Browsing by Author "Narnaware, Yuwaraj"
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Item Academic performance of nursing students in anatomy and physiology before, during and after a stability period of COVID-19(2022) Narnaware, Yuwaraj; Cuschieri, SarahThe COVID-19 has drastically disrupted nursing education globally. The present study demonstrated that the mean class average of anatomy and physiology midterms and final examinations during synchronous online teaching was significantly higher (P<0.001) compared with face-to-face teaching. However, the class average and GPA were not different between faceto-face and hybrid/flex teaching. Virtual teaching of these subjects also significantly (P<0.001) increased the students’ GPA in both courses during Covid-19 compared to before and after a stability period of Covid-19. The present study demonstrates that due to a strict lockdown and self-isolation, students either spent more time studying these subjects or took advantage of the lack of online supervision of their exams which may have increased their class average and GPA.Item Anatomical knowledge loss in fourth year nursing students(2022) Narnaware, YuwarajThere is growing concern over the loss of anatomical and physiological knowledge in medical, allied-health & nursing students over time (Narnaware & Neumeier, 2020a, Narnaware, Y. 2021). Numerous studies have demonstrated the difficulty of the students in these disciplines to retain and apply anatomical knowledge as they progress through their programs of study (Narnaware and Neumeier, 2020a). However, physiological knowledge retention has not been studied as extensively as anatomical knowledge retention in health care disciplines, with very few studies focusing on nursing students (Aari et al., 2004). Of those studies, most are carried out after graduation (Aari et al., 2004) or are focused on a single or a limited number of organ systems (Pourshanazari et al., 2013). We have previously shown that physiology students retained approximately 86.6% of their first-year physiological knowledge over four months (Narnaware et al., 2020b). To improve the acquisition and retention of physiological knowledge, the present study aims to develop an interventional strategy that includes the repeated assessment of cardiovascular physiology and defenses knowledge over eight weeks. Nursing students were quizzed on two components of cardiovascular physiology (vascular system and blood) and defenses using the online quizzing system Kahoot. Each Kahoot quiz included 9-11 knowledge and comprehension level multiple-choice questions, and new sets of questions were used for each week’s Kahoot quiz. Data were statistically analyzed using SPSS II, and means were compared using 2-sample t-tests. The scores are described as the mean and standard deviation (SD) and are presented in figure 1 and table 1. Statistical significance was set at P < 0.05 for all tests. Compared to week 1, repeating knowledge of the vascular physiology and defenses yielded a significantly higher (P<0.05) knowledge retention at week 2 (8.4% & 11.7%). However, this retention was highest at weeks 3 (18.7% & 16.9%) and weeks 4 (21.6% & 14.3%), P<0.001) in both organ systems, with less significant improvement (P<0.05) at week 6 (13.3%) and no significant difference in defenses (4.6%). No significant differences in knowledge retention were found between vascular and defenses at week 8. However, compared to vascular and defenses, content reinforcement of blood was highly significant at all weeks. Compared to week 1, knowledge retention of blood was highest at week 4 (69.5%), week 6 (55.2%), and week 8 (54.7%), P<0.0001), with less significant retention at week 2 (27.8%) and week 3 (31.2%), P<0.001). Although organ system-specific improvements in knowledge retention were found, the study results show that repeated knowledge assessment can significantly improve knowledge retention of cardiovascular physiology and defenses in nursing students and agrees with previously reported studies in medical students (Pourshanazari et al., 2013). Therefore, content reinforcement should be used as one of the interventional strategies to improve knowledge retention in nursing students, and further research should be conducted to explore effective ways to maintain increased retention over more extended periods.Item Anatomical knowledge retention & interventional strategies in nursing education(2019) Neumeier, Melanie; Narnaware, YuwarajCreating experiential learning opportunities to improve knowledge acquisition and retention is a common goal in post-secondary education, but it may not be clear how to start. In this presentation, we discuss how to develop and use a knowledge retention study to identify gaps in learning and implement targeted learning strategies.Item Anatomical knowledge retention in second‐year Bachelor of Science & Psychiatric Nursing students(2020) Narnaware, Yuwaraj; Neumeier, MelanieThere is growing concern that nursing, medical and allied health students do not retain enough anatomical knowledge to confidently and successfully apply it in future classroom and clinical settings ( Doomernik et al., 2017). Evidence now shows that knowledge retention is impacted by many factors including admission criteria, teaching hours (Narnaware and Neumeier, 2019), age, sex, ethnicity, prior knowledge of science/biology, a gap between high school and university, and health care discipline (McVicar et al., 2015; Vogl , 2017). In Canada, the discipline of nursing can be subdivided into three professional designations, each with different educational requirements; Registered Nurses, Licensed Practical Nurses, and Registered Psychiatric Nurses (Canadian Nurses Association, 2019).Item Anatomical knowledge retention in third-year nursing students(2021) Narnaware, Yuwaraj; Neumeier, MelanieHuman anatomy and physiology are considered a cornerstone of any health related profession and serve as a pre requisite for future nursing courses and clinicals (McVicar et al., 2015). However, numerous studies suggest that students experience great difficulty in transferring the fundamental anatomical knowledge that they gain in the first year of their programs to future theory/clinical practice ( Gunay & Kilinc, 2018). Most of the knowledge transfer, loss and/or retention studies have been carried out in medical, allied health disciplines, and this has been assessed only in second year nursing students recently (Narnaware & Neumeier, 2020). This study seeks to determine the percent of anatomical knowledge retained by third year nursing students and determine the levels of knowledge retention in the body’s organ systems.Item Bioscience student’s perspectives & academic performance before, during & after a stability period of COVID-19(2022) Narnaware, Yuwaraj; Cuschieri, SarahFindings suggest that nursing students may have counter-balanced the missing active learning strategies of face-to-face learning and adopted self-directed learning during the COVID-19 period through synchronized learning. Virtual, synchronized learning by using a ‘blended, multi-modal & pedagogical’ approach may serve as a “new normal” of teaching and learning of biosciences if pandemics like Covid-19 re-emerge in the future.Item Brain regulation of feeding behavior and food intake in fish(2000) Lin, Xinwei; Volkoff, Hélène; Narnaware, Yuwaraj; Bernier, Nicholas J.; Peyon, Pierre P.; Peter, Richard E.In mammals, the orexigenic and anorexigenic neuronal systems are morphologically and functionally connected, forming an interconnected network in the hypothalamus to govern food intake and body weight. However, there are relatively few studies on the brain control of feeding behavior in fish. Recent studies using mammalian neuropeptides or fish homologs of mammalian neuropeptides indicate that brain orexigenic signal molecules include neuropeptide Y, orexins, galanin and β-endorphin, whereas brain anorexigenic signal molecules include cholecystokinin, bombesin, corticotropin-releasing factor, cocaine- and amphetamine-regulated transcript, and serotonin. Tachykinins may also have an anorectic action in fish. The brain hypothalamic area is associated with regulation of food intake, while sites outside the hypothalamus are also involved in this function. There is correlation between short-term changes in serum growth hormone levels and feeding behavior, although possible mechanisms integrating these functions remain to be defined.Item Content reinforcement of cardiovascular physiology improves knowledge retention in nursing students(2022) Narnaware, YuwarajThere is growing concern over the loss of anatomical and physiological knowledge in medical, allied-health & nursing students over time (Narnaware & Neumeier, 2020a, Narnaware, Y. 2021). Numerous studies have demonstrated the difficulty of the students in these disciplines to retain and apply anatomical knowledge as they progress through their programs of study (Narnaware and Neumeier, 2020a). However, physiological knowledge retention has not been studied as extensively as anatomical knowledge retention in health care disciplines, with very few studies focusing on nursing students (Aari et al., 2004). Of those studies, most are carried out after graduation (Aari et al., 2004) or are focused on a single or a limited number of organ systems (Pourshanazari et al., 2013). We have previously shown that physiology students retained approximately 86.6% of their first-year physiological knowledge over four months (Narnaware et al., 2020b). To improve the acquisition and retention of physiological knowledge, the present study aims to develop an interventional strategy that includes the repeated assessment of cardiovascular physiology and defenses knowledge over eight weeks. Nursing students were quizzed on two components of cardiovascular physiology (vascular system and blood) and defenses using the online quizzing system Kahoot. Each Kahoot quiz included 9-11 knowledge and comprehension level multiple-choice questions, and new sets of questions were used for each week’s Kahoot quiz. Data were statistically analyzed using SPSS II, and means were compared using 2-sample t-tests. The scores are described as the mean and standard deviation (SD) and are presented in figure 1 and table 1. Statistical significance was set at P < 0.05 for all tests. Compared to week 1, repeating knowledge of the vascular physiology and defenses yielded a significantly higher (P<0.05) knowledge retention at week 2 (8.4% & 11.7%). However, this retention was highest at weeks 3 (18.7% & 16.9%) and weeks 4 (21.6% & 14.3%), P<0.001) in both organ systems, with less significant improvement (P<0.05) at week 6 (13.3%) and no significant difference in defenses (4.6%). No significant differences in knowledge retention were found between vascular and defenses at week 8. However, compared to vascular and defenses, content reinforcement of blood was highly significant at all weeks. Compared to week 1, knowledge retention of blood was highest at week 4 (69.5%), week 6 (55.2%), and week 8 (54.7%), P<0.0001), with less significant retention at week 2 (27.8%) and week 3 (31.2%), P<0.001). Although organ system-specific improvements in knowledge retention were found, the study results show that repeated knowledge assessment can significantly improve knowledge retention of cardiovascular physiology and defenses in nursing students and agrees with previously reported studies in medical students (Pourshanazari et al., 2013). Therefore, content reinforcement should be used as one of the interventional strategies to improve knowledge retention in nursing students, and further research should be conducted to explore effective ways to maintain increased retention over more extended periods.Item Content reinforcement of cell and membrane transport between kinesiology and arts & science students(2023) Ma, Robin; Chahal, Paul; Narnaware, YuwarajThe present study evaluates content reinforcement of cell membrane transport over eight weeks for Physical Education and Arts and Science physiology students. The highest retention for physical education students was in weeks 1 and 3, whereas for the Arts and Science students, it was the highest in weeks 2 and 3. Knowledge was comparatively higher for Physical Education students than for the Arts and Science students. Therefore, relatively more robust interventional strategies need to be implemented for Arts and Science students to improve knowledge retention.Item Content retention of cell and membrane transport for physical education students(2023) Martin, Noah; Chahal, Paul; Narnaware, YuwarajHuman physiology is considered a foundational course in the Physical Education program. The objective of the present study was to evaluate content retention of cell and plasma membrane transport for first-year Physical Education University Transfer physiology students over eight weeks. Results show that the knowledge retention was observed to be week-specific, highest in weeks one and three and lower for other weeks. Therefore, content reinforcement can be used as an interventional strategy to improve long-term knowledge retention in Physical Education University Transfer students.Item Effect of injected growth hormone on phagocytosis in silver sea bream (Sparus sarba) adapted to hyper- and hypo-osmotic salinities(1997) Narnaware, Yuwaraj; Kelly, Scott; Woo, NormanGrowth hormone (GH) is known to exert a myriad of functions throughout the vertebrates and in fish, its growth-stimulating and osmoregulatory e#ects are most prominent (Sakamoto et al., 1993; Chen et al., 1994). In mammals, GH is generally considered to be the principal hormone which exerts immunoregulatory properties and there is recent evidence for a similar e#ect of GH in fish (Sakai et al., 1996a,b,c). GH influences the immune processes from antibody formation to the appearance of di#erentiation markers on lymphocytes and augments the cytolytic activity of T cells, their proliferation and delayed type hyper-sensitivity (Blalock, 1989, 1994). These also include the enhancement of natural killer cell activity, mitogenic responses of lymphocytes and antibody production (Kelley, 1989).Item Effect of salinity and ration size on macrophage phagocytosis in juvenile black sea bream (Mylio macrocephalus)(2000) Narnaware, Yuwaraj; Kelly, Scott; Woo, Ying Shiu NormanThe effects of salinity adaptation and ration size on macrophage phagocytosis were assessed in black sea bream (Mylio macrocephalus) juveniles. Salinity had no effect on phagocytosis in fish that were fed a 10% ration size. Reducing ration size from 10 to 5% resulted in a significant reduction in splenic and pronephric macrophage phagocytosis of fish adapted to hyper-(33 p.p.t.) and hypo-osmotic (6 p.p.t.) salinities. The fish that were adapted to an iso-osmotic salinity (12 p.p.t.) and fed a 5% ration size were able to maintain macrophage phagocytic activity at levels comparable to those of fish that were fed a 10% ration size. It is proposed that the adaptation of sea bream to an iso-osmotic medium is beneficial in that it stimulates the immune response through activation of macrophage phagocytosis.Item The effect of various stresses, corticosteroids and adrenergic agents on phagocytosis in the rainbow trout Oncorhynchus mykiss(1994) Narnaware, Yuwaraj; Baker, Bridget; Tomlinson, MikeThe effect of acute and chronic stress on the phagocytic activity of putative macrophages from the rainbow trout. Oncorhynchus mykiss has been assessed, using an in vitro phagocytic index, in which the average number of engulfed yeast cells in a population of phagocytes is determined. An injection stress given under light anaesthesia, or a longer noise stress combined with confinement, both significantly reduced, within 3 h, the level of phagocytic activity of macrophages from the spleen and pronephros. Daily injection stress over six days had a lesser effect on the proportion of phagocytically active cells even though plasma cortisol levels were equally raised. Daily dexamethasone injection depressed the proportion of phagocytically active cells more than saline injection. In these in vivo experiments, it was not possible to determine whether stress and steroids depressed the phagocytic activity of individual macrophages or caused the active macrophages to migrate out of the spleen and pronephros. Administration of cortisol (200 nM) to trout macrophages in vitro failed to depress phagocytic activity within a 3h period but both α- and β-adrenergic agonists (10 μM) were usually depressive. It is proposed that the autonomic nervous system may be an early regulator of macrophage phagocytosis following stress and that corticosteroids only exert their suppressive effect on macrophage activity in the longer term.Item An effective teaching strategies to improve student’s academic performance(2022) Narnaware, YuwarajBiosciences (Anatomy, Physiology, Microbiology & Immunology) and life sciences (Botany, Zoology & Biochemistry) are considered a cornerstone of any health-and life sciences-related professions. However, these subjects serve as a pre-requisite for future health care and life sciences courses. A strong knowledge base of these subjects is crucial for health care and life sciences students to become successful practitioners after graduation. Traditionally, these courses are taught in a didactic, content-driven way. The author’s research and scholarship program focus on ways to change this way of thinking and move teaching in these courses toward a concept-based and student-centered approach that fosters student engagement and knowledge retention and improves their academic performance. Moreover, teaching and learning of the biosciences and life sciences worldwide are impacted by reduced face-to-face instructional hours, increased student enrollment, student demographics, fewer dedicated faculty members, minimal or no use of human and animal dissection, and requirements to move classes and labs on-line due to pandemics such as COVID-19. In this interactive presentation, first, the author will discuss factors impacting the teaching and learning of biosciences and life sciences. Secondly, he will employ and evaluate the impact of various teaching strategies that are designed to enhance engagement and knowledge retention in order to equip students with the skills they need to successfully apply their biosciences and life sciences knowledge in their professional practice. These initiatives include but are not limited to: the use of the most advanced and cutting-edge educational teaching technology, inclusion of anatomical images in their examinations, various on-line and in-class activities and content reinforcement (repeated knowledge testing) aimed to improve knowledge of their subjects, academic performance, reduce exam anxiety and stress, and reduce cognitive load while improving their interactive and communication skills, critical thinking and prepare them as active learners.Item Effects of food deprivation and refeeding on neuropeptide Y (NPY) mRNA levels in goldfish(2001) Narnaware, Yuwaraj; Peter, Richard E.In mammals, NPY is a key factor in the regulation of feeding behavior. In the present study, the effects of refeeding for 1–3 h in 72–75-h food deprived (FD) goldfish on the levels of NPY mRNA in telencephalon-preoptic (TEL-POA), hypothalamus (HYP) and optic tectum-thalamus (OT-THAL) were examined, using Northern blot analysis. Goldfish FD for 72 h exhibited a significant increase in NPY mRNA levels in all brain regions. At 1 h after 72-h FD (73-h FD), NPY mRNA was significantly increased in TEL-POA and OT-THAL, but remained the same as 72-h FD fish in HYP. At 3 h after 72-h FD (75 h), all brain regions exhibited a significant increase in NPY mRNA levels. However, subsequent refeeding for 1–3 h rapidly and completely reversed the effects of FD in all brain regions, reaching fed levels within 1–3 h of refeeding. Serum GH levels were highest in 72-h FD fish, but decreased significantly over 1–3 h after 72-h FD; whereas, refeeding reversed the increase in serum GH levels only at 3 h after refeeding. Taken together, these results further support that NPY is a physiological brain transducer involved in the regulation of daily appetite and feeding in goldfish.Item Evaluating the knowledge acquisition of lower limb anatomy among medical students during the post-acute COVID-19 era(2022) Cuschieri, Sarah; Narnaware, YuwarajAnatomy is the foundation of many medical and surgical specialties yet knowledge acquisition and retention among medical students is questionable. Over the years the anatomy teaching environment and teaching modalities have changed, even more so with the onset of the COVID-19 pandemic and the shift to a virtual environment. The aim of this study was to evaluate the knowledge acquisition of applied musculoskeletal lower limb clinical anatomy among first year medical students in Malta following the transition back to face-to-face lectures. The Kahoot online game-based quiz platform was used through a best out of four multiple-choice setting across four sessions. Scores generated by the platform along with frequencies of correctly answered questions were utilized to measure knowledge acquisition. The average scores for each question across sessions were statistically analyzed using ANOVA and student's t-test accordingly. Across the four sessions, the positive percentage response for clinical based questions remained higher than for pure anatomy questions. Anatomy knowledge acquisition appears to be subjective to clinical based knowledge rather than pure anatomy. There may be a plethora of reasons as to this outcome including the misconception that anatomy is not essential for clinical practice as well as the potential aftermath of the COVID-induced virtual learning environment. Further research is merit to ensure that students are provided with the best tools to enhance their knowledge acquisition, both as students and as future doctors.Item Evidence that cortisol may protect against the immediate effects of stress on circulating leukocytes in the trout(1996) Narnaware, Yuwaraj; Baker, B. I.Rainbow trout stressed by an intraperitonal injection of saline displayed reduced phagocytic activity of their spleen and head-kidney macrophages within 3 hr. Phagocytic activity was similarly depressed by injecting noradrenalin, but was maintained in fish injected with the adrenergic blocking agent phentolamine, suggesting that endogenous catecholamines are involved in this stress response. Since stress may increase the number of circulating granulocytes, it is proposed that noradrenalin, released during stress, causes the liberation of active macrophages from the lymphocytic tissue, the remaining macrophages therefore showing a lowered phagocytic index. Cortisol injection, like phentolamine, prevented the depressive effect of stress on the phagocytic index but did not antagonize the depressive effect of exogenous noradrenalin. It is suggested that the stress-induced release of endogenous catecholamines may be prevented by cortisol. Injection stress caused a decline in the number of circulating lymphocytes/thrombocytes, indicating their retrafficking into some other tissue. This was opposed by cortisol and by high doses of noradrenalin. It is proposed that cortisol or noradrenalin may oppose, directly or indirectly, the expression of adhesion molecules which are normally induced after stress.Item How do we make our students remember what we teach?(2023) Narnaware, YuwarajBiosciences like human anatomy and physiology are a cornerstone of any health related profession. These courses serve as a pre-requisite for future nursing courses and clinical. A strong knowledge base of these subjects is crucial for medical, allied health, and nursing students to become successful practitioners after graduation. However, a growing concern is that students are not retaining the essential bioscience knowledge from these courses over time. Numerous studies have demonstrated the difficulty students retain and apply the knowledge of these courses as they progress through their programs of study. Nursing programs worldwide are impacted by reduced face-to-face instructional hours, increased student enrollment, student demographics, fewer dedicated faculty members, minimal or no use of cadaveric dissection, and requirements to move anatomy and physiology classes and labs online due to pandemics such as COVID-19. These factors have impacted the teaching and learning of biosciences. In this interactive keynote presentation, an author will describe a study that evaluated how much anatomical and physiological knowledge nursing students retained throughout the duration of their four-year program. Comparisons and trends by body system and over time will be presented to clearly understand the gaps of knowledge retention between classroom to future nursing courses and clinical. Based on the assessment, he will discuss how interventional strategies were implemented to address those gaps. Attendees will then be encouraged to identify what concepts are essential to their own courses and to outline a project to evaluate whether those concepts are retained over time and what type of learning strategies could impact that retention.Item How much do students remember? An examination of anatomical knowledge retention by system over time(2023) Neumeier, Melanie; Narnaware, YuwarajNursing students struggle to retain enough anatomical knowledge to meet their entry to practice competencies, but what knowledge is missing and when this occurs has been previously unexplored. This study examined anatomical knowledge retention by system over time to identify gaps that can be targeted with focused educational interventions.Item The impact of active learning strategies on class average and grade point average (GPA) in bioscience students(2022) Narnaware, YuwarajBiosciences (Anatomy, Physiology, Microbiology & Immunology) and life sciences (Botany, Zoology & Biochemistry) are considered a cornerstone of any health-and life sciences-related professions. However, these subjects serve as a pre-requisite for future health care and life sciences courses. A strong knowledge base of these subjects is crucial for health care and life sciences students to become successful practitioners after graduation. Traditionally, these courses are taught in a didactic, content-driven way. The author’s research and scholarship program focus on ways to change this way of thinking and move teaching in these courses toward a concept-based and student-centered approach that fosters student engagement and knowledge retention and improves their academic performance. Moreover, teaching and learning of the biosciences and life sciences worldwide are impacted by reduced face-to-face instructional hours, increased student enrollment, student demographics, fewer dedicated faculty members, minimal or no use of human and animal dissection, and requirements to move classes and labs on-line due to pandemics such as COVID-19. In this interactive presentation, first, the author will discuss factors impacting the teaching and learning of biosciences and life sciences. Secondly, he will employ and evaluate the impact of various teaching strategies that are designed to enhance engagement and knowledge retention in order to equip students with the skills they need to successfully apply their biosciences and life sciences knowledge in their professional practice. These initiatives include but are not limited to: the use of the most advanced and cutting-edge educational teaching technology, inclusion of anatomical images in their examinations, various on-line and in-class activities and content reinforcement (repeated knowledge testing) aimed to improve knowledge of their subjects, academic performance, reduce exam anxiety and stress, and reduce cognitive load while improving their interactive and communication skills, critical thinking and prepare them as active learners.
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