ABSTRACT
Various models of evaluating eLearning system success have been identified in the past and the need for effective evaluation of eLearning systems has been highlighted during the COVID-19 pandemic. The purpose of the present work is to elicit how both academic staff and students (the evaluators) view the performance of eLearning attributes when being taught using an eLearning system. The attributes are ranked using a multi-criteria evaluation algorithm called the Fuzzy Technique for Order Preference by Similarity to the Ideal Solution (Fuzzy TOPSIS). Here, using linguistic-response expert questionnaires, a set of eLearning system attributes and a set of eLearning system criteria are evaluated. The Fuzzy TOPSIS algorithm yields weightings for each of the attributes which can then be ranked to arrive at the optimal solution in terms of how well they contributed to the success of the current eLearning system. IT service quality is found to rank highest, followed by technical system quality, information quality and finally the consideration of different learning styles. Large agreement is seen between academic staff and student evaluators, with minor disagreement between students of two different disciplines. As regards practical implications, it is shown from the rankings that the eLearning system must be reorganized and consideration of different learning styles must be improved. The Fuzzy TOPSIS method has been found to be a reliable and economic evaluation approach of eLearning systems, since it does not require large numbers of evaluators and provides a ranking of attributes which translate directly into priorities for improvement.
ABSTRACT
Background: Children with CF (CwCF) often suffer from inadequate weight gain, failure to thrive, and muscle weakness. The latter may be secondary to disuse atrophy associated with reduced physical activityand inflammation [1]. Hand grip strength (HGS) has been shown to be a reliable surrogate for overall muscle strength and lean body mass in CwCF. Data from our CF center has shown an association between low HGS and FEV1 in CwCF [2]. High intensity interval training (HIIT) improves physical fitness inchildren and improves quality of life in patients with chronic respiratory disorders [3]. HIITexercises are offered tothe patients in ourcenter during inpatient stays. We devised a project to assess the utility of implementing a HIIT exercise program in the home setting, in order to improve physical strength. Methods: Trained personnel measured HGS for CwCF with a well-calibrated JaymarPlus digital hand dynamometer using the American Society of Hand therapists' measurement protocol. Age- and genderspecific percentile for absolute grip strength (AGS) were determined from pre-published percentile charts. A HIIT home training program was offered to CwCF in the outpatient setting if their HGS was below the 50th percentile. Verbal and written instructions were provided by our physical therapist, with recommendations for sessions 3-5 times per week. If an individual was unable/unwilling to participate in the HIIT program, they were encouraged to continue with exercises of their choice, which was documented. Paired t tests were used to compare HGS, FEV1, and BMI percentile at the start of the project and at a follow-up clinic visit. Results: A total of 40 CwCF, age 12-18, were found to have AGS < 50th percentile. Follow-up of our cohort was limited due to the COVID pandemic, which resulted in delayed or canceled in-person visits. Of the 40 CwCF, 30 returned for follow- up visits and were included in theanalysis. The mean time to follow-up was 6.73 ± 2.16 months. There was poor adherence to the HIIT exercise program overall with notable barriers, including perceived difficulty, competing priorities, or lack of interest. About 1/4 of CwCF (7/30) reported at least moderate activity at baseline, which they continued throughout the project (stable activity group). Six CwCF (20%) who were previously inactive began participation in moderate activity of their choice (increased activity group). Inboth groups, there was a statistically significant increase in AGS;however the increased activity group had greater improvement in AGS and AGS percentile when compared to the stable activity group (Table 1). There was no significant increase in FEV1 and BMI percentile within the groups. (Table presented.) Conclusion: Encouraging regular physical activity in CwCF can result in increased HGS and overall physical strength. Even though implementation of a home HIIT protocol was not followed, the project proved that moderate activity in general would lead to significant improvement in muscle strength and general well-being of CwCF.
ABSTRACT
Global fatalities related to COVID-19 are expected to be high in 2020-2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase II and phase III trials could take less long to conduct if they used human challenge methods-that is, deliberately infecting participants with COVID-19 following inoculation. This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approval processes so that they are in place when applications for trials are made.