Instituting Universal Secondary Education: Caribbean Students' Perceptions of their Schooling Experiences

As Caribbean governments continue to invest heavily in education as a major strategy for national and economic development, the question of student achievement and the need for increasing the effectiveness of schools in producing maximum student learning remains a dominant feature on the regional educational agenda, especially given recent education reforms which have mandated secondary educational provisions for every student in most Caribbean territories. However, despite this no Caribbean study thus far has examined Universal Secondary Education (USE) from the perspective of the students in the Caribbean who have now been afforded access to secondary education. This study takes an in-depth look at students’ experiences at eight secondary classrooms in the tri-island state of Grenada, Carriacou and Petite Martinique with the inception of Universal Secondary Education (USE). The study sought to examine the experiences of students in the lower performing secondary schools most affected by USE. Data were collected through a mixed method approach which included a survey of fifty (50) students and one (1) student focus group from each of the eight targeted schools. Student responses were grouped according to the following categories derived from data coding and analysis: classroom relationships, classroom teaching and learning, school curriculum, and school infrastructure. The findings present students’ explanations for the causes of poor student-teacher relationships, and inadequacies in teaching and learning, curriculum organization and physical infrastructure at the secondary level. This study therefore adds students’ voices to the persevering debate on educational improvement in the Caribbean in the 21st century of universal access to education. Keywords: universal secondary education, secondary schooling, caribbean education, access to education, student voice, schooling experience, student-teacher relationship, teaching and learnin

The effect of orthodontic treatment on smile attractiveness: a systematic review.

BACKGROUND Smile attractiveness is a primary factor for patients to seek orthodontic treatment, however, there is yet no systematic evaluation of this topic in the literature. OBJECTIVES To assess the current evidence on the effect of orthodontic treatment on smile attractiveness. SEARCH METHODS Seven electronic databases (MEDLINE, Cochrane Library, Virtual Health Library, SCOPUS, Web of Science, Google Scholar and Embase) were searched on 14 September 2022. SELECTION CRITERIA Studies evaluating smile attractiveness before and after orthodontic treatment or only after completion of orthodontic treatment. DATA COLLECTION AND ANALYSIS Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomised studies. Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were planned a priori. METHODS After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, an evaluation of the overall evidence was performed. The included studies were evaluated based on the characteristics of their study and control groups and based on their main research question. Also, all outcome measures were standardized into a common assessment scale (0-100), in order to obtain more easily interpretable results. RESULTS Ten studies were included in this review, nine of which were assessed as being at serious risk of bias and one at moderate risk of bias. The large heterogeneity between the included studies did not allow for a meta-analysis. Orthodontic treatment has a moderately positive effect on smile attractiveness. When compared to no treatment, orthodontic treatment with premolar extractions improves smile attractiveness by 22%. Also, surgical correction of Class III cases increases smile attractiveness by 7.5% more than camouflage treatment. No other significant differences were shown between different types of treatment. CONCLUSION Based on the available data, orthodontic treatment seems to moderately improve the attractiveness of the smile. There is significant bias in the current literature assessing the effect of orthodontics on smile attractiveness; therefore, the results cannot be accepted with certainty

The Complexity of the Practice of Ecosystem-Based Management.

In the United States, there are more than 20 federal agencies that manage over 140 ocean statutes (Crowder et al., 2006). A history of disjointed, single sector management has resulted in a one-dimensional view of ecosystems, administrative systems, and the socio-economic drivers that affect them. In contrast, an ecosystem-based approach to management is inherently multi-dimensional. Ecosystem-based approaches to management (EBM) are at the forefront of progressive science and policy discussions. Both the U.S. Commission on Ocean Policy (USCOP, 2004) and the Pew Oceans Commission (POC, 2003) reports called for a better understanding of the impact of human activities on the coastal ocean and the result was President Obama’s National Policy for the Stewardship of the Ocean, our Coasts, and the Great Lakes (2010). EBM is holistic by seeking to include all stakeholders affected by marine policy in decision-making. Stakeholders may include individuals from all levels of government, academia, environmental organizations, and marine-dependent businesses and industry. EBM processes require decision-makers to approach marine management differently and more comprehensively to sufficiently require a more sophisticated conceptual understanding of the process and the people involved. There are implicit cognitive, interpersonal, and intra-personal demands of EBM that are not addressed by current literature. This research seeks to understand the mental demands of EBM. A constructive developmental framework is used to illuminate how decision-makers reason or make sense of the ideals and values underlying EBM, the mutual relationships that must be built among natural resource management agencies, and the personal experiences and emotions that accompany change

Improvement of functional bloating by an enterovaccine: a preliminary study

Background: bloating is a fastidious symptom reported by many patients who also have other gastrointestinal functional dis orders. Bloating is more common in women, and it is often asso ciated with meals and improves or disappears overnight. No spe cific treatments are to date available for this disturbing symptom. Aims: to evaluate the effects of an oral enterovaccine (Colifag ina ® ) on bloating and other abdominal symptoms in patients with prevalent complaints of functional bloating. Patients and methods: one hundred and forty-eight patients with functional bloating according to Rome III criteria were re cruited. Questionnaires and a VAS scale on their symptoms were administered at baseline and after four weeks of therapy with Colifagina ® . Results: after treatment, a significant amelioration of bloating (p < 0.0001), abdominal pain (p < 0.0001) and flatus (p < 0.0001) was observed; nausea and vomiting scores were not sig nificantly different at the end of the treatment. Subjective wellbe ing was also generally improved (p < 0.001) in treated patients. Conclusion: treatment with an enterovaccine may help im prove symptoms in patients with functional bloating

Opioid switching from and to tapentadol extended release in cancer patients: conversion ratio with other opioids

Objectives: The aim of this exploratory study was to assess the conversion ratios between tapentadol and other opioids in patients requiring an opioid switching. Methods: A prospective study was carried out in a convenience sample of consecutive patients admitted to an acute palliative care unit and a home care unit for a period of 1 year. Patients who were switched from/to tapentadol were selected. The initial ratio between tapentadol and other opioids, expressed as oral morphine equivalents was 1:3.3. The subsequent doses were flexible and were changed to fit the patients’ needs. Pain intensity and distress score were recorded until opioid doses were stable. In all, 37 patients were examined; 24 and 13 patients were switched from and to tapentadol, respectively. Results: The most frequent sequences were tapentadol–morphine (18 patients) in one direction, and morphine–tapentadol (8 patients) in the other direction. In the sequence tapentadol–morphine and morphine–tapentadol, the mean final tapentadol–morphine ratios were 3.9:1 (SD 2.3), and 1:4.5 (SD 3.2), respectively, which did not differ significantly from the initial established conversion ratio. A minority of patients were switched from/to tapentadol to/from other opioids. Globally, the initial ratio did not change after switching took place. Conclusion: Data suggest that a conversion ratio between tapentadol and other opioids, expressed in oral morphine equivalents could be 1:3.3 in both direction, particularly in patients who are switched in conditions of equianalgesia. The limited number of patients prevents a definitive conclusion to be drawn, and data should be interpreted with caution, given the exploratory nature of the study and the question of the low number of patients should be addressed in future studie

A structured comparison of decentralized additive manufacturing centers based on quality and sustainability

Companies are increasingly adopting decentralized manufacturing strategies to manage multiple, geographically scattered manufacturing centers that are characterized not only by similar types of equipment, working methods, and productions, but also by variable mixes and volumes. This trend also applies to additive manufacturing, a well-established technology that allows the flexibility and customization of production to be increased, without significantly increasing the per unit cost. Thus, the need arises to monitor the performance of individual centers in a structured way, and to make practical comparisons of such centers. However, achieving this task is not so straightforward, given the inevitable differences in the characteristics of manufacturing centers and their productions. This paper presents a methodology that can be used to analyze and com-pare the production performance of a plurality of manufacturing centers from two different viewpoints: (i) quality, through a multivariate statistical analysis of product data concerning conformity with geometrical specifications, and (ii) process sustainability, with the aim of achieving a reduction in energy consumption, carbon dioxide emissions, and manufactur-ing time, through regression models pertaining to the selected metrics. The proposed methodology can be adopted during regular production operations, without requiring any ad hoc experimental tests. The description of the method is supported by an industrial case study

Influence of licorice root feeding on chemical-nutritional quality of cow milk and stracciata cheese, an italian traditional fresh dairy product

The aim of this study was to evaluate the effect of dietary licorice root supplementation on chemical and nutritional characteristics of cow milk and Stracciata cheese. Licorice did not influence milk and Stracciata fat content but induced modifications in fatty acid profile. Both in milk and Stracciata, a decrease in saturated fatty acids was detected and in cheeses an increase of monounsaturated and polyunsaturated fatty acids was observed. Stracciata obtained from the experimental group showed an improved oxidative stability after six days of ripening, a finding partly justifiable by the well-known richness of antioxidant compounds in the licorice root. The volatile profile of Stracciata was also affected by dietary licorice intake, with an increase in esters and a reduction of aldehydes and ketones. These results suggest a positive role of licorice in modifying chemical and physical properties of cow cheeses, reducing lipid oxidation and inducing changes in color and flavor with a presumable improvement in consumer acceptability

Alcohol‐Associated Liver Disease Before and After COVID‐19 – An Overview and Call for Ongoing Investigation

The Coronavirus Disease-2019 (COVID-19) pandemic has exacted a heavy toll on patients with alcohol-associated liver disease (ALD) and alcohol use disorder (AUD). The collective burden of ALD and AUD was large and growing prior to the COVID-19 pandemic. There is accumulating evidence that this pandemic has had a large direct effect on these patients and is likely to produce indirect effects via delays in care, psychological strain, and increased alcohol use. Now a year into the pandemic, it is important that clinicians fully understand the effects of the COVID-19 pandemic on patients with ALD and AUD. To fill existing gaps in knowledge, the scientific community must set research priorities for patients with ALD regarding their risk of COVID-19, prevention/treatment of COVID-19, changes in alcohol use during the pandemic, best use of AUD treatments in the COVID-19 era, and downstream effects of this pandemic on ALD. Conclusion: The COVID-19 pandemic has already inflicted disproportionate harms on patients with ALD and ongoing, focused research efforts will be critical to better understand the direct and collateral effects of this pandemic on ALD