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The gamification of learning has increased in popularity in recent years as a tool for enhancing student engagement and attainment. In undergraduate chemistry courses, hybridization is a fundamental concept that students need to master in order to understand introductory organic and inorganic topics. This study focused on the development of a card game for use as a revision tool (i.e., a learning resource that can be used by students to engage with a topic they have previously encountered and develop their understanding of the topic in advance of an assessment) based on the topic of hybridization for students taking introductory chemistry courses. The game was designed to both engage students and support their learning. Covering the core concepts of hybridization, including molecular geometry, orbital character, and hybridization states, the speed-based game requires students to answer "question cards" before their opponents by placing down the correct "hybridization card". The game was implemented with chemistry cohorts at the University of Birmingham, United Kingdom, and Xi'an Jiatong-Liverpool University, China. The impact of the game on student learning was evaluated through pre- and postintervention quizzes, as well as a survey based on student impressions of the game play experience. Students responded positively about the game play experiences, and a comparison of quiz scores suggests a positive impact on student understanding of the topic.

The study covers the development and testing of the alternative mechanics survey (AMS), a modified force concept inventory (FCI), which used automatically marked free-response questions. Data were collected over a period of three academic years from 611 participants who were taking physics classes at high school and university level. A total of 8,091 question responses were gathered to develop and test the AMS. The AMS questions were tested for reliability using classical test theory (CTT). The AMS computer marking rules were tested for reliability using inter-rater reliability (IRR). Findings from the CTT and IRR studies demonstrated that the AMS questions and marking rules were overall reliable. Therefore, the AMS was established as a physics concept inventory which uses automatically-marked, free-response questions. The approach used to develop and test the AMS could be used in further attempts to develop concept inventories which make use of automatically-marked, free-response questions.

Abstract Background Consumer involvement in healthcare service organisation and policy development is recognised globally as a vital strategy in improving the quality and patient-centredness of care. There are significant gaps in knowledge about consumer involvement in practice, including consumers’ engagement in the process of enhancing cancer services. This study aimed to explore consumers’ perspectives on their involvement in cancer service improvement. Methods Cancer consumer representatives were recruited through Victorian Integrated Cancer Services, Australia. Eligible consumers were, or had been, a member of a health service improvement-related committee or project and attended at least one meeting with health professionals. Semi-structured qualitative interviews were conducted online and transcribed verbatim. Data were analysed using inductive thematic analysis. Results Six experienced consumer representatives were interviewed. Perspectives on their involvement in improving cancer services were categorised into three major topics. The first addressed personal aspects of involvement, in which participants described personal motivations (e.g., having lived experience of cancer themselves or in their family), challenges encountered in committee involvement, experiences of received support in their role as a consumer representative, concerns about narrow representation, and their evolving identity as a consumer representative. The second discussed practical contributions made by consumer representatives to improve systems and services. Participants detailed their active engagement with committees and consumer-led projects, contributing both their cancer experiences and general or professional skills. The third topic focused on directions for improving consumer involvement in the health system. Suggestions highlighted widening consumer representation to include often marginalised voices to inform decision-making at local committee and health system levels. Conclusions This study enhances the real-world understanding of the role that consumer representatives play in improving cancer health services. The strategies suggested in our research provide the opportunity to enhance consumer involvement and pave the way for more effective cancer service planning and implementation across diverse healthcare settings.

Abstract Background Alcohol use disorder (AUD) and major depressive disorder (MDD) drive HIV transmission in many sub-Saharan African settings. The impact of screening and treating AUD and MDD on HIV outcomes is unknown. We aimed to identify the cost-effectiveness of AUD and MDD interventions in Zimbabwe, and their potential contribution to reaching Zimbabwe’s Ending the HIV Epidemic 2030 goal. Methods Using a validated HIV compartmental transmission model in Zimbabwe, we compared four policy scenarios: prevention as usual (baseline); implement AUD screening (using AUDIT) and treatment (motivational interviewing and cognitive-behavioral therapy); implement MDD screening (using PHQ-9) and treatment (cognitive-behavioral therapy); and implement screening and treatment for both. Outcomes were HIV incidence projections, infections averted through 2030, quality-adjusted life-years gained, cost per infection averted, and cost per QALY gained. Analyses considered “spillover,” when treatment for AUD also results in an improvement in MDD and the converse. Sensitivity analyses identified cost reductions necessary for AUD and MDD interventions to be as cost-effective as other HIV interventions, particularly the scale-up of long-acting PrEP. Results AUD and MDD combined will be responsible for 21.1% of new HIV infections in Zimbabwe by 2030. Without considering spillover, compared to the baseline, MDD intervention can reduce new infections by 5.4% at $2039/infection averted and $3186/QALY. AUD intervention can reduce new infections by 5.8%, but at $2,968/infection averted and $4753/QALY, compared to baseline. Both MDD and AUD interventions can reduce new infections by 11.1% at $2810/infection averted and $4229/QALY, compared to baseline. Considering spillover, compared to the baseline, MDD intervention can reduce new infections by 6.4% at $1714/infection averted and $2630/QALY. AUD intervention can reduce new infections by 7.4%, but at $2299/infection averted and $3560/QALY compared to baseline. Both MDD and AUD interventions can reduce new infections by 11.9% at $2247/infection averted and $3382/QALY compared to baseline. For MDD intervention to match the cost-effectiveness of scaling long-acting PrEP, the cost of MDD intervention would need to be reduced from $16.64 to $12.88 per person. Conclusions Implementing AUD and MDD interventions can play an important role in HIV reduction in Zimbabwe, particularly if intervention cost can be decreased while preserving effectiveness.

Abstract Background Staff in health systems everywhere have exhibited flexibility and a capacity for improvisations during, and in response to, the COVID-19 pandemic. Looking to other examples of such resilient behaviours outside of those induced by the pandemic is instructive for those involved with researching or understanding change, or making health systems improvements. Methods Here, we synthesise and then assess the value of eight case studies of in situ resilient performance from Canada, Sweden, Japan, Belgium, the United Kingdom, Norway, the United States and Brazil. The cases are divided into four categories: responsiveness to a crisis; adaptiveness over time; local adoption in accommodating to a top down, national policy change; and the consequential outcomes of an intervention. Results The cases illuminate the resourcefulness of translational and social researchers in examining such behaviours and practices. More than that, they also foreground the ingenuity and adaptive capacity of staff on-the-ground who continually anticipate, respond and adapt to make systems work and provide continuous care in the face of many challenges, including resource deficiencies, policy misalignments, and new technologies, policies and procedures that need to be integrated into local workflows. Front line clinicians make care systems work, pre-empting issues and sorting out problems before they occur or as they arise. Conclusions A key lesson amongst a range of findings is that, rather than focusing on shiny new tools of change (checklists, frameworks, policy mandates), it is much more insightful and satisfying to deeply apprehend care at the sharp end, where clinicians deliver care to patients, understanding how everyday work is executed. This, rather than the Health Ministry, the Boardroom, or the Management Consultant’s office, is where and how change is being enabled, and where street level actors solve problems, thwart issues in advance, and constantly avoid pitfalls.

Deaf-sighted, deaf-blind, and hearing-sighted people have been interacting within a small community in the Bay Islands of Honduras for over a century (Ali 2023; Ali and Braithwaite 2020). In this article, we sketch the history of the community and the ways in which signers make use of their own and their interlocutor's bodies to co-construct meaning. Based on a short conversation between two deaf-blind signers, we identify mechanisms used to regulate turn-taking, including some which are familiar from other visual and tactile sign languages, and some which are rather novel in the literature. We show that signers make use of visual and tactile-proprioceptive channels, bearing in mind, but not entirely determined by, the sensorial orientations of their interlocutors. We conclude that this way of languaging is not a visual sign language and not yet fully adapted to the tactile modality, nor is it undeveloped or disordered in any other sense. Rather, we believe that this case demonstrates the ways in which human languaging makes use of multiple modalities and adapts to the needs of each interactional context. While linguists have sometimes been inclined to classify languages into neat modality boxes (auditory-vocal, visual-gestural, tactile-gestural), this analysis supports Henner and Robinson's (2023) calls for what they term a "crip linguistics," which embraces disabled ways of languaging, rejects ideas of disordered language, and recognizes languaging as multimodal.

Context: Sudden cardiac arrest is the leading cause of sport-related deaths in young athletes. Athletic training students must understand cardiovascular anatomy and physiology in addition to pathophysiology to appropriately care for patients with cardiovascular conditions. Objective: Describe a teaching technique to actively engage students in lecture about cardiovascular anatomy, physiology, pathophysiology, and electrocardiograms. Background: Drawing for retention is an educational technique used in medical education to help students recognize patterns, reinforce knowledge, and retain information. Using drawing for abstract concepts that cannot always be visualized or applied enhances comprehension. Description: An educational technique using drawing for retention to teach cardiovascular concepts, conditions, and basic electrocardiogram interpretation was implemented in an emergency care in athletic training course. The instructor drew and lectured on concepts of anatomy, physiology, pathophysiology, electrocardiograms, and interventions while the students drew and took notes on the concepts. Educational Advantage(s): Students describe this activity as a beneficial way to learn and apply cardiovascular anatomy and physiology to cardiovascular conditions and treatment. Conclusions: Faculty may consider implementing drawing for retention as an active learning technique to engage students with complex or abstract topics.

The motivation of linguistically diverse young adults to learn Korean as a Foreign Language (KFL) was studied at a university on the US-Mexico border. This diglossic setting permitted a complex investigation of multiple elements, including L2-motivation theoretical attributes, exposure to Korean contemporary pop culture, and the linguistic and cultural diversity of the local community. 152 KFL university students completed an online survey. Participants were sorted into four language groups according to the degree to which English/Spanish predominated in their daily life: Spanish-dominant, balanced, and English-dominant bilinguals, in addition to English monolinguals. Maximum Likelihood Exploratory Factor Analysis found two underlying KFL motivation factors, which were conceptualised as a social-cultural factor (F1) and an educational factor (F2). This underlying motivation structure was then further explored to find associations between the factor-based motivational attributes and the four language groups. Repeated MANOVA measures found statistically significant interactional effects and between-group differences between the balanced and non-balanced bilingual groups and the English monolinguals. Further discussion highlights the diglossic environment, the cultural interests of bilingual young adults in L3 learning, and the role of English as a power language.