A Phenomenological Study of the Lived Experiences of Tagumpay National High School Teachers Involved in Online Learning Action Cell Session

A qualitative phenomenological approach was used in this study to describe the lived experiences of Tagumpay National High School (TNHS) teachers on Online Learning Action Cell (LAC) session. LAC is a school-based professional development for teachers implemented by the Philippine Department of Education (DepEd). Due to teacher’s lack of participation on classroom LAC, a fully-online mode option is explored by offering TNHS teachers Online LAC session using Facebook as a Learning Management System (LMS). To capture the lived experience of teachers, an in-depth interview with a purposive sample of one TNHS teacher is done in the process. The data gathered went through “Hycner’s Explicitation Process” (1999, in Groenewald, 2004) which includes bracketing, delineating, clustering, summarizing and extracting unique themes. Validity and Credibility were accomplished through an intercoder agreement between researchers, Facebook chat records, bracketing, and member checking. Results identified three themes in relation to teacher’s experience of Online LAC session including usefulness, barriers, and preference. Findings revealed the major role of TNHS teacher’s context on how Online LAC is utilized. Recommendations include administrator and expert teacher working with classroom teachers and the inclusion of teachers’ voices as input in the program design, implementation and evaluation stages of Online LAC to better address curriculum needs and facilitate the delivery of high-quality professional development for teachers’ professional growth.

The Role of Inflammation in Contrast Induced Nephropathy

Background: Intravenously administered iodinated contrast media are widely and liberally used in daily diagnostic radiological investigations. Contrast-induced nephropathy (CIN) is notable as the third commonest cause of hospital-acquired renal injury. Justification: The global prevalence of CIN from various studies ranges from 2-5% but an incidence of CIN of 12-14% in Kenya was highlighted by a recent study without an explanation for the markedly increased incidence. Intravascular contrast has been demonstrated to commonly cause renal vasoconstriction. However, the low incidence of CIN in the general population infers that contrast alone cannot be a causative insult. This study proposes that inflammatory states, which are prothrombotic, when coupled with renal vasoconstriction may confer a higher relative risk for development of CIN. Objective: To determine the risk of developing CIN given the presence of an inflammatory state in patients presenting to a private university hospital in Kenya. Study design: Prospective cohort study of patients undergoing a contrast- enhanced CT scan (CECT) in Aga Khan University Hospital, Nairobi (AKUHN) Radiology department and who have no known risk factors for CIN. Methodology: A total of 423 patients were recruited over a period of 4 months. The patients were grouped into those without inflammation (unexposed) having serum C-reactive protein (CRP) levels ≤5mg/dL and those with inflammation(exposed) having CRP levels >5mg/dl. Serum creatinine (SCr) was measured before the CECT and 48 hours following the CECT with CIN diagnosed when there was an increase of >25% in the SCr from the baseline value. Relative risk was determined and multiple logistic regression analysis performed on the biophysical variables (age, weight, sex) and contrast volume to assess their effect on development of CIN. Results: CIN was present in 42 (9.92%) patients. Of the exposed group (elevated CRP), 29 out of 215 patients (13.5%) developed CIN. In the unexposed group, 13 out of 208 patients (6.25%) developed CIN. This gave arelative risk of developing CIN of 2.16(1.15 to 4.04, P=0.016).The attributable risk percentage is 7.24% (1.1% to 12.2%). No statistically significant association was seen between the biophysical variables and volume of contrast and development of CIN. Conclusion: Inflammation doubles the likelihood of development of CIN. Therefore a patient presenting with inflammation and any other risk factor for CIN should have a risk-benefit analysis to assess the need for administration of iodinated intravenous contrast.