Search results for: teaching hospital of Oran

Authors: Darshana Sharma

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Distance Education has emerged as a viable alternative to serve the higher educational needs of the socially and economically disadvantaged people of the remote, rural areas of Jammu region. The University of Jammu is a National Accreditation, and Assessment Council accredited, A+ university and has been accorded graded autonomy by the University Grants Commission. It is a dual mode university offering academic programmes through the regular departments and through the Directorate of Distance Education. The Directorate of Distance Education, University of Jammu still uses printed study material as a mode of instructional delivery. The development of technologies has assured increased interaction and communication for distance learners throughout the distance open learning institutions. Though it is tempting and convenient to adopt technology already being used by others, it may not prove effective for the simple reason that two institutions may be unlike in some respect. The use of technology must be conceived in view of the needs of the learners; geographical socio-economic-cultural and technological contexts and financial, administrative and academic resources of the institution. Mobile learning (m-learning) is a novel approach to knowledge acquisition and dissemination and is gaining global attention. It has evolved as one of the useful channels of distance learning promoting interaction between learners and teachers. It is felt that the Directorate of Distance Education, University of Jammu also needs to adopt new technologies to provide more effective academic and information support to distance learners in order to keep them motivated and also to develop self-learning skills. The chief objective of the research on which this paper is based was to measure the opinion of the distance learners of the DDE, the University of Jammu about the merits of mobile learning. It also explores their preferences for implementing mobile learning. The survey research design of descriptive research has been used. The data was collected from 400 distance learners enrolled with undergraduate and post-graduate programmes using self-constructed questionnaire containing five-point Likert scale items arranging from strongly agree, agree, indifferent, disagree and strongly disagree. Percentages were used to analyze the data. The findings lead to conclude that mobile learning has a great potential for the DDE for reaching out to the rural, remotely located distance learners of the Jammu region and also to improve the teaching-learning environment. The paper also finds out the challenges in the implementation of mobile learning in the region and further makes suggestions for effective implementation of mobile learning in DDE, University of Jammu.

Keywords: directorate of distance education, mobile learning, national accreditation and assessment council, university of Jammu

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Authors: Anne-Marie Dionne

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Teacher reading aloud to students is a practice that is well established in preschool and primary classrooms. Many benefits of this pedagogical activity have been highlighted in multiple studies. However, it has also been shown that teachers are not keen on choosing informational texts for their read aloud, as their selections for this venue are mainly fictional stories, mostly written in a unique narrative story-like structure. Considering that students soon have to read complex informational texts by themselves as they go from one grade to another, there is cause for concern because those who do not benefit from an early exposure to informational texts could be lacking knowledge of informational text structures that they will encounter regularly in their reading. Exposing students to informational texts could be done in different ways in classrooms. However, since read aloud appears to be such a common and efficient practice in preschool and primary grades, it is important to examine more deeply the factors taken into account by teachers when they are selecting their readings for this important teaching activity. Moreover, it seems critical to know why teachers are not inclined to choose more often informational texts when they are reading aloud to their pupils. A group of 22 preschool or primary grade teachers participated in this study. The data collection was done by a survey and an individual semi-structured interview. The survey was conducted in order to get quantitative data on the read-aloud practices of teachers. As for the interviews, they were organized around three categories of questions (exploratory, analytical, opinion) regarding the process of selecting the texts for the read-aloud sessions. A statistical analysis was conducted on the data obtained by the survey. As for the interviews, they were subjected to a content analysis aiming to classify the information collected in predetermined categories such as the reasons given to favor fictional texts over informative texts, the reasons given for avoiding informative texts for reading aloud, the perceptions of the challenges that the informative texts could bring when they are read aloud to students, and the perceived advantages that they would present if they were chosen more often for this activity. Results are showing variable factors that are guiding the teachers when they are making their selection of the texts to be read aloud. As for example, some of them are choosing solely fictional texts because of their convictions that these are more interesting for their students. They also perceive that the informational texts are not good choices because they are not suitable for pleasure reading. In that matter, results are pointing to some interesting elements. Many teachers perceive that read aloud of fictional or informational texts have different goals: fictional texts are read for pleasure and informational texts are read mostly for academic purposes. These results bring out the urgency for teachers to become aware of the numerous benefits that the reading aloud of each type of texts could bring to their students, especially the informational texts. The possible consequences of teachers’ perceptions will be discussed further in our presentation.

Keywords: fictional texts, informational texts, preschool or primary grade teachers, reading aloud

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Authors: Yun Yu Stephanie Law

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Sociometer Theory is well tested among young adults in western population, however, limited research is found for other age groups, like adolescent and middle-adulthood in Asia population. Thus, one of the main purposes of this study is to verify the validity of Sociometer Theory in different age groups among Asian. To be specific, we hypothesized that an increase in one’s perceived social rejection is associated to a decrease in his/her state self-esteem among all age groups in Asian population. And we expected that this association can be found among all age groups including adolescent, young adults and middle-adults group in our first study. In this way, we can verify the validity of Sociometer Theory across different age groups as well as its significance in Asian population. Furthermore, those participants who received rejection about ‘mate-role’ would also receive some negative feedbacks regarding their current/future capacity of being a good mate. Results suggested that participants’ state self-esteem sensitivity for mating-capacity rejection is higher when comparing to that of friend-capacity rejection, i.e. greater drop in state self-esteem when receiving mating-capacity feedbacks then receiving friend-capacity feedbacks. These results, however, is just applicable on young adults. Thus, the main purpose of study two would be testing the state self-esteem sensitivity towards social rejection in different domains among three age groups. We hypothesized that group differences would be found for three age groups regarding state self-esteem sensitivity. Research question 1: perceived social rejection is associated to decrease in state self-esteem, is applicable among different age groups in Asia population. Research question 2: there are significant group differences for three age groups regarding state self-esteem sensitivity. Methods: 300 subjects are divided into three age groups, adolescents group, young adult group and middle-adult group, with 100 subjects in each group. Two questionnaires were used in testing this fundamental concept. Subjects were then asked to rate themselves on questionnaire in measuring their current state self-esteem in order to obtain the baseline measurements for later comparison. In order to avoid demand characteristics from subjects, other unrelated tasks like word matching were also given after the first test. Results: A positive correlation between scores in questionnaire 1 and questionnaire 2 among all age groups. Conclusion: State self-esteem decrease to both imagined social rejection (study1) and experienced social rejection (study2). Moreover, level of decrease in state self-esteem vary when receiving different domains of social rejection. Implications: a better understanding of self-esteem development for various age group might bring insights for education systems and policies for teaching approaches and learning methods among different age groups.

Keywords: state self-esteem, social rejection, stage theory, self-feelings

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Authors: Fatemeh Moosavi, Tumelo Franck Nkoshwane

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Peter Drucker the renowned management guru once said, “The best way to predict the future is to create it.” Mr. Drucker is also the man who placed human capital as the most vital resource of any institution. As such any institution bent on creating a better future, requires a competent human capital, one that is able to execute with efficiency and effectiveness the objective a society aspires to. Technology today is accelerating the rate at which many societies transition to knowledge based societies. In this accelerated paradigm, it is imperative that those in leadership establish a platform capable of sustaining the planned future; intellectual capital. The capitalist economy going into the future will not just be sustained by dollars and cents, but by individuals who possess the creativity to enterprise, innovate and create wealth from ideas. This calls for cities of the future, to have this premise at the heart of their future plan, if the objective of designing sustainable and liveable future cities will be realised. The knowledge economy, now transitioning to the creative economy, requires cities of the future to be ‘gardens’ of inspiration, to be places where knowledge, creativity, and innovation can thrive as these instruments are becoming critical assets for creating wealth in the new economic system. Developing nations must accept that learning is a lifelong process that requires keeping abreast with change and should invest in teaching people how to keep learning. The need to continuously update one’s knowledge, turn these cities into vibrant societies, where new ideas create knowledge and in turn enriches the quality of life of the residents. Cities of the future must have as one of their objectives, the ability to motivate their citizens to learn, share knowledge, evaluate the knowledge and use it to create wealth for a just society. The five functional factors suggested by Kevin Lynch;-vitality, meaning/sense, adaptability, access, control, and monitoring should form the basis on which policy makers and urban designers base their plans for future cities. The authors of this paper believe that developing nations “creative economy clusters”, cities where creative industries drive the need for constant new knowledge creating sustainable learning creative cities. Obviously the form, shape and size of these districts should be cognisant of the environmental, cultural and economic characteristics of each locale. Gaborone city in the republic of Botswana is presented as the case study for this paper.

Keywords: learning city, sustainable creative city, creative industry, good city form

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Authors: Lorato Itumeleng Kenosi

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Background: Negative attitudes towards the mentally ill are widespread and a course for concern as they have a detrimental impact on individuals affected by mental illness. A possible avenue for changing attitudes towards mental illness is through mental health literacy. In a college or university setting, an abnormal psychology course may be introduced in an attempt to change student’s attitudes towards the mentally ill. Objective: To determine if and how students’ attitudes towards the mentally ill change as a result of taking a course in abnormal psychology. Methods: Twenty nine (29) students were recruited from an abnormal psychology class at the University of Botswana. Attitude Scale for Mental Illness (ASMI) questionnaire was administered to participants at the beginning and end of the semester. SPSS was employed to analyze data. Pooled means were used to determine whether the student’s attitudes towards mental illness were negative or positive. A mean of 2.5 translated to negative attitude for both total attitude and attitudes in different domains of the scale. Paired sample t-test was then used to assess whether any changes noted in attitudes were statistically significant or not. Statistical significance was assumed at p < 0.05. Results: Students’ general attitude towards mental illness remained positive although the pooled mean value increased from 2.08 to 2.24. The change was not statistically significant. In relation to different sub scales, the values of the pooled means for all the sub scales showed an increase although the changes were not statistically significant except for the Stereotyping sub scale (p = 0.031). The stereotyping domain reflected a statistically significant change in student’s attitude from positive attitude to negative (X² = 2.06 to X² = 2.55). For the pessimistic prediction domain, students consistently showed a negative attitude (X² = 3.34 to X² = 3.55). The other 4 domains indicated that students had positive attitude toward mentally ill throughout. Discussion: Abnormal psychology students have a positive attitude towards the mentally ill generally. This could be attributed to the fact that all students in the abnormal psychology course are majoring in psychology and research has shown that interest in psychology can affect one’s attitude towards mental illness. The students continuously held the view that people with mental illness are unlikely to improve as evidenced by a high score for Pessimistic prediction domain for both pre and post-test. Students initially had no stereotyping attitude towards the mentally ill, but at the end of the course, they were of the opinion that people with mental illness can be defined in a certain behavioural pattern and mental ability. This results could be an indication that students have learnt well how to differentiate abnormal from normal behaviour not necessarily that students had developed a negative attitude. Conclusion: A course in abnormal psychology does have an impact on the students’ attitudes towards the mentally ill. The impact does not solely depend on knowledge of mental illness but also on several other factors such as contact with the mentally ill, interest in psychology, and teaching methods. However, it should be noted that sometimes improved knowledge in mental illness can be misunderstood for a negative attitude. For example, stereotyping attitudes may be a reflection of the ability to differentiate between abnormal and normal behaviour.

Keywords: attitudes, mental illness, psychopathology, students

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Authors: Thanduxolo Elford Fana

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Rationale and Purpose: Performance management and development system are central to effective and efficient service delivery, especially in highly labour intensive sectors such as South African public health. Performance management and development systems seek to ensure that good employee performance is rewarded accordingly, while those who underperform are developed so that they can reach their full potential. An effective and efficiently implemented performance management system motivates and improves employee engagement. The purpose of this study is to examine the implementation of the performance management and development system and the challenges that are encountered during its implementation in the Eastern Cape Provincial Department of Health. Methods: A qualitative research approach and a case study design was adopted in this study. The primary data were collected through observations, focus group discussions with employees, a group interview with shop stewards, and in-depth interviews with supervisors and managers, from April 2019 to September 2019. There were 45 study participants. In-depth interviews were held with 10 managers at facility level, which included chief executive officer, chief medical officer, assistant director’s in human resources management, patient admin, operations, finance, and two area manager and two operation managers nursing. A group interview was conducted with five shop stewards and an in-depth interview with one shop steward from the group. Five focus group discussions were conducted with clinical and non-clinical staff. The focus group discussions were supplemented with an in-depth interview with one person from each group in order to counter the group effect. Observations included moderation committee, contracting, and assessment meetings. Findings: The study shows that the performance management and development system was not properly implemented. There was non-compliance to performance management and development system policy guidelines in terms of time lines for contracting, evaluation, payment of incentives to good performers, and management of poor performance. The study revealed that the system is ineffective in raising the performance of employees and unable to assist employees to grow. The performance bonuses were no longer paid to qualifying employees. The study also revealed that lack of capacity and commitment, poor communication, constant policy changes, financial constraints, weak and highly bureaucratic management structures, union interference were challenges that were encountered during the implementation of the performance management and development system. Lastly, employees and supervisors were rating themselves three irrespective of how well or bad they performed. Conclusion: Performance management is regarded as vital to improved performance of the health workforce and healthcare service delivery among populations. Effective implementation of performance management and development system depends on well-capacitated and unbiased management at facility levels. Therefore, there is an urgent need to improve communication, link performance management to rewards, and capacitate staff on performance management and development system, as it is key to improved public health sector outcomes or performance.

Keywords: challenges, implementation, performance management and development system, public hospital

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Authors: Emilie Vandevelde, Ellen Claes

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This study aims to develop a comprehensive model for the civic socialization process of teachers. Citizenship has become one of the main objectives for the European education systems. It is expected that teachers are well prepared and equipped with the necessary knowledge, skills, and attitudes to also engage students in democratic citizenship. While a lot is known about young peoples’ civic competence development and how schools and teachers (don’t) support this process, less is known about how teachers themselves engage with (the teaching of) civics. Other than the civic socialization process of young adolescents that focuses on personal competence development, the civic socialization process of teachers includes the development of professional, civic competences. These professional competences make that they are able to prepare pupils to carry out their civic responsibilities in thoughtful ways. Existing models for the civic socialization process of young adolescents do not take this dual purpose into account. Based on these observations, this paper will investigate (1)What personal and professional civic competences teachers need to effectively teach civic education and (2) how teachers acquire these personal and professional civic competences. To answer the first research question, a systematic review of literature of existing civic education frameworks was carried out and linked to literature on teacher training. The second research question was addressed by adapting the Octagon model, developed by the International Association for the Evaluation of Educational Achievement (IEA), to the context of teachers. This was done by carrying out a systematic review of the recent literature linking three theoretical topics involved in teachers’ civic competence development: theories about the civic socialization process of young adolescents, Schulmans (1987) theoretical assumptions on pedagogical content knowledge (PCK), and Nogueira & Moreira’s (2012) framework for civic education teachers’ knowledge and literature on teachers’ professional development. This resulted in a comprehensive conceptual framework describing the personal and professional civic competences of civic education teachers. In addition, this framework is linked to the OctagonT model: a model that describes the processes through which teachers acquire these personal and professional civic competences. This model recognizes that teachers’ civic socialization process is influenced by interconnected variables located at different levels in a multi-level structure (the individual teacher (e.g., civic beliefs), everyday contacts (e.g., teacher educators, the intended, informal and hidden curriculum of the teacher training program, internship contacts, participation opportunities in teacher training, etc.) and the influence of the national educational context (e.g., vision on civic education)). Furthermore, implications for teacher education programs are described.

Keywords: civic education, civic competences, civic socialization, octagon model, teacher training

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Authors: Golson Mohamed, Yasmine Gamasy, Khaled EL-Khatib, Anas Al-Natour, Shady Fadel, Haytham Rashwan, Haytham Badawy, Nadia Farghaly

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Introduction: Wilm's tumor is the most common malignant renal tumor in children. Much progress has been made in the management of patients with this malignancy over the last 3 decades. Today treatments are based on several trials and studies conducted by the International Society of Pediatric Oncology (SIOP) in Europe and National Wilm's Tumor Study Group (NWTS) in the USA. It is necessary for us to understand why do we follow either of the protocols, NWTS which follows the upfront surgery principle or the SIOP which follows the upfront chemotherapy principle in all stages of the disease. Objective: The aim of is to assess outcome in patients treated with preoperative chemotherapy and patients treated with upfront surgery to compare their effect on overall survival. Study design: to decide which protocol to follow, study was carried out on records for patients aged 1 day to 18 years old suffering from Wilm's tumor who were admitted to Alexandria University Hospital, pediatric oncology, pediatric urology and pediatric surgery departments, with a retrospective survey records from 2010 to 2015, Design and editing of the transfer sheet with a (PRISMA flow study) Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. (11) Qualitative data were described using number and percent. Quantitative data were described using Range (minimum and maximum), mean, standard deviation and median. Comparison between different groups regarding categorical variables was tested using Chi-square test. When more than 20% of the cells have expected count less than 5, correction for chi-square was conducted using Fisher’s Exact test or Monte Carlo correction. The distributions of quantitative variables were tested for normality using Kolmogorov-Smirnov test, Shapiro-Wilk test, and D'Agstino test, if it reveals normal data distribution, parametric tests were applied. If the data were abnormally distributed, non-parametric tests were used. For normally distributed data, a comparison between two independent populations was done using independent t-test. For abnormally distributed data, comparison between two independent populations was done using Mann-Whitney test. Significance of the obtained results was judged at the 5% level. Results: A significantly statistical difference was observed for survival between the two studied groups favoring the upfront chemotherapy(86.4%)as compared to the upfront surgery group (59.3%) where P=0.009. As regard complication, 20 cases (74.1%) out of 27 were complicated in the group of patients treated with upfront surgery. Meanwhile, 30 cases (68.2%) out of 44 had complications in patients treated with upfront chemotherapy. Also, the incidence of intraoperative complication (rupture) was less in upfront chemotherapy group as compared to upfront surgery group. Conclusion: Upfront chemotherapy has superiority over upfront surgery.As the patient who started with upfront chemotherapy shown, higher survival rate, less percent in complication, less percent needed for radiotherapy, and less rate in recurrence.

Keywords: Wilm's tumor, renal tumor, chemotherapy, surgery

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Authors: Inkeri Jaaskelainen

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The aim of this study is to shed light on what is it like to study in apprenticeship training using intermediate (or even lower level) Finnish. The aim is to find out and describe these students' experiences and feelings while acquiring a profession in Finnish as it is important to understand how immigrant background adult learners learn and how their needs could be better taken into account. Many students choose apprenticeships and start vocational training while their language skills in Finnish are still very weak. At work, students should be able to simultaneously learn Finnish and do vocational studies in a noisy, demanding, and stressful environment. Learning and understanding new things is very challenging under these circumstances, and sometimes students get exhausted and experience a lot of stress - which makes learning even more difficult. Students are different from each other, and so are their ways to learn. Both duties at work and school assignments require reasonably good general language skills, and, especially at work, language skills are also a safety issue. The empirical target of this study is a group of students with an immigrant background who studied in various fields with intensive L2 support in 2016–2018 and who by now have completed a vocational upper secondary qualification. The interview material for this narrative study was collected from those who completed apprenticeship training in 2019–2020. The data collection methods used are a structured thematic interview, a questionnaire, and observational data. Interviewees with an immigrant background have an inconsistent cultural and educational background - some have completed an academic degree in their country of origin while others have learned to read and write only in Finland. The analysis of the material utilizes thematic analysis, which is used to examine learning and related experiences. Learning a language at work is very different from traditional classroom teaching. With evolving language skills, at an intermediate level at best, rushing and stressing makes it even more difficult to understand and increases the fear of failure. Constant noise, rapidly changing situations, and uncertainty undermine the learning and well-being of apprentices. According to preliminary results, apprenticeship training is well suited to the needs of an adult immigrant student. In apprenticeship training, students need a lot of support for learning and understanding a new communication and working culture. Stress can result in, e.g., fatigue, frustration, and difficulties in remembering and understanding. Apprenticeship training can be seen as a good path to working life. However, L2 support is a very important part of apprenticeship training, and it indeed helps students to believe that one day they will graduate and even get employed in their new country.

Keywords: apprenticeship training, vocational basic degree, Finnish learning, wee-being

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Authors: Hsiu Tan Liu, Chun Jung Liu

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It has multiple purposes to develop a sign language receptive skills test. For example, this test can be used to be an important tool for education and to understand the sign language ability of deaf children. There is no available test for these purposes in Taiwan. Through the discussion of experts and the references of standardized Taiwanese Sign Language Receptive Test for adults and adolescents, the frame of Taiwanese Sign Language Receptive Skills Test (TSL-RST) for deaf children was developed, and the items were further designed. After multiple times of pre-trials, discussions and corrections, TSL-RST is finally developed which can be conducted and scored online. There were 33 deaf children who agreed to be tested from all three deaf schools in Taiwan. Through item analysis, the items were picked out that have good discrimination index and fair difficulty index. Moreover, psychometric indexes of reliability and validity were established. Then, derived the regression formula was derived which can predict the sign language receptive skills of deaf children. The main results of this study are as follows. (1). TSL-RST includes three sub-test of vocabulary comprehension, syntax comprehension and paragraph comprehension. There are 21, 20, and 9 items in vocabulary comprehension, syntax comprehension, and paragraph comprehension, respectively. (2). TSL-RST can be conducted individually online. The sign language ability of deaf students can be calculated fast and objectively, so that they can get the feedback and results immediately. This can also contribute to both teaching and research. The most subjects can complete the test within 25 minutes. While the test procedure, they can answer the test questions without relying on their reading ability or memory capacity. (3). The sub-test of the vocabulary comprehension is the easiest one, syntax comprehension is harder than vocabulary comprehension and the paragraph comprehension is the hardest. Each of the three sub-test and the whole test are good in item discrimination index. (4). The psychometric indices are good, including the internal consistency reliability (Cronbach’s α coefficient), test-retest reliability, split-half reliability, and content validity. The sign language ability are significantly related to non-verbal IQ, the teachers’ rating to the students’ sign language ability and students’ self-rating to their own sign language ability. The results showed that the higher grade students have better performance than the lower grade students, and students with deaf parent perform better than those with hearing parent. These results made TLS-RST have great discriminant validity. (5). The predictors of sign language ability of primary deaf students are age and years of starting to learn sign language. The results of this study suggested that TSL-RST can effectively assess deaf student’s sign language ability. This study also proposed a model to develop a sign language tests.

Keywords: comprehension test, elementary school, sign language, Taiwan sign language

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Authors: Lisa Graham, Kathleen Grant

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South Africa is a multicultural country with eleven official languages, yet most of the formal education at institutions of higher education in the country is in English. It is well known that many students, irrespective of their home language, struggle to grasp difficult scientific concepts and the same is true for students enrolled in the Extended Curriculum Programme at the Cape Peninsula University of Technology (CPUT), studying biomedical sciences. Today we are fortunate in that there is a plethora of resources available to students to research and better understand subject matter online. For example, the students often use YouTube videos to supplement the formal education provided in our course. Unfortunately, most of this material is presented in English. The rationale behind this project lies in that it is well documented that students think and grasp concepts easier in their home language and addresses the fact that the lingua franca of instruction in the field of biomedical science is English. A project aimed at addressing the lack of available resources in most of the South African languages is planned, where students studying Bachelor of Health Science in Medical Laboratory Science will collaborate with those studying Film and Video Technology to create educational videos, explaining scientific concepts in their home languages. These videos will then be published on our own YouTube channel, thereby making them accessible to fellow students, future students and anybody with interest in the subject. Research will be conducted to determine the benefit of the project as well as the published videos to the student community. It is suspected that the students engaged in making the videos will benefit in such a way as to gain further understanding of their course content, a broader appreciation of the discipline, an enhanced sense of civic responsibility, as well as greater respect for the different languages and cultures in our classes. Indeed, an increase in student engagement has been shown to play a central role in student success, and it is well noted that deeper learning and more innovative solutions take place in collaborative groups. We aim to make a meaningful contribution towards the production and repository of knowledge in multilingual teaching and learning for the benefit of the diverse student population and staff. This would strengthen language development, multilingualism, and multiculturalism at CPUT and empower and promote African languages as languages of science and education at CPUT, in other institutions of higher learning, and in South Africa as a whole.

Keywords: educational videos, multiculturalism, multilingualism, student engagement

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Authors: David Ofosu-Hamilton, John K. E. Edumadze

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Universities have come to recognize the role Information and Communication Technology (ICT) skills plays in the daily activities of tertiary students. The ability to use ICT – essentially, computers and their diverse applications – are important resources that influence an individual’s economic and social participation and human capital development. Our society now increasingly relies on the Internet, and the Cloud as a means to communicate and disseminate information. The educated individual should, therefore, be able to use ICT to create and share knowledge that will improve society. It is, therefore, important that universities require incoming students to demonstrate a level of computer proficiency or trained to do so at a minimal cost by deploying advanced educational technologies. The training and standardized assessment of all in-coming first-year students of the University of Cape Coast in Information Technology Skills (ITS) have become a necessity as students’ most often than not highly overestimate their digital skill and digital ignorance is costly to any economy. The one-semester course is targeted at fresh students and aimed at enhancing the productivity and software skills of students. In this respect, emphasis is placed on skills that will enable students to be proficient in using Microsoft Office and Google Apps for Education for their academic work and future professional work whiles using emerging digital multimedia technologies in a safe, ethical, responsible, and legal manner. The course is delivered in blended mode - online and self-paced (student centered) using Alison’s free cloud-based tutorial (Moodle) of Microsoft Office videos. Online support is provided via discussion forums on the University’s Moodle platform and tutor-directed and assisted at the ICT Centre and Google E-learning laboratory. All students are required to register for the ITS course during either the first or second semester of the first year and must participate and complete it within a semester. Assessment focuses on Alison online assessment on Microsoft Office, Alison online assessment on ALISON ABC IT, Peer assessment on e-portfolio created using Google Apps/Office 365 and an End of Semester’s online assessment at the ICT Centre whenever the student was ready in the cause of the semester. This paper, therefore, focuses on the digital culture approach of hybrid teaching, learning and paperless examinations and the possible adoption by other courses or programs at the University of Cape Coast.

Keywords: assessment, blended, cloud, paperless

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Authors: Iliana Georganta, Clare Deehan, Marysia Thomson, Miriam McDonald, Kerrie McNulty, Anna Strachan, Elizabeth Anderson, Alyaa Mostafa

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Context: A meta-analysis of randomized controlled trials (RCTs) comparing hysterectomy versus endometrial ablation and resection in the management of heavy menstrual bleeding. Objective: To evaluate the clinical efficacy, satisfaction rates and adverse events of hysterectomy compared to more minimally invasive techniques in the treatment of HMB. Evidence Acquisition: A literature search was performed for all RCTs and quasi-RCTs comparing hysterectomy with either endometrial ablation endometrial resection of both. The search had no language restrictions and was last updated in June 2020 using MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, PubMed, Google Scholar, PsycINFO, Clinicaltrials.gov and Clinical trials. EU. In addition, a manual search of the abstract databases of the European Haemophilia Conference on women's health was performed and further studies were identified from references of acquired papers. The primary outcomes were patient-reported and objective reduction in heavy menstrual bleeding up to 2 years and after 2 years. Secondary outcomes included satisfaction rates, pain, adverse events short and long term, quality of life and sexual function, further surgery, duration of surgery and hospital stay and time to return to work and normal activities. Data were analysed using RevMan software. Evidence synthesis: 12 studies and a total of 2028 women were included (hysterectomy: n = 977 women vs endometrial ablation or resection: n = 1051 women). Hysterectomy was compared with endometrial ablation only in five studies (Lin, Dickersin, Sesti, Jain, Cooper) and endometrial resection only in five studies (Gannon, Schulpher, O’Connor, Crosignani, Zupi) and a mixture of the Ablation and Resection in two studies (Elmantwe, Pinion). Of the 1² studies, 10 reported women’s perception of bleeding symptoms as improved. Meta-analysis showed that women in the hysterectomy group were more likely to show improvement in bleeding symptoms when compared with endometrial ablation or resection up to 2-year follow-up (RR 0.75, 95% CI 0.71 to 0.79, I² = 95%). Objective outcomes of improvement in bleeding also favored hysterectomy. Patient satisfaction was higher after hysterectomy within the 2 years follow-up (RR: 0.90, 95%CI: 0.86 to 0.94, I²:58%), however, there was no significant difference between the two groups at more than 2 years follow up. Sepsis (RR: 0.03, 95% CI 0.002 to 0.56; 1 study), wound infection (RR: 0.05, 95% CI: 0.01 to 0.28, I²: 0%, 3 studies) and Urinary tract infection (UTI) (RR: 0.20, 95% CI: 0.10 to 0.42, I²: 0%, 4 studies) all favoured hysteroscopic techniques. Fluid overload (RR: 7.80, 95% CI: 2.16 to 28.16, I² :0%, 4 studies) and perforation (RR: 5.42, 95% CI: 1.25 to 23.45, I²: 0%, 4 studies) however favoured hysterectomy in the short term. Conclusions: This meta-analysis has demonstrated that endometrial ablation and endometrial resection are both viable options when compared with hysterectomy for the treatment of heavy menstrual bleeding. Hysteroscopic procedures had better outcomes in the short term with fewer adverse events including wound infection, UTI and sepsis. The hysterectomy performed better when measuring more long-term impacts such as recurrence of symptoms, overall satisfaction at two years and the need for further treatment or surgery.

Keywords: menorrhagia, hysterectomy, ablation, resection

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Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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Authors: Hafsa Memona, Farkhanda Manzoor

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Cockroaches are termed as medically important pests because of their wide distribution in human habitation including houses, hospitals, food industries and kitchens. They may harbor multiple drug resistant pathogenic bacteria and protozoan parasites on their external surfaces, disseminate on human food and cause serious diseases and allergies to human. Hence, they are regarded as mechanical vector in human habitation due to their nocturnal activity and nutritional behavior. Viable eggs and dormant cysts of parasites can hitch a ride on cockroaches. Ova and cysts of parasitic organism may settle into the crevices and cracks between thorax and head. There are so many fissures and clefts and crannies on a cockroach which provide site for these organisms. This study aimed with identifying role of cockroaches in mechanically transmitting and disseminating gastrointestinal parasites in two environmental settings; hospitals and houses in urban area of Lahore. Totally, 250 adult cockroaches were collected from houses and hospitals by sticky traps and food baited traps and screened for parasitic load. All cockroaches were captured during their feeding time in natural habitat. Direct wet smear, 1% lugols iodine and modified acid-fast bacilli staining were used to identify the parasites from the body surfaces of cockroaches. Among human habitation two common species of cockroaches were collected i.e. P. americana and B. germanica. The results showed that 112 (46.8%) cockroaches harbored at least one human intestinal parasite on their body surfaces. The cockroaches from hospital environment harboured more parasites than houses. 47 (33.57%) cockroaches from houses and 65 (59.09%) from hospitals were infected with parasitic organisms. Of these, 76 (67.85%) were parasitic protozoans and 36(32.15%) were pathogenic and non-pathogenic intestinal parasites. P. americana harboured more parasites as compared to B. germanica in both environment. Most common human intestinal parasites found on cockroaches include ova of Ascaris lumbricoides (giant roundworm), Trichuris trichura (whipworm), Anchylostoma deodunalae (hookworm), Enterobius vermicularis (pinworm), Taenia spp. and Strongyloides stercoralis (threadworm). The cysts of protozoans’ parasites including Balantidium coli, Entomoeba hystolitica, C. parvum, Isospora belli, Giardia duodenalis and C. cayetenensis were isolated and identified from cockroaches. Both experimental sites were significantly different in carriage of parasitic load on cockroaches. Difference in the hygienic condition of the environments, including human excrement disposal, variable habitat interacted, indoor and outdoor species, may account for the observed variation in the parasitic carriage rate of cockroaches among different experimental site. Thus a finding of this study is that Cockroaches are uniformly distributed in human habitation and act as a mechanical vector of pathogenic parasites that cause common illness such as diarrhea and bowel disorders. This fact contributes to epidemiological chain therefore control of cockroaches will significantly lessen the prevalence of illness in human. Effective control strategies will reduce the public health burden of the gastro-intestinal parasites in the developing countries.

Keywords: cockroaches, health risks, hospitals, houses, parasites, protozoans, transmission

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Authors: Oyvind Nordvik, Peder O. L. Heggdal, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing Loss (HL) is a condition that may affect people in all stages of life, but the prevalence increases with age, mostly because of age-related HL, generally referred to as presbyacusis. As human speech is related to relatively high frequencies, even a limited hearing loss at high frequencies may cause impaired speech intelligibility. Being diagnosed with, treated for and living with a chronic condition such as HL, must for many be a disabling and stressful condition that put ones coping resources to test. Stress is a natural part of life and most people will experience stressful events or periods. Chronic diseases, such as HL, are risk factor for distress in individuals, causing anxiety and lowered mood. How an individual cope with HL may be closely connected to the level of distress he or she is experiencing and to personality, which can be defined as those characteristics of a person that account for consistent patterns of feelings, thinking, and behavior. Thus, as to distress in life, such as illness or disease, available coping strategies may be more important than the challenge itself. The same line of arguments applies to level of experienced health-related quality of life (HRQoL). Aim: The aim of this study was to investigate the relationship between distress, HRQoL, reported hearing loss, personality and coping in patients with HL. Method: 158 adult (aged 18-78 years) patients with HL, referred for hearing aid (HA) fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals were included. First-time users had been pre-examined by an ENT-specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2, and 4 kHz) was determined for each ear. The Eysenck personality inventory, neuroticism and lie scales, the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) measuring active coping, hopelessness and helplessness, as well as distress (General Health Questionnaire (GHQ) - 12 items) and the EORTC Quality of Life Questionnaire general part were answered. In addition, we used a revised and shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) as a measure of patient-reported hearing loss. Results: Significant correlations were determined between APHAB (weak), HRQoL scores (strong), distress scores (strong) on the one side and personality and choice of coping scores on the other side. As measured by stepwise regression analyses, the distress and HRQoL scores were scored secondary to the obtained personality and coping scores. The APHAB scores were as determined by regression analyses scored secondary to PTA (best ear), level of neuroticism and lie score. Conclusion: We found that reported employed coping style, distress/HRQoL and personality are closely connected to each other in this patient group. Patient-reported HL was associated to hearing level and personality. There is need for further investigations on these questions, and how these associations may influence the clinical context.

Keywords: coping, distress, hearing loss, personality

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Authors: Charléa M. Smith, Raiden L. Schodowski, Arletty Pinel

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Due to the COVID-19 pandemic, the Faculty of Medical Sciences of The University of the West Indies (UWI) Mona in Kingston, Jamaica, had to rapidly migrate to digital and blended learning. Students in the preclinical stage of the program transitioned to full-time online learning, while students in the clinical stage experienced decreased daily patient contact and the implementation of a blend of online lectures and virtual clinical practice. Such sudden changes were coupled with the institutional pressure of the need to introduce a novel approach to education without much time for preparation, as well as additional strain endured by the faculty, who were overwhelmed by serving as frontline workers. During the period July 20 to August 23, 2021, this study surveyed preclinical and clinical students to capture their experiences with these changes and their recommendations for future use of digital modalities of learning to enhance medical education. It was conducted with a fellow student of the 2021 cohort of the MultiPod mentoring program. A questionnaire was developed and distributed digitally via WhatsApp to all medical students of the UWI Mona campus to assess students’ experiences and perceptions of the advantages, challenges, and impact on individual knowledge proficiencies brought about by the transition to predominantly digital learning environments. 108 students replied, 53.7% preclinical and 46.3% clinical. 67.6% of the total were female and 30.6 % were male; 1.8% did not identify themselves by gender. 67.2% of preclinical students preferred blended learning and 60.3% considered that the content presented did not prepare them for clinical work. Only 31% considered that the online classes were interactive and encouraged student participation. 84.5% missed socialization with classmates and friends and 79.3% missed a focused environment for learning. 80% of the clinical students felt that they had not learned all that they expected and only 34% had virtual interaction with patients, mostly by telephone and video calls. Observing direct consultations was considered the most useful, yet this was the least-used modality. 96% of the preclinical students and 100% of the clinical ones supplemented their learning with additional online tools. The main recommendations from the survey are the use of interactive teaching strategies, more discussion time with lecturers, and increased virtual interactions with patients. Universities are returning to face-to-face learning, yet it is unlikely that blended education will disappear. This study demonstrates that students’ perceptions of their experience during mobility restrictions must be taken into consideration in creating more effective, inclusive, and efficient blended learning opportunities.

Keywords: blended learning, digital learning, medical education, student perceptions

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Authors: Kayliegh Richardson, Ana Speed

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The international campaign, '16 Days of Activism against Gender Based Violence', seeks to raise awareness and understanding of gender based violence in a variety of settings. The campaign requires its participants to join in for advancing the right to education and challenging violence, discrimination, and inequality and take into account intersections such as gender, race, ethnicity, religion, sexual orientation, socio-economic status and other social identifiers. The authors of this paper are both clinic supervisors at Northumbria University in Newcastle Upon Tyne, England. As part of their research project, the authors are going to ask final year students on the MLaw degree at Northumbria University to become involved in the campaign by participating in a variety of awareness-raising activities during the course of the 16 days, which runs from 27 November 2017 until 10 December 2017. As part of the campaign, the authors will be running the following activities for students to participate in 1. Documentary showing of Banaz, a love story followed by discussion group. 2. 16 blogs for 16 days. Students will contribute to our family law blog over the 16 days, with articles about gender based violence. 3. Guest lecture on domestic violence (potentially run by a domestic violence organisation) 4. Workshop by Professor Ruth Lewis who will be presenting her innovative research in gender based violence and online abuse. 5. Poster competition - the students are asked to submit a poster about the different forms of gender based violence or proposals for ending violence against women and girls. The research aims are to identify whether participation in the project: 1. increases the students' engagement with issues of gender justice 2. is an effective educational tool for raising the students' awareness and understanding of gender based violence in its many forms. 3. increases the students' understanding of the domestic and international framework for protecting victims (in particular women and children) of gender based violence. After the activities, an impartial, experienced researcher will be holding a focus group with volunteering students to discuss their experiences of participating in the activities and whether they felt that participation in the project achieved the aims set out above. This paper will discuss the activities undertaken by the students and will address the data gathered during the focus group. Finally, the authors will discuss their thoughts on whether awareness of gender-based violence and other international family law issues can be appropriately raised in an educational setting.

Keywords: gender based violence, clinical legal education, international family law, domestic abuse

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Authors: Theophilus Asante, Comfort Nyarko, Daniel Antwi

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Drug-resistant tuberculosis, together with the associated comorbidities like pulmonary fibrosis and silicosis, has been one of the most serious global public health threats that requires immediate action to curb or mitigate it. This prolongs hospital stays, increases the cost of medication, and increases the death toll recorded annually. Crinum asiaticum bulb (CAE) and betulin (BET) are known for their biological and pharmacological effects. Pharmacological effects reported on CAE include antimicrobial, anti-inflammatory, anti-pyretic, anti-analgesic, and anti-cancer effects. Betulin has exhibited a multitude of powerful pharmacological properties ranging from antitumor, anti-inflammatory, anti-parasitic, anti-microbial, and anti-viral activities. This work sought to investigate the anti-tuberculosis and resistant modulatory effects and also assess their effects on mitigating pulmonary fibrosis and silicosis. In the anti-tuberculosis and resistant modulatory effects, both CAE and BET showed strong antimicrobial activities (31.25 ≤ MIC ≤ 500) µg/ml against the studied microorganisms and also produced significant anti-efflux pump and biofilm inhibitory effects (ρ < 0.0001) as well as exhibiting resistance modulatory and synergistic effects when combined with standard antibiotics. Crinum asiaticum bulbs extract and betulin were shown to possess anti-pulmonary fibrosis effects. There was an increased survival rate in the CAE and BET treatment groups compared to the BLM-induced group. There was a marked decrease in the levels of hydroxyproline and collagen I and III in the CAE and BET treatment groups compared to the BLM-treated group. The treatment groups of CAE and BET significantly downregulated the levels of pro-fibrotic and pro-inflammatory cytokine concentrations such as TGF-β1, MMP9, IL-6, IL-1β and TNF-alpha compared to an increase in the BLM-treated groups. The histological findings of the lungs suggested the curative effects of CAE and BET following BLM-induced pulmonary fibrosis in mice. The study showed improved lung functions with a wide focal area of viable alveolar spaces and few collagen fibers deposition on the lungs of the treatment groups. In the anti-silicosis and pulmonoprotective effects of CAE and BET, the levels of NF-κB, TNF-α, IL-1β, IL-6 and hydroxyproline, collagen types I and III were significantly reduced by CAE and BET (ρ < 0.0001). Both CAE and BET significantly (ρ < 0.0001) inhibited the levels of hydroxyproline, collagen I and III when compared with the negative control group. On BALF biomarkers such as macrophages, lymphocytes, monocytes, and neutrophils, CAE and BET were able to reduce their levels significantly (ρ < 0.0001). The CAE and BET were examined for anti-oxidant activity and shown to raise the levels of catalase (CAT) and superoxide dismutase (SOD) while lowering the level of malondialdehyde (MDA). There was an improvement in lung function when lung tissues were examined histologically. Crinum asiaticum bulbs extract and betulin were discovered to exhibit anti-tubercular and resistance-modulatory properties, as well as the capacity to minimize TB comorbidities such as pulmonary fibrosis and silicosis. In addition, CAE and BET may act as protective mechanisms, facilitating the preservation of the lung's physiological integrity. The outcomes of this study might pave the way for the development of leads for producing single medications for the management of drug-resistant tuberculosis and its accompanying comorbidities.

Keywords: fibrosis, crinum, tuberculosis, antiinflammation, drug resistant

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Authors: Chua Si Wen Alicia, Marcus Goh Tian Xi, Eunice Gan Ghee Wu, Helen Bound, Lee Liang Ying, Albert Lee

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In a world full of rapid changes, people often need a set of skills to help them navigate an ever-changing workscape. These skills, often known as “future-oriented skills,” include learning to learn, critical thinking, understanding multiple perspectives, and knowledge creation. Future-oriented skills are typically assumed to be domain-general, applicable to multiple domains, and can be cultivated through a learning approach called Dialogical Inquiry. Dialogical Inquiry is known for its benefits of making sense of multiple perspectives, encouraging critical thinking, and developing learner’s capability to learn. However, it currently exists as a quantitative tool, which makes it hard to track and compare learning processes over time. With these concerns, the present research aimed to develop and validate a quantitative tool for the Map of Dialogical Inquiry, focusing Imagining aspect of learning. The Imagining aspect four dimensions: 1) speculative/ look for alternatives, 2) risk taking/ break rules, 3) create/ design, and 4) vision/ imagine. To do so, an exploratory literature review was conducted to better understand the dimensions of Imagining. This included deep-diving into the history of the creation of the Map of Dialogical Inquiry and a review on how “Imagining” has been conceptually defined in the field of social psychology, education, and beyond. Then, we synthesised and validated scales. These scales measured the dimension of Imagination and related concepts like creativity, divergent thinking regulatory focus, and instrumental risk. Thereafter, items were adapted from the aforementioned procured scales to form items that would contribute to the preliminary version of the Imagining Scale. For scale validation, 250 participants were recruited. A Confirmatory Factor Analysis (CFA) sought to establish dimensionality of the Imagining Scale with an iterative procedure in item removal. Reliability and validity of the scale’s dimensions were sought through measurements of Cronbach’s alpha, convergent validity, and discriminant validity. While CFA found that the distinction of Imagining’s four dimensions could not be validated, the scale was able to establish high reliability with a Cronbach alpha of .96. In addition, the convergent validity of the Imagining scale was established. A lack of strong discriminant validity may point to overlaps with other components of the Dialogical Map as a measure of learning. Thus, a holistic approach to forming the tool – encompassing all eight different components may be preferable.

Keywords: learning, education, imagining, pedagogy, dialogical teaching

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Authors: Mona Isazad Mashinchi, Davood Roshan Sangachin, Francis J. Sullivan, Dietrich Rebholz-Schuhmann

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Background: Decision-making processes are nowadays driven by data, data analytics and Business Intelligence (BI). BI as a software platform can provide a wide variety of capabilities such as organization memory, information integration, insight creation and presentation capabilities. Visualizing data through dashboards is one of the BI solutions (for a variety of areas) which helps managers in the decision making processes to expose the most informative information at a glance. In the healthcare domain to date, dashboard presentations are more frequently used to track performance related metrics and less frequently used to monitor those quality parameters which relate directly to patient outcomes. Providing effective and timely care for patients and improving the health outcome are highly dependent on presenting and visualizing data and information. Objective: In this research, the focus is on the presentation capabilities of BI to design a dashboard for prostate cancer (PC) data that allows better decision making for the patients, the hospital and the healthcare system related to a cancer dataset. The aim of this research is to customize a retrospective PC dataset in a dashboard interface to give a better understanding of data in the categories (risk factors, treatment approaches, disease control and side effects) which matter most to patients as well as other stakeholders. By presenting the outcome in the dashboard we address one of the major targets of a value-based health care (VBHC) delivery model which is measuring the value and presenting the outcome to different actors in HC industry (such as patients and doctors) for a better decision making. Method: For visualizing the stored data to users, three interactive dashboards based on the PC dataset have been developed (using the Tableau Software) to provide better views to the risk factors, treatment approaches, and side effects. Results: Many benefits derived from interactive graphs and tables in dashboards which helped to easily visualize and see the patients at risk, better understanding the relationship between patient's status after treatment and their initial status before treatment, or to choose better decision about treatments with fewer side effects regarding patient status and etc. Conclusions: Building a well-designed and informative dashboard is related to three important factors including; the users, goals and the data types. Dashboard's hierarchies, drilling, and graphical features can guide doctors to better navigate through information. The features of the interactive PC dashboard not only let doctors ask specific questions and filter the results based on the key performance indicators (KPI) such as: Gleason Grade, Patient's Age and Status, but may also help patients to better understand different treatment outcomes, such as side effects during the time, and have an active role in their treatment decisions. Currently, we are extending the results to the real-time interactive dashboard that users (either patients and doctors) can easily explore the data by choosing preferred attribute and data to make better near real-time decisions.

Keywords: business intelligence, dashboard, decision making, healthcare, prostate cancer, value-based healthcare

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Authors: Zeite Shumneiyang Koireng

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Liberation is the act of liberating or the state of being liberated. Indian philosophy, in general, understands liberation as moksa, which etymological is derived from the Sanskrit root muc+ktin meaning to loose, set free, to let go, discharge, release, liberate, deliver, etc. According to Indian schools of thought, moksa is the highest value on realizing which nothing remains to be realized. It is the cessation of birth and death, all kinds of pain and at the same time, it is the realization of one’s own self. Sankara’s Advaita philosophy is based on the following propositions: Brahman is the only Reality; the world has apparent reality, and the soul is not different from Brahman. According to Sankara, Brahman is the basis on which the world form appears; it is the sustaining ground of all various modification. It is the highest self and the self of all reveals himself by dividing himself [ as it was in the form of various objects] in multiple ways. The whole world is the manifestation of the Supreme Being. Brahman modifying itself into the Atman or internal self of all things is the world. Since Brahman is the Upadhana karana of the world, the sruti speaks of the world as the modification of Brahman into the Atman of the effect. Contemplation as the fulfillment of man finds a radical foundation in Aquinas teaching concerning the natural end or as he also referred to it, natural desire. The third book of the Summa Contra Gentiles begins the study of happiness with a consideration of natural desire. According to him, all creatures, even those devoid of understanding are ordered to God as an ultimate end. Intrinsically, a part of every nature is a tendency or inclination, originating in the natural form and tendency toward the end for which the possessor of nature exists. It is the study of the nature and finality of inclination that Aquinas establishes through an argument of induction man’s Contemplation of God as the fulfillment of his nature. The present paper is attempted to critically approach two important, seminal and originated thought, representing Indian and Western traditions which mark on the thinking of their respective times. Both these thoughts- Advaitic concept of Liberation in the Indian tradition and the concept of Contemplation in Thomas Aquinas’ Summa Contra Gentiles’- confront directly the question of the ultimate meaning of human existence. According to Sankara, it is knowledge and knowledge alone which is the means of moksa and the highest knowledge is moksa itself. Liberation in Sankara Vedanta is attained as a process of purification of self, which gradually and increasingly turns into purer and purer intentional construction. Man’s inner natural tendency for Aquinas is towards knowledge. The human subject is driven to know more and more about reality and in particular about the highest reality. Contemplation of this highest reality is fulfillment in the philosophy of Aquinas. Rather, Contemplation is the perfect activity in man’s present state of existence.

Keywords: liberation, Brahman, contemplation, fulfillment

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Authors: Umedov Mekhroz, Griaznova Svetlana

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In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

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Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal

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Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.

Keywords: bariatric, biomarkers, inflammation, laparoscopy

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Authors: Kari Björn, Mikael Soini

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Higher Education system reforms, especially Finnish system of Universities of Applied Sciences in 2014 are discussed. The new steering model is based on major legislative changes, output-oriented funding and open information. The governmental steering reform, especially the financial model and the resulting institutional level responses, such as a curriculum reforms are discussed, focusing especially in engineering programs. The paper is motivated by management need to establish objective steering-related performance indicators and to apply them consistently across all educational programs. The close relationship to governmental steering and funding model imply that internally derived indicators can be directly applied. Metropolia University of Applied Sciences (MUAS) as a case institution is briefly introduced, focusing on engineering education in Information and Communications Technology (ICT), and its related programs. The reform forced consolidation of previously separate smaller programs into fewer units of student application. New curriculum ICT students have a common first year before they apply for a Major. A framework of parallel and longitudinal comparisons is introduced and used across Majors in two campuses. The new externally introduced performance criteria are applied internally on ICT Majors using data ex-ante and ex-post of program merger.  A comparative performance of the Majors after completion of joint first year is established, focusing on previously omitted Majors for completeness of analysis. Some new research questions resulting from transfer of Majors between campuses and quota setting are discussed. Practical orientation identifies best practices to share or targets needing most attention for improvement. This level of analysis is directly applicable at student group and teaching team level, where corrective actions are possible, when identified. The analysis is quantitative and the nature of the corrective actions are not discussed. Causal relationships and factor analysis are omitted, because campuses, their staff and various pedagogical implementation details contain still too many undetermined factors for our limited data. Such qualitative analysis is left for further research. Further study must, however, be guided by the relevance of the observations.

Keywords: engineering education, integrated curriculum, learning outcomes, performance measurement

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Authors: Rosaline Govender, Shubnam Rambharos

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Universities are, to a certain extent, the source of under-preparedness ideologically, structurally, and pedagogically, particularly since organizational cultures often alienate students by failing to enable epistemological access. This is evident in the unsustainably low graduation rates that characterize South African higher education, which indicate that under 30% graduate in minimum time, under two-thirds graduate within 6 years, and one-third have not graduated after 10 years. Although the statistics for the Faculty of Accounting and Informatics at the Durban University of Technology (DUT) in South Africa have improved significantly from 2019 to 2021, the graduation (32%), throughput (50%), and dropout rates (16%) are still a matter for concern as the graduation rates, in particular, are quite similar to the national statistics. For our students to succeed, higher education should take a multi-pronged approach to ensure student success, and student engagement is one of the ways to support our students. Student engagement depends not only on students’ teaching and learning experiences but, more importantly, on their social and academic integration, their sense of belonging, and their emotional connections in the institution. Such experiences need to challenge students academically and engage their intellect, grow their communication skills, build self-discipline, and promote confidence. The aim of this mixed methods study is to explore the multi-pronged nature of student success within the Faculty of Accounting and Informatics at DUT and focuses on the enabling and constraining factors of student success. The sources of data were the Mid-year student experience survey (N=60), the Hambisa Student Survey (N=85), and semi structured focus group interviews with first, second, and third year students of the Faculty of Accounting and Informatics Hambisa program. The Hambisa (“Moving forward”) focus area is part of the Siyaphumelela 2.0 project at DUT and seeks to understand the multiple challenges that are impacting student success which create a large “middle” cohort of students that are stuck in transition within academic programs. Using the lens of the sociocultural influences on student engagement framework, we conducted a thematic analysis of the two surveys and focus group interviews. Preliminary findings indicate that living conditions, choice of program, access to resources, motivation, institutional support, infrastructure, and pedagogical practices impact student engagement and, thus, student success. It is envisaged that the findings from this project will assist the university in being better prepared to enable student success.

Keywords: social and academic integration, socio-cultural influences, student engagement, student success

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Authors: Barbara Peric

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The study of acquiring a third and additional language has garnered significant focus within second language acquisition (SLA) research. Initially, it was commonly viewed as merely an extension of second language acquisition (SLA). However, in the last two decades, numerous researchers have emphasized the need to recognize the unique characteristics of third language acquisition (TLA). This recognition is crucial for understanding the intricate cognitive processes that arise from the interaction of more than two linguistic systems in the learner's mind. This study investigates cross-linguistic influences in the acquisition of Spanish as a fourth language by students who have Croatian as a first language (L1). English as a second language (L2), and Italian as a third language (L3). Observational data suggests that influence or transfer of linguistic elements can arise not only from one's native language (L1) but also from non-native languages. This implies that, for individuals proficient in multiple languages, the native language doesn't consistently hold a superior position. Instead, it should be examined alongside other potential sources of linguistic transfer. Earlier studies have demonstrated that high proficiency in a second language can significantly impact cross-linguistic influences when acquiring a third and additional language. Among the extensively examined factors, the typological relationship stands out as one of the most scrutinized variables. The goal of the present study was to explore whether language typology and formal similarity or proficiency in the second language had a more significant impact on L4 acquisition. Participants in this study were third-year undergraduate students at Rochester Institute of Technology’s subsidiary in Croatia (RIT Croatia). All the participants had exclusively Croatian as L1, English as L2, Italian as L3 and were learning Spanish as L4 at the time of the study. All the participants had a high level of proficiency in English and low level of proficiency in Italian. Based on the error analysis the findings indicate that for some types of lexical errors such as coinage, language typology had a more significant impact and Italian language was the preferred source of transfer despite the law proficiency in that language. For some other types of lexical errors, such as calques, second language proficiency had a more significant impact, and English language was the preferred source of transfer. On the other hand, Croatian, Italian, and Spanish are more similar in the area of morphology due to higher degree of inflection compared to English and the strongest influence of the Croatian language was precisely in the area of morphology. The results emphasize the need to consider linguistic resemblances between the native language (L1) and the third and additional language as well as the learners' proficiency in the second language when developing successful teaching strategies for acquiring the third and additional language. These conclusions add to the expanding knowledge in the realm of Second Language Acquisition (SLA) and offer practical insights for language educators aiming to enhance the effectiveness of learning experiences in acquiring a third and additional language.

Keywords: third and additional language acquisition, cross-linguistic influences, language proficiency, language typology

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Authors: Marina Gold, Yves Jackson, David Parrat

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The high predominance of Latin American migrants in Geneva from countries where Chagas disease is endemic (Bolivia, Brazil, Argentina, Colombia) is increasing the incidence of chronic Chagas-related problems, especially cardiovascular complications. The precarious migratory status of what are mostly undocumented migrants complicates access to health and affects patients’ and doctors’ health perceptions regarding screening, treatment and monitoring of Chagas-related health concerns. This project results from a 3 year collaboration between the Geneva University Hospital and the NGO Mundo Sano to understand the following questions: 1) how do Latin American migrants perceive their health? 2) What do they understand from Chagas disease? 3) Are patients’ and doctors’ health perceptions similar or do they have competing agendas? This paper aims to present the results of a long-term study that interrogates health perceptions among Latin American migrants in Geneva. The first phase consisted in completing surveys at three community screening events (2016, 2017. 2018), and the results of these surveys reveal the subordination of the importance of health to that of having met economic family obligation. That is, health is important only when it becomes an impediment to economic gain. The contradictory result emerged that people are aware of the importance of health prevention in order to ensure long-term health, but they do not always have agency over their life-style habits (healthy food, regular exercise, emotional stability). The second phase of the research collected open-ended interviews with selected participants, in order to explore in more detail how Latin American migrants deal with Chagas in a different socio-political and economic context to that of endemic countries. These interviews (5 in total) reveal mixed methods of managing health: social networks, access to health care transnationally (in Geneva, Spain and back in their home country), and different valuations of health problems in each situation. The third phase consisted in observations of doctor-patient consultations and further extended interviews with patients to determine doctor/patient health perceptions around Chagas disease. This phase is ongoing, but it has yielded preliminarily observations regarding the expectations that patients’ have of doctors, and the understanding of doctors’ to patients’ complex situations. Positive and complementary health perceptions include patients’ feeling that doctors in Geneva are more understanding, more knowledgeable and less racist than those in their home country, who do not provide detailed information about Chagas or its treatment and discriminate against them for being indigenous or from poor rural areas, enabling a better communication between doctors and patients. Possible conflicting health perceptions include patients addressing their health concerns more holistically and encountering the specialist’s limitations to only treating one health concern, given time limitations and lack of competition with their colleagues (the general practitioner that referred the patient, for example). The implications of this study extend the case of Chagas disease in Geneva and is relevant for all chronic concerns and migratory contexts of precarity.

Keywords: chagas disease, health perceptions, Latin American Migrants, non-endemic countries

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Authors: Nezha Badi

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It has been shown in the literature that Algerian university students suffer from low levels of reading comprehension proficiency, which hinder their overall proficiency in English. This low level is mainly related to the methodology of teaching reading which is employed by the teacher in the classroom (a teacher-centered environment), as well as students’ poor sense of self-efficacy to undertake reading comprehension activities. Arguably, what is needed is an approach necessary for enhancing students’ self-beliefs about their abilities to deal with different reading comprehension activities. This can be done by providing them with opportunities to take responsibility for their own learning (learners’ autonomy). As a result of learning autonomy, learners’ beliefs about their abilities to deal with certain language tasks may increase, and hence, their language learning ability. Therefore, this experimental research study attempts to assess the extent to which an integrated approach combining one particular reading approach known as ‘collaborative strategic reading’ (CSR), and teacher’s attributional feedback (on students’ reading performance and strategy use) can improve the reading comprehension skill and the sense of self-efficacy of EFL Algerian university students. It also seeks to examine students’ main reasons for their successful or unsuccessful achievements in reading comprehension activities, and whether students’ attributions for their reading comprehension outcomes can be modified after exposure to the instruction. To obtain the data, different tools including a reading comprehension test, questionnaires, an observation, an interview, and learning logs were used with 105 second year Algerian EFL university students. The sample of the study was divided into three groups; one control group (with no treatment), one experimental group (CSR group) who received a CSR instruction, and a second intervention group (CSR Plus group) who received teacher’s attribution feedback in addition to the CSR intervention. Students in the CSR Plus group received the same experiment as the CSR group using the same tools, except that they were asked to keep learning logs, for which teacher’s feedback on reading performance and strategy use was provided. The results of this study indicate that the CSR and the attributional feedback intervention was effective in improving students’ reading comprehension proficiency and sense of self-efficacy. However, there was not a significant change in students’ adaptive and maladaptive attributions for their success and failure d from the pre-test to the post-test phase. Analysis of the perception questionnaire, the interview, and the learning logs shows that students have positive perceptions about the CSR and the attributional feedback instruction. Based on the findings, this study, therefore, seeks to provide EFL teachers in general and Algerian EFL university teachers in particular with pedagogical implications on how to teach reading comprehension to their students to help them achieve well and feel more self-efficacious in reading comprehension activities, and in English language learning more generally.

Keywords: attributions, attributional feedback, collaborative strategic reading, self-efficacy

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Authors: Per Blomqvist

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The overall aim of this study is to highlight how the degree project-course in teacher education has developed over time at Swedish universities, above all regarding changes in the formative assessment practices in relation to student's opportunities to take part in writing processes that can develop both their independent critical thinking, subject knowledge, and academic writing skills. Theoretically, the study is based on deliberative and transformative perspectives of teaching academic writing in higher education. The deliberative perspective is motivated by the fact that it is the universities and their departments' responsibility to give the students opportunities to develop their academic writing skills, while there is little guidance on how this can be implemented. The transformative perspective is motivated by the fact that education needs to be adapted to the student's prior knowledge and developed in relation to the student group. Given the academisation of education and the new student groups, this is a necessity. The empirical data consists of video recordings of teacher groups' conversations at three Swedish universities. The conversations were conducted as so-called collective remembering interviews, a method to stimulate the participants' memory through social interaction, and focused on addressing issues on how the degree project-course in teacher education has changed over time. Topic analysis was used to analyze the conversations in order to identify common descriptions and expressions among the teachers. The result highlights great similarities in how the degree project-course has changed over time, both from a deliberative and a transformative perspective. The course is characterized by a “strong framing,” where the teachers have great control over the work through detailed instructions for the writing process and detailed templates for the text. This is justified by the fact that the education has been adapted based on the student teachers' lack of prior subject knowledge. The strong framing places high demands on continuous discussions between teachers about, for example, which tools the students have with them and which linguistic and textual tools are offered in the education. The teachers describe that such governance often leads to conflicts between teachers from different departments because reading and writing are always part of cultural contexts and are linked to different knowledge, traditions, and values. The problem that is made visible in this study raises questions about how students' opportunities to develop independence and make critical judgments in academic writing are affected if the writing becomes too controlled and if passing students becomes the main goal of education.

Keywords: formative assessment, academic writing, degree project, higher education, deliberative perspective, transformative perspective

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