Literacy Levels Research Articles

AN ANALYSIS OF THE HEALTH LITERACY LEVELS OF STUDENTS IN A PUBLIC UNIVERSITY'S FACULTY OF HEALTH SCIENCES

Aim: This study aimed to assess the health literacy levels of students in the Faculty of Health Sciences at a public university and to investigate the relationships and differences between participants' sociodemographic characteristics and their health literacy levels. Methods: The study employed a quantitative, descriptive, cross-sectional, and correlational research design. Data were gathered through face-to-face surveys, utilizing a socio-demographic data form and the THLS-32 scale. Data analysis was conducted using IBM SPSS 22.00. Descriptive statistics, including frequency distributions, percentages, standard deviations, and arithmetic means, were calculated. The Kolmogorov-Smirnov test was used to evaluate the normality of data distribution, which revealed a non-normal distribution. As a result, non-parametric tests (Mann-Whitney U Test and Kruskal-Wallis H Test) were applied. Correlation analyses were performed using Spearman’s Rho coefficient, and statistical significance was evaluated at a 95% confidence interval with a 5% margin of error. Results: The findings indicated that 66.3% of participants exhibited sufficient or excellent health literacy levels. Female students had significantly higher TS-AI perceptions than male students. Health Management (HM) students demonstrated higher health literacy levels compared to Emergency Aid and Disaster Management (EADM) students. The highest literacy levels were observed among final-year students, and students with social security had higher TS perceptions than those without. Conclusion: The study concluded that the health literacy levels of students in the Faculty of Health Sciences were generally high, with significant differences based on gender, department, academic year, and social security status. These findings suggest a need for targeted strategies to improve health literacy, particularly among students in certain departments and those without social security

A Prospective Evaluation of Health Literacy Levels of Pregnant Women in Antenatal Classes: Impact on Delivery Outcomes in Nulliparous and Multiparous Women

Backgrounds/Objectives: Modern technology and educational activities, such as antenatal classes (ACs), increase patient informedness in medicine and improve collaboration between physicians and patients. The present study aimed to evaluate and compare the impact of maternal health literacy (HL) on delivery outcomes between nulliparous and multiparous women who attended antenatal classes. Methods: This prospective study recruited 281 pregnant women who regularly attended ACs, but only 188 who gave birth at our academic tertiary hospital were included in the final analysis. Socio-demographic characteristics, peripartum data (cervical dilatation at the time of admission to the hospital, duration of labor, and mode of delivery), and obstetric interventions (cesarean section (C/S) rate and rate of instrumental vaginal birth and episiotomy) were recorded, and the level of HL was assessed using the European Health Literacy Survey Questionnaire (HLS-EU-Q16). HL levels did not significantly affect peripartum and postpartum outcomes. Results: The study results showed that HL levels did not impact labor duration and newborn Apgar scores (p > 0.05). Patient education levels and employment status affected the peripartum duration of labor (p = 0.048 and p = 0.001, respectively). There were no differences in the HL total score and subscale scores (p > 0.05) between nulliparous and multiparous patients, and the rate of primary C/S was similar in both groups. Conclusions: HL levels did not impact delivery (peripartum) outcomes in pregnant women who attended antenatal classes. However, the primary C/S rate was similar between the nulliparous and multiparous groups, which may indicate that antenatal education services can correct the negative impact of low HL levels on the primary C/S rate.

A Narrative Review on the Conceptual and Methodological Advancements in Digital Disruption: A Way to Improved Quality of Services in Health Care

Background: The adoption and successful implementation of digital health solutions heavily depend on digital health literacy, which is particularly critical in the current COVID-19 era. Low levels of digital health literacy are associated with poor preventative practices, the spread of inaccurate information, vaccine hesitancy, and reduced subjective well-being. Thus, the aim of this review was to highlight areas of current scholarly interest and identify any gaps in the literature regarding conceptual and methodological advancements in digital disruption. Methods: The authors conducted a literature search using the databases Scopus, Embase, Web of Science, PubMed, and Google Scholar, focusing on papers released between 2003 and October 2023. The following keywords were used to conduct a thorough literature search: ((digital health OR digital disruption OR digital dental health)) AND (medical health OR telemedicine)), ((online doctor OR online consultation OR online health app)) AND (COVID-19 OR pandemic)). A total of 1,244 studies were screened, including duplicates and non- English research. After applying inclusion and exclusion criteria, 72 articles were selected for the review. Results: A total of 72 articles were included in this review. The studies discussed the potential reasons for disrupted access to healthcare, which is linked to avoidable hospital admissions. Delayed care due to disruptions can lead to disease progression, the exacerbation of existing conditions, and chronic ambulatory care-sensitive conditions. Digital health innovations were presented as solutions to enhance care, reduce clinical workload, and promote independent living. Conclusions: In conclusion, this narrative review provides a comprehensive overview of the conceptual and methodological advancements in digital technology related to healthcare. It demonstrates the potential of digital technology to revolutionize both medical and dental education.

The Effect of Financial Literacy on Village Government Business Performance

This study was conducted to study the impact of financial literacy and financial management on the performance of Village government businesses (Village-Owned Enterprises) located in Lobuk Village, Bluto District, Sumenep Regency. As a village economic institution, Village government plays a strategic role in improving the progress and prosperity of the community. The level of financial literacy and effective financial management are considered to be able to influence the operational success of Village government, especially in making strategic decisions, optimizing the use of funds, and increasing profits. This study adopted a descriptive quantitative method involving all administrators, employees, and tenants of Pelangi Nusantara Village government kiosks in Lobuk Village as the population and sample. There are three variables studied, two of which are independent variables, namely Financial Literacy (X1) and Financial Management (X2), while the dependent variable is Village government Business Performance (Y). Data analysts use several techniques including data quality testing, multiple regression analysis and determination coefficient testing. Hypothesis testing was conducted through t-test (partial) and F-test (simultaneous) with the help of IBM SPSS software version 25. The research findings revealed that financial literacy does not affect Village Government Business Performance, financial management has a significant positive effect on Village Government Business Performance, financial literacy and financial management have a significant effect simultaneously on Village Government business performance.

Heterogeneity in the level of dementia literacy among community doctors in China: A latent profile analysis.

This study aimed to explore the heterogeneity of community doctors based on their knowledge of dementia and the potential factors associated with their dementia literacy. A total of 1288 community doctors completed the Alzheimer disease knowledge scale (ADKS) in a cross-sectional study conducted between December 2021 and January 2022. We used latent class analysis (LCA) to explore potential clusters based on responses to the ADKS. Multivariate multinomial logistic regression analysis was performed to evaluate the associations between potential risk factors and the knowledge of community doctors. Community doctors were divided into four clusters according to their knowledge structure (Akaike information criterion (AIC) = 35672.83, Bayesian information criterion (BIC) = 36307.63, adjusted BIC (aBIC) = 35916.91, entropy = 0.814): the severity-focused subgroup (n = 269), the physical issues-focused group (n = 370), the knowledge uncertainty group (n = 191), and the general-focused group (n = 458). Age, education level, type of practice, and professional title were associated with the knowledge structure of Alzheimer's disease (AD). In addition, the perception that patients seek care in community health centres for physical reasons and community doctors' failure to manage patients with recently identified cognitive impairment were associated with the structures of the ADKS among community doctors (P < 0.05). There is heterogeneity in the level of AD knowledge among community doctors and their demographic characteristics, perceptions, and practices. Further efforts are needed to optimise the knowledge structure of dementia among community health care professionals.

Association of Maternal Immigration Status with Emotional Eating in Taiwanese Children: The Mediating Roles of Health Literacy and Feeding Practices.

Emotional eating has been linked to childhood obesity. A variety of emotions often trigger this form of eating, which has been associated with stress-induced overeating, loss of control eating, and binge eating in children. However, research on how maternal immigration status and feeding practices influence emotional eating in children within Asian contexts is sparse. This study examines the association between maternal immigration status and emotional eating in children, exploring the mediating roles of health literacy and feeding practices. The study focused on children aged 10-11 and their mothers in Taiwan, utilizing a sample of 2,308 mother-child dyads. The Child Feeding Questionnaire (CFQ) was used to assess mothers' feeding practices, while emotional eating was measured using a subscale of the Three-Factor Eating Questionnaire-Revised 18 (TFEQ-R18). Health literacy was evaluated using the Health Literacy Survey Questionnaire (HLS-EU-Q12). Confirmatory factor analysis, Pearson's correlation, and Structural Equation Models (SEMs) were employed to explore the potential pathways leading to children's emotional eating. Children of mothers with foreign nationality demonstrate higher emotional eating scores compared to those with native-born mothers (5.73 vs. 5.35, p = 0.04). These mothers also have significantly lower health literacy levels (35.21 vs. 38.52, p < 0.0001). They are more inclined to use rewarding and pressure-to-eat feeding practices while showing reduced tendencies toward monitoring and restriction. Serial mediation models suggest that maternal foreign nationality influences children's emotional eating primarily by increasing rewarding and pressure-to-eat practices alongside reduced health literacy, which ultimately lowers monitoring practices. Interventions should improve maternal health literacy and promote healthy feeding practices. Future research should investigate these pathways across various geographic regions and age groups to develop targeted interventions for immigrant families.

An Assessment of Rural Midwestern Schoolteachers' Nutrition Literacy and MyPlate Knowledge: Implications for Current Practice and Policy.

Background. Rural schoolchildren outpace their urban counterparts in obesity and diet-related chronic disease rates. Educating students on nutrition basics may help reduce these health burdens in this focus population. Rural schoolteachers are ideally positioned to teach students about nutrition; however, to teach nutrition, one must first understand basic nutrition concepts. The nutrition literacy and knowledge of rural schoolteachers, as well as strategies to and barriers for integrating nutrition into rural classrooms, are understudied. Examining these topics may provide a deeper understanding of nutrition education in rural schools. Methods. Data were collected via an online survey of K-12 teachers (n = 153) from seven Midwestern rural school districts. This survey collected data on nutrition literacy, nutrition knowledge, and preferred methods for implementing nutrition education into current curricula. Descriptive statistics were reported; associations between nutrition literacy and knowledge were examined. Results. Nutrition literacy levels were borderline low (mean score 45.7 out of 64). Nutrition knowledge and literacy were associated (p < .001). Most teachers (n = 108, 70%) were/may be willing to change lessons to incorporate nutrition information, with hands-on and group activities being preferred strategies. Barriers to including nutrition information into curricula included lack of time, knowledge, and resources. Most teachers reported little support from administration for promoting nutrition in the classroom. Discussion. Implementing nutrition education into teachers' continuing education requirements may provide a means of improving teacher nutrition literacy and knowledge. Support from both state-level and local administration could benefit both nutrition knowledge acquisition by schoolteachers and implementation of nutrition education throughout the curriculum.

The Role of Awareness and Level of Digital Literacy in Creating Entrepreneurial Intentions of Generation Z Women

Currently, modern market conditions for the development of entrepreneurship are extremely uncertain and highly turbulent. The speed and intensity of changes in the business environment make starting your own business a high risk. Entrepreneurial intentions play a particularly interesting role in the decision-making process to start your own business. The literature review indicates that the factors influencing intentions include the abilities and skills of future entrepreneurs, including their level of digital skills and competence. Knowledge of digital technologies enables future entrepreneurs to access reliable and up-to-date information and increases the opportunities for continuous learning. Digital literacy facilitates effective communication and collaboration between businesses. These competencies help to understand the implications of using digital technologies and support the use of digital tools in company management. The aim of the paper is to identify the awareness and digital literacy that influence the entrepreneurial intentions of Generation Z women. The study conducted in 2024 is based on the results of research on a group of 193 Polish women, representatives of Generation Z. An original survey questionnaire was used to collect the data. An original survey questionnaire was used to collect the data. The analysis based on the data showed the level of digital literacy of Polish Generation Z women and which of them influence the level of entrepreneurial intentions. The novelty of the paper is the indication of areas of knowledge regarding digital skills that determine the entrepreneurial intentions of Polish Generation Z women.

Assessing Littering Centric Environmental Literacy of University Graduates in Bangladesh

To create a sustainable society, this study aims to assess the littering centric environmental literacy and impact of socio-demographic variables on environmental literacy among university graduates in Bangladesh. By using multistage sampling technique, we collect 209 responses from bachelor and master level students from different higher educational institutions from Khulna city. Descriptive statistics, ANOVA and weighted mean index has been used to trace out the research objective. This study finds that students have a moderate level of environment literacy (3.67 in a scale of 5.00). Students have a higher score on environmental knowledge (3.77 in a scale of 5.00) and a lower score on environmental attitude and concern (3.62). Noticeable, students have the most positive attitude in the affective tendency but least positive attitude in the cognitive tendency. It also finds that students are aware about the environmental issues but did not perform that responsibility in their daily life. ANOVA analysis reports that parental education and income has a significant impact on environmental literacy and its components. Alternatively, number of highly educated member in family and hometown status has significant impact on knowledge, attitude and environmental literacy. This finding helps stakeholders to understand the students’ literacy about a pro-environmental issue.

Navigation literacy of primary health care personnel (using the example of the heads of medical and obstetric centers in Orenburg region)

Objective. To assess navigation literacy of primary health care personnel (using the example of the heads of medical and obstetric centers in Orenburg region). Materials and methods. Navigation literacy of primary health care personnel was assessed among all heads of medical and obstetric centers in Orenburg region (n = 58). For this purpose, a single-stage continuous online survey was conducted using a combined questionnaire developed by the Central Research Institute for Healthcare Organization and Informatization of the Ministry of Heath of the Russian Federation. Results. The level of navigation literacy among the heads of the medical and obstetric centers of Orenburg region in 65.7 % of cases was excellent and sufficient. In the list of navigation skills, the heads of the medical and obstetric centers noted difficulties in the implementation of: issues of medical insurance (48.3 %), legal aspects of medical care and protection of patients' rights (27.5-48.3 %), healthcare reform (36.2 %). It was found out that from 63.7 % to 91.4 % of the heads of the medical and obstetric centers are aware of the ongoing state measures in the field of public health. The majority of the respondents (60.0 %) noted that they search for necessary information for professional purposes using digital tools. However, every third respondent (32.7 %) mentioned the difficulties in finding it on legislative issues, interpreting the quality and safety of food products according to their product labeling (27.6 %), solving problems related to mental health and well-being (18.9 %). These data demonstrate the need to improve navigation literacy of medical and obstetric centers managers in the digital environment. Conclusions. The modern multilevel and multicomponent healthcare system is associated with the need to improve the navigation literacy of medical personnel. The data obtained determined the main directions for improving navigation literacy of the heads of medical and obstetric centers.

The effect of awe in wildlife tourists on animal-friendly behavioural intentions: a serial mediation model of connectedness to nature and empathy

ABSTRACT Wildlife tourism is experiencing rapid growth as people's desire to connect with nature intensifies, making the improvement of tourist behaviour in wildlife destinations a crucial research issue. In light of this, the current study, grounded in the appraisal theory of emotion, scrutinises how awe, connectedness to nature (CN), and empathy impact animal-friendly behavioural intentions (AFBI) by establishing and appraising a model incorporating serial mediation and moderation. The results reveal that awe positively influences AFBI, with CN and empathy serving as serial mediators. Furthermore, the extent to which awe, CN, and empathy affect AFBI is amplified at higher levels of animal welfare literacy. This research represents a beneficial attempt to investigate AFBI and its internal mechanisms. Destination management organisations (DMOs), tourism product and service designers, marketers, and policymakers can derive valuable practical insights from this study to enhance sustainable development in wildlife tourism.

Oral health literacy of patients attending community dental outreach program: A cross-sectional study

BackgroundLimited health literacy among adults contributes to poor health outcomes. Low health and oral health literacy (OHL) are particularly more visible among rural population of developing countries.ObjectiveThe present study was done to assess OHL among patients attending a community dental outreach program in Punjab, India.Material and methodsA cross-sectional study was conducted on 652 patients who attended who attended community dental out-reach program regularly organized by the institute. A self-constructed questionnaire (divided into Section A and Section B) written in English and Punjabi language was given to each subject. OHL was graded on a 15-point Likert scale and was assessed as low, medium and high on the basis of sum of total responses. Statistical analysis was done using SPSS-21 statistical package. ANOVA and Student t-test were used to do comparisons between different groups.Results52.4% of the study subjects had low OHL scores and only 19.3% of subjects had high scores. Dental terms like ‘mouth-guard’, ‘abrasion’ and ‘abscess’ were known to only 20.4%, 37.4% and 32.5% of the subjects respectively. The mean OHL score revealed a significant association with the occupation (p=0.035) of study subjects. Only 45.2% of study subjects were ‘interested in seeking more information on oral health’ and it was significantly associated with the educational qualification of study subjects.ConclusionsMore than half of the subjects had low OHL scores. There is an urgent need to address this problem, especially among the rural population by taking appropriate measures by the government so that their health literacy level can be raised.

Integration of Technology in EFL Writing Instruction: A Systematic Review of Insights from SIELE Journal Articles

This systematic review examines the integration of technology in English as a Foreign Language (EFL) writing instruction, focusing on articles published in the SIELE Journal from 2019 to 2024. Utilizing the PRISMA methodology, the study synthesizes findings on the effectiveness of digital tools in enhancing EFL writing skills. The analysis indicates that technology significantly boosts student engagement, writing proficiency, and the quality of feedback provided to learners, making the learning process more interactive and conducive to writing development. However, several challenges impede the full potential of technology integration, such as varying levels of digital literacy among students and educators, inconsistent access to technology and internet, and the need for comprehensive teacher training programs. Addressing these issues is crucial for maximizing the benefits of technology in EFL writing instruction. By overcoming these barriers, educators can better leverage digital tools to improve educational outcomes, equipping students with essential skills for success in an increasingly digital world. This research underscores the transformative role of technology in modern education.

Examining the Financial Literacy of Healthcare Professionals: A Research on a Provincial Health Directorate.

This research aimed to assess the financial literacy levels of healthcare professionals working at a Provincial Health Directorate and examine their relationships with various financial domains. The study utilized a cross-sectional online survey. The financial literacy scale was employed to assess the financial knowledge and compentencies of healthcare professionals, providing a structured evaluation of their understandig across various financial domains. Statistical analyses, including correlation analysis, independent samples t-test, and one-way ANOVA, were performed using SPSS-25 and R programs. A total of 240 participants took part, comprising 52.1% males and 47.9% females, aged between 20 and 65 years. Younger healthcare professionals (p=.017) and males (p=.001) demonstrated higher financial literacy levels. Significant correlations were found between financial literacy and domains such as investment instruments, debt and risk management, and personal finance management. Weak but positive relationships were observed between financial literacy and digital assets, indicating emerging trends in digital finance awareness. For instance, males exhibited higher proficiency in investment instruments and debt management, while younger professionals displayed higher knowledge in investment areas. The findings underscore the importance of targeted financial education for healthcare professionals, highlighting the need for sector-specific training programs. Enhanced financial literacy is essential for improving financial decision-making, ultimately benefiting both personal financial well-being and professional performance in the healthcare sector.

Enhancing Reading Ability Through the Cooperative Integrated Reading and Composition (CIRC) Model: A Study with Fifth-Grade Elementary School Students

Reading comprehension is a vital aspect of language proficiency that elementary school students must master. Proficient reading skills enable students to actively acquire diverse information efficiently. The cooperative integrated reading and composition (CIRC), is a teaching model designed to enhance students’ reading comprehension skills through collaborative learning activities. This research aims to investigate the impact of the CIRC model on the reading comprehension abilities of fifth-grade students at SD Negeri 1 Kairatu. Employing an experimental design with a one-group pretest and post-test setup, the study involved 41 students. The CIRC model served as an independent variable, while reading comprehension ability constituted the dependent variable. The research instrument utilized was a reading comprehension test. Data analysis was conducted via a paired sample t-test, revealing a significant difference in students’ reading comprehension abilities before and after learning with the CIRC model (p = 0.00, &lt; 0.05). These findings underscore the effectiveness of the CIRC model in improving students’ reading proficiency. The study’s results underscore the importance of prioritizing reading skills development to enhance elementary students’ literacy levels. It recommends the widespread adoption and continuous practice of the CIRC model in elementary schools to cultivate students’ interest and competence in reading. This research contributes to the ongoing efforts to enhance reading education methodologies and promote literacy among elementary school students. Keywords: CIRC model, reading comprehension, reading literacy, elementary school students

Cryptocurrency, International Aid, and Development: Opportunities and Challenges

In this study, the author focuses on how cryptocurrency and blockchain technology can be used to improve delivery of international aid since traditional methods include problems such as corruption, inefficiency and lack of transparency. The main research question addresses the question of how cryptocurrency could enhance efficiency, enhance transparency, accountability, and fight corruption in the dispensation of aid. The authors performed a qualitative content analysis of data collected from multiple articles, reports, and case studies including World Food Programme and United Nations Children's Fund(UNICEF).The study shows that blockchain’s distributed digital ledger minimizes misappropriation of funds risk, maintains real-time tracking; cryptocurrencies, specifically stablecoins, are more effective in real and low-cost transactions. Nevertheless, the work also points to the threats evident in legal and regulatory frameworks, low levels of digital literacy, and technological constraints. In conclusion, if all the challenges are solved, the cryptocurrency will enable the complete redesign of the distribution of the funds for aid.

Students as collaborative partners

In contemporary society, Artificial Intelligence (AI) pervades numerous facets of our lives and is likely to impact many sectors and professions, including education. Tertiary-level students in particular face challenges regarding the use of AI for studies and assessment, including limited understanding of AI tools, as well as a lack of deep critical engagement with AI for learning (Shibani et al., 2024). To respond to emerging developments in generative AI, the recent Australian Tertiary Education Quality and Standards Agency (TEQSA) report suggests tertiary-level learning and assessments be designed to foster responsible and ethical use of AI (Lodge et al., 2023). This involves the development of AI literacy among students to engage with AI in critical, ethical ways that aid their learning and not hinder it. Our project aims to narrow the AI literacy gap among students from diverse study backgrounds by providing foundational knowledge and developing critical skills for practical use of AI tools for learning and professional practice, in collaboration with students and academics as part of a Students as Partners (SAP) initiative. Staff bring expertise in AI critical engagement and students bring practical, first-hand experiences of learning in this collaboration, supported by the university’s SAP program. Building on the current UNESCO recommendations for the use of generative AI in education (UNESCO, 2023) and prior theoretical frameworks on AI literacy (Chiu et al., 2024; Ng, et al., 2021; Southworth et al., 2023) we target key skills that higher education students should develop to meaningfully engage with AI. By creating accessible and engaging resources, such as instructional videos and comprehensive guides on generative AI applications like ChatGPT and ways to prompt for enhancing learning, we introduce existing AI tools and teach students to use them effectively, promoting a hands-on learning environment. Using learning design principles, the developed curriculum will be presented in an AI Literacy module on a Canvas site, with supporting instruction workshopped with student participants for evaluation. Student cohorts recruited from diverse disciplines will pilot and assess the effectiveness of the program, and qualitative methods such as focus groups and interviews will be used for evaluation of our intervention and continuous improvements. Findings will inform tertiary students’ current level of AI literacy and the effectiveness of interventions to improve key skills beyond their disciplinary knowledge, better preparing them for life beyond university. Indeed, the implementation of similar AI literacy courses has demonstrated statistically significant improvements in AI literacy and understanding of AI concepts amongst university students (Kong, Cheung, &amp; Zhang, 2021). Our approach underscores the importance of relational engagement in higher education with students as partners (Matthews, 2018) and participatory design with students in a topic that is significant in the current age of AI (Laupichler et al., 2022). The course's flexibility to be accessed directly or embedded into other curricula ensures scalability and broader impact, solidifying the validity of our multifaceted approach. Through utilising relevant research methodologies and learning design principles, we endeavour to create an AI literacy course that is robust, accessible, educational, and engaging to use by tertiary-level students from diverse study backgrounds.

TEL Pedagogies: Gamification – Grammar Guru

The Centre for English Communication (CEC) developed and launched Grammar Guru (GG), a browser-based game application, as part of Singapore Management University’s (SMU) TEL initiative in 2023. GG is used as part of CEC’s blended learning resources, which complements our core curriculum module for undergraduates, Writing &amp; Reasoning (WR). GG is an upgraded iteration of Power Grammar 1.0, a basic grammar game developed by students several years ago. GG is an effective TEL tool for teaching grammar as it uses gamification to make learning engaging and caters to the needs of learners with different language proficiency levels. GG improves student engagement through gamification. Gamification is the application of game design, techniques and elements in non-game contexts and activities (Deterding et al., 2011, p. 1). Research shows gamification is highly effective in increasing student engagement, attention, motivation, creativity, digital literacy and performance level (Barua &amp; Bharali, 2023; Fernandez-Antolin et al. 2021; Skritsovali, 2023). GG includes elements such as points, leaderboards, hints, and non-playable characters (NPC) to teach grammar in a professional, corporate context. By contextualizing grammatical and linguistic forms in sentences and paragraphs, GG helps students achieve greater competence and fluency in their English language abilities. The gamification elements make learning more interactive and enjoyable which improves students’ knowledge retention and application. A primary quantitative study conducted by CEC established that “the positive correlation observed suggests that the higher level a student played, the higher the student’s English language proficiency”. CEC is currently conducting a qualitative study to gather students’ feedback. GG also addresses the requirements of learners with diverse language proficiency levels by varying the difficulty of questions. These questions include sentence and text correction, matching, re-arrangement, true/false, fill-in-the-blanks and multiple-choice questions. Players work their way through eight levels that comprises Junior and Senior Intern, Junior and Senior Management Trainee, Junior and Senior Middle Management and Junior and Senior Director. Perez (2020) and Langendah (2016) highlight how certain game elements such as storytelling, challenges, progression, and feedback can boost student drive and learning. The gamification elements in GG have a similar effect, motivating learners of different proficiency levels. GG’s interface is designed to be simple and intuitive. Regardless of students’ socioeconomic background or gaming aptitude, they would be able to navigate it effectively. One challenge GG faces is striking a balance between entertainment and education. Limited game development funds result in limited game design features and less engaging gameplay for students, especially in comparison to commercial games with substantial budgets that offer high entertainment value through advanced graphics and intricate storylines. Furthermore, as CEC instructors are not game design experts, we have limited knowledge that restricts our capacity in designing and maintaining GG. Currently, CEC outsources game design and maintenance to a third parties. This results in instructors not being able to directly make changes to the game questions and content. Moreover, the process of retrieving relevant data for analysis is tedious and time consuming. Despite these constraints, thoughtful and strategic approaches can create valuable TEL resources that improve student learning.

Numeracy Literacy Capability of Junior High School Students at Inamosol District

It is important for students to master numeracy literacy as part of the minimum competency assessment, in order to have the thinking skills needed in the 21st century. This research aims to describe the numeracy literacy abilities of junior high school students in mountainous areas. This research uses a mixed method. The data collected is quantitative in the form of numeracy literacy test results and qualitative data in the form of interview results to describe students’ weaknesses in numeracy literacy. The research results showed that student’s literacy skills still remain at levels 1 and 2. Less than 20% of students were at level 3, and there were no students at levels 5 and 6. The category of students is that intervention and basic literacy skills are needed. The qualitative analysis concluded that the cause of low literacy was low communication, mathematization, and representation skills. In terms of indicators of mathematical ability, there are various basic concepts that students have not mastered so they experience difficulty in solving mathematical problems. Apart from that the reasoning that occurs is still imitation in nature, students still tend to memorize and use standard and imperfect procedures. The strategy used only imitates the teacher’s strategy, while students have not used new strategies which causes literacy to still be at a lower level. Keywords: numeracy, literacy, numeracy literacy level, mountains areas

Experiences and psychological issues affecting parents of children born with atypical genitalia in India.

Parents of children with differences of sex development (DSD) are known to suffer from psychological distress at the time of diagnosis and thereafter. We analyzed the prevalence of anxiety and depression in Indian parents of children with DSD and its associated risk factors, as well as their experiences, perceptions and expectations from the healthcare system. This cross-sectional study included parents of children aged ≤6 years with atypical genitalia. Data was collected through face-to-face semi-structured interview using specially designed questionnaire. Depression and anxiety have been assessed using PHQ9 (Patient health questionnaire) and GAD-7 (Generalized anxiety disorder scale), respectively. The current mean age of the 43 children (46,XY=26, 46,XX=16 and chromosomal DSD=1) was 36.5±21.4months with a median age of diagnosis of 5months (range- 0-60months). 68 parents (35 mothers and 33 fathers) were interviewed. The score was above the cut-off for clinically significant depression in 27.2 and 25.7 % of the fathers and mothers, respectively; and for clinically significant anxiety in 15.1 and 28.6 % of the fathers and mothers, respectively. The most significant factor associated with psychological distress was rearing a boy with lower EMS in fathers and lower literacy levels (with higher perception of stigma) in mothers. Absence of family support was associated with high levels of distress in both parents. There is a high level of depression and anxiety amongst Indian parents of children born with atypical genitalia and requirement for psychological support and counseling.