Changes in perceptions of teaching quality in secondary schools in Rwanda during the COVID-19 global pandemic and the subsequent closing and reopening of schools.

The stability of measures of teaching quality is essential for making generalizations of results stemming from these measures to other teaching situations. However, no research has examined the effects of unexpected situational factors on the stability of these measures. Therefore, the purpose of this two-phase quantitative research study was to examine the following aspects among secondary school teachers in Rwanda, using a score-validated, multiple-dimension measure: (a) perceptions of teaching quality (PTQ) prior to the onset of the COVID-19 context (Phase 1; descriptive and correlational design); and (b) the extent to which COVID-19 and the subsequent closing and reopening of secondary schools affected PTQ among STEM teachers in Rwanda, and the associations between these changes in PTQ and selected socio-demographic/locational variables (Phase 2; descriptive and correlational research design). Phase 1 findings revealed that two measures of cultural values (i.e., Attitudes Towards Cultural Values Scale, Inculcating Cultural Values Scale, respectively) generated the most positive attitudes, whereas the Satisfaction with Resources and Material Subscale yielded the least positive attitudes. Phase 2 findings revealed that for four of the nine PTQ scales/subscales, the COVID-19 context negatively affected PTQ. These findings provide compelling evidence of the importance of monitoring PTQ, especially during times of crises. Moreover, these findings have implications for Rwandan educational policymakers, Rwandan administrators, teacher training administrators, and, above all, the teachers themselves, as they all seek to maximize teaching quality in Rwandan secondary schools.

Whose voice counts? Examining government-donor negotiations in the design of Ethiopia's large-scale education reforms for equitable learning.

Motivation: The Government of Ethiopia has a long-standing commitment to improving the quality of education. In recent years, this has shifted to include a more explicit focus on equity in learning outcomes. In this paper, we examine the education reform design process in the context of Ethiopia's political environment which is widely recognised as a strong developmental state. Purpose: The article examines how federal, regional, and international donor actors negotiate their interests in relation to Ethiopia's national quality education reform programme, the General Education Quality Improvement Programme for Equity (GEQIP-E). Methods and approach: We conducted 81 semi-structured, key informant interviews with federal and regional government officials and international donors who were involved in the design of GEQIP-E. Findings: We find that federal government was able to leverage considerable political influence over high-level priorities and the framing of GEQIP-E. Large donors leveraged financial influence to exclude some specific priorities, while smaller donors were able to draw on social influence and technical expertise to include priorities aligned with their interests. Regional governments-which are responsible for policy implementation-were largely excluded from the reform design process. Policy implications: Our analysis highlights the importance of recognizing and understanding different forms of influence in the dynamic process of negotiating reform between government and donors. It identifies that both government and donor voices counted in the process of negotiations, but in different ways and to varying degrees. Understanding how different actors draw on their relative political, financial, and social influence is vital for ensuring successful implementation and sustainability. Importantly, we identify that voices of local actors are left out.

Ruptured school trajectories: understanding the impact of COVID-19 on school dropout, socio-emotional and academic learning using a longitudinal design.

This paper presents the findings of longitudinal research conducted in Ethiopia exploring the effects of COVID-19 school closures on children's holistic learning, including their socio-emotional and academic learning. It draws on data from over 2,000 pupils captured in 2019 and 2021 to compare primary school children's dropout and learning before and after school closures. The study adapts self-reporting scales used in similar contexts to measure grade 4-6 pupils' social skills and numeracy. Findings highlight the risk of widening inequality regarding educational access and outcomes, related to pupils' gender, age, wealth and location. They also highlight a decline in social skills following school closures and identify a positive and significant relationship between pupils' social skills and numeracy over time. In conclusion, we recommend a need for education systems to promote children's holistic learning, which is even more vital in the aftermath of the pandemic.

The effects of language preference and home resources on foundational literacy retention during school holiday closures in Ghana: Lessons from the Complementary Basic Education Programme.

This article assesses the extent to which children's language preference and their home environment matter for literacy retention. Using data from the Complementary Basic Education (CBE) program in Ghana, the authors found that large numbers of disadvantaged students reverted to not even being able to read a single word following school closures over a four-month holiday period. Widening literacy gaps were found for girls who reported they did not receive instruction in a language that they understood or did not have the resources, support, or activities at home to enable them to continue to learn while schools were closed. For boys, widening literacy gaps were only influenced by resources, support, or activities at home, but not by language preferences. The article findings suggest that schools and teachers must pay closer attention to language preference, particularly for girls, in order to ensure that language of instruction is not a barrier to literacy retention. The article also provides further evidence to support the growing claims that home supports are essential for reducing inequities in learning outcomes during school closures.

The Implications of COVID-19 for Early Childhood Education in Ethiopia: Perspectives from Parents and Caregivers.

Recent research on the effects of COVID-19 on school closures has mainly focused on primary and secondary education, with extremely limited attention to early childhood education (ECE). To address this gap, we identify the extent to which parents and caregivers with pre-primary school-aged children were engaged in their children's learning during school closures in Ethiopia. Our focus on Ethiopia is of particular relevance given that ECE provision has expanded dramatically in recent years, aimed at ensuring children are prepared for primary school. Using data collected through a phone survey with 480 parents and caregivers, the results revealed that learning disruption due to COVID-19 school closures is likely to be substantial and will probably widen existing inequalities further. Many poorer households and those where parents or caregivers are not literate, are less likely to have child-oriented learning resources, and home learning activities between parents and children in these households are limited. The study highlights that greater attention needs to be paid to mitigate the threats of COVID-19 on Ethiopia's recent gains in ECE, to prevent the pandemic from further reinforcing inequalities between children from advantaged and disadvantaged households.

Radiation-induced skin toxicity: prophylaxis or management?

This editorial aims to provide context for changing skin care interventions for radiation-induced skin toxicities over several decades.

Patients' characteristics informing practice: improving individualized nursing care in the radiation oncology setting.

PURPOSE: A large number of patients attend for radiotherapy daily. Primary nurses in the study settings aim to individualize care for their patients. The individual characteristics of patients may determine their perceptions of nursing care, and provide guidance in tailoring their care. This study aimed to assess patients' personal characteristics on their perceptions of individualized care (IC) provided by nurses during a course of radiotherapy, and to determine predictor variables that may inform nursing practice. METHODS: This cross-sectional, exploratory study was conducted in three radiotherapy departments in Australia. Patients (n = 250) completed the Individualized Care Scale_Patient (ICS_P). Data were analyzed using descriptive and inferential statistics, univariate analysis, and multiple regression analysis. RESULTS: Males reported significantly higher perceptions of IC than females in 7/9 subscales. Patients with head and neck and prostate cancer, as well as those requiring hospitalization during radiotherapy, scored significantly higher in 5/9 subscales. Courses > 30 days, those not receiving chemotherapy, and partnered patients reported greater IC across all subscales. Gender and hospitalization were the main predictor variables for IC. CONCLUSION: Patients reported moderately high levels of IC during their radiotherapy; however, standard demographic information may provide limited insight into improving care for the individual. Patient characteristics routinely chosen, such as age, gender, and education may not predict how patients perceive their care or support the tailoring of interventions to improve IC. Researching a range of related patient characteristics may prove a more useful concept for future nursing studies aiming to predict outcomes to tailor nursing practice.

Individualized Care in the Radiation Oncology Setting From the Patients' and Nurses' Perspectives.

BACKGROUND: Radiation oncology nurses engage in individualized supportive care of people undergoing radiotherapy. A primary nursing/collaborative practice framework guides the delivery of individualized care to patients. OBJECTIVE: The aim of this study was to describe and compare patients' and nurses' perceptions of individualized care in 2 radiotherapy centers. METHODS: This cross-sectional, comparative study collected data from patients (n = 173) undergoing curative radiotherapy and their nurses (n = 30), using the Individualized Care scales: patient and nurse. RESULTS: Moderate to high levels of individual care were perceived by both patients and nurses. More than a third of the item scores for patients reached the more than 4.5 mean score (13/34 [38.2%]), whereby more than half of the items reached this level for nurses (20/34 [58.8%]). The highest scores for both patients and nurses were in the Decisional Control subscales, and the lowest scores were in the Personal Life subscales. Males rated being treated as individuals significantly higher than did females across the majority of subscales. Patients receiving chemotherapy perceived less acknowledgement of individuality overall. Older nurses (46-70 years) reported acknowledging and supporting patient individuality more than did younger nurses. Nurses perceived greater individualized care than patients for the Personal Life scales (A: p = .001); (B: p = .001) and in the acknowledgement of Decisional Control (p = .001). CONCLUSION: A moderate level of individualized nursing care was perceived by the largely outpatient cohort of patients undergoing radiotherapy. IMPLICATIONS FOR PRACTICE: The model of care in these departments may contribute to patient individuality. Further work into gender differences and those receiving chemotherapy may improve care for these patients.

Patients' outcomes related to person-centred nursing care in radiation oncology: A case study.

PURPOSE: The aim of this case study is to describe patients' responses to nursing care following the implementation of a person-centred model in a radiation oncology department. METHOD: An instrumental case study design utilised surveys to collect data on a range of key patient outcomes: patient satisfaction (PSS), informational issues (RSEP), quality of life (FACT_G), comfort (RTCQ), and emotional status (HADS). This occurred at the beginning of, and twelve months following, the implementation of the new model of care. RESULTS: This study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being in the latter part of their course of radiation therapy, patients continue to be satisfied with nursing care. There were significant differences between groups in perceptions of the care environment and the use of the nurse as an acknowledged source of information are noteworthy, since these variables were key targets of the new model of care. The finding that nurses were seen by the post-implementation cohort as more likely to be a source of information is an important indicator that the nurses' presence was noted by patients, and they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. CONCLUSION: The person-centred nursing approach in the radiotherapy setting has contributed to some improvements in the provision of patient care. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

Person centred nursing care in radiation oncology: a case study.

PURPOSE: The aim of this case study is to describe clinical staff perceptions of implementing a person-centred model of nursing in an outpatient radiotherapy treatment department, using a Primary Nursing/Collaborative Practice framework. The questions are: 1) what are the nursing and radiotherapy staff perspectives of the changed model of care, 2) what factors impacted on aspects of the evolving model?, and 3) how was interdisciplinary collaboration influenced by the new model? METHODS: An instrumental case study addressed the multiple perspectives of several radiotherapy health professionals, within a qualitative approach, to assess the new model of nursing care. Interview data were obtained from thirteen clinical staff over a six month period approximately one year after the model was implemented. RESULTS: The new model supports nurses to work more closely with the individual patient, with some perceived positive patient outcomes. Nurses reported increased satisfaction with their work, more autonomy and responsibility, and improved working relationships with medical staff. They also became more aware of the holistic approach to support positive patient outcomes. However, this study acknowledged that education was required for nurses to provide holistic care, especially in the context of complex interdisciplinary relationships. CONCLUSIONS: A person-centred nursing approach in radiotherapy represents a radical change to the functional approach, providing some benefits for patients. However, the challenges of providing holistic care in the context of complex interdisciplinary relationships are evident, and this study acknowledges the importance of a team approach to addressing changes in practice in the future.

Evaluating patient education materials about radiation therapy.

Targeted treatment education for cancer patients has the potential to promote adjustment through assisting patients to participate in treatment decision making, comply with treatment regimens and cope more effectively with treatment side effects. A quasi-experimental longitudinal pre-test post-test and follow-up design was used to assess the effect of a patient education video about radiation therapy on patients' psychological distress, knowledge about radiation therapy, self-efficacy about coping with treatment and physical symptoms. Patients with head and neck (n=26) and breast cancer (n=66) were recruited into the study and allocated into control and intervention groups. No significant differences were found between the control and intervention groups on any of the outcome variables. However, patients in the intervention group reported high levels of satisfaction with the video and all reported that they would recommend the video to other patients preparing for radiation therapy. As well, 90% of patients in the intervention group reported that some or all of the information in the video was new to them. Education materials that have excellent face validity and that are well received by patients may fail to produce significant change using standard controlled study designs. Future research in this area may need to consider alternative paradigms for evaluating the helpfulness of such materials.

A Phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue.

The aim of the study was to see if topical aloe vera gel would be beneficial in reducing the identified skin side-effects of radiation therapy, including erythema, pain, itching, dry desquamation, and moist desquamation, when compared with aqueous cream. The secondary aim was to assess the effect of other factors known to predict severity of radiation skin reaction, ie, breast size, smoking habit, and one or more drainages of lymphocele after surgery, on other skin side effects. A Phase III study was conducted involving 225 patients with breast cancer after lumpectomy or partial mastectomy, who required a course of radiation therapy using tangential fields. Patients were randomized to either topical aloe vera gel or topical aqueous cream to be applied 3 times per day throughout and for 2 weeks after completion of radiation treatment. Weekly skin assessments were performed by nursing staff. Aqueous cream was significantly better than aloe vera gel in reducing dry desquamation and pain related to treatment. Subjects with D cup or larger size breasts experienced significantly more erythema, regardless of treatment arm. For subjects who had undergone lymphocele drainage, the aloe vera group experienced significantly more pain than the aqueous cream group. Within the aqueous cream arm, smokers were significantly more likely to experience itching within the treatment field than were nonsmokers. Within the aloe vera arm, subjects who had undergone one or more lymphocele drainages after surgery were significantly more likely to experience erythema and itching within the treatment field than those who did not have drainage. In this study, aloe vera gel did not significantly reduce radiation-induced skin side effects. Aqueous cream was useful in reducing dry desquamation and pain related to radiation therapy.