Barriers in adopting blended learning in a private university of Pakistan and East Africa: Faculty members’ perspective

Background: Education methods have undergone transformation over the centuries. Use of technology is the cornerstone for innovation in teaching methods. Hence, blended learning which includes face to face and online modalities is being increasingly explored as effective method for learning. This pilot study determines the perceptions of faculty members in a private international university on barriers influencing adoption of technology for teaching and learning. Methods: A cross-sectional survey was conducted through a self-reported questionnaire using ‘survey monkey’. The data was entered and analyzed using Statistical Package for the Social Sciences (SPSS version 20). Frequencies and proportions are reported. Results: Findings indicated that 51.6% faculty members perceived the importance of integration of technology in their teaching. Around 54% of the participants recognized that they do possess the ability and accessibility to integrate information communication technology (ICT) in teaching and learning, but there is a need to hone the basic information technology (IT) skills to initiate technology driven teaching. Findings revealed that 55% faculty members acknowledged the constraint of not getting protective time to develop and deliver technology driven courses. Further, results showed that 45% faculty members perceived that their innovation efforts in terms of teaching as blended learning do not count towards their professional promotion or recognition, as usually priority is given to research over teaching innovation. The findings also indicated that 54.5% participants asserted that university lack mentorship in the field of blended learning. Conclusions: Therefore, study suggests that universities should provide adequate mentorship programmes for the faculty members in enhancing their skills of integrating technology in their teaching

Utilisation of whatsapp for emergency medical services in Garissa, Kenya.

Garissa county, Kenya is a geographically large county with a mobile pastoralist population that has developed a method for emergency medical services (EMS) coordination using the WhatsApp communication platform. This work was based on a site visit, to better understand and describe the current operations, strengths, and weaknesses of the EMS communication system in Garissa. The use of WhatsApp in Garissa county seems to work well in the local context and has the potential to serve as a cost-effective solution for other EMS systems in Kenya, Africa, and other LMICs

Advancing research on emergency care systems in low-income and middle-income countries: ensuring high-quality care delivery systems

Emergency care systems (ECS) address a wide range of acute conditions, including emergent conditions from communicable diseases, non-communicable diseases, pregnancy and injury. Together, ECS represent an area of great potential for reducing morbidity and mortality in low-income and middle-income countries (LMICs). It is estimated that up to 54% of annual deaths in LMICs could be addressed by improved prehospital and facility-based emergency care. Research is needed to identify strategies for enhancing ECS to optimise prevention and treatment of conditions presenting in this context, yet significant gaps persist in defining critical research questions for ECS studies in LMICs. The Collaborative on Enhancing Emergency Care Research in LMICs seeks to promote research that improves immediate and long-term outcomes for clients and populations with emergent conditions. The objective of this paper is to describe systems approaches and research strategies for ECS in LMICs, elucidate priority research questions and methodology, and present a selection of studies addressing the operational, implementation, policy and health systems domains of health systems research as an approach to studying ECS. Finally, we briefly discuss limitations and the next steps in developing ECS-oriented interventions and research

The cost‐effectiveness of prophylaxis strategies for individuals with advanced HIV starting treatment in Africa

Introduction Many HIV‐positive individuals in Africa have advanced disease when initiating antiretroviral therapy (ART) so have high risks of opportunistic infections and death. The REALITY trial found that an enhanced‐prophylaxis package including fluconazole reduced mortality by 27% in individuals starting ART with CD4 <100 cells/mm3. We investigated the cost‐effectiveness of this enhanced‐prophylaxis package versus other strategies, including using cryptococcal antigen (CrAg) testing, in individuals with CD4 <200 cells/mm3 or <100 cells/mm3 at ART initiation and all individuals regardless of CD4 count. Methods The REALITY trial enrolled from June 2013 to April 2015. A decision‐analytic model was developed to estimate the cost‐effectiveness of six management strategies in individuals initiating ART in the REALITY trial countries. Strategies included standard‐prophylaxis, enhanced‐prophylaxis, standard‐prophylaxis with fluconazole; and three CrAg testing strategies, the first stratifying individuals to enhanced‐prophylaxis (CrAg‐positive) or standard‐prophylaxis (CrAg‐negative), the second to enhanced‐prophylaxis (CrAg‐positive) or enhanced‐prophylaxis without fluconazole (CrAg‐negative) and the third to standard‐prophylaxis with fluconazole (CrAg‐positive) or without fluconazole (CrAg‐negative). The model estimated costs, life‐years and quality‐adjusted life‐years (QALY) over 48 weeks using three competing mortality risks: cryptococcal meningitis; tuberculosis, serious bacterial infection or other known cause; and unknown cause. Results Enhanced‐prophylaxis was cost‐effective at cost‐effectiveness thresholds of US$300 and US$500 per QALY with an incremental cost‐effectiveness ratio (ICER) of US$157 per QALY in the CD4 <200 cells/mm3 population providing enhanced‐prophylaxis components are sourced at lowest available prices. The ICER reduced in more severely immunosuppressed individuals (US$113 per QALY in the CD4 <100 cells/mm3 population) and increased in all individuals regardless of CD4 count (US$722 per QALY). Results were sensitive to prices of the enhanced‐prophylaxis components. Enhanced‐prophylaxis was more effective and less costly than all CrAg testing strategies as enhanced‐prophylaxis still conveyed health gains in CrAg‐negative patients and savings from targeting prophylaxis based on CrAg status did not compensate for costs of CrAg testing. CrAg testing strategies did not become cost‐effective unless the price of CrAg testing fell below US$2.30. Conclusions The REALITY enhanced‐prophylaxis package in individuals with advanced HIV starting ART reduces morbidity and mortality, is practical to administer and is cost‐effective. Efforts should continue to ensure that components are accessed at lowest available prices

Late Presentation With HIV in Africa: Phenotypes, Risk, and Risk Stratification in the REALITY Trial.

This article has been accepted for publication in Clinical Infectious Diseases Published by Oxford University PressBackground: Severely immunocompromised human immunodeficiency virus (HIV)-infected individuals have high mortality shortly after starting antiretroviral therapy (ART). We investigated predictors of early mortality and "late presenter" phenotypes. Methods: The Reduction of EArly MortaLITY (REALITY) trial enrolled ART-naive adults and children ≥5 years of age with CD4 counts .1). Results: Among 1711 included participants, 203 (12%) died. Mortality was independently higher with older age; lower CD4 count, albumin, hemoglobin, and grip strength; presence of World Health Organization stage 3/4 weight loss, fever, or vomiting; and problems with mobility or self-care at baseline (all P < .04). Receiving enhanced antimicrobial prophylaxis independently reduced mortality (P = .02). Of five late-presenter phenotypes, Group 1 (n = 355) had highest mortality (25%; median CD4 count, 28 cells/µL), with high symptom burden, weight loss, poor mobility, and low albumin and hemoglobin. Group 2 (n = 394; 11% mortality; 43 cells/µL) also had weight loss, with high white cell, platelet, and neutrophil counts suggesting underlying inflammation/infection. Group 3 (n = 218; 10% mortality) had low CD4 counts (27 cells/µL), but low symptom burden and maintained fat mass. The remaining groups had 4%-6% mortality. Conclusions: Clinical and laboratory features identified groups with highest mortality following ART initiation. A screening tool could identify patients with low CD4 counts for prioritizing same-day ART initiation, enhanced prophylaxis, and intensive follow-up. Clinical Trials Registration: ISRCTN43622374.REALITY was funded by the Joint Global Health Trials Scheme (JGHTS) of the UK Department for International Development, the Wellcome Trust, and Medical Research Council (MRC) (grant number G1100693). Additional funding support was provided by the PENTA Foundation and core support to the MRC Clinical Trials Unit at University College London (grant numbers MC_UU_12023/23 and MC_UU_12023/26). Cipla Ltd, Gilead Sciences, ViiV Healthcare/GlaxoSmithKline, and Merck Sharp & Dohme donated drugs for REALITY, and ready-to-use supplementary food was purchased from Valid International. A. J. P. is funded by the Wellcome Trust (grant number 108065/Z/15/Z). J. A. B. is funded by the JGHTS (grant number MR/M007367/1). The Malawi-Liverpool–Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine (grant number 101113/Z/13/Z) and the Kenya Medical Research Institute (KEMRI)/Wellcome Trust Research Programme, Kilifi (grant number 203077/Z/16/Z) are supported by strategic awards from the Wellcome Trust, United Kingdom. Permission to publish was granted by the Director of KEMRI. This supplement was supported by funds from the Bill & Melinda Gates Foundation

Mapping the medical outcomes study HIV health survey (MOS-HIV) to the EuroQoL 5 Dimension (EQ-5D-3L) utility index

10.1186/s12955-019-1135-8Health and Quality of Life Outcomes1718

A study of dynamics of stakeholders\u27 participation in school management

Stakeholder participation in school management is a widely accepted phenomenon for shared decision-making required for effective policies. This study attempts to explore the influences of stakeholder participation towards an effective school management. It further seeks to understand the relationship between existing practices, modes and dynamics of stakeholders\u27 participation at school level. The study adopts a qualitative design; case study approach with respondents who include teachers, parents, students, principal, and board of governors. In order to gather relevant information, semi-structured interviews were conducted with a selected group of stakeholders followed by an analysis of relevant school documents along with non-participant observation of the management practices. The case study reveals that three major dynamics at the individual, institutional and group level significantly influence the stakeholders\u27 participation. The study further suggests that these dynamics are complimentary to each other and are required for an effective participation at school level. The study finally concludes by discussing recommendations and implications for effective stakeholders\u27 participation which include: a) creating linkages between the three dynamics; b) wider participation in policy formulation; and c) adopting a participatory management approach for ensuring effective participation. Across all the findings of this study, it appears that effective management and effective participation are interdependent and can be considered as a vehicle\u27 for managing schools effectively

Making the link: Integrating design thinking, making and STEMx in education

This chapter is mainly proposing an approach, which is Taking Making into schools that disrupts existing teaching practice. It integrates subject areas such as Science, Technology, Engineering, Mathematics and human-centred designs (STEMx)

Ideologising revolutionary egalitarianism in Jared Angira’s and John Clare’s poetry

Accruing knowledge, critical to understanding societal systems and structures constitutes a basal philosophical problematic to the human intellect. Notably, as disciplines that revolve around aspects of human society and culture, imaginative writing and literary studies rank among the major branches of inquiry invoked to generate ideas, solutions and initiatives for the betterment of human life. Comparatively scrutinising the ideological kinship between the poetry of Jared Angira and John Clare, the objective of this paper is to demonstrate that these poems constitute latent grounds for reflection on and critical engagement with the nature of existence and articulation of social thought and ideologies. Thus, this paper is a nominal effort in appreciating their commonality as an ideological catalytic agency of changing and transforming the social and cultural fabric of life in their societies. Drawing from the critical insights of New Historicism theory, the paper employs textual analysis and historical context study towards illuminating how both poets prescribe a common ideological guiding pattern that it designates Revolutionary Egalitarianism

The crisis of post-colonial intellectual thought and knowledge production: Examining Jared Angira’s African revolutionary egalitarianism

This paper critiques Jared Angira’s poetry, and the ideology it manifests with a view to interrogating the “Marxist” label scholars attach to him. Although justifications abound for the prevailing perspectives on Angira’s ideology as “Marxist”, they are limited in their subconscious reinforcement of the traditional white-supremacist image-branding of Africa in terms of deficiency and inferiority. In further contributing to the decolonisation of knowledge generation and consumption in the Global South, the paper interprets these views as theoretically misleading and ideologically incorrect. It adopts the contrary position that Angira is an African Revolutionary Egalitarian, thus paving way for the appreciation of his uniquely African contribution to endogenous knowledge production and the intellectual armoury of African political ideas. Though African Revolutionary Egalitarianism, a term we coin to try and apprehend the ideology we read in Angira’s poetry, has Marxist inclinations, in contexture, it is not Marxism. Angira’s poems are the primary data. Besides critical evaluations on the primary texts, knowledge situated around the general context of contemporary African ideological paradigms and knowledge systems constitutes secondary data. Knowledge on the broad range of historical factors, experiences and contours which shape Angira’s worldview, personality and writing also constitute an essential category of secondary data