Putting Adequate Financial and Human Resources in Healthcare for Effective Universal Health Coverage in Kenya: Lessons and Experiences from China

In recent years, most low and middle-income countries, have adopted different approaches to universal health coverage (UHC), to ensure equity and financial risk protection in accessing essential healthcare services. UHC-related policies and delivery strategies are largely based on existing healthcare systems, a result of gradual development (based on local factors and priorities). Most countries have emphasized on health financing, and human resources for health (HRH) reform policies, based on good practices of several healthcare plans to deliver UHC for their population.

Health financing and labor market frameworks were used, to understand health financing, HRH dynamics, and to analyze key health policies implemented over the past decade in Kenya’s effort to achieve UHC. Through the understanding, policy options are proposed to Kenya; analyzing, and generating lessons from health financing, and HRH reforms experiences in China. Data was collected using mixed methods approach, utilizing both quantitative (documents and literature review), and qualitative (in-depth interviews) data collection techniques.

The problems in Kenya are substantial: high levels of out-of-pocket health expenditure, slow progress in expanding health insurance among informal sector workers, inefficiencies in pulling of health are revenues, inadequate deployed HRH, maldistribution of HRH, and inadequate quality measures in training health worker. The government has identified the critical role of strengthening primary health care and the National Hospital Insurance Fund (NHIF) in Kenya’s move towards UHC. Strengthening primary health care requires; re-defining the role of hospitals, and health insurance schemes, and training, deploying and retaining primary care professionals according to the health needs of the population; concepts not emphasized in Kenya’s healthcare reforms or programs design. Kenya’s top leadership commitment is urgently needed for tougher reforms implementation, and important lessons from China’s extensive health reforms in the past decade are beneficial. Key lessons from China include health insurance expansion through rigorous research, monitoring, and evaluation, substantially increasing government health expenditure, innovative primary healthcare strengthening, designing, and implementing health policy reforms that are responsive to the population, and regional approaches to strengthening HRH.

The implementation of a literacy intervention 'Station Teaching' in infant classes in Irish primary schools

Background: I conducted my research in the context of The National Literacy Strategy (DES, 2011), which maintains that every young person should be literate and it outlines targets for improving literacy in schools from 2011 to 2020. There has been much debate on the teaching of literacy and in particular the teaching of reading. Clark (2014) outlines how learning to read should be a developmental language process and that the approaches in the early years of schooling will colour the children’s motivation and their perception of reading as a purposeful activity. The acquisition of literacy begins in the home but this study focuses on the implementation of a literacy intervention Station Teaching in the infant classes in primary school. Station Teaching occurs when a class is divided into four or five small groups of pupils and they receive intensive tuition at four or five different Stations with the help of Support teachers: New Reading, Familiar Reading, Phonics, Writing and Oral Language. Research Questions: These research questions frame my study: How is Station Teaching implemented? What is the experience of the intervention Station Teaching from the participants’ point of view: teachers, pupils, parents? What notion of literacy is Station Teaching facilitating? Methods: I chose a pragmatic parallel mixed methods design as suggested by Mertens (2010). I collected and analysed both the quantitative and qualitative data to answer the study’s research questions. In the study the quantitative data were collected from a questionnaire issued to 21 schools in Ireland. I used Excel as a data management package and thematic analysis to analyse and present the data in themes. I collected qualitative data from a case study in a school. This data included observations of two classes over a period of a year; interviews with teachers, pupils and parents; children’s drawings, photographs, teachers’ diaries and video evidence. I analysed and presented the evidence from the qualitative data in themes. Main Findings: There are many skills and strategies that are essential to effective literacy teaching in the early years including phonological awareness, phonics, vocabulary, fluency, comprehension and writing. These skills can be taught during Station Teaching. Early intervention in the early years is essential to pupils’ acquisition of literacy. The expertise of the teacher is key to improving the literacy achievement of pupils Teachers and pupils enjoy participating in ST. Pupils are motivated to read and engage in meaningful activities during ST. Staff collaboration is vital for ST to succeed ST facilitates small group work and teachers can differentiate accordingly while including all pupils in the groups. Pupils’ learning is extended in ST but extension activities need to be addressed in the Writing Station. More training should be provided for teachers on the implementation of ST and more funding for resources should be available to schools Significant contribution of the work: The main significance of the study includes: insights into the classroom implementation of Station Teaching in infant classes and extensive research into characteristics of an effective teacher of literacy.

Immersive Learning Research Network

Computer games have now been around for over three decades and the term serious games has been attributed to the use of computer games that are thought to have educational value. Game-based learning (GBL) has been applied in a number of different fields such as medicine, languages and software engineering. Furthermore, serious games can be a very effective as an instructional tool and can assist learning by providing an alternative way of presenting instructions and content on a supplementary level, and can promote student motivation and interest in subject matter resulting in enhanced learning effectiveness. REVLAW (Real and Virtual Reality Law) is a research project that the departments of Law and Computer Science of Westminster University have proposed as a new framework in which law students can explore a real case scenario using Virtual Reality (VR) technology to discover important pieces of evidence from a real-given scenario and make up their mind over the crime case if this is a murder or not. REVLAW integrates the immersion into VR as the perception of being physically present in a non-physical world. The paper presents the prototype framework and the mechanics used to make students focus on the crime case and make the best use of this immersive learning approach.

Inclusión digital de los estudiantes adultos que acceden a la universidad: análisis de sus actitudes y competencias digitales

Esta investigación se propone identificar las actitudes y competencias de los estudiantes adultos en relación con el uso de las TIC, con especial atención al uso de plataformas digitales de aprendizaje y redes sociales (Web 2.0). Asimismo, evalúa la incidencia de algunas variables sociodemográficas (género y edad) en el uso estas herramientas y en la autopercepción de los estudiantes sobre sus competencias digitales. Se ha realizado un estudio tipo encuesta con una muestra de 382 estudiantes que acceden a la Universidad de Sevilla a través de las vías establecidas para mayores de 25, de 40 y 45 años. Los resultados ponen de manifiesto una actitud generalmente positiva ante las TIC que puede calificarse como de pragmática, ya que estas herramientas se valoran positivamente en función de sus potenciales beneficios en los procesos de aprendizaje. Se constata a la vez que no han recibido formación específica en el uso de las TIC. El nivel de competencia que este alumnado percibe tener en el uso de estos recursos es medio-bajo. Además, el grupo de estudiantes mayores de 45 años se considera menos competente que los mayores de 25 y de 40 años. En consecuencia, se realizan algunas propuestas para mejorar la participación de los estudiantes maduros en la enseñanza universitaria.

Assessment of the EEE-4 oral test: a discourse analysis based on complex networks.

With the development of information technology, the theory and methodology of complex network has been introduced to the language research, which transforms the system of language in a complex networks composed of nodes and edges for the quantitative analysis about the language structure. The development of dependency grammar provides theoretical support for the construction of a treebank corpus, making possible a statistic analysis of complex networks. This paper introduces the theory and methodology of the complex network and builds dependency syntactic networks based on the treebank of speeches from the EEE-4 oral test. According to the analysis of the overall characteristics of the networks, including the number of edges, the number of the nodes, the average degree, the average path length, the network centrality and the degree distribution, it aims to find in the networks potential difference and similarity between various grades of speaking performance. Through clustering analysis, this research intends to prove the network parameters’ discriminating feature and provide potential reference for scoring speaking performance.

Proposing the deep dynamic Bayesian network as a future computer based medical system

The development of new learning models has been of great importance throughout recent years, with a focus on creating advances in the area of deep learning. Deep learning was first noted in 2006, and has since become a major area of research in a number of disciplines. This paper will delve into the area of deep learning to present its current limitations and provide a new idea for a fully integrated deep and dynamic probabilistic system. The new model will be applicable to a vast number of areas initially focusing on applications into medical image analysis with an overall goal of utilising this approach for prediction purposes in computer based medical systems.

The Use of a Computer-Based Simulation Game (CSG) for Learning and Teaching

Introduction A computer-based simulation game (CSG) was used for the first time in a final-year undergraduate module. A change management simulation game was used in the seminar classes as a formative exercise that was linked to parts of the students’ summative assessment. The module evaluation suggests that most students learned from using the CSG.

An Investigation into the Use of Computer-based Simulation Games for Learning and Teaching in Business Management Courses

Computer-based simulation games (CSG) are a form of innovation in learning and teaching. CGS are used more pervasively in various ways such as a class activity (formative exercises) and as part of summative assessments (Leemkuil and De Jong, 2012; Zantow et al., 2005). This study investigates the current and potential use of CGS in Worcester Business School’s (WBS) Business Management undergraduate programmes. The initial survey of off-the-shelf simulation reveals that there are various categories of simulations, with each offering varying levels of complexity and learning opportunities depending on the field of study. The findings suggest that whilst there is marginal adoption of the use CSG in learning and teaching, there is significant opportunity to increase the use of CSG in enhancing learning and learner achievement, especially in Level 5 modules. The use of CSG is situational and its adoption should be undertaken on a case-by-case basis. WBS can play a major role by creating an environment that encourages and supports the use of CSG as well as other forms of innovative learning and teaching methods. Thus the key recommendation involves providing module teams further support in embedding and integrating CSG into their modules.

Approaches to Developing Educational Resources Using AI Embedded in Computer Game Technology. A Case Study: Primary School Literacy

In this extended abstract, we discuss recent research at Worcester into the inclusion of AI into ‘Serious Games’. Serious Games research intends to harness the power of computer game technology to produce educational and training materials. We prefer the name ‘Immersive Environments’ (IEs) since this emphasises the human psychological dimension. Creation of compelling and convincing learning software requires a rich engagement of the learner, and a convincing learning experience. We believe that various aspects of the AI tradition can inform the production of such learning.

Computer simulations of soft particles in flow

Understanding the dynamics of blood cells is a crucial element to discover biological mechanisms, to develop new efficient drugs, design sophisticated microfluidic devices, for diagnostics. In this work, we focus on the dynamics of red blood cells in microvascular flow. Microvascular blood flow resistance has a strong impact on cardiovascular function and tissue perfusion. The flow resistance in microcirculation is governed by flow behavior of blood through a complex network of vessels, where the distribution of red blood cells across vessel cross-sections may be significantly distorted at vessel bifurcations and junctions. We investigate the development of blood flow and its resistance starting from a dispersed configuration of red blood cells in simulations for different hematocrits, flow rates, vessel diameters, and aggregation interactions between red blood cells. Initially dispersed red blood cells migrate toward the vessel center leading to the formation of a cell-free layer near the wall and to a decrease of the flow resistance. The development of cell-free layer appears to be nearly universal when scaled with a characteristic shear rate of the flow, which allows an estimation of the length of a vessel required for full flow development, $l_c \approx 25D$, with vessel diameter $D$. Thus, the potential effect of red blood cell dispersion at vessel bifurcations and junctions on the flow resistance may be significant in vessels which are shorter or comparable to the length $l_c$. The presence of aggregation interactions between red blood cells lead in general to a reduction of blood flow resistance. The development of the cell-free layer thickness looks similar for both cases with and without aggregation interactions. Although, attractive interactions result in a larger cell-free layer plateau values. However, because the aggregation forces are short-ranged at high enough shear rates ($\bar{\dot{\gamma}} \gtrsim 50~\text{s}^{-1}$) aggregation of red blood cells does not bring a significant change to the blood flow properties. Also, we develop a simple theoretical model which is able to describe the converged cell-free-layer thickness with respect to flow rate assuming steady-state flow. The model is based on the balance between a lift force on red blood cells due to cell-wall hydrodynamic interactions and shear-induced effective pressure due to cell-cell interactions in flow. We expect that these results can also be used to better understand the flow behavior of other suspensions of deformable particles such as vesicles, capsules, and cells. Finally, we investigate segregation phenomena in blood as a two-component suspension under Poiseuille flow, consisting of red blood cells and target cells. The spatial distribution of particles in blood flow is very important. For example, in case of nanoparticle drug delivery, the particles need to come closer to microvessel walls, in order to adhere and bring the drug to a target position within the microvasculature. Here we consider that segregation can be described as a competition between shear-induced diffusion and the lift force that pushes every soft particle in a flow away from the wall. In order to investigate the segregation, on one hand, we have 2D DPD simulations of red blood cells and target cell of different sizes, on the other hand the Fokker-Planck equation for steady state. For the equation we measure force profile, particle distribution and diffusion constant across the channel. We compare simulation results with those from the Fokker-Planck equation and find a very good correspondence between the two approaches. Moreover, we investigate the diffusion behavior of target particles for different hematocrit values and shear rates. Our simulation results indicate that diffusion constant increases with increasing hematocrit and depends linearly on shear rate. The third part of the study describes development of a simulation model of complex vascular geometries. The development of the model is important to reproduce vascular systems of small pieces of tissues which might be gotten from MRI or microscope images. The simulation model of the complex vascular systems might be divided into three parts: modeling the geometry, developing in- and outflow boundary conditions, and simulation domain decomposition for an efficient computation. We have found that for the in- and outflow boundary conditions it is better to use the SDPD fluid than DPD one because of the density fluctuations along the channel of the latter. During the flow in a straight channel, it is difficult to control the density of the DPD fluid. However, the SDPD fluid has not that shortcoming even in more complex channels with many branches and in- and outflows because the force acting on particles is calculated also depending on the local density of the fluid.

ASSESSING THE LEVEL OF TECHNOLOGY INTEGRATION OF TITLE I TEACHERS IN A LARGE URBAN SCHOOL DISTRICT

By law, Title I schools employ teachers who are both competent in their subject knowledge and State certified. In addition, Title I teachers receive ongoing professional development in technology integration and are equipped with the latest innovative resources to integrate technology in the classroom. The aim is higher academic achievement and the effective use of technology in the classroom. The investment to implement technology in this large urban school district to improve student achievement has continued to increase. In order to infuse current and emerging technology throughout the curriculum, this school district needs to know where teachers have, and have not, integrated technology. Yet the level of how technology is integrated in Title I schools is unknown. This study used the Digital-Age Survey Levels of Teaching Innovation (LoTi) to assess 508 Title I teachers’ technology integration levels using three major initiatives purchased by Title I— the iPads program, the Chromebook initiative, and the interactive whiteboards program. The study used a quantitative approach. Descriptive statistics, regression analysis, and statistical correlations were used to examine the relationship between the level of technology integration and the following dependent variables: personal computer use (PCU), current instructional practices (CIP), and levels of teaching innovation (LoTi). With this information, budgetary decisions and professional development can be tailored to the meet the technology implementation needs of this district. The result of this study determined a significant relationship between the level of teaching innovation, personal computer use, and current instructional practices with teachers who teach with iPad, Chromebook, and/or interactive whiteboard. There was an increase in LoTi, PCU, and CIP scores with increasing years of experience of Title I teachers. There was also a significant relationship between teachers with 20 years or more teaching experience and their LoTi score.

The authenticity of resources for the teaching of foreign languages and cultures in France: variable geometry notion

International audience

Online Resources for Improving EFL Teaching and Learning

El presente artículo plantea el beneficio de utilizar recursos en línea en la enseñanza del inglés. Destaca que los estudiantes fortalecerán, no solo el uso de la lengua meta, sino también el de los recursos tecnológicos. Para ejemplificar, se presenta una serie de ejercicios en línea que desarrollan diversas habilidades de la lengua meta como también las ventajas y desventajas del uso de los mismos. Por último, se comparten los resultados obtenidos de una encuesta aplicada sobre el uso de recursos en línea en las clases de inglés.The benefit of using online sources in the EFL class is analyzed here starting from the perspective that this helps students improve not only their use of the language but also their use of technology. Sample online exercises focusing on the development of different language skills are described here, along with the advantages and disadvantages of using online sources. Finally, the results obtained from a survey on the use of online sources in the EFL classes are presented.