Secondary Education Research Articles

Status and associated factors of health insurance enrollment among women in Nepal

AbstractThe Government of Nepal (GoN) introduced a Health Insurance Program (HIP) in 2016 aiming to ensure quality healthcare for all Nepalese citizens without financial hardship. However, the HIP has not attracted as many people as expected. It shows low enrollment and high dropout rates. Studies on this issue are scarce, particularly regarding women. To identify the factors associated with women enrollment in health insurance (HI), this study utilized a cross‐sectional design, analyzing secondary data (n = 14,845) from the Nepal Demographic and Health Survey 2022. Chi‐square test and logistic regression were used to identify associations with women participation in the HIP. Women enrollment in HI was positively and significantly associated with province, age, ethnicity, educational level, religion, place of residence, ecological region, wealth index, women's autonomy in household decisions, household head status, and current employment (p < 0.01). Socioeconomic and demographic factors of the respondents, such as being over 35 years old (aOR = 1.98; 95% confidence interval [CI]: 1.65–2.39), having a secondary or higher education (aOR = 2.96; 95% CI: 2.43–3.64), being currently employed in a paid job (aOR = 1.31; 95% CI: 1.17–1.47), and belonging to the richest wealth status (aOR = 5.64; 95% CI: 4.33–7.34), were more likely to be enrolled in the HIP compared to their respective reference groups. In conclusion, being of privileged socioeconomic status, belonging to a specific ethnic group, having a higher educational level, being employed, and living in the Mountain region are all associated with women enrollment in HIP. Policymakers may consider these findings when planning and implementing future interventions.

FLIPPED CLASSROOM IN SCIENCE EDUCATION: CORRELATING STUDENT EXPERIENCE WITH ATTITUDES

Despite the growing adoption of the Flipped Classroom (FC) model in higher education, there is limited exploration of its impact on secondary education and students' attitudes toward science. Thus, this study aimed to examine the correlation between secondary school students' perceptions of the Flipped Classroom experience in learning science and their attitudes towards the subject. The research focused on five perception constructs: Collaborative Environment, Self-Directed Learning, Learning Impact, Motivation and Enjoyment, and Technology Integration. Students' attitudes towards science were measured across five constructs: Importance of Science, Practical Work in Science, Learning Science in School, Science Outside School, and Future Participation in Science. The study utilized a quantitative survey methodology, collecting data from a sample of 100 Form Four students at School A, Sabah, Malaysia as of the year 2024. Through the analysis of the survey, the study found a significant positive correlation between students' positive perceptions of the FC experience and their attitudes towards science. Notably, high ratings for ‘Motivation and Enjoyment’ indicated enhanced student engagement, while lower ratings for ‘Technology Integration’ highlighted areas needing improvement. The findings underscore the potential of the FC to positively influence students' attitudes towards science. This research implies that educators should seek ways to enhance student engagement and foster a positive attitude towards science through innovative teaching methods such as Flipped Classroom. Keywords: attitude towards science, Flipped Classroom (FC), perceptions of the FC experience, science education, secondary education

Cartografía temática y recursos TIC en la enseñanza y aprendizaje de la Geografía regional de Europa

In this article, we present a classroom experience with university students in training to be secondary school geography teachers. It is based on a didactic proposal using thematic cartography (Eurostat, ESPON, ESPON-SIESTA and the Information Society Atlas in Galicia) and ICT resources (statistical sources, free picture banks, aerial photography, Google Earth and Google Maps). The proposal´s aim is to use contents from the regional geography of Europe as a base or starting point to show a series of didactic recommendations for the teaching and learning of geography and social sciences. What is more, everything is with a clear idea, from a descriptive and rote geography to an active and critical geography, in which students participate in the construction of knowledge and increase their ability to reflect on geographical issues. The results of the experience will highlight the value of these tools in secondary education. We had also previously assessed the presence of thematic cartography and ICT resources within the required official Galicia curriculum to teach geography in compulsory secondary education. The idea is to deepen the value of the curriculum in didactic code, to know what tools it offers, how it offers them and with what intentions. This solution, among other opportunities, will allow us to identify a curriculum offering a specific teaching model. On the other hand, it will also give us the opportunity to firmly rebuke all the proposals considered to be erroneous, repetitive, or of little didactic value.

A Service-Learning Program to Prevent Online Hate Speech Perpetration Among Secondary Education Students: A Pilot Study.

The evolution and rapid expansion of online hate speech perpetration (OHSP) behaviors among adolescents toward different groups contrast with the lack of theory-based and empirically evaluated programs targeting this phenomenon. This study, developed by the Spanish Volunteering Platform, contributes to reversing this situation by investigating the impact of a service-learning program to prevent OHSP among students in secondary education. To do so, a cluster-randomized research design was adopted with a sample of secondary school students (n = 60) from two public schools. After the random assignment of each class group to either the intervention or control condition, the service-learning program previously designed was implemented for 3 months. Regression results in model 7 with all predictors and controls yield a significant effect on the variable experimental group = 0.803, p < .05, and gender = 0.987, p < .05, explaining 45.9% of the variance. The effect size for this intervention was 0.42. From a theoretical perspective, participants are moving in the right direction to reduce and/or prevent OHSP behaviors, which demonstrates the theoretical utility of the theory of planned behavior in hate speech research. Finally, several recommendations are made to improve the impact of future replications or adaptations of this program.

MOTIVATION AND SELF-REGULATION OF LEARNING IN HOMESCHOOLED STUDENTS

In the context of education, motivation and self-regulation of learning are dominant issues. The degree of intrinsic and extrinsic motivation to learn is related to students’ academic achievement and literacy development. This study aimed to research the regulatory styles and motivation to learn among homeschooled students, with a particular focus on those who practice unschooling, a form of self-directed learning. A quantitative research strategy was employed, and data were collected using the standardised SQR-Academic questionnaire adapted for the homeschooling context. The questionnaire was completed by 143 homeschooled children (4th to 9th grade), of whom 10.88% reported engaging in unschooling or self-directed learning. The results indicated that identified regulation was prevalent among homeschooled students, who tended to exhibit intrinsic rather than extrinsic motivation. This contrasts with full-time attending students, who generally display a more external regulation style. Among unschoolers, identified regulation was equally prevalent, but the Relative Autonomy Index (RAI) values were higher, indicating a stronger inclination towards intrinsic motivation. Despite these differences in RAI between unschoolers and other homeschoolers, the differences were not statistically significant. The findings are consistent with relevant research from other countries. Future research should explore the factors that influence the degree of intrinsic and extrinsic motivation in homeschooled students. Keywords: homeschooled students, intrinsic motivation, lower secondary education students, primary education students, regulation of learning, unschooled students

Multilevel survival analysis of the age at first birth among women in Ethiopia.

The age at first birth refers to the age at which a woman has her first child. It can significantly influence the demographic behavior of women and the general community. Moreover, teenage childbearing is a serious public health and social problem. The main objective of this study was to identify factors associated with age at first birth among women in Ethiopia. Secondary data on women were obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). These population-based cross-sectional data were downloaded from the Measure Demographic and Health Survey website (http://www.measuredhs.com). The study included a random sample of 8,885 women aged 15-49 years from 305 enumeration areas. A multilevel survival analysis was employed to identify the factors associated with teenage childbearing among women in Ethiopia. The majority (67.7%) of randomly sampled women were subjected to teenage childbearing. Women being rural dwellers [hazard ratio (HR) = 1.27, 95% CI: 1.05, 1.54]; women from middle-income families (HR = 1.43, 95% CI: 1.18, 1.74); and women from higher-income families (HR = 1.40, 95% CI: 1.15, 1.70) were associated with a higher risk of teenage childbearing. Conversely, contraception method users (HR = 0.87, 95% CI: 0.77, 0.99), Muslims (HR = 0.75, 95% CI: 0.64, 0.89), Orthodoxes (HR = 0.68, 95% CI: 0.57, 0.80), women with secondary education (HR = 0.53, 95% CI: 0.43, 0.65), women with higher education (HR = 0.28 (95% CI: 0.22, 0.37), and the higher age of household head (HR = 0.99, 95% CI: 0.98, 0.99) were associated with a lower risk of teenage childbearing among women in Ethiopia. Since the median age of women to have their first child was 18 years old, this study strongly suggests that stakeholders at the federal and regional levels must work closely toward enforcing the legal age of marriage and implementing national adolescents' and youths' targeted sexual and reproductive health programs.

Benefits and Objectives of ECVET Implementation in Bulgaria: an Empirical Study

The comprehensive analysis presented in this article examines the potential positive effects of complete ECVET implementation in Bulgaria, aligning with the European guidelines established by CEDEFOP. By focusing on a diverse range of topics, the report offers valuable insights for policymakers and practitioners seeking to enhance the quality and relevance of VET in Bulgaria. Despite the potential benefits of ECVET, its implementation in Bulgarian vocational education has not yet been realized and lacks a comprehensive credit system for credit exchange within both secondary and higher vocational education. Consequently, the development of an effective ECVET implementation system, including a robust assessment framework, remains an ongoing challenge. ECVET is poised to support learners in Bulgaria across several key dimensions. Its ability to foster adaptability, practical skill acquisition, and alternative learning strategies equip learners with the competencies necessary to thrive in today’s dynamic job market. Moreover, ECVET promotes the development of organizational skills, facilitates informed career choices, and accelerates professional implementation. The successful implementation of ECVET necessitates a concerted effort from various stakeholders, including VET institutions, employers, and learners. By embracing ECVET, Bulgaria can significantly improve the quality and relevance of its VET systems, better prepare learners for the workforce, and stimulate economic growth. Ultimately, ECVET contributes to learners’ personal satisfaction, self-esteem, and shorter paths to the labor market. These benefits underscore the transformative potential of ECVET in enhancing the educational experience and career prospects of learners in Bulgaria.

Socioeconomic determinants of male contraceptive use in South Africa: a secondary analysis of the 2016 SADHS data

BackgroundHistorically, family planning discussions have predominantly centred on women, overlooking the crucial role men play in contraception. This is particularly concerning in regions like Sub-Saharan Africa (SSA), where reproductive health challenges are pronounced. South Africa, a key country within SSA, continues to grapple with issues such as high unintended pregnancy rates and increasing pregnancy-related mortality. Understanding the factors that deter male contraceptive use is essential for achieving universal access to sexual and reproductive health (SRH) services. This study investigates the socioeconomic disparities influencing male contraceptive use in South Africa, drawing on data from the 2016 South Africa Demographic Health Survey.MethodsThe study utilised data from the 2016 South African Demographic and Health Survey, which employed a stratified, two-stage sampling design across all provinces based on the 2011 Census. The survey focused on men aged 15–59 using the “Man’s Questionnaire.” Various socio-demographic and attitudinal variables were analysed using STATA 17. The analysis included multinomial logistic regression to identify determinants of male contraceptive use and the Erreygers Normalized Concentration Index to assess socioeconomic inequalities in contraceptive uptake.ResultsAmong the surveyed men, 47% reported not using any contraception, 40% used male methods, and 13% relied on their partners’ contraceptive use. A majority began sexual activity between the ages of 14–17 (54%), resided in urban areas (56%), were unmarried (67%), and had attained secondary education (70%). Notably, 78% disagreed that contraception is solely a woman’s responsibility, and 64% expressed positive attitudes toward contraception. Age, marital status, and education level emerged as significant factors influencing contraceptive use. The study revealed a slight pro-rich inequality in male contraception use, with socioeconomic status (SES) being the most significant contributor to this disparity (223.22%). This suggests that higher SES is associated with increased inequality in the adoption of modern male contraceptive methods.ConclusionThese findings highlight the impact of socioeconomic disparities and entrenched cultural beliefs on male contraceptive use in South Africa. To address these challenges, comprehensive strategies that prioritise education, expand family planning media campaigns and ensure equitable access to contraception are urgently needed.

Psychological Distress Among Ethnically Diverse Participants From Eastern and Southern Africa

Psychological distress is characterized by anxiety and depressive symptoms. Although prior research has investigated the occurrence and factors associated with psychological distress in low- and middle-income countries, including those in Africa, these studies' findings are not very generalizable and have focused on different kinds of population groups. To investigate the prevalence and characteristics (sociodemographic, psychosocial, and clinical) associated with psychological distress among African participants. This case-control study analyzed data of participants in the Neuropsychiatric Genetics in African Populations-Psychosis (NeuroGAP-Psychosis) study, which recruited from general outpatient clinics in Eastern (Uganda, Kenya, and Ethiopia) and Southern (South Africa) Africa. Individuals who participated in the control group of NeuroGAP-Psychosis from 2018 to 2023 were analyzed as part of this study. Data were analyzed from May 2023 to January 2024. The prevalence of psychological distress was determined using the Kessler Psychological Distress Scale (K10), which measures distress on a scale of 10 to 50, with higher scores indicating more distress. Participants from the NeuroGAP-Psychosis study were categorized into cases as mild (score of 20-24), moderate (score of 25-29), and severe (score of 30-50), and participants with scores less than 20 were considered controls. Factors that were associated with psychological distress were examined using binomial logistic regression. From the data on 21 308 participants, the mean (SD) age was 36.5 (11.8) years, and 12 096 participants (56.8%) were male. The majority of the participants were married or cohabiting (10 279 participants [48.2%]), most had attained secondary education as their highest form of learning (9133 participants [42.9%]), and most lived with their families (17 231 participants [80.9%]). The prevalence of mild, moderate, and severe psychological distress was 4.2% (869 participants), 1.5% (308 participants), and 0.8% (170 participants), respectively. There were 19 961 participants (93.7%) who served as controls. Binomial logistic regression analyses indicated that the independent associations of psychological distress were experience of traumatic events, substance use (alcohol, tobacco, or cannabis), the physical comorbidity of arthritis, chronic neck or back pain, and frequent or severe headaches. In this case-control study among ethnically diverse African participants, psychological distress was associated with traumatic stress, substance use, and physical symptoms. These findings were observed to be consistent with previous research that emphasizes the importance of traumatic events as a factor associated with risk for psychopathology and notes the frequent co-occurrence of conditions such as physical symptoms, depression, and anxiety.

To Assess the Patient Awareness and Level of Knowledge about Risk and Management of Surgical Site Infections

Background: Surgical site infection (SSI) is an infection occurring within 30 days after surgery involving the incision or deep tissues at the surgical site and often requires surgical intervention for treatment. Despite advances in surgical techniques, the incidence of SSI remains significantly high and a recent meta-analysis has estimated the global incidence. Assessing patients' knowledge level can help physicians assess their knowledge level and train them on hygiene procedures. Methods: A prospective observational study was conducted from July to December 2023 in the Department of Surgery, Patuakhali Medical College Hospital, Patuakhali, Bangladesh. Forty patients aged between 20 and 60 years participated in the study. Forty patients aged between 20 and 60 years participated in the study. Patients who underwent surgery were also included in the study. Demographic parameters were recorded and patient knowledge was assessed using a standard questionnaire. Results: Majority of patients belong to the age group of 41-50 years. More men than women participated in the study. Most of the patients were working. Most of the patients belonged to the group of patients with higher secondary education. Most of the patients lived in rural areas. Furthermore, most of the patients had been hospitalized 1 to 5 times. The majority of patients responded that they had no prior knowledge about wound infections. The majority of patients responded that they would be interested in improving their knowledge about wound infections if an educational program were offered. Conclusion: This study extends existing knowledge regarding patients' knowledge and awareness of wound infections. The majority of patients stated that their level of knowledge in this area was insufficient and expressed a willingness to improve their knowledge. The study recommends further research in this area and also to increase patients' awareness about wound infections.

Exclusive Breastfeeding Among Adolescent Mothers in Indonesia: Does Maternal Education Level Matter?

Exclusive breastfeeding (EBF) is a vital element in the early stages of life. Feeding newborns solely breast milk from birth until they are six months old is sufficient. However, EBF by adolescent mothers is still not optimal. The study analyzed the effect of maternal education on EBF among babies with adolescent mothers in Indonesia. The cross-sectional study examined 560 babies (a–5 months). We analyzed EBF practice as a dependent variable. We included six mothers' characteristics (education, residence, age, marital, employment, and wealth) and two baby characteristics (sex and early breastfeeding initiation) as independent variables. In this study, the initial stage was a bivariate analysis using chi-square. Then, a multicollinearity test was conducted to ensure no strong relationship between the independent variables. Finally, a multivariate test was conducted to determine the factors of EBF in babies with adolescent mothers. The results showed that adolescent mothers with primary education were 2.920 times more likely than those without education to perform EBF (AOR = 2.920, 95% CI [2.521–3.382]). Moreover, adolescent mothers with secondary education were 2.325 times more likely to achieve EBF than those without (AOR = 2.325, 95% CI [2.001–2.701]). The study concluded that all education levels were likelier to perform EBF than those without formal education. Further research is needed to understand the breastfeeding experience of adolescent mothers. Exceptional support and attention regarding EBF should be directed to adolescent mothers who are without formal education.

Characterization of Pasture Production Systems in Makueni County of Kenya

Livestock feed is a key factor influencing animal production and productivity as evidenced by the increased demand for animal source foods (ASFs) to feed a growing human population in Kenya. However, there exists untapped potential of pasture commercialization and hence the need to harness the social, economic and environmental benefits in the ASALs for overall rural development. A study was conducted to characterize the existing pasture production systems in Makueni County. A purposive random sampling of 300 respondents drawn from 3 Sub-counties and 12 wards was conducted in Makueni County in January, 2021. The study aimed to characterize existing pasture production systems using a structured questionnaire. Data were analyzed using descriptive and inferential statistics. Multivariate statistical techniques; principal Component Analysis (PCA) and Cluster Analysis (CA) were used to determine whether or not there were significant differences in the pasture production systems in Makueni County. Results of the study showed that majority (97%) of the farmers were small scale farmers (SSFs) who dedicated less than 5 acres of their land to pasture production. The mean age of small- scale farmers was 52 years compared to 55 years for the large-scale farmers (LSFs). Most of the households were male headed (83%). Most of the SSFs household heads had primary level of education level or lower while most of the large-scale household heads had secondary education and above. Majority (35%) of SSFs owned the land under pasture without a title while most of the LSFs had a title. The land under pasture for SSFs was about 2 acres with an average of 102 bales per season while LSFs had about 23 acres under pasture and produced about 1,762 bales per season. Majority (92%) grew local grass varieties and sold their pasture in form of a bale. 58% of SSFs sited NGOs as their main source of grass seeds while LSFs mainly sourced from agrovets Results of PCA revealed that 6 of the 17 components had eigen values greater than 1 and accounted for 58% of the total variance. Based on Euclidian distance, six clusters were determined using the agglomeration schedule. ANOVA analysis of the six profiles were estimated to have p-values of 0.000, suggesting the existence of significance difference between cluster 1 to 6 in relation to the 6 profiles and hence concluding the existence of variations in pasture production systems in Makueni County. Development strategies should focus on knowledge of and improved access to grass seeds to farmers as well as development of standards of the mode of sale of pasture.

Speaking like a ‘good student’: Norms and deviations in contemporary upper secondary education in Denmark

Abstract Based on a linguistic ethnographic study of student–teacher classroom interactions, this article sheds light on language norms in a contemporary Danish STX school (upper secondary education, also known as gymnasiums). The analysis reveals that neither classrooms with the explicit teaching of an ‘academic register’ nor classrooms where teachers orient towards a youth norm constitute spaces where students have equal access to perform as good students. Even when students can decode and reproduce the language preferred by the teachers, they do not experience an equal opportunity to conform to this. It is argued that performing linguistically as good and competent students is more complex than just adapting to a specific school norm, as the students have to navigate different teacher’s norms as well as peer norms emphasising authenticity.

The predictive power of Dutch end of primary school tests for educational attainment in ninth grade

AbstractDutch secondary education is a multi‐tiered system, and many students are placed in a single track in the first year (seventh grade) of secondary education. As part of the placement procedure, all sixth‐grade students take an end of primary school test. Although these standardised attainment tests (SATs) are considered high‐stakes tests, the predictive accuracy of many of these SATs has not been studied comprehensively. In the current study, three SATs commonly used in The Netherlands (CET, IEP and R8) were compared on their predictive accuracy of educational attainment in ninth grade. The predictive accuracy was also investigated for particular track recommendations, using multiple cohorts of population data, each of around 160,000 students. For the two most recent cohorts, CET was overall a more accurate predictor of educational attainment in ninth grade than R8, which in turn was a more accurate predictor than IEP. All three attainment tests had only mediocre to acceptable predictive power overall. Furthermore, all three tests had very poor predictive power for certain single‐track recommendations. For these track recommendations, many students attained a lower or higher educational level in ninth grade. This study is the first to compare the predictive accuracy of these SATs. While statistical noise is normal when using tests, since different tests are used that vary widely in predictive accuracy, there is much more noise than is acceptable. As long as the predictive accuracy is poor to mediocre, these SATs should not have a large role to play in the Dutch placement procedure for secondary education.

Indie Games for Ethical and Socioemotional Development in Secondary Education

Video games, particularly those developed in the independent scene, are a form of media with great educational possibilities. This work in progress will be completed in three years and it aims to improve teachers video game literacy and help them implementing activities for ethical and socioemotional development (European key competencies 5 and 6) through indie games. Therefore, through design-based research and mixed-method designs, it aims to achieve three goals: (O1) identify the perception and meaning-making processes that teachers and students have about videogames and learning through video games; (O2) design a measurable training program for teachers around the educational possibilities of indie games and help them implement activities for ethical and socioemotional development; and (O3) evaluate the programs impact based on the indicators of key competencies 5 and 6. The project is in its first phases and it will be developed in the next three years. First, representative samples of each agent will be accessed to analyze their beliefs, types of knowledge, and practical experience in the field. Subsequently, four independent video games that promote key competencies 5 and 6 will be selected, and classroom activities will be designed for each of them. Next, teachers from four high schools in Spain (Cantabria, Baleares, Andalucía and Catalonia) will be trained in the use of the educational resources, and they will be accompanied in its implementation with students. Finally, the programs impact on students will be evaluated based on various psychological variables associated with key competences 5 and 6 (e.g., empathy, emotional identification, civic skills, etc.) as well as the participants perceptions of the experience, enabling the generation of design principles for future iterations and for the programs scalability.

Prescribing Pattern and Medication Adherence in Patients with Epilepsy in a Tertiary Neuro-Center, Kathmandu

Abstract Background Epilepsy is a chronic condition characterized by unusual, frequent, excessive, and self-terminating neuronal firing. Adherence to medication is crucial to achieve the intended therapeutic outcome. However, not much research has been done on drug adherence in our context. Thus, the purpose of this study is to investigate the antiseizure medication prescribing pattern, medication adherence, and associated factors. Methodology A cross-sectional, analytical research was done on randomly selected epileptic patients through interview and documentary analysis using a semi-structured interview schedule and the eight-item Morisky Medication Adherence Scale (MMAS-8). The clinical and demographic characteristics were described using descriptive statistics (median, interquartile range [IQR], frequency, and percentage). The Shapiro–Wilk and chi-squared tests were used to examine the factors influencing medication adherence and the relationships between research variables. The analysis was performed using SPSS version 16. Result From a total of 104 patients, 77.3% were males, the median age was 29 years (IQR: 16), the majority (42.3%) had higher secondary education, 15.4% had secondary education and 5.8% were illiterate, 25% were job holders, 26% were laborers, 41.3% were from province 3, and 16.3% were from province 4. Two-thirds (63.5%) of the patients were highly adherent to antiseizure medication and 54.8% were seizure free for more than 2 years.The most common type of epilepsy diagnosed was generalized epilepsy (54.8%). Seizures were usually treated with monotherapy (65.4%), with sodium valproate being the most often used single antiseizure medicine (26.8%), followed by carbamazepine (16.3%) and levetiracetam (15.4%). Additionally, sodium valproate was the medication most frequently used in polytherapy for epilepsy. There was a strong association established between adherence and drug therapy type, age, adverse drug reaction, and seizure control. The study revealed that adherence was not significantly associated with factors such as gender, occupation, regional distribution, or type of epilepsy. Conclusion Low adherence was observed in 36.5% of patients. As a significant association was observed between medication adherence and seizure control, health care providers should focus on improving medication adherence. Evaluation of adherence needs to be a regular component of managing epilepsy. Further patients who do not stick to their drug regimens should receive more attention and assistance. It will support better therapy results.

Game-based Pedagogy in Teacher Training: Results of a Pilot Course

Game-based learning (GBL) and gamification can improve the learning experience of students by making learning more fun, interesting, and motivating. However, integrating games in practice is challenging for many teachers as it requires competences that not necessarily are part of their teaching repertoire. Game-based pedagogy (GBP) refers to the teaching methods and learning processes involved in learning with games. Research stresses the need for adequate professional development and teacher education on GBP. However, there is a lack of empirical knowledge on effective methods to prepare pre-service and in-service teachers for using game-based learning. The aim of our research is to gain insight into the design of effective GBP learning experiences for teachers. The guiding research question was: What design elements of a course on GBL impacted in-service teachers' GBP competences and teaching practice? We investigated this question in the context of a teacher education program in the Fall 2023. We conducted an empirical study in which a course on GBL was designed, implemented, and evaluated in practice. The participants were 16 in-service secondary teachers from different disciplines in secondary education, from which 13 agreed to participate in this study, and three course leaders. We investigated participants’ and course leaders’ experiences, participants’ competences in GBP, the impact on participants’ teaching practice and the way design elements contributed to it. The data consisted of participant reflections, transcripts from participants and course leaders’ interviews and answers to a questionnaire. The data was collected and analysed using quantitative and qualitative methods between January and April 2024. Results reveal that in-service teachers’ improved their competences on GBP and increased their use of GBL in practice. Qualitative data analysis provides insight into the course's design elements and on participants’ learning process. This study contributes to GBP-education by offering a possible design solution and framework for developing effective teacher education.

Community-Based Mycetoma Surveillance in Uganda: Identifying Knowledge Gaps and Training of Community Health Workers to Improve Case Detection.

Mycetoma is an uncommon and neglected tropical disease in Uganda. We aimed to assess baseline knowledge and provide community health workers (CHWs) in Northern Uganda with knowledge to identify and refer presumptive mycetoma cases. Between March and August 2023, we conducted a concurrent triangulation mixed methods study among CHWs in Gulu and Pader districts on mycetoma. We conducted a 1 day in person training on mycetoma. Quantitative data were collected before (pretest), immediately (immediate posttest) and six months (6-month posttest) after the training and results compared using paired sample t test or one-way ANOVA. Qualitative data were collected using four focused group discussions, audio recorded, and analyzed using thematic content analysis. Forty-five CHWs were enrolled, mostly male (66.7%, n = 30), with a median age of 36 years (IQR 29 43). Out of a total score of 18, the baseline mean knowledge score was 7±2.42, improving to 11±1.99 immediately posttest (p<0.001), and 10±2.35 at 6 months (p<0.001), without additional training. Significant knowledge improvements at 6 months were observed among female participants (p = 0.004), those aged 30 40 years (p = 0.031) or 40+ years (p = 0.035), and those with secondary education (p = 0.007). Over 6 months, CHWs screened 2,773 adults, identifying and referring 30 presumptive mycetoma cases. Qualitative findings revealed challenges and barriers to early identification and referral of mycetoma presumptive cases including limited knowledge, stigma, myths, lack of an indigenous name for mycetoma, delayed decision making, and transportation barriers. This study highlights a significant knowledge gap among CHWs about mycetoma, with substantial improvement following training. The identification of presumptive cases by CHWs reflects their potential in community-based surveillance, emphasizing the need to integrate well-trained CHW to lead efforts for mycetoma surveillance and capacity building to enhance health outcomes in Uganda.

Exploring the Effect of Mathematics Skills on Student Performance in Physics Problem-Solving: A Structural Equation Modeling Analysis

AbstractStudents’ success in physics problem-solving extends beyond conceptual knowledge of physics, relying significantly on their mathematics skills. Understanding the specific contributions of different mathematics skills to physics problem-solving can offer valuable insights for enhancing physics education. Yet such studies are rare, particularly at the high school level. This study addresses the underexplored area of this topic in secondary education by investigating the associations between physics problem-solving performance using a robust methodological framework. We applied exploratory factor analysis (EFA) to identify latent sub-mathmetics skills relevant to physics problem-solving and employed structural equation modeling (SEM) to examine the causal impact of these skills on students’ performance in physics. The study analyzed data from a municipal-wide assessment involving 1,878 grade 12 students in Southern China. The results demonstrate that mathematics skills impacting high school students’ physics problem-solving performance can be categorized into two sub skills, algebraic skills and geometric skills. It also indicates that algebraic skills have a stronger direct effect on physics problem-solving performance compared to geometric skills in high school setting. These findings suggest that integrating focused algebraic training within physics education can significantly improve student outcomes in STEM fields. We recommend that educators design curricula and instructional strategies that emphasize the development of algebraic skills necessary for solving complex physics problems. Additionally, these findings have important implications for policymakers, who should consider integrating targeted mathematics training within physics curricula to foster interdisciplinary learning and better prepare students for challenges in STEM education.

Immunosuppressive medication adherence and affecting factors in solid organ transplantation patients: a mixed-methods study

Objectives: Transplantation is a form of treatment that requires long-term pharmacotherapy. After transplantation, patients may have difficulty adapting to medication use for various reasons, and this may result in rejection. The aim of this study is to determine participants’ medication compliance and the factors affecting it. Methods: The research was conducted with a sequential explanatory mixed method. In the study, quantitative data were collected using the Turkish Immunosuppressive Medication Adherence Scale, and qualitative data were collected using the In-Depth Individual Interview Guide. Quantitative data were analyzed using statistical methods, and qualitative data were examined according to Braun and Clarke's thematic analysis framework. Results: In this study, 62.3% of the participants were male, 37.0% were 50 years old and over, 71.3% lived with their spouse, 54.0% had primary and secondary school education, and 42.0% could not work due to their current health condition. From a clinical perspective, it was determined that 78% of the transplants were kidney transplants, and 41.3% were more than 4 years after transplantation. 74.3% of the transplants were from living donors. The mean score of the immunosuppressive medication compliance scale was determined to be 40.91±4.09. In the qualitative data analysis of the study, factors affecting medication adherence were examined and the themes of "individual factors", "complexity of the regimen" and "social support resources" were obtained. The sub-themes of the individual factors theme are reluctance, hopelessness and addiction; Sub-themes of the complexity of the regimen theme are drug side effects and polypharmacy; The sub-themes of the social support resources theme are loneliness and family pressure. Conclusions: The factors influencing medication adherence among organ transplant recipients have been investigated, revealing that adherence levels vary significantly depending on various factors. These findings underscore the importance of tailored care strategies and individualized support approaches.