Search results for: education game

Authors: Upasana G. Singh, Meera Gungea

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Learning is no more confined to the traditional classroom, teacher, and student interaction. Many universities offer courses through the Open and Distance Learning (ODL) mode, attracting a diversity of learners in terms of age, gender, and profession to name a few. The ODL mode has surfaced as one of the famous sought-after modes of learning, allowing learners to invest in their educational growth without hampering their personal and professional commitments. This mode of learning, however, requires that those who ultimately choose to adopt it must be prepared to undertake studies through such medium. The purpose of this research is to assess whether students who join universities offering courses through the ODL mode are ready to embark and study within such a framework. This study will be helpful to unveil the challenges students face in such an environment and thus contribute to developing a framework to ease adoption and integration into the ODL environment. Prior to the implementation of e-learning, a readiness assessment is essential for any institution that wants to adopt any form of e-learning. Various e-learning readiness assessment models have been developed over the years. However, this study is based on a conceptual model for e-Learning Readiness Assessment which is a ‘hybrid model’. This hybrid model consists of 4 main parameters: 1) Technological readiness, 2) Culture readiness, 3) Content readiness, and 4) Demographics factors, with 4 sub-areas, namely, technology, innovation, people and self-development. The model also includes the attitudes of users towards the adoption of e-learning as an important aspect of assessing e-learning readiness. For this study, some factors and sub-factors of the hybrid model have been considered and adapted, together with the ‘Attitude’ component. A questionnaire was designed based on the models and students where the target population were students enrolled at the Open University of Mauritius, in undergraduate and postgraduate courses. Preliminary findings indicate that most (68%) learners have an average knowledge about ODL form of learning, despite not many (72%) having previous experience with ODL. Despite learning through ODL 74% of learners preferred hard copy learning material and 48% found difficulty in reading learning material on electronic devices.

Keywords: open learning, distance learning, student readiness, a hybrid model

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Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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Authors: Clarisse Umutoni, Augustine Ayantunde, Matthew Turner, Germain J. Sawadogo

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Decentralized governance of natural resources is considered one of the key strategies for promoting sustainable management of natural resources at local level. The rationale behind decentralization of natural resources is that local populations are both better situated and more highly motivated than outside agencies to manage the resources in an ecologically and economically sustainable manner. Effective decentralized natural resource management requires strong local natural resource institutions. Therefore, strengthening local institutions governing natural resource management is essential to promoting strong participation of local communities in managing their resources. This paper investigated the existing local institutions (rules, norms and or local conventions) governing the management of natural resources and forms of community participation in the development of these natural resource institutions. Group discussions and individual interviews were conducted to collect data. Our findings showed significant variation within the study sites regarding the level of knowledge of existing local rules and norms governing the management of natural resources by the respondents. The results also show that participation was dominated by a small group of individuals, often community leaders and elites. The results suggest that women are marginalized. In general, factors which influence the level of participation include; age, year of residence in the community, gender and education level. This study also highlights the strengths of local natural resource institutions especially if enforced. Presently, the big challenge that faces the institutions governing natural resource use in the study area is the system of representativeness in the community in the development of local rules and norms as community leaders and household heads often dominate, which does not encourage active participation of community members. Therefore, for effective implementation of local natural resource institutions, the interest of key natural resource users should be taken into account. It is also important to promote rules and norms that attempt to protect or strengthen women’s access to natural resources in the community.

Keywords: decentralization, land use plan, local institutions, Mali

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Authors: Ayodeji Motunrayo Omoare

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Economically fish provides an important source of food and income for both men and women especially many households in the developing world and fishing has an important social and cultural position in river-rine communities. However, fish is highly susceptible to deterioration. Consequently, this study was carried out to correlate income generation of small-scale women fish processors in Abeokuta metropolis, Ogun State, Nigeria. Eighty small-scale women fish processors were randomly selected from five communities as the sample size for this study. Collected data were analyzed using both descriptive and inferential statistics. The results showed that the mean age of the respondents was 31.75 years with average household size of 4 people while 47.5% of the respondents had primary education. Most (86.3%) of the respondents were married and had spent more than 11 years in fish processing. The respondents were predominantly Yoruba tribe (91.2%). Majority (71.3%) of the respondents used traditional kiln for processing their fish while 23.7% of the respondents used hot vegetable oil to fry their fish. Also, the result revealed that respondents sourced capital from Personal Savings (48.8%), Cooperatives (27.5%), Friends and Family (17.5%) and Microfinance Banks (6.2%) for fish processing activities. The respondents generated an average income of ₦7,000.00 from roasted fish, ₦3,500.00 from dried fish, and ₦5,200.00 from fried fish daily. However, inadequate processing equipment (95.0%), non-availability of credit facility from microfinance banks (85.0%), poor electricity supply (77.5%), inadequate extension service support (70.0%), and fuel scarcity (68.7%) were major constraints to fish processing in the study area. Results of chi-square analysis showed that there was a significant relationship between personal characteristics (χ2 = 36.83, df = 9), processing methods (χ2 = 15.88, df = 3) and income generated at p < 0.05 level of significance. It can be concluded that significant relationship existed between processing methods and income generated. The study, therefore, recommends that modern processing equipment should be made available to the respondents at a subsidized price by the agro-allied companies.

Keywords: correlates, income, fish processors, women, small-scale

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Authors: Israel Ekanade, Richard Molapo, Patrick Dzimiri, Isaac Ndlovu

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This study aims to unravel the myth behind animosity towards foreign nationals in South Africa. Systemic violence against foreign African nationals since 2008 to date necessitates critical research with regards to migration issues connected to social upheavals. Extensive research ubiquitously tagged black-on-black violence as xenophobia or Afrophobia. In all, escalation of violence indicates a connotation of belonging. With unemployment rates approaching a crescendo, other vices have also soared in the same regard. As a result, this present generation seems cynical as the South African state has not fulfilled her obligations towards the indigent population; a situation pitching locals against foreigners. Locals have repeatedly blamed African foreign nationals for the economic downturn, using service delivery strikes to express their grievances. These strikes have continued unabatedly over the years but February 2017 marked a turning point in ‘insider-outsider’ relations as the strike was now turned to an anti-immigrant march resulting into widespread violence as the police failed to restore normalcy at some point. Over time, migration has been a harbinger of violence against the foreign black population in South Africa. Our paper encourages the state and civil society to invent new peace-building mechanisms to reduce xenophobic orchestrated violence. Our paper also contends that since the political class has hijacked the situation by using the youths for political propaganda during crises periods, a re-education of the political class and a culture of tolerance is inevitable for peace and harmony between locals and foreigners in post-apartheid South Africa.

Keywords: anti-immigrant march, politics of belonging, service delivery strikes, South Africa

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Authors: Soojin Kim, Yongjae Kim

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Continuous economic downturn and ongoing budget cuts poses higher education with profound challenges which has a direct impact on the collegiate athletic programs. In response to the ever-changing landscape of the fiscal environment, universities seek to boost revenues, resorting to alternative sources of funding. In particular, athletic programs have become increasingly dependent on financial support from their alumni and boosters, which is how athletic departments attempt to offset budget shortfalls and make capital improvements. Although there currently exists three major divisions within National Collegiate Athletic Association (NCAA), the majority of the sport management studies on college sport tend to focus on Division I level. Particularly within the donor motivation literature, a plethora of donor motivation studies exist, but mainly on NCAA Division I athletic programs. Since each athletic department functions differently in a number of different dimensions, while institutional difference can also have a huge impact on athletic donor motivations, the current study attempts to fill this gap that exists in the literature. As such, the purpose of this study was to (I) reexamine the factor structure of the Athletic Donor motivation scale; and (II) identify the prominent athletic donor motives in a NCAA Division II athletic program. For the purpose of this study, a total of 232 actual donors were used for analysis. A confirmatory factor analysis (CFA) was employed to test construct validity, and the reliability of the scale was assessed using Composite Reliability. To identify the prominent motivational factors, the means and standard deviations were examined. Results of this study indicated that Vicarious Achievement, Philanthropy, and Commitment are the three primary motivational factors, while Tangible Benefits, was consistently found as an important motive in prior studies was found low. Such findings highlight the key difference and suggest different salient motivations exist that are specific to the context.

Keywords: college athletics, donor, motivation, NCAA

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Authors: Luis Amador Jimenez, Md. Shohel Amin

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Pavement performance models are based on projections of observed traffic loads, which makes uncertain to study funding strategies in the long run if history does not repeat. Neural networks can be used to estimate deterioration rates but the learning rate and momentum have not been properly investigated, in addition, economic evolvement could change traffic flows. This study addresses both issues through a case study for roads of Montreal that simulates traffic for a period of 50 years and deals with the measurement error of the pavement deterioration model. Travel demand models are applied to simulate annual average daily traffic (AADT) every 5 years. Accumulated equivalent single axle loads (ESALs) are calculated from the predicted AADT and locally observed truck distributions combined with truck factors. A back propagation Neural Network (BPN) method with a Generalized Delta Rule (GDR) learning algorithm is applied to estimate pavement deterioration models capable of overcoming measurement errors. Linear programming of lifecycle optimization is applied to identify M&R strategies that ensure good pavement condition while minimizing the budget. It was found that CAD 150 million is the minimum annual budget to good condition for arterial and local roads in Montreal. Montreal drivers prefer the use of public transportation for work and education purposes. Vehicle traffic is expected to double within 50 years, ESALS are expected to double the number of ESALs every 15 years. Roads in the island of Montreal need to undergo a stabilization period for about 25 years, a steady state seems to be reached after.

Keywords: pavement management system, traffic simulation, backpropagation neural network, performance modeling, measurement errors, linear programming, lifecycle optimization

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Authors: Damilola Mofikoya

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Developed countries account for a large proportion of greenhouse gas emissions. In the last decade, countries including the United States and China have made a commitment to cut down carbon emissions by signing the Paris Climate Agreement. However, carbon neutrality is a challenging issue to tackle at the country level because of the scale of the problem. To overcome this challenge, cities are at the forefront of these efforts. Many cities in the United States are taking strategic actions and proposing programs and initiatives focused on renewable energy, green transportation, less use of fossil fuel vehicles, etc. There have been concerns about the implications of those strategies and a lack of community engagement. This paper is focused on community-based efforts that help actualize the reduction of carbon footprint through sustained and inclusive action. Existing zero-carbon assessment tools are examined to understand variables and indicators associated with the zero-carbon goals. Based on a broad, systematic review of literature on community strategies, and existing zero-carbon assessment tools, a dashboard was developed to help simplify and demystify carbon neutrality goals at a community level. The literature was able to shed light on the key contributing factors responsible for the success of community efforts in carbon neutrality. Stakeholder education is discussed as one of the strategies to help communities take action and generate momentum. The community-based efforts involving individuals and residents, such as reduction of food wastages, shopping preferences, transit mode choices, and healthy diets, play an important role in the context of zero-carbon initiatives. The proposed community-based dashboard will emphasize the importance of sustained, structured, and collective efforts at a communal scale. Finally, the present study discusses the relationship between life expectancy and quality of life and how it affects carbon neutrality in communities.

Keywords: carbon footprint, communities, life expectancy, quality of life

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Authors: Jana Vermaas, Carien Denner

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Waste has become a global issue and the management regarding it a priority. Some of the main problems in South Africa (SA) include: (1) the lack of information and education, (2) waste collection services, (3) reusing and recycling is not encouraged, (4) illegal dumping, and the biggest problem of all (5) the lack of waste related regulations and enforcement by the government and municipalities. In SA, there are provinces such as Gauteng and the Western Cape that have some recycling programs in place, but nothing yet in the central part of the country. By identifying the barriers preventing these businesses from recycling, the local municipalities and recycling services could create a solution. Owners or employees of eateries and bars completed a self-administered questionnaire. Information were obtained on knowledge of recycling, participation in recycling and to which extent, barriers that prevent them from recycling and motives that would encourage recycling. The data obtained from the questionnaire indicated that most (98%) participants knew only the basics, that recycling is a process of converting waste materials into new materials and objects. Further knowledge questions indicated that individuals were not educated about recycling as almost half (49%) of the participants believe that they can’t reuse plastic bottles. They do not understand which items of their waste could be re-used or recycled. They had limited knowledge about the recycling opportunities or practices in the area. Only a small number (34%) were involved in recycling or sustainable practices. Many did not even know of any collection services or buy-back centres in their vicinity. Most of the participants (94%) indicated that they would be willing to recycle if it would have a financial benefit. Many also stated that they would be more willing to recycle if the recyclable waste will be collected from their establishment, on a regular basis. The enforcement of recycling by municipalities or government by awarding fines for waste offenders was indicated as a significant motive. It could be concluded that the most significant barrier is knowledge and lack of information. These businesses do not comprehend the impact that they can have with their recycling contributions, not only on the environment, but also on the consumers that they serve. Another barrier is the lack of collection services. There are currently no government or municipal services for the collection of recyclable waste. All waste are taken to landfills. Many of the larger recycling initiatives and companies do not reach as far as central SA. Therefore, the buy-back component of recycling is not present.

Keywords: eateries, recycling, sustainable practices, waste

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Authors: Erkingul Soltanaeva, Omyrkhan Abdimanuly, Alua Temirbolat

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In this article, the public and social functions of literature and art in the Republic of Kazakhstan were analyzed on the basis of formal and informal literary organizations. The external and internal, subjective and objective factors which influenced the modern literary process were determined. The literary forces, their consolidation, types of organization in the art of word were examined. The periods of the literary process as planning, organization, promotion, and evaluation and their leading forces and approaches were analyzed. The right point of view to the language and mentality of the society force will influence to the literary process. The Ministry of Culture, the Writers' Union of RK and various non-governmental organizations are having different events for the promotion of literary process and to glorify literary personalities in the entire territory of Kazakhstan. According to the cultural plan of different state administration, there was a big program in order to publish their literary encyclopedia, to glorify and distribute books of own poets and writers of their region to the country. All of these official measures will increase the reader's interest in the book and will also bring up people to the patriotic education and improve the status of the native language. The professional literary publications such as the newspaper ‘Kazakh literature’, magazine ‘Zhuldyz’, and journal ‘Zhalyn’ materials which were published in the periods 2013-2015 on the basis of statistical analysis of the Kazakh literature topical to the issues and the field of themes are identified and their level of connection with the public situations are defined. The creative freedom, relations between society and the individual, the state of the literature, the problems of advantages and disadvantages were taken into consideration in the same articles. The level of functions was determined through the public role of literature, social feature, personal peculiarities. Now the stages as the literature management planning, organization, motivation, as well as the evaluation are forming and developing in Kazakhstan. But we still need the development of literature management to satisfy the actual requirements of the today’s agenda.

Keywords: literature management, material, literary process, social functions

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Authors: Chamtouri I., Kechida M.

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Background: Evaluation has a prominent role in medical education and graduation. This evaluation has usually done in face-to-face, by written or oral questions. Simulation is increasingly taking a part as a method of evaluation. Due to the Covid-19 pandemic, which disrupted face-to-face evaluation, simulation using serious games (SG) is emerging in the field of training and assessment of medical students. The aim of our study is to compare the results of the evaluation of medical students by virtual simulation by online serious games versus clinical case-multiple choice questions (MCQ) and to assess the degree of satisfaction from these two evaluation methods. Methods: Medical students from the same study level were voluntarily participated in this study. Groupe 1 had an evaluation by SG dealing with “diagnosis and management of ST-segment elevationmyocardialinfarction (STEMI)alreadyprepared on the website www.Mediactiv.com. Groupe 2 were evaluated by clinical case-MCQ having thes same topic as SG. Results of the two groups were compared. Satisfaction questionnaire was filled by the two groups. Satisfaction degree was compared between the two groups. Results. In this study, 64 medical students (G1:31 and G2: 33) were enrolled. Obtaining complete notes in the "questioning" and "clinical examination" parts is significantly more important in-group 1 compared to group 2. No significant difference detected between the two groups in terms of “ECG interpretation” and “diagnosis of STEMI” parts. A greater number of students of group 1 obtained the full note compared to group 2 in “the initial treatment part” (54.8% vs. 39.4%; p = 0.04). Thirty learners (96.8%) in-group 1 obtained a total score ≥ 50% versus 69.7% in-group 2 (p = 0.004). The full score of 100% was obtained in three learners in-group1, while no student scored 100% in-group2 (p = 0.027). Medical evaluation using SG was reported as more innovative, fun, and realistic compared to evaluation by clinical case-MCQ. No significant difference detected between the two methods in terms of stress. Conclusion: Simulation by SG can be considered as an innovative and effective method in evaluating medical students with a higher degree of satisfaction.

Keywords: evaluation, serious games, medical students, satisfaction

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Authors: Sipho Mbatha, Anne Mastament-Mason

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South African manufacturing global competitiveness was ranked 22nd (out of 38 countries), dropped to 24th in 2013 and is expected to drop further to 25th by 2018. These impacts negatively on the industrialisation project of South Africa. For industrialization to be achieved through labour intensive industries like the Apparel Manufacturing Industries of South Africa (AMISA), South Africa needs to identify and respond to factors negatively impacting on the development of competitive advantage This paper applied factor conditions from Porter’s Diamond Model (1990) to understand the various challenges facing the AMISA. Factor conditions highlighted in Porter’s model are grouped into two groups namely, basic and advance factors. Two AMISA associations representing over 10 000 employees were interviewed. The largest Clothing, Textiles and Leather (CTL) apparel retail group was also interviewed with a government department implementing the industrialisation policy were interviewed The paper points out that while AMISA have basic factor conditions necessary for competitive advantage in the clothing and textiles industries, Advance factor coordination has proven to be a challenging task for the AMISA, Higher Education Institutions (HEIs) and government. Poor infrastructural maintenance has contributed to high manufacturing costs and poor quick response as a result of lack of advanced technologies. The use of Porter’s Factor Conditions as a tool to analyse the sector’s competitive advantage challenges and opportunities has increased knowledge regarding factors that limit the AMISA’s competitiveness. It is therefore argued that other studies on Porter’s Diamond model factors like Demand conditions, Firm strategy, structure and rivalry and Related and supporting industries can be used to analyse the situation of the AMISA for the purposes of improving competitive advantage.

Keywords: compliance rule, apparel manufacturing industry, factor conditions, advance skills and South African industrial policy

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Authors: Maja Ruzic-Baf, Vedrana Keteles, Andrea Debeljuh

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Younger and younger children are now using a smartphone, a device which has become ‘a must have’ and the life of children would be almost ‘unthinkable’ without one. Devices are becoming lighter and lighter but offering an array of options and applications as well as the unavoidable access to the Internet, without which it would be almost unusable. Numerous features such as taking of photographs, listening to music, information search on the Internet, access to social networks, usage of some of the chatting and messaging services, are only some of the numerous features offered by ‘smart’ devices. They have replaced the alarm clock, home phone, camera, tablet and other devices. Their use and possession have become a part of the everyday image of young people. Apart from the positive aspects, the use of smartphones has also some downsides. For instance, free time was usually spent in nature, playing, doing sports or other activities enabling children an adequate psychophysiological growth and development. The greater usage of smartphones during classes to check statuses on social networks, message your friends, play online games, are just some of the possible negative aspects of their application. Considering that the age of the population using smartphones is decreasing and that smartphones are no longer ‘foreign’ to children of pre-school age (smartphones are used at home or in coffee shops or shopping centers while waiting for their parents, playing video games often inappropriate to their age), particular attention must be paid to a very sensitive group, the teenagers who almost never separate from their ‘pets’. This paper is divided into two sections, theoretical and empirical ones. The theoretical section gives an overview of the pros and cons of the usage of smartphones, while the empirical section presents the results of a research conducted in three elementary schools regarding the usage of smartphones and, specifically, their usage during classes, during breaks and to search information on the Internet, check status updates and 'likes’ on the Facebook social network.

Keywords: education, smartphone, social networks, teenagers

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Authors: Beatrice Wamuyu Muchiri, Monika M. L. Dos Santos

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An increasingly recognised prevention approach for substance use entails reduction in risk factors and enhancement of promotive or protective factors in individuals and the environment surrounding them during their growth and development. However, in order to enhance the effectiveness of this approach, continuous study of risk aspects targeting different cultures, social groups and mixture of society has been recommended. This study evaluated the impact of potential risk and protective factors associated with family management and relations on adolescent substance abuse in South Africa. Exploratory analysis and cumulative odds ordinal logistic regression modelling was performed on the data while controlling for demographic and socio-economic characteristics on adolescent substance use. The most intensely used substances were tobacco, cannabis, cocaine, heroin and alcohol in decreasing order of use intensity. The specific protective or risk impact of family management or relations factors varied from substance to substance. Risk factors associated with demographic and socio-economic factors included being male, younger age, being in lower education grades, coloured ethnicity, adolescents from divorced parents and unemployed or fully employed mothers. Significant family relations risk and protective factors against substance use were classified as either family functioning and conflict or family bonding and support. Several family management factors, categorised as parental monitoring, discipline, behavioural control and rewards, demonstrated either risk or protective effect on adolescent substance use. Some factors had either interactive risk or protective impact on substance use or lost significance when analysed jointly with other factors such as controlled variables. Interaction amongst risk or protective factors as well as the type of substance should be considered when further considering interventions based on these risk or protective factors. Studies in other geographical regions, institutions and with better gender balance are recommended to improve upon the representativeness of the results. Several other considerations to be made when formulating interventions, the shortcomings of this study and possible improvements as well as future studies are also suggested.

Keywords: risk factors, protective factors, substance use, adolescents

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Authors: Kashi Raj Pandey

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Transformative learning is a form of learning rooted in learners' life experiences and their inherent love for learning. It emphasizes the importance of incorporating students' everyday work through the use of learning diaries and reflective journals. It encourages learners to take a proactive role in their own improvement, fostering creativity and promoting informed discussions about the learning process. Reflecting on the personal experience with English language learning in a rural village in Nepal where rote memorization was the prevailing teaching method, this traditional approach hindered a deeper understanding of the language, prompting the author to recognize the need for more effective pedagogy. In this study, the author delved into the cultural contextualization of English language learning, taking into account learners' backgrounds. The study’s findings highlighted the importance of equity, inclusion, mutuality, and social justice in the classroom, emphasizing the significance of integrating students' lived experiences into the pedagogical approach. This, in turn, can encourage students to engage in profound and collaborative learning practices within the realm of English language education. Upon successfully implementing the research findings, including the eight key conditions of transformative learning, in multiple classrooms, the author collaborated with international educationists and government stakeholders in Nepal. The purpose was to disseminate the research findings, conduct teacher training workshops, and systematically enhance Nepali students’ English language learning. These methods have already demonstrated a significant improvement in student engagement within the same school where the author once learned English as a child. This study aims to explore teachers’ decision-making process regarding the transition from traditional teaching methods to interactive ones, which have gained national recognition within the ESL/EFL teaching community in Nepal. By sharing these experiences, it is expected that other teachers will also contemplate adopting transformative learning pedagogy in their own classrooms.

Keywords: reflection, student engagement, pedagogy, transformative learning

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

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Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

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Authors: Misganaw Chere Siferih

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This study assessed the impact of crossbreed dairy cows on household income and food security. The study area is found in Dejen Woreda, East Gojam Zone, and Amhara region of Ethiopia. Random sampling technique was used to obtain a sample of 80 crossbreed dairy cow owners and 176 indigenous dairy cow owners. The study employed food consumption score analytical framework to measure food security status of the household. No Statistical significant mean difference is found between crossbreed owners and indigenous owners. Logistic regression was employed to investigate crossbreed dairy cow adoption determinants , the result indicates that gender, education, labor number, land size cultivated, dairy cooperatives membership, net income and food security status of the household are statistically significant independent variables, which explained the binary dependent variable, crossbreed dairy cow adoption. Propensity score matching (PSM) was employed to analyze the impact of crossbreed dairy cow owners on farmers’ income and food security. The average net income of crossbreed dairy cow owners was found to be significantly higher than indigenous dairy cow owners. Estimates of average treatment effect of the treated (ATT) indicated that crossbreed dairy cow is able to impact households’ net income by 42%, 38.5%, 30.8% and 44.5% higher in kernel, radius, nearest neighborhood and stratification matching algorithms respectively as compared to indigenous dairy cow owners. However, estimates of average treatment of the treated (ATT) suggest that being an owner of crossbreed dairy cow is not able to affect food security significantly. Thus, crossbreed dairy cow enables farmers to increase income but not their food security in the study area. Finally, the study recommended establishing dairy cooperatives and advice farmers to become a member of them, attention to promoting the impact of crossbreed dairy cows and promotion of nutrition focus projects.

Keywords: crossbreed dairy cow, net income, food security, propensity score matching

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Authors: Eveline Muika Kabongo, Peter Delobelle, Ferdinand Mukumbang, Edward Nicol

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Introduction: Studies have been conducted to establish the effect of the MomConnect program in South Africa, but these studies did not focus on the stakeholders' and implementers' perspectives and the underlying program theory of the MomConnect initiative program. We strived to obtain stakeholders’ perspectives and assumptions on the MomConnect program and develop an initial program theory (IPT) of how the MomConnect initiative was expected to work. Methods: A realist-informed explanatory design used. The interviewer was performed with 10 key informants selected purposively among MomConnect key informants at the a national level of NDoH South Africa. The interview was done via zoom and lasted for 30 to 60 minutes. Introduction and abduction inferencing approaches were applied. The deductive and inductive approaches were performed during the analysis. ICAMO hereustic framework was used to analysed the data in order to get key informants expectations on how the MomConnect will work or not. Results: We developed three folk’s theories illustrating how the key informants’ expected the MomConnect to work. These theories showed that the MomConnect intended to provide users with health information and education that will empower and motivate them with knowledge which will allow the improvement of health services delivery among HCPs and improvement of the uptake of MCH services among pregnant women and mothers and decrease the rate of maternal and child mortality in the country. The lack of an updated mechanism to link women to the outcome was an issue. Another problem enlightened was the introduction of the WhatsApp program instead of SMS messaging, which was free of charge to women. Conclusion: The Folk’s theory developed from this study provided an insight into how the MomConnect was expected to work and what did not work. The folk’s theory will be merged with information from candidate theories on synthesis review and document review to develop our initial program theory of the MomConnect initiative.

Keywords: mHealth, MomConnect program, realist evaluation, maternal and child health, maternal and child health services, introduction, theory-driven

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Authors: Eunjoo Lee

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Background: As the number of surgeries increases, the incidence of adverse events is likely to become more prevalent. Patients who are somewhat knowledgeable about surgery-related adverse events are more likely to engage in safety initiatives to prevent them. Objectives: To evaluate the impact of a smartphone application developed during the study to enhance patients’ knowledge of surgery-related adverse events during hospitalization. Design: Non-randomized, one group, measured pre- and post-intervention. Participants: Thirty-six hospitalized patients admitted to the orthopedics unit of a general hospital in South Korea. Methods. First, a smartphone application to enhance patients’ knowledge of surgery-related adverse events was developed through an iterative process, which included a literature review, expert consultation, and pilot testing. The application was installed on participants’ smartphones, and research assistants taught the participants to use it. Twenty-five true/false questions were used to assess patients’ knowledge of preoperative precautions (eight items), surgical site infection (five items), Foley catheter management (four items), drainage management (four items), and anesthesia-related complications (four items). Results: Overall, the percentage of correct answers increased significantly, from 57.02% to 73.82%, although answers related to a few specific topics did not increase that much. Although the patients’ understanding of drainage management and the Foley catheter did increase substantially after they used the smartphone application, it was still relatively low. Conclusions: The smartphone application developed during this study enhanced the patients’ knowledge of surgery-related adverse events during hospitalization. However, nurses must make an additional effort to help patients to understand certain topics, including drainage and Foley catheter management. Relevance to clinical practice: Insufficient patient knowledge increases the risk of adverse events during hospitalization. Nurses should take active steps to enhance patients’ knowledge of a range of safety issues during hospitalization, in order to decrease the number of surgery-related adverse events.

Keywords: patient education, patient participation, patient safety, smartphone application, surgical errors

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Authors: Michaels Aibangbee, Sowbhagya Micheal, Pranee Liamputtong, Elias Mpofu, Tinashe Dune

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Background: The challenges migrants and refugee youth (MRY) experience in maintaining their sexual and reproductive health and rights (SRHR) continues to be a global public health issue. Consequently, MRY is more likely to encounter adverse SRH experiences due to limited access to and knowledge of SRH services. Using a socio-ecological framework, this study examined the MRY’s SRHR micro-level experiences to macro-levels analyses of SRH-related social systems and constructions. Methods: Eighteen focus groups were conducted using participatory action research (PAR) methodology to understand the phenomena. The focus groups included MRY participants (ages 16-26) living in Greater Western Sydney and facilitated by youth project liaisons (YPL). The data was afterward synthesised and analysed using the thematic-synthesis method. Results: In total, 86 MRY (male n= 25, female n= 61) MRY (across 20 different cultural backgrounds) participated in the focus groups. The findings identified socio-ecological factors characterising MRY SRHR, highlighting facilitators such as social media and significant barriers such as lack of access to services and socio-cultural dissonance, and the under-implementation of SRHR support and services by MRY. Key themes from the data included traditional and institutional stigma, lack of SRH education, high reliance on social media for SRH information, anonymity, and privacy concerns. Conclusion: The data shows a limited extent to which MRY SRHR is considered and the intergenerational understanding and stigma affecting the rights of MRY. Therefore, these findings suggest a need for policies and practices to empower MRY’s agency through a collaborative SRHR strategy and policy design to maintain relevance in multicultural contexts.

Keywords: migrant and refugee youth, sexual health, reproductive health, sexual and reproductive health and rights, culture, agency

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Authors: B. McGovern, J. F. Luck, A. Gade, I. V. Lake, D. O’Connell, H. C. Cutcliffe, K. P. Shah, E. E. Ginalis, C. M. Lambert, N. Christian, J. R. Kait, A. W. Yu, C. P. Eckersley, C. R. Bass

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Mild traumatic brain injury (mTBI) in the form of post-concussive injuries and attention deficit / hyperactivity disorder (ADHD) share similar cognitive impairments, including impaired working memory and executive function. The memory-guided oculomotor task separates working memory and inhibitory components to provide further information on the nature of these deficits in each pathology. Eleven subjects with ADHD, fifteen control subjects, and ten subjects with recent concussive injury were matched on age, gender, and education (all high school-age males). Eye movements were recorded during memory-guided oculomotor tasks with varying delays using EyeLink 1000 (SR Research). The percentage of premature saccades and the latency of correct response are the analyzed measures for response inhibition and working memory, respectively. No significant differences were found in latencies between controls subjects and subjects with ADHD or post-concussive injuries, in accordance with previous studies. Subjects with ADHD and post-concussive injuries both demonstrated a trend of increased percentages of premature saccades compared to control subjects in the same oculomotor task. This trend reached statistical significance between the post-concussive and control groups (p < 0.05). These findings support the primary nature of the executive function deficits in response inhibition in ADHD and mTBI. The interpretation of results is limited by the small sample size and the exploratory nature of the study. Further investigation into oculomotor performance differences in mTBI and ADHD may help in differentiating these pathologies in consequent diagnoses and provide insight into the interaction of these deficits in mTBI.

Keywords: attention deficit / hyperactivity disorder (ADHD), concussion, diagnosis, oculomotor, pediatrics

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Authors: Sadhana Sharma, Neha Sharma, Hardik Khandelwal, Arti Sharma

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Background: It is widely acknowledged globally that parents must advocate for their children's drug and substance abuse prevention. However, many parents find it difficult to advocate due to systemic and logistical barriers. Alternatives to introducing advocacy, awareness, and support for the prevention of drug and substance abuse to children could occur in schools. However, little research has been conducted on the development of advocates for substance abuse in school settings. Objective: to evaluate the effectiveness of a school-based addiction prevention and control created as part of the Rajasthan Addiction Prevention Project (a partnership between state-community initiative). Methods: We conducted an evaluation in this study to determine the impact of a RAPP on a primary outcome (substance abuse knowledge) and other outcomes (family–school partnership, empowerment, and support). Specifically, between September-December 2022, two schools participated in the intervention group (advocacy training), and two schools participated in the control group (waiting list). The RAPP designed specialised 2-hrs training to equip teachers-parents with the knowledge and skills necessary to advocate for their own children and those of other families. All participants were required to complete a pre- and post-survey. Results: The intervention group established school advocates in schools where trained parents volunteered to lead support groups for high-risk children. Compared to the participants in the wait list control group, those in the intervention group demonstrated greater education knowledge, P = 0.002, and self-mastery, P = 0.04, and decreased family–school partnership quality, P = 0.002.Conclusions: The experimental evaluation of school-based advocacy programme revealed positive effects on substance abuse that persist over time. The approach wa s deemed feasible and acceptable by both parents and the school.

Keywords: prevention, school based, addiction, advocacy

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Authors: M. A. Ojo, E. O. Ogbole, A. O. Ojo

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This study analysed improved household solid waste management system in Minna metropolis, Niger state. Multi-staged sampling technique was used to administer 155 questionnaires to respondents, where Minna was divided into two income groups A and B based on the quality of the respondent’s houses. Primary data was collected with the aid of structured questionnaires and analysed using descriptive statistics to obtain results for the socioeconomic characteristics of respondents, types of waste generated and methods of disposing solid waste, the level of awareness and reliability of waste disposal methods as well as the willingness of households to pay for solid waste management in the area. The results revealed that majority of the household heads in the study area were male, 94.20% of the household heads fell between the ages of 21 and 50 and also that 96.80% of them had one form of formal education or the other. The results also revealed that 47.10% and 43.20% of the households generated food wastes and polymers respectively as a major constituent of waste disposed. The results of this study went further to reveal that 81.90% of the household heads were aware of the use of collection cans as a method of waste disposal while only 32.90% of them considered the method highly reliable. Multiple regression was used to determine the factors affecting the willingness of households to pay for waste disposal in the study area. The results showed that 76.10% of the respondents were willing to pay for solid waste management which indicates that households in Minna are concerned and willing to cater for their immediate environment. The multiple regression results revealed that age, income, environmental awareness and household expenditure have a positive and statistically significant relationship with the willingness of households to pay for waste disposal in the area while household size has a negative and statistically significant relationship with households’ willingness to pay. Based on these findings, it was recommended that more waste management services be made readily available to residents of Minna, waste collection service should be privatised to increase their effectiveness through increased competition and also that community participatory approach be used to create more environmental awareness amongst residents.

Keywords: household, solid waste, management, WTP

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Authors: Kalayanee Senasu

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This research investigates the influences of different factors on the happiness of Thai people, including both general factors and sustainable ones. Additionally, this study also monitors Thai people’s happiness via Thai Happiness Index developed in 2017. Besides reflecting happiness level of Thai people, this index also identifies related important issues. The data were collected by both secondary related data and primary survey data collected by interviewed questionnaires. The research data were from stratified multi-stage sampling in region, province, district, and enumeration area, and simple random sampling in each enumeration area. The research data cover 20 provinces, including Bangkok and 4-5 provinces in each region of the North, Northeastern, Central, and South. There were 4,960 usable respondents who were at least 15 years old. Statistical analyses included both descriptive and inferential statistics, including hierarchical regression and one-way ANOVA. The Alkire and Foster method was adopted to develop and calculate the Thai happiness index. The results reveal that the quality of household economy plays the most important role in predicting happiness. The results also indicate that quality of family, quality of health, and effectiveness of public administration in the provincial level have positive effects on happiness at about similar levels. For the socio-economic factors, the results reveal that age, education level, and household revenue have significant effects on happiness. For computing Thai happiness index (THaI), the result reveals the 2018 THaI value is 0.556. When people are divided into four groups depending upon their degree of happiness, it is found that a total of 21.1% of population are happy, with 6.0% called deeply happy and 15.1% called extensively happy. A total of 78.9% of population are not-yet-happy, with 31.8% called narrowly happy, and 47.1% called unhappy. A group of happy population reflects the happiness index THaI valued of 0.789, which is much higher than the THaI valued of 0.494 of the not-yet-happy population. Overall Thai people have higher happiness compared to 2017 when the happiness index was 0.506.

Keywords: happiness, quality of life, sustainability, Thai Happiness Index

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Authors: Antonios Paraskevas, Michael Madas

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For a university to maintain its international competitiveness in education, it is essential to recruit qualitative academic staff as it constitutes its most valuable asset. This selection demonstrates a significant role in achieving strategic objectives, particularly by emphasizing a firm commitment to the exceptional student experience and innovative teaching and learning practices of high quality. In this vein, the appropriate selection of academic staff establishes a very important factor of competitiveness, efficiency and reputation of an academic institute. Within this framework, our work demonstrates a comprehensive methodological concept that emphasizes the multi-criteria nature of the problem and how decision-makers could utilize our approach in order to proceed to the appropriate judgment. The conceptual framework introduced in this paper is built upon a hybrid neutrosophic method based on the Neutrosophic Analytical Hierarchy Process (N-AHP), which uses the theory of neutrosophy sets and is considered suitable in terms of a significant degree of ambiguity and indeterminacy observed in the decision-making process. To this end, our framework extends the N-AHP by incorporating the Neutrosophic Delphi Method (N-DM). By applying the N-DM, we can take into consideration the importance of each decision-maker and their preferences per evaluation criterion. To the best of our knowledge, the proposed model is the first which applies the Neutrosophic Delphi Method in the selection of academic staff. As a case study, it was decided to use our method for a real problem of academic personnel selection, having as the main goal to enhance the algorithm proposed in previous scholars’ work, and thus taking care of the inherent ineffectiveness which becomes apparent in traditional multi-criteria decision-making methods when dealing with situations alike. As a further result, we prove that our method demonstrates greater applicability and reliability when compared to other decision models.

Keywords: multi-criteria decision making methods, analytical hierarchy process, delphi method, personnel recruitment, neutrosophic set theory

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Authors: Gjergji Buzo

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This paper presents the communist policy about tangible and intangible religious heritage in Pogradec District, Albania. The district of Pogradec lies in the southeast of Albania and consists of the municipality, located on the shore of Ohrid Lake, and 7 Administrative Units, with a population of about 61,530 inhabitants. From the statistical data provided by the Institute of Statistics, the city of Pogradec has 55.9% Muslims, 19.9% Orthodox, 1.4% Catholic and 1.1% Bektashi. While the religious affiliation in the Administrative Unit is as follows: Muslim 72.1%, Orthodox 3.32%, Catholic 1.18%, Bektashi 0.2%. The percentages are approximate values, taking into consideration that 13.8% of the total population preferred not to answer the question on religion and that for 2.4% of the persons who answered, the information provided was not relevant or stated. The percentage of the persons who declared themselves as believers without belonging to any religion was 5.5 and the persons who declared themselves as a non-believer and not belonging to any religion was 2.5. Number of persons who declared themselves as evangelists was 0.1% and the number of them declared as "other Christians" was 0.1%. About 80% of the population believe in God, and most of them practice one of the monotheist religions. We have divided religious practices into three major periods. The first is until 1967, when different religions were practiced in Pogradec in harmony with each other; the second is the period 1967-1990, during which the practice of religion was prohibited, and the period after 1990, when religious freedom was restored. This article is focused on the communist period 1967-1990 when Albania (and Pogradec as part of it) became the only atheist country in the world. The object of the study is the impact of these policies on spiritual and material religious identity. The communist regime destroyed or transformed the religious objects, whether Islamic or Christian and prohibited practicing religious rituals in Albania. They followed an education policy with an atheistic spirituality among young people, characterizing religion as opium for the people. All these left traces on the people and brought a deformation of the religious identity. In order to better understand the reality of that time and how this policy was experienced by the people, we conducted a survey in Pogradect District with the participation of 1000 people.

Keywords: communism policy, heritage, identity, religion, statistics, survey

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Authors: Ignatius Madu

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The study aims at assessing the environmental and socioeconomic determinants of climate change resilience in rural Nigeria. This is necessary because researches and development efforts on building climate change resilience of rural areas in developing countries are usually made without the knowledge of the impacts of the inherent rural characteristics that determine resilient capacities of the households. This has, in many cases, led to costly mistakes, delayed responses, inaccurate outcomes, and other difficulties. Consequently, this assessment becomes crucial not only to policymakers and people living in risk-prone environments in rural areas but also to fill the research gap. To achieve the aim, secondary data were obtained from the Annual Abstract of Statistics 2017, LSMS-Integrated Surveys on Agriculture and General Household Survey Panel 2015/2016, and National Agriculture Sample Survey (NASS), 2010/2011.Resilience was calculated by weighting and adding the adaptive, absorptive and anticipatory measures of households variables aggregated at state levels and then regressed against rural environmental and socioeconomic characteristics influencing it. From the regression, the coefficients of the variables were used to compute the impacts of the variables using the Stochastic Regression of Impacts on Population, Affluence and Technology (STIRPAT) Model. The results showed that the northern States are generally low in resilient indices and are impacted less by the development indicators. The major determining factors are percentage of non-poor, environmental protection, road transport development, landholding, agricultural input, population density, dependency ratio (inverse), household asserts, education and maternal care. The paper concludes that any effort to a successful resilient building in rural areas of the country should first address these key factors that enhance rural development and wellbeing since it is better to take action before shocks take place.

Keywords: climate change resilience; spatial impacts; STIRPAT model; Nigeria

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Authors: Malephole Philomena Sefotho

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Nowadays, it is a fact that the majority of people, worldwide, are bilingual rather than monolingual due to the surge of globalisation and mobility. Consequently, bilingual education is a topical issue of discussion among researchers. Several studies that have focussed on it have highlighted the importance and need for incorporating learners’ linguistic repertoires in multilingual classrooms and move away from the colonial approach which is a monolingual bias – one language at a time. Researchers pointed out that a systematic approach that involves the concurrent use of languages and not a separation of languages must be implemented in bilingual classroom settings. Translanguaging emerged as a systematic approach that assists learners to make meaning of their world and it involves allowing learners to utilize all their linguistic resources in their classrooms. The South African language policy also room for diverse languages use in bi/multilingual classrooms. This study, therefore, sought to explore how teachers apply translanguaging in bilingual classrooms in incorporating learners’ linguistic repertoires. It further establishes teachers’ perspectives in the use of more than one language in teaching and learning. The participants for this study were language teachers who teach at bilingual primary schools in Johannesburg in South Africa. Semi-structured interviews were conducted to establish their perceptions on the concurrent use of languages. Qualitative research design was followed in analysing data. The findings showed that teachers were reluctant to allow translanguaging to take place in their classrooms even though they realise the importance thereof. Not allowing bilingual learners to use their linguistic repertoires has resulted in learners’ negative attitude towards their languages and contributed in learners’ loss of their identity. This article, thus recommends a drastic change to decolonised approaches in teaching and learning in multilingual settings and translanguaging as a decolonial move where learners are allowed to translanguage freely in their classroom settings for better comprehension and making meaning of concepts and/or related ideas. It further proposes continuous conversations be encouraged to bring eminent cultural and linguistic genocide to a halt.

Keywords: bilingualism, decolonisation, linguistic repertoires, translanguaging

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Authors: Metrek Almetrek, Naser Alqahtani, Eisa Ghazwani, Mona Asiri, Mohammed Alqahtani, Magboolah Balobaid

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Background: Advocacy of potential for community coalitions to positively address social determinants of health and quality of life, little is known about the views of stakeholders involved in such efforts. This study sought to assess the provinces leaders’ perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Method and Subjects: We used a descriptive, qualitative study using personal interviews in 2022. We conducted it in the community coalition's “main cities committees” set across service planning areas that serve vulnerable groups located in the seven registered healthy cities to WHO (Abha, Tareeb, Muhayel, Balqarn, Alharajah, Alamwah, and Bisha). We conducted key informant interviews with 76 governmental, profit, non-profit, and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders’ views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results: Provinces leaders described multiple social determinants of health and quality of life that were relevant to the HNI community coalitions: housing and safety, community violence, economic stability, city services coordination and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve health and quality of life. Conclusions: Community coalitions have an opportunity to address multiple social determinants of health and quality of life to meet the social needs of vulnerable groups. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.

Keywords: social determinants, health and quality of life, vulnerable groups, qualitative research

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Authors: Miriam Colleran, Barbara Sheehy-Skeffington

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Background: To explore if there are unique features in the palliative care needs of patients with intellectual disability that may impact on planning for resource and service provision for them. Aim: The purpose of this practice review is to assess the indications for, numbers of and outcomes of care for adults with intellectual disabilities referred to a specialist palliative care service over a twoyear period. Service utilization aspects considered included the frequency of home visits by a specialist palliative care doctor or clinical nurse specialist and the number of hospice admissions that occurred for the patients. Method: A retrospective review was carried out of persons 18 years and older with intellectual disabilities referred to a specialist palliative care service over a 5-year period from 30.11.3018 to 29.11.2023. A manual review was carried out of the register using key terms, namely, known residential care and community dwelling places of service providers for persons with intellectual disabilities in the area and registered diagnoses in addition to the patients known to the clinicians who had intellectual disabilities. Results: 25 referrals were made to the specialist palliative care service of 23 persons with intellectual disabilities during that time. However, this may be an underestimate. 15 women and 8 men were referred with an age range of 19 to 86 years of age. The majority had a diagnosis of Down’s syndrome or Trisomy 21. 5 patients referred did not have home visits from the specialist palliative care team. A range of 2 to 48 phone calls per person occurred by the specialist palliative care team regarding this cohort of patients. The outcomes for the patients included discharge and death. The majority of patients that died, did so in the community. One person however died in hospital. Another person died in a hospice out of area. Conclusion: Providing specialist palliative care for adults with intellectual disabilities is an important element of palliative care. The dominance of the community as the place of death for these patients and the limited number of patients dying in either hospice or hospital are noteworthy. Further research is necessary and education to inform, support, and empower specialist palliative care professionals in optimizing palliative and end-of-life care for persons with intellectual disabilities and to inform service development and provision.

Keywords: about intellectual disability, palliative care

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