Connectivity Issues Research Articles

Compliant and Seamless Hybrid (Star and Mesh) Network Topology Coexistence for LoRaWAN: A Proof of Concept

Long-range wireless area networks (LoRaWAN) typically use a simple star topology. However, some nodes may experience connectivity issues with the gateway due to signal degradation or limited coverage, often resulting from challenging environments in sectors such as agriculture, industry, smart cities, smart grids, and healthcare, where LoRaWAN-based IoT solutions have expanded. The main contribution of this paper is the implementation of a hybrid topology for LoRaWAN networks that remains fully transparent to current spec LoRaWAN servers and IoT applications. It enables the coexistence of mesh (multi-hop) and star (single-hop) communication schemes, dynamically adapting a node’s transmission mode based on physical link quality metrics. Additionally, the user interface allows for customizing network topology and parameters. Experimental proof-of-concept tests were conducted on a campus-wide testbed. Results showed that all devices successfully switched topology mode in 100% of the instances, enabling data transmission across all three scenarios under test. Network performance metrics were evaluated, with latencies ranging from 0.5 to 3.2 s for both single-hop and multi-hop transmissions. Additionally, improvements in RSSI and SNR were observed, validating the efficiency of the proposed solution. These results demonstrate the feasibility and effectiveness of our approach in extending network connectivity to areas beyond the gateway’s coverage.

Unveiling Teacher Resilience in French Language Distance Teaching: A Case Study

This study investigates teachers’ experiences during the sudden shift to online teaching due to COVID-19. It explores their adaptation to the situation and their resilience in ensuring uninterrupted educational continuity. The study focuses on the resilience strategies used by teachers of French at Algerian universities during the pandemic and their teaching adaptation to distance education. The primary aim is to examine the teachers’ constraints, their perception of pedagogical resilience, and the strategies they developed to overcome the challenges of transitioning from face-to-face to online education. This qualitative study, conducted through questionnaires among 50 French language teachers, with 42 responses received, concentrated on teachers’ experiences with distance teaching, the digital platforms they used, and the strategies they employed to remain resilient. The analysis revealed significant challenges: a lack of familiarity with digital tools, connectivity issues, and a decline in student motivation. Despite these hurdles, teachers demonstrated resilience by embracing new social media platforms, videoconferencing, and collaborative teleworking tools to maintain student engagement and ensure pedagogical continuity. These findings underscore the urgent need for flexible support systems to address distance education challenges during a crisis. The study delved into the concept of resilience and discovered that participants perceived it as embodying a positive portrayal of distance learning amidst the health crisis.

The era of telesurgery: insights from ultra-long-distance Asia to Middle East human telesurgery robotic assisted radical prostatectomy

To show the feasibility of performing human telesurgery robotic-assisted radical prostatectomy (RARP) between two countries using low-latency ultra-long-distance connectivity. This study described the outcomes of performing RARP on a man in his 60’s with localized intermediate-risk prostatic adenocarcinoma located in Kuwait City while the surgeon (SA) was approximately 7000 kilometers (Km) away at Toumai robotic surgical system (TRSS) headquarters in Shanghai. Operative and connectivity details were reported. RARP was performed in December 2024. There were no major clinical or technical problems encountered during the procedure. The average round-trip latency (RTL) was 181.4 milliseconds (ms) using fiber optic broadband network with 5G network as back-up. On the Shanghai end two wired broadband networks were employed as back-up to ensure patient safety. There was an experienced fellowship-trained robotic surgeon (AA) in the operating room in Kuwait capable of taking over in case of clinical or connectivity issues. There were no reported complications. The patient was discharged on postoperative day (POD) 2. Final pathology described Gleason score 7(3 + 4), ISUP 2, and negative surgical margins (pT2Nx). The catheter was removed on POD 9, and the patient was continent a week later. His serum prostate specific antigen (PSA) was undetectable seven weeks post-operatively. This study described the feasibility of human RARP telesurgery between two countries using low-latency, long-distance fiber optic broadband network with 5G network as back-up with successful clinical outcomes. There is a need to establish robust legal and regulatory framework to allow wider international expansion of telesurgery.

Vehicular Ad-Hoc Networks for Intelligent Transportation System: A Brief Review of Protocols, Challenges, and Future Research

Vehicular Ad Hoc Networks (VANET) play an essential role in the advancement of intelligent transportation systems, facilitating real-time communication between vehicles (V2V), infrastructure (V2I), and surrounding environments (V2X). This systematic review analyzes a range of VANET routing protocols, highlighting the strengths and weaknesses of topology-based, position-based, cluster-based, and hybrid methods. Additionally, this review explores core challenges in VANET, including high mobility, data security, Quality of Service (QoS) requirements, and connectivity issues in dynamic and high-density traffic environments. The paper also provides insights into simulation tools and performance metrics employed in VANET research alongside practical applications in modern transportation systems, such as autonomous driving, traffic management, and safety-related communication. Furthermore, this review emphasizes the need for ongoing research to address the identified challenges and optimize VANET performance. Integrating emerging technologies, including 5G, artificial intelligence (AI), and edge computing, offers promising avenues for enhancing system efficiency and sustainability. This review establishes a comprehensive foundation for further advancements in VANET by highlighting key findings and research gaps. Ultimately, the effective implementation of VANET has the potential to significantly improve transportation safety, efficiency, and sustainability, contributing to the realization of smart city initiatives and innovative mobility solutions. This work aims to guide future research directions, ensuring that VANET continues to evolve in alignment with the demands of modern transportation systems and the broader context of intelligent mobility.

European Youth and Digital Engagement: Attitudes, Skills, and Civic Participation

Abstract This study investigates the attitudes of young individuals aged 15–35 years toward digital communication, with a focus on digital skills, citizenship, and civic engagement. Utilising data from the European Social Survey (ESS) round 10 (2020), the research explores variations across over 30 European countries, examining responses to the ESS’s rotating module on “Digital social contacts in work and family life.” Key questions, such as exposure to misinformation and online political engagement, are analysed to uncover factors influencing young Europeans’ perceptions of information and communication technology (ICT). The study explores digital scepticism, optimism, and digital skills, linking them to civic participation and socio-demographic factors. Statistical analysis, including chi-square tests and multiple regression analysis, identifies predictors and disparities among countries. Correspondence analysis dissects interrelationships among categories, constructing plots to showcase proximity between factors. Evaluating Internet accessibility, civic engagement, and connectivity issues, the study also compares data with the prior ESS round (round 9, 2018) to assess changes over the past 4 years. Through empirical investigation, this study sheds light on young Europeans’ perspectives on ICT, offering valuable insights into the complex interplay between digital communication, civic engagement, and beneficial Internet time.

Learners’ Perceptions of the Challenges and Improvement Strategies in Distance and Online Undergraduate Mathematics Learning

In order to address the diverse needs of the present-day distance and online Mathematics learners, it is necessary to obtain the opinions of the learners on the improvement strategies of their Mathematics programmes. In distance and online learning (DOL) education in Nigeria, different strategies to improve mathematics learning have been initiated. The aim of this paper is to provide students’ standpoint on the challenges and improvement strategies of learning mathematics through the distance and online method of education. The study explores how internet connectivity issues, institutional strategies and facilitation skill development impacted upon mathematics students’ engagement in distance and online mode of learning. In this study, distance and online mathematics learners from two Open and Distance Learning (ODL) universities who were in the third year of their study were interviewed. A thematic analysis and a word-for-word narrative inquiry approach that encourages students to tell their story were adopted in the analysis. The findings indicated among others a need for provision of efficient, viable and affordable internet connectivity in their schools. Moreover, inclusion of several online mathematics activities for students learning in this mode and provision of relevant mathematical resources for effective learning were evident. It was recommended that the school in collaboration with the government should provide costless personal computers equipped with mathematical capabilities for effective mathematics learning. The students’ opinions presented in this paper can be used as informed improvement strategies designed to enhance distance and online mathematics learning in ODL universities in Nigeria.

Ancient DNA analysis of elite nomadic warrior from Chinge-Tey I funerary commemorative complex in the “Valley of the Kings”, Tuva

BackgroundIn the Ist millennium BC bearers of the Scythian-type nomadic cultures inhabited the steppes of Eurasia, from Northern China to the Carpathians. According to archaeological data, the origin of nomadic life style and economy can be traced to the eastern part of this steppe “corridor”, primarily to the territory of the present-day Republic of Tuva in Russia. Here, in the Turan-Uyuk Basin, also known as the “Valley of the Kings”, some of the earliest known Scythian-type archaeological sites called Arzhan-1, Arzhan-2, Chinge-Tey I, Tunnug 1 were studied. Each of them is a large-scale funerary commemorative complex with burials of tribal nomadic leaders, surrounded by graves of supposed members of their families or associates. All these people belonged to the societies which are associated with the earliest nomadic cultures in Asia. Representatives of similar cultures will later be known and described as the Scythians/the Saka in Assyrian, Achaemenid, and Greek sources. Arzhan 2 and Chinge-Tey I elite level sites as well as ordinary pastoralist burials of the early-Scythian period in Tuva are attributed to the Aldy-Bel archaeological culture of the Early Iron Age (8th– 6th century BC). Taking the first step to shed light on the genetic origin of Aldy-Bel elites, we carried out a comparative genome-wide analysis of an elite level person buried in grave 9 at Chinge-Tey I (7th– 6th centuries BC) and two published earlier genomes of individuals, whose burials (graves 14 and 22) accompanied the ‘royal couple’ (grave 5) at Arzhan-2. This study aims also at checking a hypothesis of genetic kinship between human individuals buried in the large-scale burial complexes of the “Valley of the Kings” and brings up the issue of possible dynastic connections of local elites, buried under different kurgans of the valley.ResultsFirst, ancient DNA analysis of an elite nomadic warrior from Chinge-Tey I has been carried out, thus a third wide-genome dataset for Aldy-Bel culture– one of the earliest nomadic cultures in Asia, is presented in this study. Second, we undertook a comparative analysis of genome-wide data of three mentioned Aldy-Bel culture representatives and individuals of the other Bronze and Early Iron Age population groups of Asia to estimate their possible genetic connections. Then, kinship analysis was undertaken for these three Aldy-Bel culture individuals. Finally, mitochondrial and Y-chromosome haplogroups of Chinge-Tey princely person were compared to those of other Aldy-Bel culture representatives and to individuals of subsequent Scythian-type Uyuk-Sagly culture in Tuva.Conclusion(1) Generating the third wide-genome of the enabled us to undertake its comparison with two other genomes of Aldy-Bel culture representatives (Arzhan-2, graves 14 and 22) and with other Bronze and Early Iron Age population groups in Asia to trace the origin and genetic connection of Aldy-Bel population, representing one of the earliest Scythian-type nomadic group. (2) The results obtained show that the princely individual from Chinge-Tey I and two ‘king’s associates’ from Arzhan-2 were genetically close to nomads of simultaneous Tasmola culture in Eastern and Central Kazakhstan and pastoralists buried in the Early Iron Age cemeteries of present-day Xinjiang (first of all, Abusanteer archaeological site). Aldy-Bel culture representatives appeared also close to individuals of the Middle Bronze Age Okunevo culture in the Minusinsk Basin. Besides, Aldy-Bel pastoralists turned out genetically close to nomads of the subsequent Uyuk-Sagly culture in Mongolia (5th − 3rd centuries BC). (3) Ancient DNA kinship analyses, undertaken for three Aldy-Bel culture individuals pointed out to the absence of their tribe kinship. (4) On the other hand, Chinge-Tey warrior’s mitochondrial haplogroup G was previously described in two (graves 14 and 5) individuals from Arzhan-2, including a female individual from the “royal” tomb 5. This result provided a possibility of maternal kinship among this so called ‘queen’ from Arzhan-2 and the princely person from Chinge-Tey I. This possibility supported a hypothesis of their family ties suggested on archaeological materials. Y-chromosome haplogroup Q1b1, revealed for the princely person, was widely distributed among local people of Aldy-Bel and subsequent Uyuk-Sagly cultures.

A Comprehensive Review on Recent Advances in Sustainable Agriculture

This article provides a detailed analysis of the Internet of Things' (IoT) use in agriculture, highlighting both its advantages and disadvantages. However, the Internet of Things (IoT) offers a great deal of promise to generate novel concepts that could progress modern agriculture and address many of the problems that farmers currently face. Smart irrigation, precision farming, crop and soil tracking, smart greenhouses, supply chain management, livestock monitoring, agricultural drones, disease and insect prevention, and farm equipment are some of the uses for IoT implementation in agriculture that this study takes into account. These innovative ideas have the potential to revolutionize farming practices, promote agricultural sustainability and production, reduce resource waste, and raise productivity. The study assesses the utility of each application and outlines the actions that need be made to improve its effectiveness. Important considerations include connectivity issues, cost control, data security and privacy, solution scaling, effective data management, and increasing knowledge and acceptance of IoT capabilities. Despite these challenges, IoT has a lot to offer the agriculture sector. The study highlights the importance of collaboration between farmers, IoT technology companies, academia, and government in order to address these issues and realize the full potential of IoT. This requires ongoing study, development, and adoption of IoT-driven solutions to keep agriculture viable as a substitute in the face of emerging problems like resource shortages and climate change.

The Mirror Class as a method for the internationalization of the curriculum in higher medical education: An analysis of an experience between Ecuador and Bolivia

Introduction: Internationalization in higher education is a key strategy for institutional development, facilitating research, international cooperation, and academic exchange. Mirror classes, which gained popularity during the COVID-19 pandemic, are a learning modality that connects students and teachers from different universities through synchronous sessions supported by Information and Communication Technologies (ICT). Objective: The article aims to share the experience and reflections on the implementation of a Mirror Class between the Universidad San Gregorio de Portoviejo (USGP) in Ecuador and the Universidad Privada Domingo Savio (UPDS) in Bolivia in the Pharmacology course, as a modality for the internationalization of the academic curriculum in higher medical education. Methods: A descriptive, non-experimental research with a qualitative approach was employed. The theoretical modeling method and the empirical-analytical methodology, based on argumentation and observation, were used. Voluntary testimonies from students and teachers were collected from the conclusions of the activity and documented in recordings of the Mirror Class. Results: The Mirror Class was implemented in the Pharmacology course between USGP and UPDS, with theoretical and practical activities. Students worked together through virtual platforms to solve clinical cases, promoting collaborative learning. Despite challenges such as differences in students' training levels and connectivity issues, the results were positive, with notable strengthening of competencies and participants' motivation. Conclusions: The Mirror Class proved to be an effective modality for the internationalization of the curriculum, benefiting all participants and allowing the development of global competencies in future health professionals. It is crucial to continue implementing this methodology in different courses to promote the formation of homogeneous profiles with global perspectives in medical education.

Development and Feasibility Study of HOPE Model for Prediction of Depression Among Older Adults Using Wi-Fi-based Motion Sensor Data: Machine Learning Study.

Depression, characterized by persistent sadness and loss of interest in daily activities, greatly reduces quality of life. Early detection is vital for effective treatment and intervention. While many studies use wearable devices to classify depression based on physical activity, these often rely on intrusive methods. Additionally, most depression classification studies involve large participant groups and use single-stage classifiers without explainability. This study aims to assess the feasibility of classifying depression using nonintrusive Wi-Fi-based motion sensor data using a novel machine learning model on a limited number of participants. We also conduct an explainability analysis to interpret the model's predictions and identify key features associated with depression classification. In this study, we recruited adults aged 65 years and older through web-based and in-person methods, supported by a McGill University health care facility directory. Participants provided consent, and we collected 6 months of activity and sleep data via nonintrusive Wi-Fi-based sensors, along with Edmonton Frailty Scale and Geriatric Depression Scale data. For depression classification, we proposed a HOPE (Home-Based Older Adults' Depression Prediction) machine learning model with feature selection, dimensionality reduction, and classification stages, evaluating various model combinations using accuracy, sensitivity, precision, and F1-score. Shapely addictive explanations and local interpretable model-agnostic explanations were used to explain the model's predictions. A total of 6 participants were enrolled in this study; however, 2 participants withdrew later due to internet connectivity issues. Among the 4 remaining participants, 3 participants were classified as not having depression, while 1 participant was identified as having depression. The most accurate classification model, which combined sequential forward selection for feature selection, principal component analysis for dimensionality reduction, and a decision tree for classification, achieved an accuracy of 87.5%, sensitivity of 90%, and precision of 88.3%, effectively distinguishing individuals with and those without depression. The explainability analysis revealed that the most influential features in depression classification, in order of importance, were "average sleep duration," "total number of sleep interruptions," "percentage of nights with sleep interruptions," "average duration of sleep interruptions," and "Edmonton Frailty Scale." The findings from this preliminary study demonstrate the feasibility of using Wi-Fi-based motion sensors for depression classification and highlight the effectiveness of our proposed HOPE machine learning model, even with a small sample size. These results suggest the potential for further research with a larger cohort for more comprehensive validation. Additionally, the nonintrusive data collection method and model architecture proposed in this study offer promising applications in remote health monitoring, particularly for older adults who may face challenges in using wearable devices. Furthermore, the importance of sleep patterns identified in our explainability analysis aligns with findings from previous research, emphasizing the need for more in-depth studies on the role of sleep in mental health, as suggested in the explainable machine learning study.

Continuous vital sign monitoring with Biobeat® wearable devices for post-ambulatory surgery patients: a pilot feasibility study.

Improvement in anesthesia and surgical practices has enabled more patients, including those undergoing higher-risk surgeries, to be treated in outpatient settings. This shift creates a need for reliable postoperative monitoring at home. Wearable devices like the Biobeat® offer continuous, real-time monitoring of vital signs have remained largely untested for home use in this context.A prospective, single-center observational study was conducted at the Centre hospitalier de l'Université de Montréal (CHUM) from February to August 2023. Fifty eligible patients underwent continuous monitoring with the Biobeat® device for five days post-surgery, with data transmitted to CHUM's telehealth service. Feasibility was assessed by the percentage of patients without data loss during consecutive 2-hour intervals.Of the 50 patients enrolled, 49 completed the study, but all experienced some level of data loss. While 39.6% of patients maintained connectivity without complete data loss for 6-8-hour intervals, challenges included device discomfort, Bluetooth disconnection, and connectivity issues. Thirteen patients removed the device early due to discomfort or technical issues. Of the 3 patients who experienced post-operative complications, no data was available within 24h prior to the episodes. Continuous vital signs monitoring is feasible for high-risk outpatient surgery patients; however, significant improvements are required in device reliability and data accessibility. Further studies are needed to refine the technology and develop reliable protocols for postoperative monitoring in the home setting.

User Perceptions of the KEMI eLearning App: A Case Study on Self-Paced Learning for School Leaders in Kenya

This study evaluated the KEMI eLearning app's effectiveness in enhancing self-paced online learning among initial users and addressed the research gap on its impact across various contexts. The KEMI eLearning App was developed by the Kenya Education Management Institute (KEMI). Utilizing a case study approach, the research aimed to provide an in-depth understanding of how adult learners interact with the app, highlighting both its strengths and challenges. The primary objective was to evaluate the app’s effectiveness in facilitating self-paced learning among school leaders. Data was collected from 173 participants through online surveys, with a 97% response rate. The findings indicate that most users rated their experience positively, appreciating the app’s content relevance, user-friendly format, and supportive facilitators. Key features such as facilitator feedback, interactive elements, and clear instructions were highly valued, while gamification elements showed room for improvement. Challenges included internet connectivity issues and technical difficulties, yet participants expressed strong motivation to continue using the app and were likely to recommend it to others. The study concludes that the KEMI eLearning app effectively supports self-paced online learning, offering a flexible and engaging educational experience. Recommendations include enhancing gamification aspects, addressing technical issues, and continuing to leverage the app’s strengths to maintain high user satisfaction

Assessing The Impact of Financial Service Digitalization on SME Businesses In Lagos, Nigeria

Purpose: This paper examines the impact of digitalization on SMEs in Lagos Nigeria, especially in digital financial services. Method: The respondents for this study were 150 owners /managers of SMEs in Lagos, Nigeria and data were analyzed descriptively and inferentially using the chi-square test. The research adopts a quantitative research strategy to analyze the difference between SME performance before and after adopting the technology, analyze the degree of technology adoption by the SMEs, and Quantitative evaluation of the advantages of digital financial services. Result: The study found that digitalization has improved SME operations, enhancing efficiency, competitiveness, and access to financial services. However, challenges like internet connectivity and security issues remain unaddressed, necessitating targeted interventions and support strategies. To maximize digitalization's benefits, the study recommends government-led awareness campaigns to highlight the advantages of digital financial services for SMEs. Additionally, partnerships with telecom firms and government agencies should be established to expand broadband access and improve internet reliability in underserved areas. Finally, training programs for SME owners and staff are essential to ensure effective use of these financial services.

Study on the preparation and mechanical properties of resistance‐welded glass fiber/polypropylene cylindrical shell structures

AbstractWhen thermoplastic composite cylindrical shell structures are applied to large‐scale structures, their connection issues remain a challenge in engineering. Particularly, the mechanical properties and structural stability of the welding areas of cylindrical shells under external forces are critical considerations in the design and manufacturing process. This paper prepared glass fiber/polypropylene (GFPP) complete cylindrical shell structures (CCS) and GFPP resistance‐welded cylindrical shell structures (RWCSS) using vacuum hot‐pressing technology and resistance welding processes. Through radial and axial compression tests, it was found that under radial compression conditions, RWCSS had an average peak load 81.50 N (14.90%) lower than CCS, Meanwhile, its initial stiffness and average crushing force increased by 3.06 N/mm (60%) and 62.46 N (22.62%) respectively. After initial radial compression, CCS was more likely to experience buckling deformation and tearing along the cracks when subjected to axial compression. In contrast, RWCSS mainly exhibited folding deformation along the connection interface, accompanied by local fiber and matrix cracking. Low‐velocity impact tests using a drop‐weight impact test indicated that the damage to RWCSS was primarily at the edges of the connection area and the fibers and matrix of the upper and lower cylindrical shells.Highlights Compared with CCS, the initial stiffness and average crushing force of RWCSS under radial compression increased by 60% and 22.62% respectively. The average peak displacement of RWCSS after radial compression under axial compression is twice that of CCS. Low‐velocity impact tests reveal damage in RWCSS is primarily at connection edges.

Improving Bank Digital Services Using Design Thinking Method

The COVID-19 pandemic accelerated the shift to digital banking, exposing critical gaps in the infrastructure of Bank IRIS, a pseudonym for a prominent international bank operating in Jakarta. During the migration process, Bank IRIS customers' complaints were also piling up; these usually include but are not limited to issues on poor connectivity, repeated errors, and poor responses from the customer service representatives. Design thinking was applied in researching these problems through a structured process divided into five phases, namely: empathize, define, ideate, prototype, and test. In the Empathy phase, consumer interviews and feedback analysis showed that there were significant problems: frequent connectivity errors and poor service recovery. The core problems highlighted in the Define phase were issues of inadequate connectivity, frequent errors, and poor responses from customer service. Proposed solutions during Ideate included the use of CDN, AI-powered chatbots for real-time support, adoption of network indicator to decrease transaction risks, thorough staff training programs, and iterative feedback loop. During the Prototype phase, this research deployed a narrative prototype, presenting scenarios to research subjects that identified problems and provided solutions. Customers were actively contributing to the improvement of these proposals by providing their views in order to co-create feasible remedies. Finally, in the Testing phase, proposed solutions effectively addressed consumer pain points, enhanced customer satisfaction, and received positive feedback from stakeholders. This study gives actionable strategies to improve digital banking services and provides insights that can benefit other banks facing similar challenges in digital transformation.

Innovations for Successful Electronic Medical Records (EMR) Implementation in Hospitals

General Background: Electronic Medical Records (EMR) enhance healthcare efficiency, cost-effectiveness, and data accessibility. However, implementation remains uneven globally. Specific Background: Despite Indonesia’s Ministry of Health Regulation No. 24 of 2022 mandating EMR adoption, many hospitals struggle with infrastructure, workforce limitations, and regulatory challenges. Knowledge Gap: While studies highlight EMR benefits, limited research addresses specific barriers in Indonesian hospitals and effective implementation strategies. Aims: This study identifies EMR adoption challenges and explores strategies for successful implementation in Indonesia. Results: Key barriers include inadequate infrastructure, unclear policies, insufficient training, and connectivity issues. Pre-implementation planning and structured training improve outcomes. Novelty: This study systematically analyzes Indonesia-specific EMR challenges and presents actionable solutions. Implications: Hospitals require better preparation, clear policies, and government support to ensure seamless EMR integration, fostering healthcare digitalization. Highlights: Regulatory Compliance: Despite mandates, many Indonesian hospitals struggle with full EMR adoption due to infrastructure and policy gaps. Key Barriers: Limited resources, lack of training, and unstable internet hinder effective EMR implementation. Strategic Solutions: Pre-implementation planning, technical support, and structured training improve adoption success. Keywords: Barriers, Strategy, Electronic Medical Record, Hospital

Geopolitical rivalry between India and China in Nepal

Nepal as a small Himalayan nation lying between two Asiatic giants India and China, has a unique geopolitical location. The study examines the geopolitical rivalry between India and China over Nepal through the security interests, connectivity issues and natural resources aspects of Nepal. The study also analyzes the challenges of Nepal’s foreign policy considering the geopolitical perspective of India and China. The study is qualitative research focusing on content analysis, and the study centers on the realist approach. The study describes geopolitics as an independent variable and the three major sub-variables for the study of geopolitics are security, connectivity, and natural resources. The contradicting security perceptions and connectivity interests of India and China regarding Nepal have sometimes heightened Nepal’s challenge to balance her immediate neighbors. The unstable government, weak diplomatic mechanism, and existing trust deficiency of neighboring nations towards Nepal have raised geopolitical challenges as high as the Himalayas.

Language Concordance and Interpreter Use for Spanish-Preferring Patients: Qualitative Study of Perspectives from Primary Care Providers.

Poor quality communication and language barriers lead to worse care experiences and inferior health care outcomes for those with limited English proficiency. Fewer than one-third of outpatient providers regularly use professional interpreters when communicating with non-English preferring patients. Effective strategies to address language barriers in primary care are lacking and in demand. Examine provider perspectives on providing in-person care to Spanish-preferring patients. Partnered with a large, urban Federally Qualified Health Center predominantly caring for Spanish-preferring Hispanic patients, we identified primary care providers who (1) were language-concordant (provider and patient speak same language); (2) used qualified interpreters; and (3) used informal strategies for interpretation/communication. We interviewed 24 providers (10 language-concordant, 9 who used qualified interpreters, 5 who used informal interpreters and other strategies; response-rate 23%). We established codes using systematic, inductive procedures to generate insights from responses and identified themes using content analysis. Providers-both language-concordant and those using interpreters-preferred to speak the same language as the patient, employed varying communication strategies, and required more time to care for Spanish-preferring patients for differing reasons. Using interpreters did not always improve communication because using qualified interpreters requires more time for initiating interpretation,connectivity issues, and conducting consecutive interpretation; using any interpreter requires provider-interpreter clarification or staff to translate, and sometimes interpreters had difficulty with medical content/terminology. Provider-patient visits also qualitatively differed based on language spoken and interpreter use in eliciting concerns, topics covered, patient comprehension, and time spent on rapport-building and patient education. Providers described barriers that organizations need to address to facilitate effective communication and language interpretation when caring for Spanish-preferring patients. Research is needed that identifies and tests language support strategies for providers and clinics and structural changes that preserve time during patient visits for providers and patients to spend on health care needs.

Remote online learning reimagined: perceptions and experiences of medical students in a post-pandemic world

BackgroundBlended learning is a key educational methodology, particularly in medical education, and involves integration of online and face-to-face interactions to enhance flexibility and engagement. Blended learning gained increased popularity during the COVID-19 pandemic due to social restrictions. Following control of the pandemic, face to face teaching and learning activities have been restored. However, some institutions continue to deliver some teaching online. This study explores the perceptions and experiences of undergraduate medical students from 15 institutions across seven countries regarding remote online learning in the post-pandemic era.MethodsThis cross-sectional study utilized an online survey to gather insights into the use of learning resources, interactivity in online sessions, barriers to online learning, and preferences for learning modalities. Descriptive data were summarized by frequency, categorical comparisons were assessed with chi-squared tests, and t-tests were used for continuous data.ResultsThe findings of the current study show a general preference for blended learning (47.78%) over traditional face-to-face instruction (41.48%). Key benefits of blended learning reported by the participants by comfort, flexibility, reduced travel, and ability to learn at own pace. The key barriers identified were internet connectivity issues and family distractions. The study also highlighted the limitations of online learning in replacing clinical experience and practical skills acquisition, with 69.26% of respondents affirming that online learning does not sufficiently substitute for direct patient contact.ConclusionThe findings underscore the importance of integrating face to face and remote online teaching and learning frameworks to align with educational objectives, particularly in fostering interactivity and practical skill development. The study suggests that while blended learning has many benefits, its effectiveness is highly context-dependent and requires thoughtful implementation to meet the diverse needs of medical education.

The adaptability and resilience of Indonesian EFL teachers during emergency online education

The COVID-19 pandemic has radically transformed the teaching and learning process from in-class instruction to remote learning. This changing situation leads to barriers for EFL teachers in executing their teaching plans. Therefore, they should be able to deal with such challenges for instructional continuity. This study aimed to investigate the challenges that EFL teachers face, examine their adaptability to the conditions, and explore their strategies in implementing online education. Seven junior high school EFL teachers were purposefully recruited from public and private schools in a town in southwestern Central Java, Indonesia, to participate in this study. The data were elicited through interviews and analyzed using qualitative thematic analysis techniques. The study revealed that the challenges encountered by the EFL teachers were mainly internet connectivity issues, low classroom participation among students, poor motivation in task completion, unsupported devices, and limited infrastructure support. In response to these challenges, the EFL teachers modified their lesson plans, improved their competencies, and adapted the material. Furthermore, in dealing with the challenges, the teachers made special efforts: selecting a simple online learning platform, monitoring students’ learning processes, contextualizing the material to daily life, providing intensive feedback, and collaborating with students’ parents. Recommendations for classroom practices, policymakers, and future research directly related to the findings of the current study are provided.