Search results for: outcome based curriculum
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 29171

Search results for: outcome based curriculum

28901 SWOT Analysis of the Industrial Sector in Kuwait

Authors: Abdullah Al-Alaian, Ahmad Al-Enzi, Hasan Al-Herz, Ahmad Bakri, Shant Tatorian, Amr Nounou

Abstract:

Kuwait is a country that has an imbalanced economy since most of its national outcome comes from the oil trade. It is so risky for a country to be dependent on a single source for income, and this increases the need to diversify its economy. In addition, according to the Public Authority for Industry, the contribution of the industrial sector to the current Gross Domestic Product (GDP) of Kuwait is low which is about 4.33%. Therefore, the development of the industrial sector can be one of the means to diversify the economy and increase the industry's contribution to the national outcome. This is in accordance with Kuwait’s vision of 2035 which aims at increasing the contribution of the industrial sector to the GDP to 12%. In order to do so, this study aims at proposing a strategic plan that will accomplish certain objectives when implemented. It is based on analyzing the industrial sectors in Kuwait taking into consideration studying the strengths, weaknesses, opportunities, and threats facing them. At the same time, it tends to gain from the experience of leading models and neighboring countries regarding the development of the industrial sector. In this study, the SWOT analysis technique will be conducted on all industrial sectors based on evaluation criteria in which it is determined whether any of them has a potential for improvement or not. In other words, it is determined whether the sectors are able to compete locally, regionally, or globally. Based on the results of the SWOT analysis, certain sectors will be chosen, assessed based on an assessment scheme, and their potentials for improvement will be aligned with the overall objectives. To ensure the achievement of the study’s objectives, an action plan will be proposed regarding recommendations for the related authorities, and for entrepreneurs. In addition, monitoring tools are going to be provided for the purpose of periodically checking the progress made in the implementation of the plan.

Keywords: industrial sector, SWOT analysis, productivity, competitiveness, GDP, Kuwait, economy

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28900 Shedding Light on the Black Box: Explaining Deep Neural Network Prediction of Clinical Outcome

Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

Abstract:

Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

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28899 Using Design Sprint For Software Engineering Undergraduate Student Projects: A Method Paper

Authors: Sobhani U. Pilapitiya, Tharanga Peiris

Abstract:

Software Engineering curriculums generally consist of industry-based practices such as project-based learning (PBL) which mainly focuses on efficient and innovative product development. These approaches can be tailored and used in project-based modules in software engineering curriculums. However, there are very limited attempts in the area especially related to the Sri Lankan context. This paper describes a tailored pedagogical approach and its results of using design sprint which can be used for project-based modules in SE curriculums. A controlled group of second-year software engineering students was selected for the study. The study results indicate that 100% of students agreed that the Design Sprint approach is effective in group-based projects and 83% of students stated that it minimized the re-work compared to traditional project approaches. The tailored process was effective, easy to implement and produced desired results at the end of the session while providing students an enjoyable experience.

Keywords: design sprint, PBL, software engineering, curriculum

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28898 Challenges of Teaching Physical Education to Students With Special Needs in Regular School Settings

Authors: Christine Okello

Abstract:

Physical Education (PE) curriculum provides school age students to explore issues that are likely to impact on health, safety, and well-being. The current curriculum includes the physical activity component, intended to improve physical fitness, social skills as well as building confidence. While this viewpoint is vital, there are challenges and stigma attached when specific issues are either ignored, inadequately addressed, or not seen to be important. The department stipulates that students attend a school that is closest to their home, to access available government transportation to and from school. Equivalently, parents of students with a disability decide where their children attend school. A choice between a regular classroom, mainstream Special Unit classroom, or a School for Specific Purposes (SSP). Parents who take their children to regular schools may be oblivious of the details of the curriculum. Physical Education outcomes does not stipulate the extent to which a student must perform or expected to perform. It is therefore due to the classroom teacher to adjust their teaching goals or outcomes to suit all students in their classroom. A student who can run a hundred meters race in 20 seconds may belong in the same classroom as a student in a wheelchair. While these students are challenged because of a lack of performance, teachers are challenged to effectively teach successful PE lessons, and on the other hand students without a disability may not be able to attain their optimum. This paper will identify areas of need, address the challenges, and explore a possible solution.

Keywords: special needs, disability, challenges, physical education

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28897 Voices of Fear: A Case Study Of Tobephobia Experienced by Female Teachers

Authors: Prakash Singh

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In this exploratory qualitative case study, the voices of female teachers are captured that describe their fear of failure in coping with their daily anxieties, stresses, and tensions in their classrooms. When teachers are usually appointed, the curriculum forms the heart of all their professional obligations. The policy of quality and equality of education for all learners is a must as part of these deliberations, otherwise it would spell the inevitable failure for teachers. Yet, how often have teachers been asked whether they are happy during their professional tenure. Research affirms that this question is not a priority, seeing that the happiness of learners and the educational administrators enjoy precedence. Teachers are often subject to undue pressures and tensions because of environmental factors that extends beyond the curriculum. School violence, bullying, drug abuse, and gangsters are not uncommon to the school milieu, no matter where such schools can be located. In this case study, the voices of female teachers find space concerning their experiences of tobephobia (TBP). The questions that inevitably arise are: Are the educational authorities aware of the effects of TBP in education? What can be done to arrest and eliminate the debilitating effects of TBP? This exploratory study contributes to the growing concerns of TBP in education. It is therefore imperative that the effects of TBP on human resources in education must be accentuated so that meaningful solutions can be found to address challenging educational issues such as school violence, bullying, and drug abuse amongst learners.

Keywords: curriculum, female teachers, school violence, tobephobia

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28896 A Comparative Study on the Use of Learning Resources in Learning Biochemistry by MBBS Students at Ras Al Khaimah Medical and Health Sciences University, UAE

Authors: B. K. Manjunatha Goud, Aruna Chanu Oinam

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The undergraduate medical curriculum is oriented towards training the students to undertake the responsibilities of a physician. During the training period, adequate emphasis is placed on inculcating logical and scientific habits of thought; clarity of expression and independence of judgment; and ability to collect and analyze information and to correlate them. At Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Biochemistry a basic medical science subject is taught in the 1st year of 5 years medical course with vertical interdisciplinary interaction with all subjects, which needs to be taught and learned adequately by the students to be related to clinical case or clinical problem in medicine and future diagnostics so that they can practice confidently and skillfully in the community. Based on these facts study was done to know the extent of usage of library resources by the students and the impact of study materials on their preparation for examination. It was a comparative cross sectional study included 100 and 80 1st and 2nd-year students who had successfully completed Biochemistry course. The purpose of the study was explained to all students [participants]. Information was collected on a pre-designed, pre-tested and self-administered questionnaire. The questionnaire was validated by the senior faculties and pre tested on students who were not involved in the study. The study results showed that 80.30% and 93.15% of 1st and 2nd year students have the clear idea of course outline given in course handout or study guide. We also found a statistically significant number of students agreed that they were benefited from the practical session and writing notes in the class hour. A high percentage of students [50% and 62.02%] disagreed that that reading only the handouts is enough for their examination as compared to other students. The study also showed that only 35% and 41% of students visited the library on daily basis for the learning process, around 65% of students were using lecture notes and text books as a tool for learning and to understand the subject and 45% and 53% of students used the library resources (recommended text books) compared to online sources before the examinations. The results presented here show that students perceived that e-learning resources like power point presentations along with text book reading using SQ4R technique had made a positive impact on various aspects of their learning in Biochemistry. The use of library by students has overall positive impact on learning process especially in medical field enhances the outcome, and medical students are better equipped to treat the patient. But it’s also true that use of library use has been in decline which will impact the knowledge aspects and outcome. In conclusion, a student has to be taught how to use the library as learning tool apart from lecture handouts.

Keywords: medical education, learning resources, study guide, biochemistry

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28895 Decision-Making Under Uncertainty in Obsessive-Compulsive Disorder

Authors: Helen Pushkarskaya, David Tolin, Lital Ruderman, Ariel Kirshenbaum, J. MacLaren Kelly, Christopher Pittenger, Ifat Levy

Abstract:

Obsessive-Compulsive Disorder (OCD) produces profound morbidity. Difficulties with decision making and intolerance of uncertainty are prominent clinical features of OCD. The nature and etiology of these deficits are poorly understood. We used a well-validated choice task, grounded in behavioral economic theory, to investigate differences in valuation and value-based choice during decision making under uncertainty in 20 unmedicated participants with OCD and 20 matched healthy controls. Participants’ choices were used to assess individual decision-making characteristics. Compared to controls, individuals with OCD were less consistent in their choices and less able to identify options that were unambiguously preferable. These differences correlated with symptom severity. OCD participants did not differ from controls in how they valued uncertain options when outcome probabilities were known (risk) but were more likely than controls to avoid uncertain options when these probabilities were imprecisely specified (ambiguity). These results suggest that the underlying neural mechanisms of valuation and value-based choices during decision-making are abnormal in OCD. Individuals with OCD show elevated intolerance of uncertainty, but only when outcome probabilities are themselves uncertain. Future research focused on the neural valuation network, which is implicated in value-based computations, may provide new neurocognitive insights into the pathophysiology of OCD. Deficits in decision-making processes may represent a target for therapeutic intervention.

Keywords: obsessive compulsive disorder, decision-making, uncertainty intolerance, risk aversion, ambiguity aversion, valuation

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28894 The Use of Coronary Calcium Scanning for Cholesterol Assessment and Management

Authors: Eva Kirzner

Abstract:

Based on outcome studies published over the past two decades, in 2018, the ACC/AHA published new guidelines for the management of hypercholesterolemia that incorporate the use of coronary artery calcium (CAC) scanning as a decision tool for ascertaining which patients may benefit from statin therapy. This use is based on the recognition that the absence of calcium on CAC scanning (i.e., a CAC score of zero) usually signifies the absence of significant atherosclerotic deposits in the coronary arteries. Specifically, in patients with a high risk for atherosclerotic cardiovascular disease (ASCVD), initiation of statin therapy is generally recommended to decrease ASCVD risk. However, among patients with intermediate ASCVD risk, the need for statin therapy is less certain. However, there is a need for new outcome studies that provide evidence that the management of hypercholesterolemia based on these new ACC/AHA recommendations is safe for patients. Based on a Pub-Med and Google Scholar literature search, four relevant population-based or patient-based cohort studies that studied the relationship between CAC scanning, risk assessment or mortality, and statin therapy that were published between 2017 and 2021 were identified (see references). In each of these studies, patients were assessed for their baseline risk for atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohorts Equation (PCE), an ACC/AHA calculator for determining patient risk based on assessment of patient age, gender, ethnicity, and coronary artery disease risk factors. The combined findings of these four studies provided concordant evidence that a zero CAC score defines patients who remain at low clinical risk despite the non-use of statin therapy. Thus, these new studies confirm the use of CAC scanning as a safe tool for reducing the potential overuse of statin therapy among patients with zero CAC scores. Incorporating these new data suggest the following best practice: (1) ascertain ASCVD risk according to the PCE in all patients; (2) following an initial attempt trial to lower ASCVD risk with optimal diet among patients with elevated ASCVD risk, initiate statin therapy for patients who have a high ASCVD risk score; (3) if the ASCVD score is intermediate, refer patients for CAC scanning; and (4) and if the CAC score is zero among the intermediate risk ASCVD patients, statin therapy can be safely withheld despite the presence of an elevated serum cholesterol level.

Keywords: cholesterol, cardiovascular disease, statin therapy, coronary calcium

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28893 Identifying the Hidden Curriculum Components in the Nursing Education

Authors: Alice Khachian, Shoaleh Bigdeli, Azita Shoghie, Leili Borimnejad

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Background and aim: The hidden curriculum is crucial in nursing education and can determine professionalism and professional competence. It has a significant effect on their moral performance in relation to patients. The present study was conducted with the aim of identifying the hidden curriculum components in the nursing and midwifery faculty. Methodology: The ethnographic study was conducted over two years using the Spradley method in one of the nursing schools located in Tehran. In this focused ethnographic research, the approach of Lincoln and Goba, i.e., transferability, confirmability, and dependability, was used. To increase the validity of the data, they were collected from different sources, such as participatory observation, formal and informal interviews, and document review. Two hundred days of participatory observation, fifty informal interviews, and fifteen formal interviews from the maximum opportunities and conditions available to obtain multiple and multilateral information added to the validity of the data. Due to the situation of COVID, some interviews were conducted virtually, and the activity of professors and students in the virtual space was also monitored. Findings: The components of the hidden curriculum of the faculty are: the atmosphere (physical environment, organizational structure, rules and regulations, hospital environment), the interaction between activists, and teaching-learning activities, which ultimately lead to “A disconnection between goals, speech, behavior, and result” had revealed. Conclusion: The mutual effects of the atmosphere and various actors and activities on the process of student development, since the students have the most contact with their peers first, which leads to the most learning, and secondly with the teachers. Clinicians who have close and person-to-person contact with students can have very important effects on students. Students who meet capable and satisfied professors on their way become interested in their field and hope for their future by following the mentor of these professors. On the other hand, weak and dissatisfied professors lead students to feel abandoned, and by forming a colony of peers with different backgrounds, they distort the personality of a group of students and move away from family values, which necessitates a change in some cultural practices at the faculty level.

Keywords: hidden curriculum, nursing education, ethnography, nursing

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28892 Extended Knowledge Exchange with Industrial Partners: A Case Study

Authors: C. Fortin, D. Tokmeninova, O. Ushakova

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Among 500 Russian universities Skolkovo Institute of Science and Technology (Skoltech) is one of the youngest (established in 2011), quite small and vastly international, comprising 20 percent of international students and 70 percent of faculty with significant academic experience at top-100 universities (QS, THE). The institute has emerged from close collaboration with MIT and leading Russian universities. Skoltech is an entirely English speaking environment. Skoltech curriculum plans of ten Master programs are based on the CDIO learning outcomes model. However, despite the Institute’s unique focus on industrial innovations and startups, one of the main challenges has become an evident large proportion of nearly half of MSc graduates entering PhD programs at Skoltech or other universities rather than industry or entrepreneurship. In order to increase the share of students joining the industrial sector after graduation, Skoltech started implementing a number of unique practices with a focus on employers’ expectations incorporated into the curriculum redesign. In this sense, extended knowledge exchange with industrial partners via collaboration in learning activities, industrial projects and assessments became essential for students’ headway into industrial and entrepreneurship pathways. Current academic curriculum includes the following types of components based on extended knowledge exchange with industrial partners: innovation workshop, industrial immersion, special industrial tracks, MSc defenses. Innovation workshop is a 4 week full time diving into the Skoltech vibrant ecosystem designed to foster innovators, focuses on teamwork, group projects, and sparks entrepreneurial instincts from the very first days of study. From 2019 the number of mentors from industry and startups significantly increased to guide students across these sectors’ demands. Industrial immersion is an exclusive part of Skoltech curriculum where students after the first year of study spend 8 weeks in an industrial company carrying out an individual or team project and are guided jointly by both Skoltech and company supervisors. The aim of the industrial immersion is to familiarize students with relevant needs of Russian industry and to prepare graduates for job placement. During the immersion a company plays the role of a challenge provider for students. Skoltech has started a special industrial track comprising deep collaboration with IPG Photonics – a leading R&D company and manufacturer of high-performance fiber lasers and amplifiers for diverse applications. The track is aimed to train a new cohort of engineers and includes a variety of activities for students within the “Photonics” MSc program. It is expected to be a successful story and used as an example for similar initiatives with other Russian high-tech companies. One of the pathways of extended knowledge exchange with industrial partners is an active involvement of potential employers in MSc Defense Committees to review and assess MSc thesis projects and to participate in defense procedures. The paper will evaluate the effect and results of the above undertaken measures.

Keywords: Curriculum redesign, knowledge exchange model, learning outcomes framework, stakeholder engagement

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28891 Innovating Translation Pedagogy: Maximizing Teaching Effectiveness by Focusing on Cognitive Study

Authors: Dawn Tsang

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This paper aims at synthesizing the difficulties in cognitive processes faced by translation majors in mainland China. The purpose is to develop possible solutions and innovation in terms of translation pedagogy, curriculum reform, and syllabus design. This research will base its analysis on students’ instant feedback and interview after training in translation and interpreting courses, and translation faculty’s teaching experiences. This research will take our translation majors as the starting point, who will be one of the focus groups. At present, our Applied Translation Studies Programme is offering translation courses in the following areas: practical translation and interpreting, translation theories, culture and translation, and internship. It is a four-year translation programme, and our students would start their introductory courses since Semester 1 of Year 1. The medium of instruction of our College is solely in English. In general, our students’ competency in English is strong. Yet in translation and especially interpreting classes, no matter it is students’ first attempt or students who have taken university English courses, students find class practices very challenging, if not mission impossible. Their biggest learning problem seems to be weakening cognitive processes in terms of lack of intercultural competence, incomprehension of English language and foreign cultures, inadequate aptitude and slow reaction, and inapt to utilize one’s vocabulary bank etc. This being so, the research questions include: (1) What specific and common cognitive difficulties are students facing while learning translation and interpreting? (2) How to deal with such difficulties, and what implications can be drawn on curriculum reform and syllabus design in translation? (3) How significant should cognitive study be placed on translation curriculum, i.e., the proportion of cognitive study in translation/interpreting courses and in translation major curriculum? and (4) What can we as translation educators do to maximize teaching and learning effectiveness by incorporating the latest development of cognitive study?. We have collected translation students’ instant feedback and conduct interviews with both students and teaching staff, in order to draw parallels as well as distinguishing from our own current teaching practices at United International College (UIC). We have collected 500 questionnaires for now. The main learning difficulties include: poor vocabulary bank, lack of listening and reading comprehension skills in terms of not fully understanding the subtext, aptitude in translation and interpreting etc. This being so, we propose to reform and revitalize translation curriculum and syllabi to address to these difficulties. The aim is to maximize teaching effectiveness in translation by addressing the above-mentioned questions with a special focus on cognitive difficulties faced by translation majors.

Keywords: cognitive difficulties, teaching and learning effectiveness, translation curriculum reform, translation pedagogy

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28890 Graphic Calculator Effectiveness in Biology Teaching and Learning

Authors: Nik Azmah Nik Yusuff, Faridah Hassan Basri, Rosnidar Mansor

Abstract:

The purpose of the study is to find out the effectiveness of using Graphic calculators (GC) with Calculator Based Laboratory 2 (CBL2) in teaching and learning of form four biology for these topics: Nutrition, Respiration and Dynamic Ecosystem. Sixty form four science stream students were the participants of this study. The participants were divided equally into the treatment and control groups. The treatment group used GC with CBL2 during experiments while the control group used the ordinary conventional laboratory apparatus without using GC with CBL2. Instruments in this study were a set of pre-test and post-test and a questionnaire. T-Test was used to compare the student’s biology achievement while a descriptive statistic was used to analyze the outcome of the questionnaire. The findings of this study indicated the use of GC with CBL2 in biology had significant positive effect. The highest mean was 4.43 for item stating the use of GC with CBL2 had saved collecting experiment result’s time. The second highest mean was 4.10 for item stating GC with CBL2 had saved drawing and labelling graphs. The outcome from the questionnaire also showed that GC with CBL2 were easy to use and save time. Thus, teachers should use GC with CBL2 in support of efforts by Malaysia Ministry of Education in encouraging technology-enhanced lessons.

Keywords: biology experiments, Calculator-Based Laboratory 2 (CBL2), graphic calculators, Malaysia Secondary School, teaching/learning

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28889 Afrikan Natural Medicines: An Innovation-Based Model for Medicines Production, Curriculum Development and Clinical Application

Authors: H. Chabalala, A. Grootboom, M. Tang

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The innovative development, production, and clinical utilisation of African natural medicines requires frameworks from systematisation, innovation, registration. Afrika faces challenges when it comes to these sectors. The opposite is the case as is is evident in ancient Asian (Traditional Chinese Medicine and Indian Ayurveda and Siddha) medical systems, which are interfaced into their respective national health and educational systems. Afrikan Natural Medicines (ANMs) are yet to develop systematisation frameworks, i.e. disease characterisation and medicines classification. This paper explores classical medical systems drawn from Afrikan and Chinese experts in natural medicines. An Afrikological research methodology was used to conduct in-depth interviews with 20 key respondents selected through purposeful sampling technique. Data was summarised into systematisation frameworks for classical disease theories, patient categorisation, medicine classification, aetiology and pathogenesis of disease, diagnosis and prognosis techniques and treatment methods. It was discovered that ancient Afrika had systematic medical cosmologies, remnants of which are evident in most Afrikan cultural health practices. Parallels could be drawn from classical medical concepts of antiquity, like Chinese Taoist and Indian tantric health systems. Data revealed that both the ancient and contemporary ANM systems were based on living medical cosmologies. The study showed that African Natural Healing Systems have etiological systems, general pathogenesis knowledge, differential diagnostic techniques, comprehensive prognosis and holistic treatment regimes. Systematisation models were developed out of these frameworks, and this could be used for evaluation of clinical research, medical application including development of curriculum for high-education. It was envisaged that frameworks will pave way towards the development, production and commercialisation of ANMs. This was piloted in inclusive innovation, technology transfer and commercialisation of South African natural medicines, cosmeceuticals, nutraceuticals and health infusions. The central model presented here in will assist in curriculum development and establishment of Afrikan Medicines Hospitals and Pharmaceutical Industries.

Keywords: African Natural Medicines, Indigenous Knowledge Systems, Medical Cosmology, Clinical Application

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28888 The Accuracy of an In-House Developed Computer-Assisted Surgery Protocol for Mandibular Micro-Vascular Reconstruction

Authors: Christophe Spaas, Lies Pottel, Joke De Ceulaer, Johan Abeloos, Philippe Lamoral, Tom De Backer, Calix De Clercq

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We aimed to evaluate the accuracy of an in-house developed low-cost computer-assisted surgery (CAS) protocol for osseous free flap mandibular reconstruction. All patients who underwent primary or secondary mandibular reconstruction with a free (solely or composite) osseous flap, either a fibula free flap or iliac crest free flap, between January 2014 and December 2017 were evaluated. The low-cost protocol consisted out of a virtual surgical planning, a prebend custom reconstruction plate and an individualized free flap positioning guide. The accuracy of the protocol was evaluated through comparison of the postoperative outcome with the 3D virtual planning, based on measurement of the following parameters: intercondylar distance, mandibular angle (axial and sagittal), inner angular distance, anterior-posterior distance, length of the fibular/iliac crest segments and osteotomy angles. A statistical analysis of the obtained values was done. Virtual 3D surgical planning and cutting guide design were performed with Proplan CMF® software (Materialise, Leuven, Belgium) and IPS Gate (KLS Martin, Tuttlingen, Germany). Segmentation of the DICOM data as well as outcome analysis were done with BrainLab iPlan® Software (Brainlab AG, Feldkirchen, Germany). A cost analysis of the protocol was done. Twenty-two patients (11 fibula /11 iliac crest) were included and analyzed. Based on voxel-based registration on the cranial base, 3D virtual planning landmark parameters did not significantly differ from those measured on the actual treatment outcome (p-values >0.05). A cost evaluation of the in-house developed CAS protocol revealed a 1750 euro cost reduction in comparison with a standard CAS protocol with a patient-specific reconstruction plate. Our results indicate that an accurate transfer of the planning with our in-house developed low-cost CAS protocol is feasible at a significant lower cost.

Keywords: CAD/CAM, computer-assisted surgery, low-cost, mandibular reconstruction

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28887 Charting the Course: Using group Charters to Enhance Engagement and Learning Outcomes

Authors: Angela Knox

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Student diversity in postgraduate classes puts major challengesoneducatorsseekingtoencouragestudentengagementand desired learning outcomes. This paper outlines the impact of a set of teaching initiatives aimed at addressing challenges associated with teaching and learning in an environment characterized by diversity in the student cohort. The study examines postgraduate students completing the core capstone unit within a specialized business degree. Although relatively small, the student cohort is highly diverse in terms of cultural backgrounds represented, prior learning and/or qualifications,aswellasdurationandtypeofworkexperiencerelevant to the degree being completed. The wide range of cultures, existing knowledge, and experience create enormous challenges with respect to students’ learning needs and outcomes. Subsequently, a suite of teaching innovations has been adopted to enhance curriculum content/delivery and the design of assessments. This paperexplores the impact of formalized group charters on students’ learning outcomes. Data from surveys and focus groups are used to assess the effectiveness of these practices. The results highlight the effectiveness of formalizedgroup charters in addressing diverse student needs and enhancing student engagement and learning outcomes. Thesefindings suggest that such practices would benefit students’ learning in environments marked by diversity in the student cohort. Specific recommendationsareofferedforothereducatorsworkingwithdiverse classes.

Keywords: assessment design, curriculum content, curriculum delivery, group charter, student diversity

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28886 A Green Analytical Curriculum for Renewable STEM Education

Authors: Mian Jiang, Zhenyi Wu

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We have incorporated green components into existing analytical chemistry curriculum with the aims to present a more environment benign approach in both teaching laboratory and undergraduate research. These include the use of cheap, sustainable, and market-available material; minimized waste disposal, replacement of non-aqueous media; and scale-down in sample/reagent consumption. Model incorporations have covered topics in quantitative chemistry as well as instrumental analysis, lower division as well as upper level, and research in traditional titration, spectroscopy, electrochemical analysis, and chromatography. The green embedding has made chemistry more daily life relevance, and application focus. Our approach has the potential to expand into all STEM fields to make renewable, high-impact education experience for undergraduate students.

Keywords: green analytical chemistry, pencil lead, mercury, renewable

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28885 Expanding Access and Deepening Engagement: Building an Open Source Digital Platform for Restoration-Based Stem Education in the Largest Public-School System in the United States

Authors: Lauren B. Birney

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This project focuses upon the expansion of the existing "Curriculum and Community Enterprise for the Restoration of New York Harbor in New York City Public Schools" NSF EHR DRL 1440869, NSF EHR DRL 1839656 and NSF EHR DRL 1759006. This project is recognized locally as “Curriculum and Community Enterprise for Restoration Science,” or CCERS. CCERS is a comprehensive model of ecological restoration-based STEM education for urban public-school students. Following an accelerated rollout, CCERS is now being implemented in 120+ Title 1 funded NYC Department of Education middle schools, led by two cohorts of 250 teachers, serving more than 11,000 students in total. Initial results and baseline data suggest that the CCERS model, with the Billion Oyster Project (BOP) as its local restoration ecology-based STEM curriculum, is having profound impacts on students, teachers, school leaders, and the broader community of CCERS participants and stakeholders. Students and teachers report being receptive to the CCERS model and deeply engaged in the initial phase of curriculum development, citizen science data collection, and student-centered, problem-based STEM learning. The BOP CCERS Digital Platform will serve as the central technology hub for all research, data, data analysis, resources, materials and student data to promote global interactions between communities, Research conducted included qualitative and quantitative data analysis. We continue to work internally on making edits and changes to accommodate a dynamic society. The STEM Collaboratory NYC® at Pace University New York City continues to act as the prime institution for the BOP CCERS project since the project’s inception in 2014. The project continues to strive to provide opportunities in STEM for underrepresented and underserved populations in New York City. The replicable model serves as an opportunity for other entities to create this type of collaboration within their own communities and ignite a community to come together and address the notable issue. Providing opportunities for young students to engage in community initiatives allows for a more cohesive set of stakeholders, ability for young people to network and provide additional resources for those students in need of additional support, resources and structure. The project has planted more than 47 million oysters across 12 acres and 15 reef sites, with the help of more than 8,000 students and 10,000 volunteers. Additional enhancements and features on the BOP CCERS Digital Platform will continue over the next three years through funding provided by the National Science Foundation, NSF DRL EHR 1759006/1839656 Principal Investigator Dr. Lauren Birney, Professor Pace University. Early results from the data indicate that the new version of the Platform is creating traction both nationally and internationally among community stakeholders and constituents. This project continues to focus on new collaborative partners that will support underrepresented students in STEM Education. The advanced Digital Platform will allow for us connect with other countries and networks on a larger Global scale.

Keywords: STEM education, environmental restoration science, technology, citizen science

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28884 Social Studies Teachers’ Sustained, Collaborative Professional Development Centered Round Innovative Curriculum Materials

Authors: Cory Callahan

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Here the author synthesizes findings and implications from two research studies that comprise a continuing line of inquiry into the potential of an innovative professional development program to help in-service teachers understand and implement a complex model of social studies instruction. The paper specifically explores the question: To what degree can a collaborative professional development program centered around innovative curriculum materials help social studies teachers understand and implement a powerful social studies approach? Findings suggest the teachers increasingly incorporated substantive thinking (i.e., second-order historical domain knowledge) into their respective practice and they facilitated students’ use of historical photographs as evidence to begin to answer a compelling question. The teachers also began to effectively support students’ abilities to make claims about the past. Implications include the foregrounding of high-quality questions during planning and the need for explicit guidance in the form of structures and procedures (i.e., scaffolds) to help teachers systematically review students’ work products. The work shared here may contribute to scholarship that posits explanations for why teacher-support is routinely ineffectual and suggests ways to provide substantive collaborative support for in-service social studies teachers.

Keywords: educative curriculum, social studies, professional development, lesson study

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28883 The Use of Respiratory Index of Severity in Children (RISC) for Predicting Clinical Outcomes for 3 Months-59 Months Old Patients Hospitalized with Community-Acquired Pneumonia in Visayas Community Medical Center, Cebu City from January 2013 - June 2

Authors: Karl Owen L. Suan, Juliet Marie S. Lambayan, Floramay P. Salo-Curato

Abstract:

Objective: To predict the outcome among patients admitted with community-acquired pneumonia (ages 3 months to 59 months old) admitted in Visayas Community Medical Center using the Respiratory Index of Severity in Children (RISC). Design: A cross-sectional study design was used. Setting: The study was done in Visayas Community Medical Center, which is a private tertiary level in Cebu City from January-June 2013. Patients/Participants: A total of 72 patients were initially enrolled in the study. However, 1 patient transferred to another institution, thus 71 patients were included in this study. Within 24 hours from admission, patients were assigned a RISC score. Statistical Analysis: Cohen’s kappa coefficient was used for inter-rater agreement for categorical data. This study used frequency and percentage distribution for qualitative data. Mean, standard deviation and range were used for quantitative data. To determine the relationship of each RISC score parameter and the total RISC score with the outcome, a Mann Whitney U Test and 2x2 Fischer Exact test for testing associations were used. A p value less of than 0.05 alpha was considered significant. Results: There was a statistical significance between RISC score and clinical outcome. RISC score of greater than 4 was correlated with intubation and/or mortality. Conclusion: The RISC scoring system is a simple combination of clinical parameters and a reliable tool that will help stratify patients aged 3 months to 59 months in predicting clinical outcome.

Keywords: RISC, clinical outcome, community-acquired pneumonia, patients

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28882 A Mixed Methods Study: Evaluation of Experiential Learning Techniques throughout a Nursing Curriculum to Promote Empathy

Authors: Joan Esper Kuhnly, Jess Holden, Lynn Shelley, Nicole Kuhnly

Abstract:

Empathy serves as a foundational nursing principle inherent in the nurse’s ability to form those relationships from which to care for patients. Evidence supports, including empathy in nursing and healthcare education, but there is limited data on what methods are effective to do so. Building evidence supports experiential and interactive learning methods to be effective for students to gain insight and perspective from a personalized experience. The purpose of this project is to evaluate learning activities designed to promote the attainment of empathic behaviors across 5 levels of the nursing curriculum. Quantitative analysis will be conducted on data from pre and post-learning activities using the Toronto Empathy Questionnaire. The main hypothesis, that simulation learning activities will increase empathy, will be examined using a repeated measures Analysis of Variance (ANOVA) on Pre and Post Toronto Empathy Questionnaire scores for three simulation activities (Stroke, Poverty, Dementia). Pearson product-moment correlations will be conducted to examine the relationships between continuous demographic variables, such as age, credits earned, and years practicing, with the dependent variable of interest, Post Test Toronto Empathy Scores. Krippendorff’s method of content analysis will be conducted to identify the quantitative incidence of empathic responses. The researchers will use Colaizzi’s descriptive phenomenological method to describe the students’ simulation experience and understand its impact on caring and empathy behaviors employing bracketing to maintain objectivity. The results will be presented, answering multiple research questions. The discussion will be relevant to results and educational pedagogy in the nursing curriculum as they relate to the attainment of empathic behaviors.

Keywords: curriculum, empathy, nursing, simulation

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28881 Construction of an Assessment Tool for Early Childhood Development in the World of DiscoveryTM Curriculum

Authors: Divya Palaniappan

Abstract:

Early Childhood assessment tools must measure the quality and the appropriateness of a curriculum with respect to culture and age of the children. Preschool assessment tools lack psychometric properties and were developed to measure only few areas of development such as specific skills in music, art and adaptive behavior. Existing preschool assessment tools in India are predominantly informal and are fraught with judgmental bias of observers. The World of Discovery TM curriculum focuses on accelerating the physical, cognitive, language, social and emotional development of pre-schoolers in India through various activities. The curriculum caters to every child irrespective of their dominant intelligence as per Gardner’s Theory of Multiple Intelligence which concluded "even students as young as four years old present quite distinctive sets and configurations of intelligences". The curriculum introduces a new theme every week where, concepts are explained through various activities so that children with different dominant intelligences could understand it. For example: The ‘Insects’ theme is explained through rhymes, craft and counting corner, and hence children with one of these dominant intelligences: Musical, bodily-kinesthetic and logical-mathematical could grasp the concept. The child’s progress is evaluated using an assessment tool that measures a cluster of inter-dependent developmental areas: physical, cognitive, language, social and emotional development, which for the first time renders a multi-domain approach. The assessment tool is a 5-point rating scale that measures these Developmental aspects: Cognitive, Language, Physical, Social and Emotional. Each activity strengthens one or more of the developmental aspects. During cognitive corner, the child’s perceptual reasoning, pre-math abilities, hand-eye co-ordination and fine motor skills could be observed and evaluated. The tool differs from traditional assessment methodologies by providing a framework that allows teachers to assess a child’s continuous development with respect to specific activities in real time objectively. A pilot study of the tool was done with a sample data of 100 children in the age group 2.5 to 3.5 years. The data was collected over a period of 3 months across 10 centers in Chennai, India, scored by the class teacher once a week. The teachers were trained by psychologists on age-appropriate developmental milestones to minimize observer’s bias. The norms were calculated from the mean and standard deviation of the observed data. The results indicated high internal consistency among parameters and that cognitive development improved with physical development. A significant positive relationship between physical and cognitive development has been observed among children in a study conducted by Sibley and Etnier. In Children, the ‘Comprehension’ ability was found to be greater than ‘Reasoning’ and pre-math abilities as indicated by the preoperational stage of Piaget’s theory of cognitive development. The average scores of various parameters obtained through the tool corroborates the psychological theories on child development, offering strong face validity. The study provides a comprehensive mechanism to assess a child’s development and differentiate high performers from the rest. Based on the average scores, the difficulty level of activities could be increased or decreased to nurture the development of pre-schoolers and also appropriate teaching methodologies could be devised.

Keywords: child development, early childhood assessment, early childhood curriculum, quantitative assessment of preschool curriculum

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28880 Predicting Match Outcomes in Team Sport via Machine Learning: Evidence from National Basketball Association

Authors: Jacky Liu

Abstract:

This paper develops a team sports outcome prediction system with potential for wide-ranging applications across various disciplines. Despite significant advancements in predictive analytics, existing studies in sports outcome predictions possess considerable limitations, including insufficient feature engineering and underutilization of advanced machine learning techniques, among others. To address these issues, we extend the Sports Cross Industry Standard Process for Data Mining (SRP-CRISP-DM) framework and propose a unique, comprehensive predictive system, using National Basketball Association (NBA) data as an example to test this extended framework. Our approach follows a holistic methodology in feature engineering, employing both Time Series and Non-Time Series Data, as well as conducting Explanatory Data Analysis and Feature Selection. Furthermore, we contribute to the discourse on target variable choice in team sports outcome prediction, asserting that point spread prediction yields higher profits as opposed to game-winner predictions. Using machine learning algorithms, particularly XGBoost, results in a significant improvement in predictive accuracy of team sports outcomes. Applied to point spread betting strategies, it offers an astounding annual return of approximately 900% on an initial investment of $100. Our findings not only contribute to academic literature, but have critical practical implications for sports betting. Our study advances the understanding of team sports outcome prediction a burgeoning are in complex system predictions and pave the way for potential profitability and more informed decision making in sports betting markets.

Keywords: machine learning, team sports, game outcome prediction, sports betting, profits simulation

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28879 Perceived Difficult Concepts in Senior Secondary School Mathematics Curriculum by Mathematics Students and Teachers in Kwara State

Authors: Siddiq Mohammed

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This study sought to identify the perceived difficult concepts in the new mathematics curriculum by senior secondary school students and mathematics teachers in Kwara State. The study involved a survey research type. Random sampling technique was used to select the 32 sampled schools, 469 students, and 103 teachers. The instrument used in data collection was a research-designed questionnaire tagged 'Perceived Difficult Concepts in Mathematics' (PDCM) was validated by two experts in mathematics education. The test-retest reliability index of 0.69 was obtained. Data analysis was carried out using frequency count percentages and chi-square. The result of the study showed that eight topics were identified as difficult to teach by the teachers, while 14 topics were also identified as difficult to learn by the students. This study also revealed that there was no significant difference in the topics perceived as difficult between the teachers teaching in the school located in urban and rural area. However, there was a significant difference in the perceived difficult topics between student schooling in the schools located in urban and rural area. It was therefore recommended among others that mathematics teachers should undergo training on how to concretize the abstractness of some of the topics especially the new ones as well as use appropriate teaching aid to facilitate teaching/learning of the difficult concepts. It was also recommended that there is a need for evenly development of human and materials among the schools in urban and rural areas.

Keywords: curriculum, difficult concepts, mathematics, perceived

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28878 Data Analytics of Electronic Medical Records Shows an Age-Related Differences in Diagnosis of Coronary Artery Disease

Authors: Maryam Panahiazar, Andrew M. Bishara, Yorick Chern, Roohallah Alizadehsani, Dexter Hadleye, Ramin E. Beygui

Abstract:

Early detection plays a crucial role in enhancing the outcome for a patient with coronary artery disease (CAD). We utilized a big data analytics platform on ~23,000 patients with CAD from a total of 960,129 UCSF patients in 8 years. We traced the patients from their first encounter with a physician to diagnose and treat CAD. Characteristics such as demographic information, comorbidities, vital, lab tests, medications, and procedures are included. There are statistically significant gender-based differences in patients younger than 60 years old from the time of the first physician encounter to coronary artery bypass grafting (CABG) with a p-value=0.03. There are no significant differences between the patients between 60 and 80 years old (p-value=0.8) and older than 80 (p-value=0.4) with a 95% confidence interval. This recognition would affect significant changes in the guideline for referral of the patients for diagnostic tests expeditiously to improve the outcome by avoiding the delay in treatment.

Keywords: electronic medical records, coronary artery disease, data analytics, young women

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28877 Self-Evaluation of the Foundation English Language Programme at the Center for Preparatory Studies Offered at the Sultan Qaboos University, Oman: Process and Findings

Authors: Meenalochana Inguva

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The context: The Center for Preparatory study is one of the strongest and most vibrant academic teaching units of the Sultan Qaboos University (SQU). The Foundation Programme English Language (FPEL) is part of a larger foundation programme which was implemented at SQU in fall 2010. The programme has been designed to prepare the students who have been accepted to study in the university in order to achieve the required educational goals (the learning outcomes) that have been designed according to Oman Academic Standards and published by the Omani Authority for Academic Accreditation (OAAA) for the English language component. The curriculum: At the CPS, the English language curriculum is based on the learning outcomes drafted for each level. These learning outcomes guide the students in meeting what is expected of them by the end of each level. These six levels are progressive in nature and are seen as a continuum. The study: A periodic evaluation of language programmes is necessary to improve the quality of the programmes and to meet the set goals of the programmes. An evaluation may be carried out internally or externally depending on the purpose and context. A self-study programme was initiated at the beginning of spring semester 2015 with a team comprising a total of 11 members who worked with-in the assigned course areas (level and programme specific). Only areas specific to FPEL have been included in the study. The study was divided into smaller tasks and members focused on their assigned courses. The self-study primarily focused on analyzing the programme LOs, curriculum planning, materials used and their relevance against the GFP exit standards. The review team also reflected on the assessment methods and procedures followed to reflect on student learning. The team has paid attention to having standard criteria for assessment and transparency in procedures. A special attention was paid to the staging of LOs across levels to determine students’ language and study skills ability to cope with higher level courses. Findings: The findings showed that most of the LOs are met through the materials used for teaching. Students score low on objective tests and high on subjective tests. Motivated students take advantage of academic support activities others do not utilize the student support activities to their advantage. Reading should get more hours. In listening, the format of the listening materials in CT 2 does not match the test format. Some of the course materials need revision. For e.g. APA citation, referencing etc. No specific time is allotted for teaching grammar Conclusion: The findings resulted in taking actions in bridging gaps. It will also help the center to be better prepared for the external review of its FPEL curriculum. It will also provide a useful base to prepare for the self-study portfolio for GFP standards assessment and future audit.

Keywords: curriculum planning, learning outcomes, reflections, self-evaluation

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28876 Motivations, Communication Dimensions, and Perceived Outcomes in the Multi-Sectoral Collaboration of the Visitor Management Program of Mount Makiling Forest Reserve in Los Banos, Laguna, Philippines

Authors: Charmaine B. Distor

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Collaboration has long been recognized in different fields, but there’s been little research on operationalizing it especially on a multi-sectoral setting as per the author’s best knowledge. Also, communication is one of the factors that is usually overlooked when studying it. Specifically, this study aimed to describe the organizational profile and tasks of collaborators in the visitor management program of Make It Makiling (MIM). It also identified the factors that motivated collaborators to collaborate in MIM while determining the communication dimensions in the collaborative process. It also determined the communication channels used by collaborators in MIM while identifying the outcomes of collaboration in MIM. This study also found out if a relationship exists between collaborators’ motivations for collaboration and their perceived outcomes of collaboration, and collaborators' communication dimensions and their perceived outcomes of collaboration. Lastly, it also provided recommendations to improve the communication in MIM. Data were gathered using a self-administered survey that was patterned after Mattessich and Monsey’s (1992) collaboration experience questionnaire. Interviews and secondary sources mainly provided by the Makiling Center for Mountain Ecosystems (MCME) were also used. From the seven MIM collaborating organizations that were selected through purposive sampling, 86 respondents were chosen. Then, data were analyzed through frequency counts, percentages, measures of central tendencies, and Pearson’s and Spearman rho correlations. Collaborators’ length of collaboration ranged from seven to twenty years. Furthermore, six out of seven of the collaborators were involved in the task of 'emergency, rescue, and communication'. For the other aspect of the antecedents, the history of previous collaboration efforts ranked as the highest rated motivation for collaboration. In line with this, the top communication dimension is the governance while perceived effectiveness garnered the highest overall average among the perceived outcomes of collaboration. Results also showed that the collaborators highly rely on formal communication channels. Meetings and memos were the most commonly used communication channels throughout all tasks under the four phases of MIM. Additionally, although collaborators have a high view towards their co-collaborators, they still rely on MCME to act as their manager in coordinating with one another indirectly. Based on the correlation analysis, antecedent (motivations)-outcome relationship generally had positive relationships. However, for the process (communication dimensions)-outcome relationship, both positive and negative relationships were observed. In conclusion, this study exhibited the same trend with existing literature which also used the same framework. For the antecedent-outcome relationship, it can be deduced that MCME, as the main organizer of MIM, can focus on these variables to achieve their desired outcomes because of the positive relationships. For the process-outcome relationship, MCME should also take note that there were negative relationships where an increase in the said communication dimension may result in a decrease in the desired outcome. Recommendations for further study include a methodology that contains: complete enumeration or any parametric sampling, a researcher-administered survey, and direct observations. These might require additional funding, but all may yield to richer data.

Keywords: antecedent-outcome relationship, carrying capacity, organizational communication, process-outcome relationship

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28875 Task Based Language Learning: A Paradigm Shift in ESL/EFL Teaching and Learning: A Case Study Based Approach

Authors: Zehra Sultan

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The study is based on the task-based language teaching approach which is found to be very effective in the EFL/ESL classroom. This approach engages learners to acquire the usage of authentic language skills by interacting with the real world through sequence of pedagogical tasks. The use of technology enhances the effectiveness of this approach. This study throws light on the historical background of TBLT and its efficacy in the EFL/ESL classroom. In addition, this study precisely talks about the implementation of this approach in the General Foundation Programme of Muscat College, Oman. It furnishes the list of the pedagogical tasks embedded in the language curriculum of General Foundation Programme (GFP) which are skillfully allied to the College Graduate Attributes. Moreover, the study also discusses the challenges pertaining to this approach from the point of view of teachers, students, and its classroom application. Additionally, the operational success of this methodology is gauged through formative assessments of the GFP, which is apparent in the students’ progress.

Keywords: task-based language teaching, authentic language, communicative approach, real world activities, ESL/EFL activities

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28874 The Standardization of Colorado Schools to Offer Opportunity Through Equal Education

Authors: Heather Caldwell

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In 1915, state superintendent, Mary C.C. Bradford initiated a state standardization plan in order to improve the quality of schools and the educational experience for all children in Colorado. This plan would change the schools, improving them and offering more opportunities for children, teachers, and the community. In a state where geography limited opportunity to make all schools equal and brought challenges to state school leaders to improve education throughout the state, the leadership prevailed and worked together with local schools and school leaders to make drastic improvements in the curriculum. This paper will discuss this plan and will highlight key contributions to this standardization plan that improved opportunities for all students in the state of Colorado through these educational initiatives.

Keywords: history of education, standardization, curriculum, state superintendent, women in education

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28873 Social Work Practice to Labour Welfare: A Proposed Model of Field Work Practicum and Role of Social Worker in India

Authors: Naeem Ahmed

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Social work is a professional activity based on the approach of “helping people to help themselves” (Stroup). Social work education and practice both are based on humanitarian philosophy in which social workers try to increase the happiness of the society and to reduce the problems of society. Labour welfare is a specialised field of social work which especially focuses on welfare of organised and unorganised labour. In India labour is facing numerous problems in both organised and unorganised sectors because of ignorance, illiteracy, high rate of unemployment etc. In most of the Indian social work institutions we have this specialization with different names like Human Resource Management or Industrial Relation and Personnel Management or Industrial Relations and Labour Welfare or Industrial Social Work etc. Field work practice is integrated part of social work education curriculum in all specialised field. In India we have different field work practice models being followed in different institutions. The main objective of this paper is to prepare a universal field work practicum model in the field of labour welfare. This paper is exploratory in nature, researcher used personal experience and secondary data (model of field work practice in different institutions like Aligarh Muslim University, Pondicherry University, Central University of Karnataka, University of Lucknow, MJP Rohilkhand University Bareilly etc.) Researcher found that there is an immediate need to upgrade the curriculum or field work practice in this particular field, as more than 40 percent of total population engaged in either unorganised or organised sector (NSSO 2011-12) and they are not aware about their rights. In this way a social worker can play an important role in existing labour welfare facilities by making them aware.

Keywords: field work, labour welfare, organised labour, social work practice, unorganised labour

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28872 Anatomically-Based Oropharyngeal Rehabilitation for the Patients with Obstructive Sleep Apnea Using a Multilevel Approach

Authors: Hsin-Yu Lin, Ching-Hsia Hung

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Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

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