Search results for: healthcare students

Authors: Ye Sun, Han-Youl Lee, Kathy Musa-Veloso, Nabil Bosco

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Japan has been experiencing global ageing of population with the World’s leading life expectancy (80.8 y for men and 86.9 y for women) and among the lowest birth rate. Preventive nutrition-based approaches have been identified by the health authorities as one of the strategies to increase the healthy life expectancy and reduce the healthcare costs. However, the nutritional needs and status of the senior population have not been well characterized to provide targeted solutions. This study aims to describe the age- and gender-specific prevalence of inadequacy of macro- and micronutrients intake based on the latest Japan National Health and Nutrition Survey (JNHNS) 2014. JNHNS collected data on the consumption of foods and beverages using 1-day semi-weight household dietary record. Nutrient intake levels were then calculated using the Japanese standard tables of food composition. Where applicable, Japanese population-specific estimated average requirements (EAR) were used as a benchmark to determine the prevalence of potential nutrient intake inadequacy, and adequate intake (AI) were used for nutrients with no available EARs. In all, 3403 senior adults aged 60 y and above and 3324 young adults aged 19 to 59 y were included in the 2014 JNHNS. Age- and gender-specific differences were observed in the mean nutrient intakes as well as the prevalence of inadequacy. Among the 22 nutrients examined, the prevalence of inadequacy for iron, vitamin C, magnesium, potassium, and folic acid in the senior adults was significantly lower than young adults, suggesting potentially healthier dietary choices by the seniors. However, there was still a considerable proportion of seniors who did not meet the requirement for key nutrients like vitamin B1 (67%), calcium (57%), vitamin A (48%), magnesium (47%), vitamin E (44%), and vitamin B6 (41%). Inadequate nutrient intake is generally more prevalent among elderly males than females for many nutrients, with the exception of iron (prevalence of inadequacy: 21% versus 42%) which could partly be explained by the higher intake recommendations for the females. In conclusion, high prevalence of nutrient inadequacy exists in older adults, with a potentially worsened picture for men. Such inadequacies could have multiple health implications including physical frailty and mental health. Further study is warranted to investigate the food consumption patterns that could explain the observed nutrient inadequacies, and to eventually develop nutrition-based solutions tailored to the needs of specific subgroups of the population.

Keywords: ageing, national health and nutrition survey, nutrients, nutrition

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Authors: Bernard Vaernes

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Creativity is thought to be of importance for educational success. Educational institutions vary greatly in regard to socioeconomic status (SES) and curricular emphasis on creativity. Research is needed to clarify the effects of age and SES on creativity. The objective of this study will be to compare the creative performance of children with different SES, low or high, and age. It is hypothesized that younger children will score higher than older children, independent of their SES. Children aged 15, 12, and 9 from four different junior and secondary schools in Warsaw, Poland, will participate in the study. The schools will differ in terms of socioeconomic, geographic localization. To assess creative performance, a Polish adaptation of the Torrance Test of Creative Thinking (TTCT) will be used. In order to select low and high SES individuals for SES grouping, a Polish adaptation of the MacArthur Scale of Subjective Social Status will be given to all participants. To control for individual differences in personality traits, a Polish adaptation of the Big Five Questionnaire for Children (BFQ-C) will be used. These measures will allow to compare the creative performance of children with different age and SES and eliminate confound variables. It is predicted that younger children, as well as high SES children, will score higher on the TTCT than older children, and low SES children. The findings of this study may provide useful insight into socioeconomic and age differences in creativity, as well as facilitating teacher’s adjustment of learning styles and emphasis on creativity in relation to the SES and age of their students.

Keywords: big five questionnaire for children, children, creativity, socioeconomic status, Torrance test of creative thinking, TTCT

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Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

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The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

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Authors: Sarayu Agarwal

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This paper aims to teach English (secondary language) by bridging the understanding between the Regional language (primary language) and the English Language (secondary language). Here primary language is the one a person has learned from birth or within the critical period, while secondary language would be any other language one learns or speaks. The paper also focuses on evolving old teaching methods to a contemporary participatory model of learning and teaching. Pilot studies were conducted to gauge an understanding of student’s knowledge of the English language. Teachers and students were interviewed and their academic curriculum was assessed as a part of the initial study. Extensive literature study and design thinking principles were used to devise a solution to the problem. The objective is met using a holistic learning kit/card game to teach children word recognition, word pronunciation, word spelling and writing words. Implication of the paper is a noticeable improvement in the understanding and grasping of English language. With increasing usage and applicability of English as a second language (ESL) world over, the paper becomes relevant due to its easy replicability to any other primary or secondary language. Future scope of this paper would be transforming the idea of participatory learning into self-regulated learning methods. With the upcoming govt. learning centres in rural areas and provision of smart devices such as tablets, the development of the card games into digital applications seems very feasible.

Keywords: English as a second language, vocabulary-building card games, learning through gamification, rural education

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Authors: Gaya Tridinanti

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Enhanching English vocabulary in early childhood is the main problem often faced by teachers. Thus, the purpose of this study was to determine the enhancement of children’s English vocabulary acquisition by using digital storytelling. This type of research was an action research. It consisted of a series of four activities done in repeated cycles: planning, implementation, observation, and reflection. The subject of the study consisted of 30 students of B group (5-6 years old) attending Happy Kids Kindergarten Palembang, Indonesia. This research was conducted in three cycles. The methods used for data collection were observation and documentation. Descriptive qualitative and quantitative methods were also used to analyse the data. The research showed that the digital storytelling learning activities could enhance the children’s English vocabulary acquisition. It is based on the data in which the enhancement in pre-cycle was 37% and 51% in Cycle I. In Cycle II it was 71% and in Cycle III it was 89.3%. The results showed an enhancement of about 14% from the pre-cycle to Cycle I, 20% from Cycle I to Cycle II, and enhancement of about 18.3% from Cycle II to Cycle III. The conclusion of this study suggests that digital storytelling learning method could enhance the English vocabulary acquisition of B group children at the Happy Kids Kindergarten Palembang. Therefore, digital storytelling can be considered as an alternative to improve English language learning in the classroom.

Keywords: acquisition, enhancing, digital storytelling, English vocabulary

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Authors: Ana Nascimento

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For several reasons and in different countries worldwide, there is an increasing difficulty of the States to finance higher education. However, most societies consider education as a public good, so it should be a State obligation to provide this service to citizens. In Portugal, over the last decades, state has diminished its contribution to public higher education and the public higher education institutions started to look for alternative incoming sources, namely charging student’s taxes and fees, provision of services to companies, production of applied research, search for sponsors, configuring new forms of fundraising. This financial policy can raise some concerns to the scientific and pedagogical autonomy of these institutions as well as concerns in access and equity in higher education. For these reasons and in the scope of a PhD research in the area of Economy of Education, a survey is taking place in all public higher education institutions in the Great Lisbon area that intends to analyze and discuss the policy measures in each institution in the search for external financing. The research aims to understand what these measures are and what implications they might have in the institution’s autonomy as well as in higher education access by students from less favored backgrounds. The research uses a qualitative approach, namely through semi-structured interviews to presidents, directors and rectors of each institution, totalizing 50 interviews. In this paper are discussed some of the results from the interviews made so far that present the subjects opinion about higher education finance, the right to education, the search for fundraising and the possible consequences to the institution’s autonomy as well as some literature on the state of the art.

Keywords: autonomy, finance, higher education, public goods

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Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

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Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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Authors: Thaiurie Govender, Shannon Verne

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The Fourth Industrial Revolution has ushered in an era where technology significantly impacts various aspects of life, including higher education. Blended learning, which combines synchronous and asynchronous learning, has gained popularity as a pedagogical approach. However, its effective implementation is a challenge, particularly in the context of the COVID-19 pandemic and technological obstacles faced in South Africa. This study focused on lecturers' teaching and learning practices to implement blended learning, aiming to understand the teaching and learning strategies used with the integration of digital tools to facilitate the blended learning approach within a private higher educational institution in South Africa. Using heutagogy and constructivism theoretical frameworks, the study aimed to uncover insights into the lecturer’s teaching and learning practices to overcome challenges in designing and facilitating blended learning modules. Through a qualitative analysis, the themes of student engagement, teaching and learning strategies, digital tools, and feedback emerged, highlighting the complexities and opportunities in a blended learning classroom. The findings emphasize the importance of tailoring methods to students' needs and subject matter, aligning with constructivist principles. Recommendations include promoting professional development opportunities, addressing infrastructure issues, and fostering a supportive learning environment.

Keywords: blended learning, digital tools, higher education, teaching strategies

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Authors: Abdullah Mohammadi

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Years of prolong war in Afghanistan has led to one of the largest refugee and migrant populations in the contemporary world. During this continuous unrest which began in 1970s (by military coup, Marxist revolution and the subsequent invasion of USSR), over one-third of the population migrated to neighboring countries, especially Pakistan and Iran. After the Soviet Army withdrawal in 1989, a new wave of conflicts emerged between rival Afghan groups and this led to new refugees. Taliban period, also, created its own refugees. During all these years, I.R. of Iran has been one of the main destinations of Afghan refugees and migrants. At first, due to the political situation after Islamic Revolution, Iran government didn’t restrict the entry of Afghan refugees. Those who came first in Iran received ID cards and had access to education and healthcare services. But in 1990s, due to economic and social concerns, Iran’s policy towards Afghan refugees and migrants changed. The government has tried to identify and register Afghans in Iran and limit their access to some services and jobs. Unfortunately, there are few studies on Afghan refugees and migrants’ situation in Iran and we have a dim and vague picture of them. Of the few studies done on this group, none of them focus on the illegal Afghan migrants’ situation in Iran. Here, we tried to study the social and economic aspects of illegal Afghan migrants’ living in Iran. In doing so, we interviewed 24 illegal Afghan migrants in Iran. The method applied for analyzing the data is thematic analysis. For the interviews, we chose family heads (17 men and 7 women). According to the findings, illegal Afghan migrants’ socio-economic situation in Iran is very undesirable. Its main cause is the marginalization of this group which is resulted from government policies towards Afghan migrants. Most of the illegal Afghan migrants work in unskilled and inferior jobs and live in rent houses on the margins of cities and villages. None of them could buy a house or vehicle due to law. Based on their income, they form one of the lowest, unprivileged groups in the society. Socially, they face many problems in their everyday life: social insecurity, harassment and violence, misuse of their situation by police and people, lack of education opportunity, etc. In general, we may conclude that illegal Afghan migrant have little adaptation with Iran’s society. They face severe limitations compared to legal migrants and refugees and have no opportunity for upward social mobility. However, they have managed some strategies to face these difficulties including: seeking financial and emotional helps from family and friendship networks, sending one of the family members to third country (mostly to European countries), establishing self-administered schools for children (schools which are illegal and run by Afghan educated youth).

Keywords: illegal Afghan migrants, marginalization, social insecurity, upward social mobility

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Authors: Mariyan Tomov

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Bulgarian working class immigrants are increasingly concerned with UK’s recent immigration policies in the context of Brexit. The new ID system would exclude many people currently working in Britain and would break the usual immigrant travel patterns. Post-Brexit Britain would aim to repeal seasonal immigrants. Measures for keeping long-term and life-long immigrants have been implemented and migrants that aim to remain in Britain and establish a household there would be more privileged than temporary or seasonal workers. The results of such regulating mechanisms come at the expense of migrants’ longings for a ‘normal’ existence, especially for those coming from Central and Eastern Europe. Based on in-depth interviews with Bulgarian working class immigrants, the study found out that their major concerns following the decision of the UK to leave the EU are related with the freedom to travel, reside and work in the UK. Furthermore, many of the interviewed women are concerned that they could lose some of the EU's fundamental rights, such as maternity and protection of pregnant women from unlawful dismissal. The soar of commodity prices and university fees and the limited access to public services, healthcare and social benefits in the UK, are also subject to discussion in the paper. The most serious problem, according to the interview, is that the attitude towards Bulgarians and other immigrants in the UK is deteriorating. Both traditional and social media in the UK often portray the migrants negatively by claiming that they take British job positions while simultaneously abuse the welfare system. As a result, the Bulgarian migrants often face social exclusion, which might have negative influence on their health and welfare. In this sense, some of the interviewed stress on the fact that the most important changes after Brexit must take place in British society itself. The aim of the proposed study is to provide a better understanding of the Bulgarian migrants’ economic, health and sociocultural experience in the context of Brexit. Methodologically, the proposed paper leans on: 1. Analysing ethnographic materials dedicated to the pre- and post-migratory experiences of Bulgarian working class migrants, using SPSS. 2. Semi-structured interviews are conducted with more than 50 Bulgarian working class migrants [N > 50] in the UK, between 18 and 65 years. The communication with the interviewees was possible via Viber/Skype or face-to-face interaction. 3. The analysis is guided by theoretical frameworks. The paper has been developed within the framework of the research projects of the National Scientific Fund of Bulgaria: DCOST 01/25-20.02.2017 supporting COST Action CA16111 ‘International Ethnic and Immigrant Minorities Survey Data Network’.

Keywords: Bulgarian migrants in UK, economic experiences, sociocultural experiences, Brexit

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Authors: Hye-Kyung Kang

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Social justice is a central principle of the social work profession and education. However, scholars have long questioned the profession’s commitment to putting social justice values into practice. Clinical social work has been particularly criticized for its lack of attention to social justice and for failing to address the concerns of the oppressed. One prominent criticism of clinical social work is that it often relies on individual intervention and fails to take on system-level changes or advocacy. This concern evokes the historical macro-micro tension of the social work profession where micro (e.g., mental health counseling) and macro (e.g., policy advocacy) practices are conceptualized as separate domains, creating a false binary for social workers. One contributor to this false binary seems to be that most clinical practice models do not prepare social work students and practitioners to make a clear link between clinical practice and social justice. This paper presents a model of clinical social work practice that clearly recognizes the essential and necessary connection between social justice, advocacy, and clinical practice throughout the clinical process: engagement, assessment, intervention, and evaluation. Contemporary relational theories, critical social work frameworks, and anti-oppressive practice approaches are integrated to build a clinical social work practice model that addresses the urgent need for mental health practice that not only helps and heals the person but also challenges societal oppressions and aims to change them. The application of the model is presented through case vignettes.

Keywords: social justice, clinical social work, clinical social work model, integrative model

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Authors: Mishack Thiza Gumbo

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The participatory action research study reported in this paper aims to explore indigenous mathematics, science, and technology to develop an indigenous Mathematics, Science and Technology Education Master’s Programme ultimately. The study is based on an ongoing collaborative project between the Mathematics, Science and Technology Education Departments of the University of South Africa, University of Botswana and Chinhoyi University of Technology. The study targets the Mathematics, Science and Technology Education Master’s students and indigenous knowledge holders in these three contexts as research participants. They will be interviewed; documents of existing Mathematics, Science and Technology Education Master’s Programmes will be analysed; mathematics, science and technology-related artefacts will also be collected and analysed. Mathematics, Science, and Technology Education are traditionally referred to as gateway subjects because the world economy revolves around them. Scores of scholars call for the indigenisation of research and methodologies so that research can suit and advance indigenous knowledge and sustainable development. There are ethnomathematics, ethnoscience and ethnotechnology which exist in indigenous contexts such as blacksmithing, woodcarving, textile-weaving and dyeing, but the current curricula and research in institutions of learning reflect the Western notions of these subjects. Indigenisation of the academic programmecontributes toward the decolonisation of education. Hence, the development of an indigenous Mathematics, Science and Technology Education Master’s Programme, which will be jointly offered by the three universities mentioned above, will contribute to the transformation of higher education in this sense.

Keywords: indigenous, mathematics, science, technology, master's program, universities, collaboration

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Authors: Desjardin, Michaels, Martinez, Ulmann

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Copper IUD is one of the most efficient and cost-effective contraception. However, pain at insertion hampers the use of this method. This is especially unfortunate in nulliparous women, often younger, who are excellent candidates for this contraception, including Emergency Contraception. Standard insertion procedure of a copper IUD usually involves measurement of uterine cavity with an hysterometer and the use of a tenaculum in order to facilitate device insertion. Both procedures lead to patient pain which often constitutes a limitation of the method. To overcome these issues, we have developed a modified insertor combined with a copper IUD. The singular design of the inserter includes a flexible inflatable membrane technology allowing an easy access to the uterine cavity even in case of abnormal uterine positions or narrow cervical canal. Moreover, this inserter makes possible a direct IUD insertion with no hysterometry and no need for tenaculum. To assess device effectiveness and patient-reported pain, a study was conducted at two clinics in Fance with 31 individuals who wanted to use a copper IUD as contraceptive method. IUD insertions have been performed by four healthcare providers. Operators completed questionnaire and evaluated effectiveness of the procedure (including IUD correct fundal placement and other usability questions) as their satisfaction. Patient also completed questionnaire and pain during procedure was measured on a 10-cm Visual Analogue Scale (VAS). Analysis of the questionnaires indicates that correct IUD placement took place in more than 93% of women, which is a standard efficacy rate. It also demonstrates that IUD insertion resulted in no, light or moderate pain predominantly in nulliparous women. No insertion resulted in severe pain (none above 6cm on a 10-cm VAS). This translated by a high level of satisfaction from both patients and practitioners. In addition, this modified inserter allowed a simplification of the insertion procedure: correct fundal placement was ensured with no need for hysterometry (100%) prior to insertion nor for cervical tenaculum to pull on the cervix (90%). Avoidance of both procedures contributed to the decrease in pain during insertion. Taken together, the results of the study demonstrate that this device constitutes a significant advance in the use of copper IUDs for any woman. It allows a simplification of the insertion procedure: there is no need for pre-insertion hysterometry and no need for traction on the cervix with tenaculum. Increased comfort during insertion should allow a wider use of the method for nulliparous women and for emergency contraception. In addition, pain is often underestimated by practitioners, but fear of pain is obviously one of the blocking factors as indicated by the analysis of the questionnaire. This evaluation brings interesting information on the use of this modified inserter for standard copper IUD and promising perspectives to set up a changement in the standard of IUD insertion procedure.

Keywords: contraceptio, IUD, innovation, pain

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Authors: Mohamed Muse Hassan

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Selling through the Internet is changing the norms of doing business globally. Today, selling and buying from the Internet is not only an option but the dominant form of shopping. But, this phenomenon is not thriving in the developing countries, mainly in Africa. Therefore, although previous studies focused on the e-retailers’ side, this study investigates the effect of consumer trust and online payment options on the awareness and perception of e-commerce in Africa. We developed a five-construct model and empirically tested the model by targeting professionals and college students who reside in Somalia. We employed structural equation modeling (SEM) technique for path analysis to probe answers for the variables under study. The main findings of the study show that there is significant evidence that online payment option impacts both the awareness level and perception of e-commerce in Somalia. Consumer trust was also found to determine both the awareness and perception of online shopping in the country. Moreover, the current global payment options available ignore local technologies popular in Africa. For example, the inclusion of a mobile payment option alone would make a big difference in Africa. The paper also determined that consumer trust toward online retailers is very low and this can be solved if consumers are given assurances for their financial transactions. The paper concludes that increased online payment options are needed in Somalia and, in Africa, in general. Limitations and further research suggestions are also included at the end of this paper.

Keywords: Africa, consumer trust, e-commerce, online payment

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Authors: Noha Hamie Haidar

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The purpose of this case study was to explore faculty attitudes toward online learning in a Lebanese Higher Education Institution (HEI). The research problem addressed the disinterest among faculty at the Arts, Sciences, and Technology University of Lebanon (AUL) in enhancing learning using online technology. The research questions for the study examined the attitudes of the faculty toward applying online learning and the extent of the faculty readiness to adopt this technological change. A qualitative case study design was used that employed multiple sources of information including semi-structured interviews and existing literature. The target population was AUL faculty including full-time instructors and administration (n=25). Data analysis was guided by the lens of Kanter’s theoretical approach, which focused on faculty’s awareness, desire, knowledge, ability, and reinforcement model (ADKAR) for adopting change. Key findings indicated negative impressions concerning online learning such as authority (ministry of education, culture, and rules); and change (increased enrollment and different teaching styles). Yet, within AUL’s academic environment, the opportunity for the adoption of online learning was identified; faculty showed positive elements, such as the competitive advantage to first enter the Lebanese Market, and higher student enrollment. These results may encourage AUL’s faculty to adopt online learning and to achieve a positive social change by expanding the ability of students in HEIs to compete globally.

Keywords: faculty, higher education, technology, online learning

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Authors: Rashmi Motwani, Ritu Raj

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The emergence of online educational environments has changed the way adolescents learn, which has benefits and drawbacks for their development. This review has as its goal the examination of how personality traits and adolescents’ well-being are associated in the setting of online education. This review analyses the effects of a variety of personality traits on the mental, emotional, and social health of online school-going adolescents by looking at a wide range of previous research. This research explores the mechanisms that mediate or regulate the connection between one's personality traits and well-being in an online educational environment. The elements can be broken down into two categories: technological, like internet availability and digital literacy, and social, including social support, peer interaction, and teacher-student connections. To improve the well-being of adolescents in online learning environments, it is essential to understand factors that moderate the effects of interventions and support systems. This review concludes by emphasising the complex nature of the association between individual differences in personality and the success of online students aged 13 to 18. This review contributes to the development of evidence-based strategies for promoting positive mental health and overall well-being among adolescents engaged in online educational settings by shedding light on the impact of personality traits on various dimensions of well-being and by identifying the mediating or moderating factors. Educators, governments, and parents can use the findings of this review to create an online learning environment that is safe and well-being for adolescents.

Keywords: personality traits, adolescent, wellbeing, online education

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Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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Authors: Ashima Sharma, Tapan K. Chaudhuri

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Human Serum Albumin (HSA) is one of the most demanded therapeutic protein with immense biotechnological applications. The current source of HSA is human blood plasma. Blood is a limited and an unsafe source as it possesses the risk of contamination by various blood derived pathogens. This issue led to exploitation of various hosts with the aim to obtain an alternative source for the production of the rHSA. But, till now no host has been proven to be effective commercially for rHSA production because of their respective limitations. Thus, there exists an indispensable need to promote non-animal derived rHSA production. Of all the host systems, Escherichia coli is one of the most convenient hosts which has contributed in the production of more than 30% of the FDA approved recombinant pharmaceuticals. E. coli grows rapidly and its culture reaches high cell density using inexpensive and simple substrates. The fermentation batch turnaround number for E. coli culture is 300 per year, which is far greater than any of the host systems available. Therefore, E. coli derived recombinant products have more economical potential as fermentation processes are cheaper compared to the other expression hosts available. Despite of all the mentioned advantages, E. coli had not been successfully adopted as a host for rHSA production. The major bottleneck in exploiting E. coli as a host for rHSA production was aggregation i.e. majority of the expressed recombinant protein was forming inclusion bodies (more than 90% of the total expressed rHSA) in the E. coli cytosol. Recovery of functional rHSA form inclusion body is not preferred because it is tedious, time consuming, laborious and expensive. Because of this limitation, E. coli host system was neglected for rHSA production for last few decades. Considering the advantages of E. coli as a host, the present work has targeted E. coli as an alternate host for rHSA production through resolving the major issue of inclusion body formation associated with it. In the present study, we have developed a novel and innovative method for enhanced soluble and functional production of rHSA in E.coli (~60% of the total expressed rHSA in the soluble fraction) through modulation of the cellular growth, folding and environmental parameters, thereby leading to significantly improved and enhanced -expression levels as well as the functional and soluble proportion of the total expressed rHSA in the cytosolic fraction of the host. Therefore, in the present case we have filled in the gap in the literature, by exploiting the most well studied host system Escherichia coli which is of low cost, fast growing, scalable and ‘yet neglected’, for the enhancement of functional production of HSA- one of the most crucial biomolecule for clinical and biotechnological applications.

Keywords: enhanced functional production of rHSA in E. coli, recombinant human serum albumin, recombinant protein expression, recombinant protein processing

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Authors: Susan Lewis

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The assessment of learning outcomes at the program level has attracted much international interest from the perspectives of quality assurance and ongoing curricular redesign and renewal. This paper examines program-level learning outcomes in the field of music and technology, an area of study that has seen an explosion in program development over the past fifteen years. The Audio Engineering Society (AES) maintains an online directory of educational institutions worldwide, yielding the most comprehensive inventory of programs and courses in music and technology. The inventory includes courses, programs, and degrees in music and technology, music and computer science, music production, and the music industry. This paper focuses on published student learning outcomes for undergraduate degrees in music and technology and analyses commonalities at institutions in North America, the United Kingdom, and Europe. The results of a survey of student learning outcomes at twenty institutions indicates a focus on three distinct student learning outcomes: (1) cross-disciplinary knowledge in the fields of music and technology; (2) the practical application of training through the professional industry; and (3) the acquisition of skills in communication and collaboration. The paper then analyses assessment mechanisms for tracking student learning and achievement of learning outcomes at these institutions. The results indicate highly variable assessment practices. Conclusions offer recommendations for enhancing assessment techniques and better communicating learning outcomes to students.

Keywords: quality assurance, student learning; learning outcomes, music and technology

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Authors: Mbah Fidelix Njong, Sabi Emile Forkwa

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Social cognition is an aspect of social psychology that focuses on how people process, store and apply information about others and social situations. It lay emphasis on how cognitive processes play in our social interactions. In this article, we try to show how culture can influence our ways of thinking about others, how we feel and interact with the world around us. Social cognitive processes involve perceiving people and how we learn about the people around us. It concerns the mental processes of remembering, thinking and attending to other people with different cultural backgrounds and how we attend to certain information about the world. Especially in an educational setting, students’ learning processes are most often than not influenced by their cultural background. We can also talk of social schemas. That’s people’s mental representation of social patterns and norms. This involves information about the societal role and the expectations of individuals within a group. These cognitive processes can also be influence by culture. There are important cultural differences in social cognition. In any social situation, two individuals may have different interpretations. Each person brings in a unique background of experiences, knowledge, social influence, feelings and cultural variations. Cultural differences can also affect how people interpret social situations. The same social behavior in one cultural setting might have completely different meaning and interpretation if observed or applied in another culture. However, as people interpret behaviors and bring out meaning from the interpretations, they act based on their beliefs about situations they are confronted with. This helps to reinforce and reproduce the cultural norms that influence their social cognition.

Keywords: social cognition, social schema, cultural influence, psychology

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Authors: Rosa Buxeda, Lorenzo Saliceti-Piazza, Rodolfo J. Romañach, Luis Ríos, Sandra L. Maldonado-Ramírez

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Biopharmaceuticals manufacturing is one of the major economic activities worldwide. Ninety-three percent of the workforce in a biomanufacturing environment concentrates in production-related areas. As a result, strategic collaborations between industry and academia are crucial to ensure the availability of knowledgeable workforce needed in an economic region to become competitive in biomanufacturing. In the past decade, our institution has been a key strategic partner with multinational biotechnology companies in supplying science and engineering graduates in the field of industrial biotechnology. Initiatives addressing all levels of the educational pipeline, from K-12 to college to continued education for company employees have been established along a ten-year span. The Amgen BioTalents Program was designed to provide undergraduate science and engineering students with training in biomanufacturing. The areas targeted by this educational program enhance their academic development, since these topics are not part of their traditional science and engineering curricula. The educational curriculum involved the process of producing a biomolecule from the genetic engineering of cells to the production of an especially targeted polypeptide, protein expression and purification, to quality control, and validation. This paper will report and describe the implementation details and outcomes of the first sessions of the program.

Keywords: biomanufacturing curriculum, interdisciplinary learning, workforce development, industry-academia partnering

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Authors: Syue-Wen Lin

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Objective: This article discusses the nursing experience of caring for a uterine cancer patient who experienced cardiogenic shock and was weaned off ECMO. The patient was placed on ECMO due to cardiogenic shock and initially struggled with anxiety caused by the physical discomfort from the disease and multiple medical devices, as well as the isolation in the ICU and restrictions on physical activity. Over time, the patient was able to wean off ECMO and perform daily activities and rehabilitation independently. Methods: The nursing period was from January 6 to January 9. Through observation, direct care, interviews, physical assessments, and case reviews, the intensive care team and bypass personnel conducted a comprehensive assessment using Gordon's 11 functional health patterns. The assessment identified three main nursing health problems: pain, anxiety, and decreased cardiac tissue perfusion. Results: The author consulted a psychologist to employ open communication techniques and empathetic care to build a trusting nurse-patient relationship. A patient-centered intensive cancer care plan was developed. Pain was assessed using a pain scale, and pain medications were adjusted in consultation with a pharmacist. Lavender essential oil therapy, light music, and pillows were used to distract and alleviate pain. The patient was encouraged to express feelings and family members were invited to increase visits and provide companionship to reduce the uncertainty caused by cancer and illness. Vital signs were closely monitored, and nursing interventions were provided to maintain adequate myocardial perfusion. Post-ECMO, the patient was encouraged to engage in rehabilitation and cardiopulmonary training. Conclusion: A key takeaway from the care process is the importance of observing not only the patient's vital signs but also their psychological state, especially when dealing with cancer patients on ECMO. The patient's greatest source of comfort was the presence of family, which helped alleviate anxiety. Healthcare providers play multiple critical roles as advocates, coordinators, educators, and counselors, listening to and accepting the patient’s emotional responses. The report aims to provide clinical cancer nurses with a reference to improve the quality of care and alleviate cancer-related discomfort.

Keywords: ECMO, uterine cancer, palliative care, Gordon's 11 functional health patterns

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Authors: Haftom Teshale Gebre

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According to the ministry of education’s school improvement program blueprint document (2007), the timely and basic aim of the program is to improve students’ academic achievement through creating conducive teaching and learning environments and with the active involvement of parents in the teaching and learning process. The general objective of the research is to examine the practices of cluster school supervisors in implementing school improvement programs and the major factors affecting the study area. The study used both primary and secondary sources, and the sample size was 93. Twelve people are chosen from each of the two clusters (Edaga Hamus and Adi-kelebes). And cluster ferewyni are Tekli suwaat, Edaga robue, and Kiros Alemayo. In the analysis stage, several interrelated pieces of information were summarized and arranged to make the analysis easily manageable by using statistics and data (STATA). Study findings revealed that the major four domains impacted by school improvement programs through their mean, standard deviation, and variance were 2.688172, 1.052724, and 1.108228, respectively. And also, the researcher can conclude that the major factors of the school improvement program and mostly cluster supervisors were inadequate attention given to supervision service and no experience in the practice of supervision in the study area.

Keywords: cluster, eastern Tigray, Saesie Tsaeda Emba, SPI

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

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Authors: Colm Barcoe, Garvan Whelan

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The purpose of this paper is to investigate the impact that US TV and movies have had on Irish tourism. This study examines how a destination marketing organisation (DMO) can use social media channels to capitalise upon the opportunities created by film tourism as it pertains to North American TV and movie productions. The findings are based on a combination of two qualitative methods, in-depth interviews with 20 industry professionals and a Netnographic analysis of social media activity between Tourism Ireland and the North American audience on Facebook and Twitter. The qualitative data were analysed in order to provide insights into the effectiveness of using North American pop culture as part of a digital marketing strategy when creating awareness of Ireland as a brand in the US and Canada. This study addresses a gap in the literature in relation to the use of social media when attracting the North American holidaymaker to Ireland. The findings from this investigation will extend an under-researched body of literature pertaining to Ireland as a destination and the successful digital marketing campaigns that have achieved exponential growth in this sector over the past five years. The empirical evidence presented also illustrates how the innovative use of social media has assisted the DMO to engage with the North American holidaymaker as part of an effective digital marketing strategy. This paper will be of value to academics and industry practitioners interested in film-induced tourism and indeed tourism in general, as well as students.

Keywords: digital marketing, tourism, strategies, movies, US TV

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Authors: Martha Wilson

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With the peak of Computer-Assisted Language Learning slowly coming to pass and Mobile-Assisted Language Learning, at times, a bit lacking in the communicative department, we are now faced with a challenging question: How can we engage the interest of our digital native students and, most importantly, sustain it? As previously mentioned, our classrooms are now experiencing an influx of “digital natives” – people who have grown up using and having unlimited access to technology. While modernizing our curriculum and digitalizing our classrooms are necessary in order to accommodate this new learning style, it is a huge financial burden and a massive undertaking for language institutes. Instead, opting for a more compact, simple, yet multidimensional pedagogical tool may be the solution to the issue at hand. This paper aims to give a brief overview into an existing device referred to as Student Response Systems (SRS) and to expand on this notion to include a new prototype of response system that will be designed as a mobile application to eliminate the need for costly hardware and software. Additionally, an analysis into recent attempts by other institutes to develop the Mobile Response System (MRS) and customer reviews of the existing MRSs will be provided, as well as the lessons learned from those projects. Finally, while the new model of MRS is still in its infancy stage, this paper will discuss the implications of incorporating such an application as a tool to support and to enrich traditional techniques and also offer practical classroom applications with the existing response systems that are immediately available on the market.

Keywords: app, clickers, mobile app, mobile response system, student response system

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Authors: Maria Zinnia Bardas Hoffmann

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Contrastive Analysis (CA) is the systematic comparison between two languages. It stems from the notion that errors are caused by interference of the L1 system in the acquisition process of an L2. CA represents a useful tool to understand the nature of learning and acquisition. Also, this particular method promises a path to un-derstand the nature of underlying cognitive processes, even when other factors such as intrinsic motivation and teaching strategies were found to best explain student’s problems in acquisition. CA study is justified not only from the need to get a deeper understanding of the nature of SLA, but as an invaluable source to provide clues, at a cognitive level, for those general processes involved in rule formation and abstract thought. It is relevant for cross disciplinary studies and the fields of Computational Thought, Natural Language processing, Applied Linguistics, Cognitive Linguistics and Math Theory. That being said, this paper intends to address here as well its own set of constraints and limitations. Finally, this paper: (a) aims at identifying some of the difficulties students may find in their learning process due to the nature of their specific variety of L1, Rio de la Plata Spanish (RPS), (b) represents an attempt to discuss the necessity for specific models to approach CA.

Keywords: second language acquisition, applied linguistics, contrastive analysis, applied contrastive analysis English language department, meta-linguistic rules, cross-linguistics studies, computational thought, natural language processing

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Authors: Aksana N. Popel, Volha A. Sujayeva, Olga V. Kоshlataja, Irеna S. Karpava

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Introduction: It is a known fact that cardiovascular pathology and its complications cause a more severe course and worse prognosis in patients with comorbid kidney pathology. Chronic kidney disease (CKD) is associated with inflammation, endothelial dysfunction, and increased activity of the sympathoadrenal system. This circumstance increases the risk of cardiovascular diseases and the progression of kidney pathology. The above determines the need to identify cardiorenal changes at early stages to reduce the risks of cardiovascular complications and the progression of CKD. Objective: To identify risk factors (RF) for the development of CKD in elderly patients with chronic ischemic heart disease (CIHD). Methods: The study included 64 patients (40 women and 24 men) with a mean age of 74.4±4.5 years with coronary heart disease, without a history of structural kidney pathology and CKD. All patients underwent transthoracic echocardiography (TTE) and kidney ultrasound (KU) using GE Vivid 9 equipment (GE HealthCare, USA), and cardiac computed tomography (CCT) using Siemens Somatom Force equipment (Siemens Healthineers AG, Germany) in 3 months and in 1 year. Data obtained were analyzed using multiple regression analysis and nonparametric Mann-Whitney test. Statistical analysis was performed using the STATISTICA 12.0 program (StatSoft Inc.). Results: Initially, CKD was not diagnosed in all patients. In 3 months, CKD was diagnosed: stage C1 had 11 people (18%), stage C2 had 4 people (6%), stage C3A had 11 people (18%), stage C3B had 2 people (3%). After 1 year, CKD was diagnosed: stage C1 had 22 people (35%), stage C2 had 5 people (8%), stage C3A had 17 people (27%), stage C3B had 10 people (15%). In 3 months, statistically significant (p<0.05) risk factors were: 1) according to TTE: mitral peak E-wave velocity (U=678, p=0.039), mitral E-velocity DT (U=514, p=0.0168), mitral peak A-wave velocity (U=682, p=0.013). In 1 year, statistically significant (p<0.05) risk factors were: according to TTE: left ventricular (LV) end-systolic volume in B-mode (U=134, p=0.006), LV end-diastolic volume in B-mode (U=177, p=0.04), LV ejection fraction in B-mode (U=135, p=0.006), left atrial volume (U=178, p=0.021), LV hypertrophy (U=294, p=0.04), mitral valve (MV) fibrosis (U=328, p=0.01); according CCT: epicardial fat thickness (EFT) on the right ventricle (U=8, p=0.015); according to KU: interlobar renal artery resistance index (RI) (U=224, p=0.02), segmental renal artery RI (U=409, p=0.016). Conclusions: Both TTE and KU are very informative methods to determine the additional risk factors of CKD development and progression. The most informative risk factors were LV global systolic and diastolic functions, LV and LA volumes. LV hypertrophy, MV fibrosis, interlobar renal artery and segmental renal artery RIs, EFT.

Keywords: chronic kidney disease, ischemic heart disease, prognosis, risk factors

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