako G. Chako

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This study reports on an ongoing research that explores pre-school mathematics. Participants in the study includes three pre-school teachers and their pre-school learners from one school in Gaborone. The school was purposefully selected based on its performance in Botswana’s 2019 national examinations. Specifically, the study is interested on teachers’ explanations of mathematics concepts embedded in pre-school mathematics tasks. The interest on explanations was informed by the view that suggests that, the mathematics learners get to learn, resides in teachers’ explanations. Recently, Botswana’s basic education has integrated pre-school education into the mainstream public primary school education. This move is part of the government’s drive to elevate Botswana to a knowledge-based-economy. It is believed that provision of pre-school education to all Batswana children will contribute immensely towards a knowledge-based-economy. Since pre-school is now a new phenomenon in our education, there is limited research at this level of education in Botswana. In particular, there is limited knowledge about what and how the teaching is conducted in Pre-Schools in Botswana. Hence, the study seeks to gain insight into what constitutes mathematics in tasks that learners are given, and how concepts are made accessible to Pre-school learners. The research question of interest for this study is stated as: What is the nature Pre-school teachers’ explanations of mathematics concepts embedded in tasks given to learners. Casting some light into what and how pre-school mathematics tasks are enacted is critical for policy and Pre-school teacher professional development. The sociocultural perspective framed the research. Adler and Rhonda’s (2014) notion of exemplification and explanatory communication are used to analyze tasks given to learners and teachers’ explanations respectively.

Keywords: classroom, explanation, mathematics, pre-school, tasks

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1199 Portable System for the Acquisition and Processing of Electrocardiographic Signals to Obtain Different Metrics of Heart Rate Variability

Authors: Daniel F. Bohorquez, Luis M. Agudelo, Henry H. León

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Heart rate variability (HRV) is defined as the temporary variation between heartbeats or RR intervals (distance between R waves in an electrocardiographic signal). This distance is currently a recognized biomarker. With the analysis of the distance, it is possible to assess the sympathetic and parasympathetic nervous systems. These systems are responsible for the regulation of the cardiac muscle. The analysis allows health specialists and researchers to diagnose various pathologies based on this variation. For the acquisition and analysis of HRV taken from a cardiac electrical signal, electronic equipment and analysis software that work independently are currently used. This complicates and delays the process of interpretation and diagnosis. With this delay, the health condition of patients can be put at greater risk. This can lead to an untimely treatment. This document presents a single portable device capable of acquiring electrocardiographic signals and calculating a total of 19 HRV metrics. This reduces the time required, resulting in a timelier intervention. The device has an electrocardiographic signal acquisition card attached to a microcontroller capable of transmitting the cardiac signal wirelessly to a mobile device. In addition, a mobile application was designed to analyze the cardiac waveform. The device calculates the RR and different metrics. The application allows a user to visualize in real-time the cardiac signal and the 19 metrics. The information is exported to a cloud database for remote analysis. The study was performed under controlled conditions in the simulated hospital of the Universidad de la Sabana, Colombia. A total of 60 signals were acquired and analyzed. The device was compared against two reference systems. The results show a strong level of correlation (r > 0.95, p < 0.05) between the 19 metrics compared. Therefore, the use of the portable system evaluated in clinical scenarios controlled by medical specialists and researchers is recommended for the evaluation of the condition of the cardiac system.

Keywords: biological signal análisis, heart rate variability (HRV), HRV metrics, mobile app, portable device.

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1198 Effective Internal Control System in the Nasarawa State Tertiary Educational Institutions for Efficiency- A Case of Nasarawa State Polytechnic Lafia

Authors: Dauda Ibrahim Adagye

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Effective internal control system in the bursary unit of tertiary educational institutions is geared toward achieving quality teaching, learning, and research environment and as well assist the management of the institutions, particularly when decisions are to be made. While internal control system exists in all institutions, the outlined objectives above are far from being achieved. The paper; therefore, assesses the effectiveness of internal control system in tertiary educational institutions in Nasarawa State, Nigeria with the specific focus on the Nasarawa state Polytechnic, Lafia. The study is survey; hence, a simple closed-ended questionnaire was developed and administered to a sample of twenty-seven (27) member staff from the Bursary and the internal audit unit of the Nasarawa State Polytechnic, Lafia to obtain data for analysis purposes and to test the study hypothesis. Responses from the questionnaire were analyzed using a simple percentage and chi-square. Findings shows that the right people are not assigned to the right job in the department, budget, and management accounting were never used in the institution’s operations and checking of subordinate by their superior officers is not regular. This renders the current internal control structure of the Polytechnic as ineffective and weak. The paper therefore, recommends that: transparency should be seen as significant, as the institution work toward meeting its objectives, therefore, it means that the right staff is assigned to the right job and regular checking of the subordinates by their ensued superiors.

Keywords: internal control, tertiary educational intuitions, efficiency

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1197 A Fresh Look at Tense System of Qashqaie Dialect of Turkish Language

Authors: Mohammad Sharifi Bohlouli

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Turkish language with many dialects is native or official language of great number of people all around the world. The Qashqaie dialect of Turkish language is spoken by the Qashqaie tribe mostly scattered in the southern part of Iran. This paper aims at analyzing the tense system of this dialect to detect the type and number of tense and aspects available to its speakers. To collect a reliable data, a group of 50 old native speakers were randomly chosen as the informants and different techniques such as; Shuy et al interviews, selective listening ,and eavesdropping were used. The results of data analysis showed that the tense system in the Qashqaie dialect of Turkish language includes 3 absolute tenses , 6 aspectual , and 2 subjunctive ones. The interesting part of the study is that Qashqaie dialect enables its speakers to make a kind of aspectual opposition through verb structure which seems to be almost impossible through verb forms in any other nonturkish languages. For example in the following examples sentences 1 &2 and 3&4 have the same translation In English although they are different in both meaning and structure. 1. Ali ensha yazirdi. 2. Ali ensha yazirmush. (Ali was writing a composition.) 3. Ali yadmishdi. 4. Ali yadmishimish. ( Ali had slept.) The changes in the verb structure in Qashqaie dialect enables its speakers to say that whether the doer of the action remembers the process of doing the action or not. So, it presents a new aspectual opposition as Observed /nonobserved. The research findings reveal many other regularities and linguistic features that can be useful for linguists interested in Turkish in general and for those interested in tense and aspect and also they can be helpful for different pedagogical purposes including teaching and translating.

Keywords: qashqaie dialect, tense, aspect, linguistics, Turkish Language

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1196 An Exploration of Inclusive Education Settings in the Context of Saudi Arabia: Stakeholder Perspectives

Authors: Nourah Alshalhoub

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As Saudi Arabia is one of the countries moving toward more inclusive schools, there are few researchers who have examined the new model of inclusive practice; that is, a model introduced by the Tatweer project. Tatweer is an initiative supported by the Saudi government to develop education with a particular focus on inclusion. This on-going doctoral work aims to find out the nature of inclusive practice that Taweer introduced to create effective practice to include students with different abilities. While stakeholders are important elements to the implementation of inclusive education practice, the study’s goal is to find out and explore their understandings and perspectives. This study considers the perspectives of stakeholders, who are involved and influential on the implementation of the practice, from different dimensions. Tatweer project’s managers, head teachers, teachers and teaching assistants will be interviewed to find out how do they understand inclusive education concept and what perspective do they hold. Reliant on this material, this work seeks to inquire into what meaning inclusion and inclusive practice holds in Tatweer and to what extent this educational models let students with different abilities be more included. Four primary schools in Riyadh were purposively selected and data will be collected through semi-structured interviews. Semi-structured interview was selected as a study tool because it is a relevant and helpful method in understanding the thoughts, views, and beliefs of the stakeholders individually, and investigating issues more thoroughly in the context of Saudi Arabia.

Keywords: inclusive education, perspective, understanding, definition, inclusion

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1195 Improvement of Students’ Active Experience through the Provision of Foundational Architecture Pedagogy by Virtual Reality Tools

Authors: Mehdi Khakzand, Flora Fakourian

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It has been seen in recent years that architects are using virtual modeling to help them visualize their projects. Research has indicated that virtual media, particularly virtual reality, enhances architects' comprehension of design and spatial perception. Creating a communal experience for active learning is an essential component of the design process in architecture pedagogy. It has been particularly challenging to replicate design principles as a critical teaching function, and this is a complex issue that demands comprehension. Nonetheless, the usage of simulation should be studied and limited as appropriate. In conjunction with extensive technology, 3D geometric illustration can bridge the gap between the real and virtual worlds. This research intends to deliver a pedagogical experience in the architecture basics course to improve the architectural design process utilizing virtual reality tools. This tool seeks to tackle current challenges in current ways of architectural illustration by offering building geometry illustration, building information (data from the building information model), and simulation results. These tools were tested over three days in a design workshop with 12 architectural students. This article provided an architectural VR-based course and explored its application in boosting students' active experiences. According to the research, this technology can improve students' cognitive skills from challenging simulations by boosting visual understanding.

Keywords: active experience, architecture pedagogy, virtual reality, spatial perception

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