Search results for: health education

Authors: Doriane Micaela Andeme Bikoro, Samuel Fosso Wamba, Jean Robert Kala Kamdjoug

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Currently one of the leading fields in the market of technological innovation is digital health. In developed countries, this booming innovation is experiencing an exponential speed. We understand that in developed countries, e-health could also revolutionize the practice of medicine and therefore fill the many failures observed in medical care. Everything leads to believe that future technology is oriented towards the medical sector. The aim of this work is to explore at the same time the technological resources and the potential of health care based on new technologies; it is a case study in a rural area of Southern Cameroon. Among other things, we will make a census of the shortcomings and problems encountered, and we will propose various appropriate solutions. The work methodology used here is essentially qualitative. We used two qualitative data collection techniques, direct observation, and interviews. In fact, we spent two weeks in the field observing and conducting some semi-directive interviews with some of those responsible for these health structures. This study was conducted in three health facilities in the south of the country; including two health centers and a rural hospital. Many technological failures have been identified in the day-to-day management of these health facilities and especially in the administration of health care to patients. We note major problems such as the digital divide, the lack of qualified personnel, the state of isolation of this area. This is why various proposals are made to improve the health sector in Cameroon both technologically and medically.

Keywords: Cameroon, capacities, census, digital health, qualitative method, rural area

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Authors: Razan Salem

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Men and women are different, and so their investment behaviors may also vary. To the author’s best knowledge, women's investment behavior and its association with demographic factors have not been explored directly in the behavioral finance literature, however, particularly in respect to the Arab region. Thus, this study extends the literature by focusing on examining the association of demographic factors (age, annual income, and education) with Arab women’s investment behavior. To achieve the study’s aim, the researcher distributed 600 close-ended online questionnaires to a sample of Arab male and female individual investors in both Saudi Arabia and Jordan; using Kruskal-Wallis H Test and the Mann-Whitney U Test to analyze the data. The findings reveal that age, education, and level of income are associated with Arab women’s investment behavior. Educational level and level of income are positively associated with Arab women investment confidence level. On the contrary, age is negatively associated with Arab women financial risk tolerance. According to annual income, Arab women with lower incomes have lower confidence and investment literacy levels. Overall, the study concludes that age, income, and education are important demographic factors that must be considered when investigating the investment behavior of women in the Arab region.

Keywords: Arab region, demographic factors, investment behavior, women investors

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Authors: Andreas Kornmaaler Hansen, Carlos Gomez Cubero, Elizabeth Jochum

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The use of the arts in therapy and rehabilitation is well established, and there is growing recognition of the value of the arts for improving health and well-being across diverse populations. Combining arts with socially assistive robots is a relatively under-explored research area. This paper presents the results of a feasibility study conducted within an existing arts and health program to scope the possibility of combining visual arts with socially assistive robots to promote mental health and well-being. Using a participatory research design with participant-led perspectives, we present the results of our feasibility study with a collaborative drawing robot among an adult population with mild to severe mental illness. We identify key methodological challenges and advantages of working with participatory and human-centered approaches. Based on the results of three pilot workshops with participants and lay health workers, we outline suggestions for authentic engagement with real stakeholders toward the development of socially assistive robots in community health contexts. Working closely with a patient population at all levels of the research process is key for developing tools and interventions that center patient experience and priorities while minimizing the risks of alienating patients and communities.

Keywords: arts and health, visual art, health promotion, mental health, collaborative robots, creativity, socially assistive robots

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Authors: Mamta Jat

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Background: The increased longevity has resulted in the increase in the percentage of the global population aged 60 years or over. With this “demographic transition” towards ageing, “epidemiologic transition” is also taking place characterised by growing share of non-communicable diseases in the overall disease burden. So, many of the older adults are ageing with chronic disease and high levels of frailty which often results in lower levels of quality of life. Although frailty may be increasingly common in older adults, prevention or, at least, delay the onset of late-life adverse health outcomes and disability is necessary to maintain the health and functional status of the ageing population. This is an effort using SAGE data to assess levels of frailty and its socio-demographic correlates and its relation with quality of life in LMICs of India, China, Ghana, Mexico, Russia and South Africa in a comparative perspective. Methods: The data comes from multi-country Study on Global AGEing and Adult Health (SAGE), consists of nationally representative samples of older adults in six low and middle-income countries (LMICs): China, Ghana, India, Mexico, the Russian Federation and South Africa. For our study purpose, we will consider only 50+ year’s respondents. The logistic regression model has been used to assess the correlates of frailty. Multinomial logistic regression has been used to study the effect of frailty on QOL (quality of life), controlling for the effect of socio-economic and demographic correlates. Results: Among all the countries India is having highest mean frailty in males (0.22) and females (0.26) and China with the lowest mean frailty in males (0.12) and females (0.14). The odds of being frail are more likely with the increase in age across all the countries. In India, China and Russia the chances of frailty are more among rural older adults; whereas, in Ghana, South Africa and Mexico rural residence is protecting against frailty. Among all countries china has high percentage (71.46) of frail people in low QOL; whereas Mexico has lowest percentage (36.13) of frail people in low QOL.s The risk of having low and middle QOL is significantly (p<0.001) higher among frail elderly as compared to non–frail elderly across all countries with controlling socio-demographic correlates. Conclusion: Women and older age groups are having higher frailty levels than men and younger aged adults in LMICs. The mean frailty scores demonstrated a strong inverse relationship with education and income gradients, while lower levels of education and wealth are showing higher levels of frailty. These patterns are consistent across all LMICs. These data support a significant role of frailty with all other influences controlled, in having low QOL as measured by WHOQOL index. Future research needs to be built on this evolving concept of frailty in an effort to improve quality of life for frail elderly population, in LMICs setting.

Keywords: Keywords: Ageing, elderly, frailty, quality of life

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Authors: Sara D. Garduno-Diaz, Lorena Loriato

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Food selection is one of the main modifiable risk factors for the avoidance of several detrimental health conditions. Excessive and regular sugar intake has been identified as highly unfavorable, yet a highly occurring practice. A proposed approach to modify this eating practice is the online program developed here. The program targets a modification of mindset and lifestyle habits around food, through a four week raw-vegan guided eating program. While the focus of the program is to set up sustainable changes in sugar intake reduction, it also aims to promote a plant-based eating style. Three pilot sessions have been run with participants from seven different countries. Participants are guided through the program via a combination of daily e-mails, a 24-hour support platform, and by-weekly remote live sessions. Meal preparation techniques, as well as cooking instructions, are provided, following set menus developed by a team of professional chefs and nutritionists. Goal setting, as well as alternatives to specific food-related challenges, is addressed. While the program is intended for both women and men, the majority of participants to date have been female. Feedback has been positive, with changes in eating habits have included an elimination of added sugars, an increase in home cooking and vegetable intake, and a reduction in foods of animal origin. Difficulties in following the program have been reported as unavailability of certain ingredients depending on the country of residence of the participants, social and cultural hurdles, and time restrictions. Nevertheless, the results obtained to date indicate this to be a highly interactive program with the potential to be scaled up and applied to various populations as a public health measure on the way to better health.

Keywords: eating habits, food addiction, nutrition education, plant-based, remote practice

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Authors: T. Holecki, J. Wozniak-Holecka, P. Romaniuk

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Due to the highly centralized model of financing health care in Poland, local self-government rarely undertook their own initiatives in the field of public health, particularly health promotion. However, since 2017 the possibility of applying for a subsidy to health policy programs has been allowed, with the additional resources to be retrieved from the National Health Fund, which is the dominant payer in the health system. The amount of subsidy depends on the number of inhabitants in a given unit and ranges about 40% of the total cost of the program. The aim of this paper is to assess the impact of newly implemented solutions in financing health policy on the management of public finances, as well as on the activity provided by local self-government in health promotion. An effort to estimate the amount of expenses that both local governments, and the National Health Fund, spent on local health policy programs while implementing the new solutions. The research method is the analysis of financial data obtained from the National Health Fund and from local government units, as well as reports published by the Agency for Health Technology Assessment and Pricing, which holds substantive control over the health policy programs, and releases permission for their implementation. The study was based on a comparative analysis of expenditures on the implementation of health programs in Poland in years 2010-2018. The presentation of the results includes the inclusion of average annual expenditures of local government units per 1 inhabitant, the total number of positively evaluated applications and the percentage share in total expenditures of local governments (16 voivodships areas). The most essential purpose is to determine whether the assumptions of the subsidy program are working correctly in practice, and what are the real effects of introducing legislative changes into local government levels in the context of public health tasks. The assumption of the study was that the use of a new motivation tool in the field of public management would result in multiplication of resources invested in the provision of health policy programs. Preliminary conclusions show that financial expenditures changed significantly after the introduction of public funding at the level of 40%, obtaining an increase in funding from own funds of local governments at the level of 80 to 90%.

Keywords: health care system, health policy programs, local self-governments, public health management

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Authors: Mumtaz Mooncey, Alexander Jolly, Megan Fisher, Kerry Robinson, Robert Lloyd, Dave Fielding

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Introduction: The integration of the WingFactors in-situ simulation programme has transformed the education landscape at the Whittington Health NHS Trust. To date, there have been a total of 90 simulations - 19 aimed at Paediatric trainees, including 2 Child and Adolescent Mental Health (CAMHS) scenarios. The opportunity for joint debriefs provided by clinical faculty and airline pilots, has created a new exciting avenue to explore human factors within psychiatry. Through the use of real clinical environments and primed actors; the benefits of high fidelity simulation, interdisciplinary and interprofessional learning has been highlighted. The use of in-situ simulation within Psychiatry is a newly emerging concept and its success here has been recognised by unanimously positive feedback from participants and acknowledgement through nomination for the Health Service Journal (HSJ) Award (Best Education Programme 2021). Methodology: The first CAMHS simulation featured a collapsed patient in the toilet with a ligature tied around her neck, accompanied by a distressed parent. This required participants to consider:; emergency physical management of the case, alongside helping to contain the mother and maintaining situational awareness when transferring the patient to an appropriate clinical area. The second simulation was based on a 17- year- old girl attempting to leave the ward after presenting with an overdose, posing potential risk to herself. The safe learning environment enabled participants to explore techniques to engage the young person and understand their concerns, and consider the involvement of other members of the multidisciplinary team. The scenarios were followed by an immediate ‘hot’ debrief, combining technical feedback with Human Factors feedback from uniformed airline pilots and clinicians. The importance of psychological safety was paramount, encouraging open and honest contributions from all participants. Key learning points were summarized into written documents and circulated. Findings: The in-situ simulations demonstrated the need for practical changes both in the Emergency Department and on the Paediatric ward. The presence of airline pilots provided a novel way to debrief on Human Factors. The following key themes were identified: -Team-briefing (‘Golden 5 minutes’) - Taking a few moments to establish experience, initial roles and strategies amongst the team can reduce the need for conversations in front of a distressed patient or anxious relative. -Use of checklists / guidelines - Principles associated with checklist usage (control of pace, rigor, team situational awareness), instead of reliance on accurate memory recall when under pressure. -Read-back - Immediate repetition of safety critical instructions (e.g. drug / dosage) to mitigate the risks associated with miscommunication. -Distraction management - Balancing the risk of losing a team member to manage a distressed relative, versus it impacting on the care of the young person. -Task allocation - The value of the implementation of ‘The 5A’s’ (Availability, Address, Allocate, Ask, Advise), for effective task allocation. Conclusion: 100% of participants have requested more simulation training. Involvement of airline pilots has led to a shift in hospital culture, bringing to the forefront the value of Human Factors focused training and multidisciplinary simulation. This has been of significant value in not only physical health, but also mental health simulation.

Keywords: human factors, in-situ simulation, inter-professional, multidisciplinary

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Authors: J. S. P. Barbosa, L. C. Pereira, K. R. Garcia, P. C. P. Bouchardet, S. C. T. Vieira, A. O. Gomes, S. S. Funghetto, M. G. O. Kanikowski

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For this population, height seems to be a good predictor of strength and body composition. This increase in life expectancy of the Brazilian's population is associated with sociodemographic variables, but also to more access to health services in the prevention and better living conditions. With the growth of elderly population, a problem that has been a concern to health's professionals and public health at all is the use of psychoactive substances. The purpose of this study was to identify the sociodemographic profile of the elderly people who was attended at the Center of Psychosocial Care of alcohol and other drugs in the Federal District of Brazil. 408 medical records of people aged 60 years or over were evaluated, and it is possible to know that most of them were males (85.3%), with a mean age of 64 years (DP ± 4.16), 60 and 84 years and a mean age of 64 years (DP ± 4.42); 88.2% have some family ties, are married and have children, with relatives living in masonry housing. The educational level of drug users was considered low with more emphasis on those who had elementary education being the majority retired or unemployed. Regarding the street situation, there was no significance (p = 0.084), and the women (OR = 2.98) had few chances of street situations compared to men (OR = 0.89). As for substance consumption, the highest quantity of drug consumption bids in relation to the number of illicit. It did not present significant statistical value, and there is a greater probability of consumption/abuse of legal and/or illicit drugs for both sexes (OR = 0.96) for men and (OR = 1.32) for women. In relation to the use of multiple drugs, there was no significant difference between the sexes, (OR = 1.1) male sex and (OR = 0.74) female sex. Based on the results found in the present study, it was concluded that alcohol consumption is the main agent that causes vulnerability in the elderly and predisposes the latter to the consumption of other associated drugs.

Keywords: centers of attention psychosocial alcohol and drugs, elderly, mental disorder due to drug use, street situations

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Authors: Adawati Suhaili, Kamisah Osman, Mohd Effendi, Ewan Mohd Matore

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The global education reform has prompted Malaysia to transform the education system in Malaysia through the Malaysian Education Blueprint (MEB) 2013-2025. This transformation is aimed to achieve the top one-third rank in international assessment. The low achievement of student scientific literacy in TIMMS (Trends in International Mathematics and Science Study ) and PISA (Programme for International Student Assessment) has caused concern to the Ministry Of Education (MOE) despite various reform efforts. Therefore, an alternative action by enhancing the role of the Head of Science Panels (HoSPs) as a key change agent in catalyzing the improvement of student performance should be considered. Highlights of previous studies have shown that subject leadership is able to enhance teacher teaching quality in order to increase student learning. To lead the Science department and guide Science teachers more effectively, HoSPs need to strengthen their leadership skills. However, the issue of weaknesses in the leadership competencies of HoSPs in Malaysia has caused them to lack confidence and ability in leading the Science Department. The main objective of this study is to explore the factors that contribute to the problems faced by HoSPs at Sarawak in their leadership roles. This study used a qualitative design framework and using a semi-structured interview method for data collection. There were six informants involved in the interview consisting of lecturers, Senior Administrative Assistant Teacher and HoSPs. The findings of the study had been identified four main factors that contribute to problems in the leadership competencies of HoSPs in Sarawak, namely leadership practices, leadership structure, academic subjects and school change. The results are significant to the MOE in strengthening the leadership competencies of HoSPs in a more focus for improving the achievement of scientific literacy of students in Malaysia. This study can help improve the Hosps' leadership competencies in Malaysia.

Keywords: issues, problems, Malaysia education blueprint, leadership competencies, head of science panels

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Authors: Hiromi Kawasaki, Satoko Yamasaki, Mika Iwasa, Tomoko Iki, Akiko Takaki

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In basic nursing, the conditions necessary for maintaining human health -temperature, humidity, illumination, distance from others, noise, moisture, meals, and excretion- were explained. Nursing students often think of these conditions in the context of a hospital room. In order to make students think of these conditions in terms of an environment necessary for maintaining health and preventing illness for residents, in the third year of community health nursing, students learned how to assess and improve the environment -particularly via the case of shelters in the event of a disaster. The importance of environmental management has increased in 2020 as a preventive measure against COVID-19 infection. We verified the effect of the lessons, which was decided to be conducted through distance learning. Sixty third-year nursing college students consented to participate in this study. Environmental standard knowledge for conducting environmental assessment was examined before and after class, and the percentage of correct answers was compared. The χ² test was used for the test, with a 5% significance level employed. Measures were evaluated via a report submitted by the students after class. Student descriptions were analyzed both qualitatively and descriptively with respect to expected health problems and suggestions for improvement. Students have already learned about the environment in terms of basic nursing in their second year. The correct answers for external environmental values concerning interpersonal distance, illumination, noise, and room temperature (p < 0.001) increased significantly after taking the class. Humidity was registered 83.3% before class and 93.3% after class (p = 0.077). Regarding the body, the percentage of students who answered correctly was 70% or more, both before and after the class. The students’ reports included overcrowding, high humidity/high temperature, and the number of toilets as health hazards. Health disorders to be prevented were heat stroke, infectious diseases, and economy class syndrome; improvement methods were recommended for hyperventilation, stretching, hydration, and waiting at home. After the public health nursing class, the students were able to not only propose environmental management of a hospital room but also had an understanding of the environment in terms of the lives of individuals, environmental assessment, and solutions to health problems. The response rate for basic items learned in the second year was already high before and after class, and interpersonal distance and ventilation were described by students. Students were able to use what they learned in basic nursing about the standards of the human mind and body. In the external environment, the memory of specific numerical values was ambiguous. The environment of the hospital room is controlled, and interest in numerical values may decrease. Nursing staff needs to maintain and improve human health as well as hospital rooms. With COVID-19, it was thought that students would continue to not only consider this point in reference to hospital rooms but also in regard to places where people gather. Even in distance learning, students were able to learn the important issues and lessons.

Keywords: environmental assessment, evacuation center, nursing education, nursing students

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Authors: Ajay Pinjani, Minha Khan, Ayesha Mehkeri, Anum Iftikhar

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There is much research available on the benefits of adopting mother tongue-based multilingual education (MTB MLE) in primary school classrooms, but there is limited guidance available on how to design such programs for low-resource and linguistically diverse contexts. This paper is an effort to bridge the gap between theory and practice by offering a practitioner’s perspective on designing an MTB MLE program for linguistically heterogeneous contexts. The research compounds findings from current academic literature on MTB MLE, the study of global MTB MLE programs, interviews with practitioners, policy-makers, and academics worldwide, and a socio-linguistic survey carried out in parts of Tharparkar, Pakistan, the area selected for envisioned pilot implementation. These findings enabled the creation of ‘guiding principles’ which provide structure for the development of a contextualized and holistic MTB-MLE program. The guiding principles direct the creation of teaching and learning materials, creating effective teaching and learning environment, community engagement, and program evaluation. Additionally, the paper demonstrates the development of a context-specific language ladder framework which outlines the language journey of a child’s education, beginning with the mother tongue/ most familiar language in the early years and then gradually transitioning into other languages. Both the guiding principles and language ladder can be adapted to any multilingual context. Thus, this research provides MTB MLE practitioners with assistance in developing an MTB MLE model, which is best suited for their context.

Keywords: mother tongue based multilingual education, education design, language ladder, language issues, heterogeneous contexts

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Authors: Nkeiruka Elsie Ezomike, Chinwe L. Onyekonwu, Anthony N. Ikefuna, Bede C. Ibe

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Superficial fungal infections (SFIs) are one of the common cutaneous infections that affect children worldwide. They may lead to school absenteeism or school drop-out and hence setback in the education of the child. Community-based studies in any locality are good reflections of the health conditions within that area. There is a dearth of information in the literature about SFI among primary school children in Enugu. This study aimed to determine the clinicomycological pattern of SFIs among primary school children in rural and urban communities in Enugu. This was a comparative descriptive cross-sectional study among primary school children in Awgu (rural) and Enugu North (urban) Local Government Areas (LGAs). Subjects' selection was made over 6 months using a multi-stage sampling method. Information such as age, sex, parental education, and occupation were collected using questionnaires. Socioeconomic classes of the children were determined using the classification proposed by Oyedeji et al. The samples were collected from subjects with SFIs. Potassium hydroxide tests were done on the samples. The samples that tested positive were cultured for SFI by inoculating onto Sabouraud's dextrose chloramphenicol actidione agar. The characteristics of the isolates were identified according to their morphological features using Mycology Online, Atlas 2000, and Mycology Review 2003. Equal numbers of children were recruited from the two LGAs. A total of 1662 pupils were studied. The mean ages of the study subjects were 9.03 ± 2.10years in rural and 10.46 ± 2.33years in urban communities. The male to female ratio was 1.6:1 in rural and 1:1.1 in urban communities. The personal hygiene of the children was significantly related to the presence of SFIs. The overall prevalence of SFIs among the study participants was 45%. In the rural, the prevalence was 29.6%, and in the urban prevalence was 60.4%. The types of SFIs were tinea capitis (the commonest), tinea corporis, pityriasis Versicolor, tinea unguium, and tinea manuum with prevalence rates lower in rural than urban communities. The clinical patterns were gray patch and black dot type of non-inflammatory tinea capitis, kerion, tinea corporis with trunk and limb distributions, and pityriasis Versicolor with face, trunk and limb distributions. Gray patch was the most frequent pattern of SFI seen in rural and urban communities. Black dot type was more frequent in rural than urban communities. SFIs were frequent among children aged 5 to 8years in rural and 9 to 12 years in urban communities. SFIs were commoner in males in the rural, whereas female dominance was observed in the urban. SFIs were more in children from low social class and those with poor hygiene. Trichophyton tonsurans and Trichophyton soudanese were the common mycological isolates in rural and urban communities, respectively. In conclusion, SFIs were less prevalent in rural than in urban communities. Trichophyton species were the most common fungal isolates in the communities. Health education of mothers and their children on SFI and good personal hygiene will reduce the incidence of SFIs.

Keywords: clinicomycological pattern, communities, primary school children, superficial fungal infections

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Authors: Ahmad Jawad Fardin

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Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.

Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan

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Authors: Sophie Huck, Knut Linke

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This study will examine how IT practitioners can be motivated for IT studies and which kind of support they need during their occupational studies. Within this research project, the challenge of supporting students being engaged in business for several years arose. Here, it is especially important to successfully guide them through their studies. The problem of this group is that they finished their school education years ago. In order to gather first experiences, preliminary e-learning courses were introduced and tested with a group of users studying General Management. They had to work with these courses and have been questioned later on about their approach to the different methods. Moreover, a second group of potential students was interviewed with the help of online questionnaires to give information about their expectations regarding extra occupational studies. We also want to present best practices and cases in e-education in the subarea of mathematics and distance learning. Within these cases and practices, we use state of the art systems and technologies in e-education to find a way to increase teaching quality and the success of students. Our research indicated that the first group of enrolled students appreciated the new preliminary e-learning courses. The second group of potential students was convinced of this way of learning as a significant component of extra occupational studies. It can be concluded that this part of the project clarified the acceptance of the e-learning strategy by both groups and led to satisfactory results with the enrolled students.

Keywords: e-learning evaluation, self-learning, virtual classroom, virtual learning environments

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Authors: A. K. O’Loughlin

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Identity doesn’t exist in discrete categories as it is defined. Kevin Kumashiro reveals the phrase 'an impossibility of identity' in Troubling Education (2000), an investigation of the intersections of culture and gender and the impact of erasure for queer POC identity. This underscores the essentiality of an insider or an outsider identity and the appearance of 'contradiction' or impossibility of these identities. The contradictions between us as subject in our own stories and in the stories of others are often silenced. This silencing of complex, 'contradicting' identity has unmissable implications in the classroom; the developing student in question is done a serious disservice, from which they may never recover. There is no more important point of contact than the teacher, for willingness to encounter a developing person as they are, not as we already think they are, or 'know' them to be, or think they should be. To decide how to regard them based on our own unilateral identity and its associated exhortations and injunctions is, as Hannah Arendt writes in The Origins of Totalitarianism (1951), to sell off our ability to rise, human-like, to the challenge of investigating things as they are. A re-reading of Kumashiro’s impossibility of identity becomes possible through the investigation of pluralism. Identities become possible and un-paradoxical by the notion that contradictions are not problems that an individual is not unilateral, but plural. In this paper, we investigate how philosophies of pluralism can inform our understanding of impossibility of identity in classroom curriculum and pedagogy.

Keywords: identity, gender, culture, pluralism, education, philosophy of education, queer theory, philosophy of mind, adolescent development

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Authors: Eneken Titov, Ly Hobe

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The collaboration between the universities and companies has been a challenging topic for many years, and although we have many good experiences, those seem to be single examples between one university and company. In Ülemiste Smart City in Estonia, the new initiative was started in 2020 fall, when five Estonian universities cooperated, led by the Ülemiste City developing company Mainor, intending to provide charge-free university courses for the Ülemiste City companies and their employees to encourage university-company wider collaboration. Every Ülemiste City company gets a certain number of free educational credit hours per year to participate in university courses. A functional and simple web platform was developed to mediate university courses for the companies. From January 2021, the education credit platform is open for all Ülemiste City companies and their employees to join, and universities offer more than 9000 hours of courses (appr 150 ECTS). Just two months later, more than 20% of Ülemiste City companies (82 out of 400) have joined the project, and their employees have registered for more than in total 3000 hours courses. The first results already show that the project supports the university marketing and the continuous education mindset in general, whether 1/4 of the courses are paid courses (e.g., when the company is out of free credit).

Keywords: education, educational credit, smart city, university-industry collaboration

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Authors: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

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The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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Authors: Jonathan Glazzard

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National student satisfaction data in England demonstrate that undergraduate students are less satisfied overall with assessment and feedback than other aspects of their higher education courses. Given that research findings suggest that high-quality feedback is a critical factor associated with academic achievement, it is important that feedback enables students to demonstrate improved academic achievement in their subsequent assessments. Given the growing importance of staff-student partnerships in higher education, this research examined students’ perceptions of assessment and feedback in one UK university. Students’ perceptions were elicited through the use of a university-wide survey which was completed by undergraduate students. In addition, three focus groups were used to provide qualitative student perception data across the three university Facilities. The data indicate that whilst students valued detailed feedback on their work, less detailed feedback could be compensated for by the development of pre-assessment literacy skills which are front-loaded into courses. Assessment literacy skills valued by students included the use of clear assessment criteria and assignment briefings which enabled students to fully understand the assessment task. Additionally, students valued assessment literacy pre-assessment tasks which enabled them to understand the standards which they were expected to achieve. Students valued opportunities for self and peer assessment prior to the final assessment and formative assessment feedback which matched the summative assessment feedback. Students also valued dialogic face-to-face feedback after receiving written feedback Above all, students valued feedback which was particular to their work and which gave recognition for the effort they had put into completing specific assessments. The data indicate that there is a need for higher education lecturers to receive systematic training in assessment and feedback which provides a comprehensive grounding in pre-assessment literacy skills.

Keywords: formative assessment, summative assessment, feedback, marking

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Authors: Divyanshi Singh

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Women’s right to have choices, sense of self-worth and their right to have access to opportunities have been a subject of serious concern. The health of women and their children in Indian society is adversely affected by the woman’s inferior status within households. The level of human development in society is a reflection of the better status of a woman, which has a clear impact on the usage of contraceptive methods and maternal health. The study is an attempt to assess the performance of Indian states on the parameters of levels of development and to see how the developmental trajectory is influencing the choice for contraception and maternal health. The objective of the paper is to study the relationship between usage of contraception, maternal health and levels of human development in Indian states. Data from NFHS-4th round, AHS (2012-13) and census 2011 is used. Three indicators of human development (effective literacy, infant mortality and gross district domestic product) have been taken. Maternal health for the study has been measured in MMR, IMR and pregnancy resulted in abortions, stillbirths and miscarriage. The multiple regression analysis has been done to analyze the relationship between them. The Developmental factor is found to be greatly influencing the choice of family planning and thus they both show strong relation with maternal health.

Keywords: human development, contraceptive usage, maternal health, effective literacy

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Authors: E. V. Fakhrutdinova, K. R. Maksimova, P. B. Chursin

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At the present stage of the society progress the health care is an integral part of both the economic system and social, while in the second case the medicine is a major component of a number of basic and necessary social programs. Since the foundation of the health system are highly qualified health professionals, it is logical proposition that increase of doctor`s professionalism improves the effectiveness of the system as a whole. Professionalism of the doctor is a collection of many components, essential role played by such personal-psychological factors as honesty, willingness and desire to help people, and motivation. A number of researchers consider motivation as an expression of basic human needs that have passed through the “filter” which is a worldview and values learned in the process of socialization by the individual, to commit certain actions designed to achieve the expected result. From this point of view a number of researchers propose the following classification of highly skilled employee’s needs: 1. the need for confirmation the competence (setting goals that meet the professionalism and receipt of positive emotions in their decision), 2. The need for independence (the ability to make their own choices in contentious situations arising in the process carry out specialist functions), 3. The need for ownership (in the case of health care workers, to the profession and accordingly, high in the eyes of the public status of the doctor). Nevertheless, it is important to understand that in a market economy a significant motivator for physicians (both legal and natural persons) is to maximize its own profits. In the case of health professionals duality motivational structure creates an additional contrast, as in the public mind the image of the ideal physician; usually a altruistically minded person thinking is not primarily about their own benefit, and to assist others. In this context, the question of the real motivation of health workers deserves special attention. The survey conducted by the American researcher Harrison Terni for the magazine "Med Tech" in 2010 revealed the opinion of more than 200 medical students starting courses, and the primary motivation in a profession choice is "desire to help people", only 15% said that they want become a doctor, "to earn a lot". From the point of view of most of the classical theories of motivation this trend can be called positive, as intangible incentives are more effective. However, it is likely that over time the opinion of the respondents may change in the direction of mercantile motives. Thus, it is logical to assume that well-designed system of motivation of doctor`s labor should be based on motivational foundations laid during training in higher education.

Keywords: motivation, quality of working life, health system, personal-psychological factors, motivational structure

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Authors: Saeyoung Lee

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As the enthusiasm for education in Korea is too much high, it is well known by others that children in Korea get good scores in Mathematics. However, behind of this good reputation, children in Korea are easy to get lose self-confidence, tend to complaint and rarely participate in the class because of too much competition which leads to lack of competences. In this regard, the main goals of this paper are, by applying the programme based on peer-communication on Mathematics education field, it would like to improve self-managemental competence to make children gain self-confidence, communicative competence to make them deal with complaint and communitive competence to make them participated in the class for the age of 10 children to solve this problem. 14 children the age of 10 in one primary school in Gangnam, Seoul, Korea had participated in the research from March 2018 to October 2018. They were under the programme based on peer-communication during the period. Every Mathematics class maintained the same way. Firstly a problem was given to children. Secondly, children were asked to find many ways to solve the problem as much as they could by themselves. Thirdly all ways to solve the problem by children were posted on the board and three of the children made a group to distinguish the ways from valid to invalid. Lastly, all children made a discuss to find one way which is the most efficient among valid ways. Pre-test was carried out by the questionnaire based on Likert scale before applying the programme. The result of the pre-test was 3.89 for self-managemental competence, 3.91 for communicative competence and 4.19 for communitive competence. Post-test was carried out by the same questionnaire after applying the programme. The result of the post-test was 3.93 for self-managemental competence, 4.23 for communicative competence and 4.20 for communitive competence. That means by applying the programme based on peer-communication on Mathematics education field, the age of 10 children in Korea could improve self-managemental, communicative and communitive competence. Especially it works very well on communicative competence by increasing 0.32 points as it marked. Considering this research, Korean Mathematics education based on competition which leads to lack of competences should be changed to cooperative structure to make students more competent rather than just getting good scores. In conclusion, innovative teaching methods which are focused on improving competences such as the programme based on peer-communication which was applied in this research are strongly required to be studied and widely used.

Keywords: competences, mathematics education, peer-communication, primary education

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Authors: Thomas Trouton, Sebastian Tanner, Manvir Sandher

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The use of simulation in undergraduate and postgraduate medical curricula is ever-growing, is a useful addition to the traditional apprenticeship model of learning within medical education, and better prepares graduates for the team-based approach to healthcare seen in real-life clinical practice. As a learning tool, however, undergraduate medical students often have little understanding of the theory behind the use of medical simulation and have little experience in planning and delivering their own simulated teaching sessions. We designed and implemented a student-selected component (SSC) as part of the undergraduate medical curriculum at the University of Buckingham Medical School to introduce students to the concepts behind the use of medical simulation in education and allow them to plan and deliver their own simulated medical scenario to their peers. The SSC took place over a 2-week period in the 3rd year of the undergraduate course. There was a mix of lectures, seminars and interactive group work sessions, as well as hands-on experience in the simulation suite, to introduce key concepts related to medical simulation, including technical considerations in simulation, human factors, debriefing and troubleshooting scenarios. We evaluated the success of our SSC using “Net Promotor Scores” (NPS) to assess students’ confidence in planning and facilitating a simulation-based teaching session, as well as leading a debrief session. In all three domains, we showed an increase in the confidence of the students. We also showed an increase in confidence in the management of common medical emergencies as a result of the SSC. Overall, the students who chose our SSC had the opportunity to learn new skills in medical education, with a particular focus on the use of simulation-based teaching, and feedback highlighted that a number of students would take these skills forward in their own practice. We demonstrated an increase in confidence in several domains related to the use of medical simulation in education and have hopefully inspired a new generation of medical educators.

Keywords: simulation, SSC, teaching, medical students

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Authors: Kazuo Nishimura, Junichi Hirata, Tadashi Yagi, Junko Urasaka

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This paper is an investigation of the effect of science education during the high school education how science graduates of universities are appreciated in the labor market in Japan. We conducted a survey utilizing the internet and analyzed the subjects they were good at and their annual income. The results confirm that among science graduates, workers adept at physics tend to have higher incomes compared to workers good at other subjects. Generational analysis based on the curriculum guideline amendments reveals that the generational difference is small among science majors who are good at physics.

Keywords: curriculum, income, physics, science

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Authors: Nitu Marilena Cristina

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Decentralization of the education system is an educational policy option necessary from the perspective of democratizing internal life and streamlining service administration public. The experience of recent years has shown that decisions taken at central level do not to take into account all situations and especially all the specific needs and interests of the various institutions and individuals. A democratic society implies that the decision-making process is brought closer to the place of application, allowing citizens to take part in the decision-making that affects them directly or indirectly. Essentially decentralization of pre-university education is the transfer of authority, responsibility and resources in decision-making and general management, and financially to the educational units and the local community. This creates a frame of an effective collaboration between school and community. Modern theories on the leadership of education advocate the adoption of decentralization measures and participatory strategies. Numerous countries confronted with the educational impasse has appealed to these strategies. Reforming projects have begun application diversified and nuanced social decentralization models according to the specific social and educational situation. Analysis of legal provisions and measures adopted in the framework of the reform process indicates that, at least formally, decentralization is the solution chosen.

Keywords: decentralization, educational, management, reforming

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Authors: V. Rekha, Rama Pal

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The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.

Keywords: child health, inequality, malnutrition, obesity

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Authors: Khin Khin Thant Sin

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This study is a case study which investigates successful and ongoing bottom-up innovations for school improvement initiatives in Hungary. Two innovative schools are selected in this study due to their outstanding achievement during the past ten years in Hungary. In one school, data from the personal experiences of a school principal who initiated the bottom-up innovation are included. For the second school, three interviews were carried out with two schoolteachers and one secondary school student. In addition, desk research, including the principal’s published articles, the schoolteachers’ master thesis, the school websites, and other published articles, are analysed to explore the schools’ innovative processes. This study investigates how bottom-up innovation led to major achievements in student learning, teacher professional development, networking and collaboration with other schools, and the establishment of successful partnerships with universities. The highlight of this study is how innovative schools can be the major sources promoting educational innovations as well as improving teacher education, especially in initial teacher education and continuous professional development.

Keywords: school innovation, teacher education, hungary, educational innovation, school improvement

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Authors: Samira Ghasempourkazemi

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In terms of the COVID-19 pandemic, lots of mutations in the urban system, which have systemic impacts, have clearly appeared. COVID-19 not only had a direct impact on health but also caused significant losses to other departments, including the economy, education, tourism, environment and the construction industry. Therefore, the pandemic caused a disruption in the whole urban system. Particularly, today’s large urban areas are not designed in order to be compatible during a pandemic. Hence, cities are more vulnerable to infectious disease threats according to the population density, built environment and socioeconomic aspects. Considering the direct relationship between population and rate of infection, higher rates are given to those individuals located in areas with high-density populations. Population density can be a factor that seems to have a strong impact on the spread of infectious diseases. Thus, the preliminary hypothesis can be related to a densely populated areas which become hotspots for the rapid spread of the pandemic due to high levels of interaction. In addition, some other indicators can be effective in this condition, such as age range, education and socio-economy. To figure out the measure of infectious disease risk in densely populated areas in Istanbul is an objective of this study. Besides, this study intends to figure out Vulnerability Index in the case of COVID-19. In order to achieve the proper result, the considered method can be Analytic Hierarchy Process (AHP) by involving the mentioned variables. In the end, the study represents the COVID Vulnerability of densely populated areas in a metro city and the gaps that need to be identified and plugged for the pandemic-resilience city of tomorrow.

Keywords: infectious disease, COVID-19, urban system, densely populated area

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Authors: Abdulaziz Kikanga, Kellen Muchira, Styvers Kathuni, Paul Saitoti

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Background: Provision of adequate levels of water, sanitation, and hygiene in schools is a strategic objective in achieving universal primary education among children in low and middle-income countries. However, lack of proper sanitation and hygiene practices in schools, especially those in informal settlement has resulted to an increased rate of school absenteeism thereby affecting the education and health outcomes of the children in those setting. Intervention or Response: Catholic Relief Services in Kenya supports five schools in informal settlements of Nairobi by painting of key hygiene messages on school walls to promote proper hygiene and sanitation practices among the school children. The mural exhibitions depict the essence of proper hygiene practices, proper latrine use, and hand washing after visiting the latrine. The artwork is context specific and its aimed at improving the uptake of proper hygiene and sanitation practices among the school children. Review of project related documents was conducted including interviews with the school children. Thematic analysis was used to interpret the qualitative information generated. Results and Lessons Learnt: 12 school children have interviewed on proper hygiene and sanitation practices and the exercise revealed that painted murals were the best communication platforms for creating awareness on proper sanitation on issues relating to water, sanitation, and hygiene in schools. The painting mural provided a strong knowledge base for the formation of healthy habits in both the school and informal settlement. In addition, these sanitation messages on the school walls empower the children to share these practices with their siblings, parents, and other family members thereby acting as agents of change to proper hygiene and sanitation in those informal settlements. The findings revealed that by adopting proper sanitation and hygiene practices, there has been a reduction of school absenteeism due to a decrease in disease related to inadequate sanitation and hygiene in schools. Conclusion: The adoption of proper sanitation in schools entails more than just a painted mural wall. Insights revealed that to have a lasting sanitation and hygiene intervention, there is a need to invest in effective hygiene educational programming that encourages the formation of proper hygiene habits and promotes changes in behavior.

Keywords: education outcomes, informal settlement, mural exhibition, school hygiene and sanitation

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Authors: Marina Shakleina, Konstantin Shaklein, Stanislav Yakiro

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The digitalization of modern human life over the last decade has facilitated the acquisition, storage, and processing of data, which are used to detect changes in consumer preferences and to improve the internal efficiency of the production process. This emerging trend has attracted academic interest in the use of big data in research. The study focuses on modeling the social comfort of the Russian population for the period 2010-2021 using big data. Big data provides enormous opportunities for understanding human interactions at the scale of society with plenty of space and time dynamics. One of the most popular big data sources is Google Trends. The methodology for assessing social comfort using big data involves several steps: 1. 574 words were selected based on the Harvard IV-4 Dictionary adjusted to fit the reality of everyday Russian life. The set of keywords was further cleansed by excluding queries consisting of verbs and words with several lexical meanings. 2. Search queries were processed to ensure comparability of results: the transformation of data to a 10-point scale, elimination of popularity peaks, detrending, and deseasoning. The proposed methodology for keyword search and Google Trends processing was implemented in the form of a script in the Python programming language. 3. Block and summary integral indicators of social comfort were constructed using the first modified principal component resulting in weighting coefficients values of block components. According to the study, social comfort is described by 12 blocks: ‘health’, ‘education’, ‘social support’, ‘financial situation’, ‘employment’, ‘housing’, ‘ethical norms’, ‘security’, ‘political stability’, ‘leisure’, ‘environment’, ‘infrastructure’. According to the model, the summary integral indicator increased by 54% and was 4.631 points; the average annual rate was 3.6%, which is higher than the rate of economic growth by 2.7 p.p. The value of the indicator describing social comfort in Russia is determined by 26% by ‘social support’, 24% by ‘education’, 12% by ‘infrastructure’, 10% by ‘leisure’, and the remaining 28% by others. Among 25% of the most popular searches, 85% are of negative nature and are mainly related to the blocks ‘security’, ‘political stability’, ‘health’, for example, ‘crime rate’, ‘vulnerability’. Among the 25% most unpopular queries, 99% of the queries were positive and mostly related to the blocks ‘ethical norms’, ‘education’, ‘employment’, for example, ‘social package’, ‘recycling’. In conclusion, the introduction of the latent category ‘social comfort’ into the scientific vocabulary deepens the theory of the quality of life of the population in terms of the study of the involvement of an individual in the society and expanding the subjective aspect of the measurements of various indicators. Integral assessment of social comfort demonstrates the overall picture of the development of the phenomenon over time and space and quantitatively evaluates ongoing socio-economic policy. The application of big data in the assessment of latent categories gives stable results, which opens up possibilities for their practical implementation.

Keywords: big data, Google trends, integral indicator, social comfort

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Authors: Sohail Bawani, Kausar S. Khan, Rozina Karmaliani, Shehnaz Mir

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Action research (AR) is one of the types of health systems research (HSR), and participatory action research (PAR) is known for being effective in health systems strengthening (HSS). The current literature on PAR for HSS cites numerous examples and case studies that led to improve health services; build child health information system; increase knowledge and awareness of people about health problems, and identify pathways for institutional and policy change by engaging people in research. But examples of marginalized communities being agents of change in health governance are not common in health systems research (HSR). This approach to PAR is at the heart of Paolo Freire’s Social Transformation Theory and Critical Consciousness building, which was used to design a community-based PAR study in the Northern/mountainous areas of Pakistan. The purpose of the study was to understand the place and role of marginalized communities in strengthening existing health governance structure (health facility and village health committees and health boards) by taking marginalized communities as partners. Community meetings were carried out to identify who is living at the social, political, cultural and economic margins in 40 different villages. Participatory reflection and analysis (PRA) tools were used during the meeting to facilitate identification. Focus group discussions were conducted with marginalized groups using PRA tools and family ethnographies with marginalized families identified through group discussions. Findings of the study revealed that for the marginalized health systems constitute more than just delivery of health services, but it also embraces social determinants that surround systems and its governance. The paper argues that from Frerian perspective people’s participation should not only be limited to knowledge generation. People must be seen active users of the knowledge that they generate for achieving better health outcomes that they want to achieve in the time to come. PAR provides a pathway to the marginalized in playing a role in health governance. The study dissemination planned shall engage the marginalized in a dialogue with service providers so that together a role for the marginalized can be outlined.

Keywords: participatory action research, health systems, marginalized, health services

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