The differences between tutor and student perceptions of design elements in online courses

Master's thesis Multimedia and Educational Technology MM500 - University of Agder 2017The purpose of this study is to examine tutor and student perceptions of how design elements are implemented in online courses. The four elements collaboration, motivation, digital tools and course structure are discussed in an attempt to identify how various ways of implementing them can impact learning in an online environment. The study discusses how course tutors justify the use of the various elements, and then discusses students perceptions of how these elements impacted learning. The two online courses used in this research are SV-408 E-teaching 1 and MM-106 Nettkunnskap, which are part of a one year program meant for teachers at primary and high school levels. The two courses were chosen as they are both online courses and have implemented the same elements discussed in this thesis but in different ways. There was a total of 5 course tutors and 12 adult students who participated in this research. While qualitative research was used to collect data on tutors’ perception, both qualitative and quantitative research methods have been used to gather data on students’ perceptions. Results of the research revealed that there were both similarities and discrepancies in how tutors and students perceive the various elements in the two online courses. While collaborative learning was perceived to be a good tool for learning, it is important to ensure that it is implemented in a way that does not take away students’ autonomy and the possibility to learn at own pace. Students also expressed their need for timely and constructive feedback in group discussions and after submissions were made. Results of the study have also shown that using digital tools can increase students’ interest and engagement in the course. In addition to this, students expressed the need for a good course structure that makes it easy to navigate and monitor their progres

Factors associated with rota virus diarrhea in the post vaccine period as seen at Moi Teaching and Referral Hospital, Kenya

Objectives: To describe the prevalence and factors associated with rotavirus diarrhea in the post vaccine era.Design: Cross-sectional study.Setting: Moi Teaching and referral Hospital, Pediatric Emergency Department.Participants: Children ≤2 years with acute diarrhea illness. Data was collected onto an interviewer administered questionnaire and a Certest® rapid rotavirus stool antigen test done.Main outcome measures: Socio-demographic and clinical characteristics including: Age, Gender, Rotavirus antigen test results, level of dehydration and anthropometric measurements.Results: 311 participants with acute diarrhea were recruited, with 55.6% (173/311) being rotavirus positive. On bivariate analysis, age appropriate completion of routine vaccination (p=0.030), two doses of rotavirus vaccination (p=0.005) and nutrition status (p=0.009) were associated with a positive rotavirus test. On logistic regression, mild wasting (OR 2.581; CI 95% 1.068-6.236;p=0.035) and moderate wasting (OR 3.424; CI 95% 1.221-9.604;p=0.019) were associated with rotavirus positive diarrhea. Receiving two rotavirus vaccines (OR 0.151; CI 95% 0.032-0.709;p=0.017) and age appropriate completion of routine vaccination (OR 0.478; CI 95% 0.256-0.892;p=0.003) was protective. The peak rotavirus prevalence was during the dry season. Receiving one rotavirus vaccine, severe malnutrition and socio-demographic characteristics e.g. age, the child’s primary caregiver, overcrowding were not statistically significant. Although majority of the children with rotavirus positive diarrhea had non-severe dehydration (63%, 109/173) this was also not significant (OR 1.066; CI 95% 0.6695- 1.699;p=0.786).Conclusion: Prevalence of Rotavirus diarrhea is still high among the under twos in our set up. Two rotavirus vaccines are needed for full protection. Advocacy and public health interventions should intensify to improve the vaccine coverag

Migrant workers' perceptions, expectations and experiences of occupational health services in Finland

The northward rising trend in the number of international migrants has resulted to unprecedented implications on healthcare sector. Events accompanying migration have impact on both the migrant population and the hosting community. To understand the challenges encountered by the migrant workers in the host country, it is imperative to explore their encounters with the services by listening to the lived experiences. The aim of this study was to bring out immigrant workers’ expectations and experiences of occupational health services in Finland. The study explored the expectations and lived experiences of the migrant workers. A qualitative research method was used for this study. The study population consisted of 12 participants who were sampled purposively. Data was collected through face-to-face interviews. The data was analyzed by thematic content analysis method. The results of the study identified barriers to occupational health services to include language and communication, difficulties arising from navigation through the Finnish healthcare system and issues related to cultural differences. The study also identified workplace safety as being associated to migration and health. In conclusion, the study recognized the process of healthcare access by the migrant worker as being multidimensional. Therefore, the study recommends for enhanced collaborative approach by employers, employees and other relevant stakeholders. The efforts invested towards strengthening health providers’ relationship with care seekers would go a long way in improving occupational health service access

A Model for real time monitoring of epileptic patients

Thesis submitted in partial fulfillment of the requirements for the Degree of Master of Science in Information Technology (MSIT) at Strathmore UniversityEffective treatment and therapy in epileptic patients require thorough monitoring of seizures. Medical care givers require information on number of seizure occurrences, duration of seizure and magnitude. People suffering from epilepsy face tremendous problems in regards to epileptic seizure monitoring. The typical way to diagnose and monitor epileptic patients is by use of electroencephalography (EEG) which requires monitoring within the confines of the hospital. EEG equipment is available in very few hospitals in Kenya and that is an impediment to proper therapy and treatment for epileptic patients. The challenges faced in using the existing methods include; lack of flexibility for the patient as there is need for long term monitoring in a hospital setup, financial burden on the patients when they are hospitalized and obtrusive nature of the EEG monitoring making it not suitable for monitoring outdoors. This study applies agile methodology to design, develop and test a model for real time monitoring of patients with tonic-clonic epileptic seizures. This model is hardware based, with the capability to send alerts to a family member in the event of a seizure. The patient can also view their seizure history from a mobile application installed on their smartphones. The device was created using Arduino Uno, a tri-axis accelerometer for motion detection and a Global system for Mobile Communication (GSM) module for communication. This model promotes long term, flexible and inexpensive mode of epileptic seizure monitoring therefore contributing to effective treatment of epileptic patients

Anti-bacterial susceptibility patterns of blood culture isolates at a referral hospital in Eldoret

Background: Hospital treatment guidelines are often guided by scientific evidence of efficacy of the anti-microbial agents. In developing countries, most of the treatment guidelines are adopted from the World Health Organisation (WHO). However, local data is often needed to confirm or adjust these guidelines to suit a local situation. In resource limited settings there is scarce data on blood culture isolates and their antimicrobial sensitivity patterns to guide anti-biotic prescription in these settings.Objectives: To assess the bloodstream bacterial isolates and their anti-biotic sensitivity patterns in patients admitted at a tertiary teaching and referral hospital.Design: Hospital based laboratory retrospective studySetting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya.Subjects: All blood culture specimens received from inpatients at MTRH over a 12 year period from 2002 to 2013.Results: The median age was 13.4yrs (IQR 0.7-29).Most of the blood samples were from female patients (51.8%). A total of 4046 blood culture samples were analysed of which 29.9% (n=1356) yielded positive growths. Majority of the positive blood cultures were from the New Born Unit (62.4%). Staph epidermidis was the most common organism isolated (43.1% n=531) followed by Klebsiella pneumoniae (22.8% n=281). Resistance to commonly used anti-biotics (penicillin, cephalosporin) was high among gram positive as well as gram negative organisms. No trend in bacterial isolates was observed over the study period.Conclusions: Staph epidermidis and Klebsiella pneumoniae were the most common organisms isolated with higher growth rates occurring in the neonatal and paediatric age groups than in adults. There was no trend in bacterial isolates over the study period. Resistance to commonly used anti-biotics was prevalent

High prevalence of multi-drug resistant Klebsiella pneumoniae in a tertiary teaching hospital in western Kenya

Introduction: Klebsiella pneumoniae is a gram negative enterobacteriaciae commonly associated with nosocomial infections. Multidrug resistant strains are increasingly being reported with corresponding increase in morbidity and mortality. The study outlines the epidemiology and antibiotic resistance pattern of K. pneumonia over a 10 year period in Moi Teaching and Referral Hospital, Eldoret, Kenya.Methodology and Study Design: This is a retrospective analysis of all the blood culture results for K. pneumoniae isolates in the hospital for the period 2002-2013.Results: K. pneumoniae accounted for 23% of the hospital isolates (231/1356) during the study period; of these, 82.6% were from the New Born Unit. Most of the isolates were multi drug resistant with highest resistance of over 80% to Penicillins, Cephalosporins, Macrolides, Tetracyclines, Sulphonamides, Lincosamides and Chloramphenicol. Aminoglycoside and Quinolone resistance was also high at 49.2% and 41.3% respectively. The lowest resistance rates were documented for Carbapenems (23.2%). For specific antibiotics, there was high resistance to commonly used antibiotics (over 80% for Ceftriaxone, Cefipime, Gentamycin and Ceftazidime). The antibiotics with least resistance were Amikacin and Meropenem (21% and 7 % respectively).Conclusion: There was a high prevalence of multidrug resistant K. pneumoniae isolates in the hospital, the majority originated from the New Born Unit. Resistance to third generation Cephalosporins and Gentamycin was high while Meropenem and Amikacin had the least resistance.Keywords: Klebsiella pneumoniae; Antibiotic resistance; Multi drug resistance; Nosocomial infection

Traversing the cascade: urgent research priorities for implementing the 'treat all' strategy for children and adolescents living with HIV in sub-Saharan Africa

Children and adolescents living with HIV (CALHIV) in sub-Saharan Africa experience significant morbidity and alarmingly high mortality rates due to critical gaps in the HIV care cascade, including late diagnosis and initiation of treatment, as well as poor retention in care and adherence to treatment. Interventions to strengthen the adult HIV care cascade may not be as effective in improving the cascade for CALHIV, for whom specific strategies are needed. Particular attention needs to be paid to the contexts of sub-Saharan Africa, where more than 85% of the world's CALHIV live. Implementing the 'treat all' strategy in sub-Saharan Africa requires dedicated efforts to address the unique diagnosis and care needs of CALHIV, in order to improve paediatric and adolescent outcomes, prevent viral resistance and reduce the number of new HIV infections. We consider the UNAIDS 90-90-90 targets from the perspective of infants, children and adolescents, and discuss the key challenges, knowledge gaps and urgent research priorities for CALHIV in implementation of the 'treat all' strategy in sub-Saharan Africa

Tablet-based disclosure counselling for HIV-infected children, adolescents, and their caregivers: a pilot study

BACKGROUND: Overwhelmed, under-trained medical staff working in resource-limited settings need efficient resources for HIV disclosure counselling. The objective of this study was to describe providers' experiences using tablet computers for disclosure-related counselling with HIV-infected children and their caregivers in western Kenya, with additional perspectives from adolescents. METHODS: A qualitative study design was implemented at three HIV clinics in western Kenya (Bumala, Busia and Port Victoria) within the Academic Model Providing Access to Healthcare (AMPATH) partnership. Twenty-one healthcare providers involved with paediatric disclosure were recruited and enrolled in the study. Initial interviews focused on understanding current disclosure practices and barriers. Tablets containing disclosure-related resources were distributed. Resources included short narrative videos created in this context to highlight issues relevant to child HIV disclosure. RESULTS: Providers reported tablets improved disclosure, child participation, and medication adherence. All reported that reviewing materials increased their knowledge and comfort with disclosure. The most frequently used materials were the narrative videos and an animated video explaining the importance of medication adherence. Time was a major barrier for using the tablet. Clinician self-education persisted at one-year follow-up. Adolescents expressed enjoyment from viewing the tablet resources and had a better understanding of the importance of medication adherence. CONCLUSIONS: Tablet computers containing resources for disclosure are an acceptable and potentially effective resource to help providers support families with disclosure. Further work is needed to train the clinical providers in using the resources in a developmentally appropriate manner, and to develop new resources on adolescent-specific and HIV-related topics

Growth of young HIV-infected and HIV-exposed children in western Kenya: A retrospective chart review

Introduction The objective of this study was to determine the growth patterns, rates of malnutrition, and factors associated with malnutrition in children born to HIV-infected mothers in western Kenya using data from an electronic medical record system. Methods This study was a retrospective chart review of HIV-infected (HIV+) and–exposed (HEU) children (<5 years) using data collected prospectively in the course of routine clinical care and stored in the electronic medical record system in western Kenya between January 2011 and August 2016. Demographics and anthropometrics were described, with Chi-square testing to compare proportions. Multiple variable logistic regression analysis was used to identify correlates of children being stunted, underweight, and wasted. We also examined growth curves, using a resampling method to compare the areas under the fitted growth curves to compare males/females and HIV+/HEU. Results Data from 15,428 children were analyzed. The children were 51.6% (n = 7,955) female, 5.2% (n = 809) orphans, 83.3% (n = 12,851) were HEU, and 16.7% (n = 2,577) were HIV+. For HIV+ children assessed at 24 months, 50.9% (n = 217) were stunted, 26.5% (n = 145) were underweight, and 13.6% (n = 58) were wasted, while 45.0% (n = 577) of HEU children were stunted, 14.8% (n = 255) were underweight, and 5.1% (n = 65) were wasted. When comparing mean z-scores, HIV+ children tended to have larger and earlier dips in z-scores compared to HIV-exposed children, with significant differences found between the two groups (p<0.001). Factors associated with an increased risk of malnutrition included being male, HIV+, and attending an urban clinic. Maternal antiretroviral treatment during pregnancy and mixed feeding at 3 months of age decreased the risk of malnutrition. Conclusions HIV+ and HEU children differ in their anthropometrics, with HIV+ children having overall lower z-scores. Continued efforts to develop and implement sustainable and effective interventions for malnutrition are needed for children born to HIV+ mothers

How Women Living With HIV React and Respond to Learning About Canadian Law That Criminalises HIV Non-disclosure: ‘How Do You Prove That You Told?’

The Women, ART and the Criminalization of HIV Study is a qualitative, arts-based research study focusing on the impact of the HIV non-disclosure law on women living with HIV in Canada. The federal law requires people living with HIV to disclose their HIV-positive status to sexual partners before engaging in sexual activities that pose what the Supreme Court of Canada called a ‘realistic possibility of transmission’. Drawing on findings from seven education and discussion sessions with 48 women living with HIV regarding HIV non-disclosure laws in Canada, this paper highlights the ways in which women living with HIV respond to learning about the criminalisation of HIV non-disclosure. The most common emergent themes included: the way the law reproduces social and legal injustices; gendered experiences of intimate injustice; and the relationship between disclosure and violence against women living with HIV. These discussions illuminate the troubling consequences inherent in a law that is antithetical to the science of HIV transmission risk, and that fails to acknowledge the multiple barriers to HIV disclosure that women living with HIV experience. Women’s experiences also highlight the various ways the law contributes to their experiences of sexism, racism and other forms of marginalisation in society