Credit accumulation and modular scheme in higher education in Rwanda : a case study of lecturers' perceptions of implications for lecturers' work.

International literature suggests that curriculum changes that have occurred in higher education globally over the last two decades, more specifically the shift from subject-based curriculum to integrated curriculum have been perceived by many academics as having affected their work with regard to course designing, teaching and assessment. Studies of academics’ response to such changes have argued that the way academics perceived these changes and the meanings they made of them influenced the implementation of these curriculum changes. This case study investigates lecturers’ perceptions of how one curriculum reform, the introduction of the Credit Accumulation and Modular Scheme (CAMS) in higher education in Rwanda, has affected lecturers’ work. One of the aims of the study was to analyse how lecturers understand CAMS and the changes it has introduced in their work. A second aim was to analyse how these perceptions and changes are negotiated in their teaching practices. Sixteen lecturers from Kigali Institute of Education were interviewed. Analyses of lecturers’ accounts of their teaching experiences revealed that lecturers espoused the intended changes that CAMS introduced in their work. However, although they claimed that the changes have affected their teaching and teaching arrangements- course designing, teaching and assessment- in actual practices many of them have not always managed to shift their thinking. CAMS requires lecturers to function in teams. However, although they have been trying to do so many of them have not managed to work out how to make more substantive changes to the way they think about the knowledge to be taught, their actual teaching and assessment practices. They have tried to keep boundaries of their disciplines while CAMS requires them to integrate their teaching

A randomised trial of a contraceptive vaginal ring in women at risk of HIV infection in Rwanda: Safety of intermittent and continuous use

<div><p>Background</p><p>Contraceptive vaginal rings could play a role in expanding the contraceptive method mix and in preparing communities for the introduction of HIV prevention and multipurpose rings.</p><p>Methods</p><p>We conducted an open label single-centre randomised clinical trial of intermittent versus continuous use of NuvaRing® in Kigali, Rwanda, in 2013–2014. We randomised 120 HIV-negative women 1:1 to intermittent use (three rings with a ring-free week in between rings) or continuous use (four rings without ring-free weeks). Women underwent an interview, counselling, and a speculum examination, and were tested for pregnancy, bacterial vaginosis (BV) by Nugent scoring, yeasts and trichomonads on wet mount, and sexually transmitted infections.</p><p>Findings</p><p>Only one woman withdrew early. Deliberate ring removals were rare, but spontaneous ring expulsions occurred during 14% of ring use periods. There were no incident pregnancies, serious adverse events, serious social harms, or early discontinuations for safety reasons. Systemic side effects were uncommon, and local side effects were not significantly differently distributed between groups except for lower abdominal pain (<i>P</i> = 0.013). The incidence of vaginal yeasts during ring use was high: 22% of intermittent users and 27% of continuous users had incident vaginal yeasts at one or multiple ring removal visits (<i>P</i> = 0.666), and symptomatic vaginal yeast cases were more common in the continuous than intermittent users (<i>P</i> = 0.031). In contrast, mean Nugent scores improved over time in both groups.</p><p>Conclusions</p><p>Intermittent and continuous NuvaRing® use were safe in Rwandan women and improved Nugent scores over time. However, attention should be paid to ring expulsions and to a potential increased risk of vaginal candidiasis.</p></div

Laboratory-confirmed bacterial vaginosis, vaginal yeasts and trichomoniasis by randomisation group.

<p>Laboratory-confirmed bacterial vaginosis, vaginal yeasts and trichomoniasis by randomisation group.</p

Spontaneously reported¹ adverse events: comparison by group for the total ring use period and per 100 used rings.

<p>Spontaneously reported<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0197572#t004fn002" target="_blank">¹</a> adverse events: comparison by group for the total ring use period and per 100 used rings.</p

Urogenital self-reported symptoms and clinician-observed signs (not associated with a laboratory-confirmed infection at the same visit) by randomisation group.

<p>Urogenital self-reported symptoms and clinician-observed signs (not associated with a laboratory-confirmed infection at the same visit) by randomisation group.</p

Mean Nugent score over time by randomisation group.

<p>X-axis: RRV = ring removal visit.Y-axis: Mean Nugent score for intermittent users (solid line) and continuous users (dashed line) with bars indicating 95% confidence intervals. The mean Nugent score for the 60 women in each randomisation group was calculated at baseline and at each ring removal visit. The intermittent users used three rings and therefore had three ring removal visits, whereas the continuous users had four.</p

Participant flow.

<p>Participant flow.</p

Baseline characteristics of the screened population and enrolled population by randomisation group.

<p>Baseline characteristics of the screened population and enrolled population by randomisation group.</p

Heterogeneity in patterns of helminth infections across populations of mountain gorillas (Gorilla beringei beringei)

Conservation efforts have led to the recovery of the endangered mountain gorilla populations. Due to their limited potential for spatial expansion, population densities increased, which may alter the epidemiology of infectious diseases. Recently, clinical gastrointestinal illnesses linked to helminth infections have been recorded in both gorilla populations. To understand drivers and patterns of helminth infections we quantified strongylid and tapeworm infections across both Virunga Massif and Bwindi populations using fecal egg counts. We assessed the impact of age, sex, group size, season and spatial differences used as a proxy, which reflects observed variation in the occurrence of gastrointestinal problems, vegetation types, gorilla subpopulation growth and associated social structure on helminth infections. We revealed striking geographic differences in strongylid infections with higher egg counts mostly in areas with high occurrences of gastrointestinal disease. Increased helminth egg counts were also associated with decreasing group size in some areas. Observed spatial differences may reflect mutual effects of variations in subpopulation growth rates, gorilla social structure, and vegetation associated with altitude across mountain gorilla habitat. Helminth infection intensities in Virunga gorillas were lowest in the youngest and the oldest animals. Elucidating parasite infection patterns of endangered species with low genetic diversity is crucial for their conservation management

Évaluation des risques induits par le changement climatique sur la santé des travailleurs [Rapport d'expertise collective]

Évaluation des risques induits par le changement climatique sur la santé des travailleursL’Anses a été saisie le 28 octobre 2013, par la Direction générale de la santé (DGS) et la Direction générale du travail (DGT), pour réaliser une expertise sur les impacts potentiels liés au changement climatique sur la santé et la sécurité des travailleurs. Cette saisine s’inscrit dans le cadre du renforcement de la gestion des risques professionnels induits par le changement climatique, action prévue par le 1er Plan national d’adaptation au changement climatique (PNACC) présenté en juillet 2011