Developing criteria for the evaluation of the ICT contribution to social and economic development

Practitioners in Information and Communication Technology (ICT) for development have repeatedly relied on evaluations of past or present initiatives to advise and facilitate the design and implementation of other development initiatives. However, current quests for measures that demonstrate the developmental contribution of ICT call for new approaches to ICT4D evaluation. In response to this, the study presented in this paper provides a starting point in the development and evaluation of the appropriateness of a set of criteria – dimensions and indicators that can be applied to the appraisal of the ICT contribution to development. Development is defined as a multidimensional concept based on Sen’s capability approach, particularly focusing on the outputs (opportunities) and outcomes (benefits) ICT can enable within a given context. Indicators are proposed for education and research, healthcare, economic opportunities and political freedom dimensions. Findings obtained through exploratory survey research show that the proposed indicators are appropriate for the evaluation of the contribution of ICT to social and economic development, especially in a developing country context. Additional indicators were also proposed for some of the dimensions. Participants further reiterated the need to combine both qualitative and quantitative indicators to supplement and balance each other in the appraisal of development initiatives. Subsequent studies will seek to devise means of how this can be addressed, as well as a process through which a combined analysis can be obtained. Such studies should seek to extensively evaluate the indicators as well as apply them for the evaluation of ICT4D initiatives

Patterns of antibiotic use, pathogens, and prediction of mortality in hospitalized neonates and young infants with sepsis: A global neonatal sepsis observational cohort study (NeoOBS).

BACKGROUND: There is limited data on antibiotic treatment in hospitalized neonates in low- and middle-income countries (LMICs). We aimed to describe patterns of antibiotic use, pathogens, and clinical outcomes, and to develop a severity score predicting mortality in neonatal sepsis to inform future clinical trial design. METHODS AND FINDINGS: Hospitalized infants <60 days with clinical sepsis were enrolled during 2018 to 2020 by 19 sites in 11 countries (mainly Asia and Africa). Prospective daily observational data was collected on clinical signs, supportive care, antibiotic treatment, microbiology, and 28-day mortality. Two prediction models were developed for (1) 28-day mortality from baseline variables (baseline NeoSep Severity Score); and (2) daily risk of death on IV antibiotics from daily updated assessments (NeoSep Recovery Score). Multivariable Cox regression models included a randomly selected 85% of infants, with 15% for validation. A total of 3,204 infants were enrolled, with median birth weight of 2,500 g (IQR 1,400 to 3,000) and postnatal age of 5 days (IQR 1 to 15). 206 different empiric antibiotic combinations were started in 3,141 infants, which were structured into 5 groups based on the World Health Organization (WHO) AWaRe classification. Approximately 25.9% (n = 814) of infants started WHO first line regimens (Group 1-Access) and 13.8% (n = 432) started WHO second-line cephalosporins (cefotaxime/ceftriaxone) (Group 2-"Low" Watch). The largest group (34.0%, n = 1,068) started a regimen providing partial extended-spectrum beta-lactamase (ESBL)/pseudomonal coverage (piperacillin-tazobactam, ceftazidime, or fluoroquinolone-based) (Group 3-"Medium" Watch), 18.0% (n = 566) started a carbapenem (Group 4-"High" Watch), and 1.8% (n = 57) a Reserve antibiotic (Group 5, largely colistin-based), and 728/2,880 (25.3%) of initial regimens in Groups 1 to 4 were escalated, mainly to carbapenems, usually for clinical deterioration (n = 480; 65.9%). A total of 564/3,195 infants (17.7%) were blood culture pathogen positive, of whom 62.9% (n = 355) had a gram-negative organism, predominantly Klebsiella pneumoniae (n = 132) or Acinetobacter spp. (n = 72). Both were commonly resistant to WHO-recommended regimens and to carbapenems in 43 (32.6%) and 50 (71.4%) of cases, respectively. MRSA accounted for 33 (61.1%) of 54 Staphylococcus aureus isolates. Overall, 350/3,204 infants died (11.3%; 95% CI 10.2% to 12.5%), 17.7% if blood cultures were positive for pathogens (95% CI 14.7% to 21.1%, n = 99/564). A baseline NeoSep Severity Score had a C-index of 0.76 (0.69 to 0.82) in the validation sample, with mortality of 1.6% (3/189; 95% CI: 0.5% to 4.6%), 11.0% (27/245; 7.7% to 15.6%), and 27.3% (12/44; 16.3% to 41.8%) in low (score 0 to 4), medium (5 to 8), and high (9 to 16) risk groups, respectively, with similar performance across subgroups. A related NeoSep Recovery Score had an area under the receiver operating curve for predicting death the next day between 0.8 and 0.9 over the first week. There was significant variation in outcomes between sites and external validation would strengthen score applicability. CONCLUSION: Antibiotic regimens used in neonatal sepsis commonly diverge from WHO guidelines, and trials of novel empiric regimens are urgently needed in the context of increasing antimicrobial resistance (AMR). The baseline NeoSep Severity Score identifies high mortality risk criteria for trial entry, while the NeoSep Recovery Score can help guide decisions on regimen change. NeoOBS data informed the NeoSep1 antibiotic trial (ISRCTN48721236), which aims to identify novel first- and second-line empiric antibiotic regimens for neonatal sepsis. TRIAL REGISTRATION: ClinicalTrials.gov, (NCT03721302)

Peer Assignment Review Process for Collaborative E-learning : Is the Student Learning Process Changing?

In recent years collaborative e-learning has been emphasized as a learning method that has facilitated knowledge construction and supported student learning. However some universities especially in developing country contexts are struggling to attain minimal educational benefits from its adoption and use. This paper investigates the application of a peer assignment review process for collaborative e-learning to third year undergraduate students. The study was aimed at evaluating the effect of the peer assignment review process on the student learning process. Data was collected using a survey questionnaire and analysed using SPSS Version 16.0. While the student reported positive impact of the peer assignment review process in terms of facilitating students to put more effort and improve their work; quick feedback on their assignments; effective sharing and development of knowledge and information and the need of computer competence to manipulate the peer assignment review system, analysis of the quantitative data indicated that the process had limited effect on the learning process. This is attributed to lack of review skills, absence of lecturer scaffolding, low ICT literacy levels and change management

Modelling a Peer Assignment Review Process for Collaborative E-learning

The educational culture in most developing countries is lecturer-centred with lecturers asproviders of information and students as receivers of information. This approach has impacted onstudent’s ability to seek and create knowledge to support their learning process. A collaborativelearning approach that promotes students process of inquiry, critical thinking and skilldevelopment thus lacks in the context, yet these aspects are crucial in the knowledge society. Ifuniversities in developing countries are to educate students to compete and become activeparticipants in society, the teaching and learning processes underpinned by relevant theories andmodels should be adopted. This paper proposes an approach to support students´ learning in adeveloping country context - Uganda. Specifically, the authors design and model a peerassignment review process for collaborative e-learning, employing the second stage ofdevelopment research. The model is based on using student to pedagogically support eachother’s learning through four process stages: familiarization, assignment, review and feedback.Empirical investigations of the process stages indicated that the peer assignment review processfacilitated the students learning. Students indicated that they were able to actively participate inthe course, gain experience in critical reading and evaluating peers work, while reflecting ontheir own work. The empirical investigation further indicated that students were able to adoptand use online technologies in their learning activities. As such the peer assignment reviewprocess impacted the students learning both as receivers and providers of reviews creating a levelof acceptance to adopt and use the proposed collaborative e-learning approach

Collaborative E-learning in a Developing Country : A University Case Study in Uganda

Universities in developing countries are increasingly adopting and using eLearning in their teaching and learning processes as one of the means for leapfrogging into the knowledge driven world. However, despite the recognition eLearning has received, it has not fulfilled the expectations in terms of impact on the delivery and quality of learning, pointing to the need for improved or new approaches. This paper explores the collaborative eLearning approach as one of the strategies for effective adoption and use of eLearning. Using the first stage of development research this paper presents an empirical study that aimed to explore and understand the current practices of collaborative eLearning in a developing country context. The study was carried out with university students in Uganda and placed focus on the value derived from and challenges encountered in adopting and using collaborative eLearning. From a general perspective, it was evident that learning and teaching methods are predominantly traditional, with limited/no integration of eLearning and there were inconsistencies in understanding the integration of technology into teaching and learning processes. The findings obtained indicated that students through collaborative eLearning were able to share and gain knowledge, understand course concepts and access various views and learning material. Factors such as inadequate bandwidth, inadequate Internet/computer access, conflict resolution, adequate ICT skills and face to face interaction challenged the adoption and use of collaborative eLearning in this context