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Medical Education in the Developing World and Resource-Poor Settings (17) Mobile Health (mhealth) (1852) e-Learning and Medical Education (447) mHealth in the Developing World/LMICs, Underserved Communities, and for Global Health (393) Continuing Medical Education (CME) for Allied Health Professionals (85)
Published on 7.6.2022 in Vol 8 , No 2 (2022) :Apr-Jun
Mobile-Social Learning for Continuing Professional Development in Low- and Middle-Income Countries: Integrative Review
Dominique Guillaume 1, 2 ; Erica Troncoso 2 ; Brenice Duroseau 1 ; Julia Bluestone 2 ; Judith Fullerton 2
Dominique Guillaume1,2, MSN, AGPCNP-BC, ACRN ;
Erica Troncoso1, MSc ;
Brenice Duroseau2, MSN, FNP-C, AAHIVS ;
Julia Bluestone1, CNM ;
Judith Fullerton1, CNM, PhD
1Jhpiego, Baltimore, MD, United States
2School of Nursing, Johns Hopkins University, Baltimore, MD, United States
Dominique Guillaume, MSN, AGPCNP-BC, ACRN
1615 Thames St # 200
Baltimore, MD, 21231
Email: dominique.guillaume@jhpiego.org
Background: Access to continuing professional development (CPD) for health care workers in low- and middle-income countries (LMICs) is severely limited. Digital technology serves as a promising platform for supporting CPD for health care workers by providing educational content virtually and enabling virtual peer-to-peer and mentor interaction for enhanced learning. Digital strategies for CPD that foster virtual interaction can increase workforce retention and bolster the health workforce in LMICs.
Objective: The objective of this integrative review was to evaluate the evidence on which digital platforms were used to provide CPD to health care workers and clinical students in LMICs, which was complemented with virtual peer-to-peer or mentor interaction. We phrased this intersection of virtual learning and virtual interaction as mobile-social learning.
Methods: A comprehensive database and gray literature search was conducted to identify qualitative, quantitative, and mixed methods studies, along with empirical evidence, that used digital technology to provide CPD and virtual interaction with peers or mentors. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Eligible articles were written in English, conducted in an LMIC, and used a mobile device to provide CPD and facilitate virtual peer-to-peer or mentor interaction. Titles, abstracts, and full texts were screened, followed by an assessment of the quality of evidence and an appraisal of the articles. A content analysis was then used to deductively code the data into emerging themes.
Results: A total of 750 articles were identified, and 31 (4.1%) were included in the review. SMS text messaging and mobile instant messaging were the most common methods used to provide continuing education and virtual interaction between peers and mentors (25/31, 81%). Across the included articles, participants had high acceptability for using digital platforms for learning and interaction. Virtual peer interaction and mentorship were found to contribute to positive learning outcomes in most studies (27/31, 87%) through increased knowledge sharing, knowledge gains, improved clinical skills, and improved service delivery. Peer-to-peer and mentor interaction were found to improve social support and reduce feelings of isolation (9/31, 29%). There were several challenges in the implementation and use of digital technology for mobile-social learning, including limited access to resources (eg, internet coverage and stable electricity), flexibility in scheduling to participate in CPD, and sociobehavioral challenges among students.
Conclusions: The summary suggests that mobile-social learning is a useful modality for curriculum dissemination and skill training and that the interface of mobile and social learning serves as a catalyst for improved learning outcomes coupled with increased social capital.
digital learning; continuing medical education; mHealth; peer learning; mentorship; health systems; global health; mobile phone
The shortage of health care providers in low- and middle-income countries (LMICs) places an insurmountable strain on health care systems. The World Health Organization estimates that nearly 57 countries lack an approximate 4.2 million health care providers (physicians, nurses, midwives, and allied health professionals) [1,2]. The strengthening of health care systems in LMICs requires multifaceted approaches to the training and retention of health care workers to meet clinical needs [3]. Continuing professional development (CPD) for health care providers is essential for the development and application of health care practices and policies necessary for health promotion, disease prevention and management, and fostering sustainable health systems. Although many high-income countries require health care workers to participate in regular CPD, many LMICs do not have such regulations or policies. Traditionally, in-person CPD training has been the primary method of providing health care education for health care providers in LMICs [4]. However, health care workers in low-resource settings, especially those in rural areas, face substantial logistical barriers to accessing in-person CPD programs (eg, cost of travel and inflexibility in scheduling). Thus, access to such programs is remarkably limited, especially when there is a lack of provider engagement [4]. Research has demonstrated that health care workers in LMICs are more likely to have higher motivation, satisfaction, and retention when they are provided with access to continuing education [3,5-7]. In countries with limited resources, addressing health care worker shortages and service needs requires tailored, cost-effective approaches for training, supervising, and mentoring health care workers. It is imperative for such approaches to minimize strain on already burdened health care systems while simultaneously providing instructional experiences that trainees need to successfully perform their jobs [8].
Mobile-Social Learning to Support CPD
Digital education strategies have gained momentum over the last decade in low-resource settings for the provision of CPD to health care workers. Digital education encompasses various modalities of learning, including but not limited to offline and web-based computer-based education, gamification, massive open web-based courses, virtual reality environments, augmented reality, virtual patient simulations, and mobile digital education [9]. Given the expansion of mobile phone use in LMICs, leveraging digital health strategies through the use of mobile technology has the potential to alleviate significant health system challenges [10,11]. CPD that is provided through mobile devices can support workplace-based practical training, reduce in-person instruction time, support social peer learning, and allow programs to reach a greater number of providers, especially those practicing in remote locations [4]. Virtual training is affordable and can be easily adapted as new information is discovered to update providers with the latest information and clinical developments. Furthermore, virtual CPD that is provided through mobile technology has demonstrated high feasibility and acceptability among health care providers in LMIC settings [4,12-14]. Mobile platforms can be used to not only provide CPD education but also complement CPD through peer-to-peer and mentorship engagement and interaction. Although there have been a number of studies that have evaluated the efficacy of digital and mobile health (mHealth) technology for providing CPD to health care workers, few studies have evaluated the potential of digital health, specifically mHealth, in providing peer interaction and mentorship for sustained education and training. The investigation of mobile-networked communication technology for health care provider CPD has been relatively understudied in low-income settings [15].
Jhpiego (a Johns Hopkins University affiliate) has supported CPD for health care providers and capacity building in multiple low-resource settings for nearly 50 years. In leveraging strategies to increase the accessibility of CPD programs, a heightened focus has been placed on using digital training approaches, including the provision of CPD through mobile phones [16-18]. Jhpiego recognizes that delivering lean, just-in-time learning via mobile devices can support workplace-based practical training, reduce in-person instruction time, support social peer learning, and allow programs to reach greater numbers of providers. As access to mobile technology continues to increase among health care providers in LMICs, so does access to platforms that foster virtual interaction and communication, such as mobile instant messaging services (eg, WhatsApp) and social media (eg, Facebook, Instagram, and Twitter). We believe that health workers should receive greater social support to improve retention rates, improve morale, and accelerate the potential of social learning. Such findings have been demonstrated in high-income countries, where social support and virtual interaction were found to foster understanding and learning among health care professionals and clinical students [19,20]. Social and mobile platforms can be used for learning and support broader, facility-based quality improvement efforts with scalable efficiency. For these purposes, we have combined the terms into a single phrase, mobile-social, to describe this key intersection that warrants further investment for achieving greater capacity-building impact. We are defining mobile-social learning as a new methodology that is powerful for supporting health care providers to improve their clinical capacity, learning, and performance. A mobile-social learning approach incorporates the following two aspects: the use of mobile technology to increase access to digital learning opportunities and social platforms that encourage the social aspect of learning by facilitating professional networks for the sharing of experiences and exchange of knowledge through virtual communication.
Through mobile-social learning, mobile distance education is provided to users and supplemented by web-based real-time discussions and a collaborative learning approach. This allows for opportunities for students to collaborate to construct knowledge while promoting the development of learning communities and supporting the learning process [21]. As part of Jhpiego's commitment to make learning available and convenient to health workers anytime, anywhere, whether in the workplace, on the road, or at home, we see fostering this modality for learning and supporting peer learning as a great investment. Given the dearth of literature that has assessed the efficacy and outcomes of mobile-social learning in LMICs, the purpose of this integrative review was to explore the potential of mobile-social learning to support capacity building and improve the quality of CPD for health care providers in LMICs.
A comprehensive literature search was undertaken using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations to guide the search and review process. Peer-reviewed literature published between January 2016 and March 2021 was searched for on the PubMed, CINAHL, and Embase bibliographic databases. A gray literature search was also undertaken using Digital Square and the US Agency for International Development mHealth database. Hand searches of references from articles that were populated from the search were also conducted to identify relevant articles that may not have been identified using the search strategy. Searches were conducted separately on each database using controlled vocabulary supplemented with keywords and Medical Subject Headings terms combined with the Boolean operators OR and AND. The key terms and medical subject heading terms included concepts pertaining to continuing education, virtual training, health care providers, e-learning, mentorship, peer-to-peer interaction, and LMICs (Multimedia Appendix 1).
Studies were included if they were written in English, took place in an LMIC, and used mobile devices (eg, cellular phones, smartphones, tablets, palmtops, and pocket PCs) to provide continuing education and skill training to health care providers or preprofessional students. We included studies in which mobile platforms that fostered the concept of mobile-social learning were used either solely or in conjunction with a traditional face-to-face learning approach (eg, blended learning approach) [9]. Interventions using mobile-social learning were defined as any teaching, learning, or training intervention along with virtual interaction delivered using wireless networking, mobile telecommunication technology, multimedia messaging services, or SMS text messaging through a mobile device [9]. Virtual interaction among the eligible articles had to consist of either peer-to-peer interactions or mentor interactions that bolstered learning and professional support. Articles that did not evaluate student learning outcomes from virtual continuing education programs and that solely focused on program design and feasibility were excluded.
Peer-reviewed studies were included in our synthesis in addition to gray literature that was not peer-reviewed. Gray literature included relevant programmatic reports, case reports, research reports, presentations, and issue papers published by government entities, nongovernmental organizations, and private organizations. We included non–peer-reviewed gray literature given the possibility of limited published research on this topic coupled with the recent shift toward digital learning modalities concurrent with the COVID-19 pandemic. Thus, including gray literature allowed for an opportunity to highlight relevant work that may not have otherwise been identified while providing a balanced view of the evidence given the lack of peer-reviewed studies on this topic [22]. Furthermore, this method mitigated the risk of publication bias, which could potentially limit the availability of research in a field that is novel and rapidly growing [11,22].
Study Identification and Selection
The search yielded a total of 750 articles (PubMed: n=484, 64.5%; CINAHL: n=202, 26.9%; Embase: n=31, 4.1%; Digital Square: n=22, 2.9%; US Agency for International Development mHealth database: n=10, 1.3%) in addition to 2 articles that were identified from a hand search of previously published systematic reviews that assessed the use of digital health for educating health care providers. Articles were imported into Mendeley (Elsevier) and subsequently uploaded to the systematic review tool Rayyan QCRI (Rayyan Systems Inc). Duplicates were identified and excluded (104/750, 13.9%), thus resulting in a total of 646 articles that were screened. Authors DG, JB, and ET conducted title and abstract screening and full-text screening. After title and abstract screening of the 646 articles, a total of 602 (93.2%) were excluded, with 44 (6.8%) remaining for full-text screening. Disagreements among the articles were identified and resolved through consensus (DG, ET, and JB). Articles were then graded on their quality of evidence using the Johns Hopkins Nursing Evidence Level and Quality Guide [23]. This tool was selected as it has been extensively used in the literature and provides grading criteria for peer-reviewed studies along with experiential, nonresearch evidence (eg, case reports, quality improvement guidelines, and programmatic reports). The following factors were assessed in evaluating the studies and determining the quality of evidence: generalizability of the results, sample size, control, consistency of the results, methodology, limitations, conclusions, and recommendations [23]. After the articles were evaluated, the research team made final agreements for inclusion.
Data Extraction and Analysis
Once the articles were agreed upon for inclusion by the research team (DG, JB, and ET), data from the included articles were extracted (DG). The extracted data from the included studies consisted of the following categories: the country in which the study was conducted, study design and methods, study aims, participant characteristics, clinical focus, intervention and comparisons, outcome measures, key findings, and limitations. An integrated approach using data conversion was used, in which quantitative and qualitative data were used to address the research question. Quantitative data were transformed into qualitative themes as described in Tashakkori and Teddlie [24]. The qualitization of quantitative data involves converting quantitative data into qualitative themes in which data are theoretically grouped based on concepts measured from cross-sectional survey data [25-28]. Quantitative data were operationalized based on the concepts that were measured, and clusters of numeric data were transformed into qualitative themes. Quantitative and qualitative data were inductively coded line-by-line followed by the codes being categorized into broader themes [28,29]. The identified themes included the following: student perspectives on mobile-social learning, forms of interaction and communication within mobile-social platforms, learning outcomes, and challenges to and facilitators of mobile-social learning.
Findings from the synthesis of the included studies were used to develop a conceptual framework depicting mobile-social learning (Figure 1). In this conceptual framework, virtual learning and virtual engagement with peers or mentors foster collaborative learning. Collaborative learning results in increased engagement followed by improved learning outcomes and performance. Collaborative learning can also increase health care provider motivation and lead to improved outcomes and performance. This relationship can also be reciprocal to improved learning outcomes, contributing to increased motivation among health care providers. We anticipate that this model will be used in providing CPD for clinical professionals, community health workers, and preclinical and clinical students on a variety of platforms in low-resource settings where there may be significant challenges in implementing and accessing face-to-face CPD.
Figure 1. Mobile-social learning conceptual framework.
Included Studies
A total of 31 articles were selected for inclusion (Figure 2). Among the included articles, sub-Saharan Africa (28/31, 90%) was the most represented geographical region [1,8,15-17,30-52]. Countries in Southeast Asia were represented in 10% (3/31) of the studies [45,53,54], and 3% (1/31) of the studies included participants across Africa, Asia, and South America [1]. A wide array of health care cadres was targeted across the studies, including nurses, physicians, midwives, community health workers, public health specialists, hospital administrators, and health officers. In addition, several studies (7/31, 23%) included preprofessional clinical trainees (eg, nursing and medical students) [32-34,37,50-52]. Of the 31 studies, 9 (29%) were qualitative in design and were conducted using descriptive thematic analysis, in-depth interviews, or focus groups [8,15,30,32,34,36,40,41,50]. A total of 39% (12/31) of the studies [1,16,31,33,35,37,45-48,51,54] were quantitative, with most quantitative studies (10/12, 83%) having observational cross-sectional designs. Of the 31 studies, 10 (32%) used both quantitative and qualitative data collection [17,38,39,42-44, 49,52,53,55] (Multimedia Appendix 2 [1,8,15-17,29-54]).
There was diversity in the clinical topics that were represented among the continuing education interventions. Nearly half (14/31, 45%) of the interventions focused on clinical topics pertaining to sexual and reproductive health (ie, maternal health, basic emergency obstetric and newborn care, HIV and AIDS prevention and treatment, treatment of sexually transmitted infections, cervical cancer screening, and family planning) [1,8,16,17,30,31,40-42,47,48,52,54,55]. Additional clinical topics included primary care, general nursing practice and skills, research, malnutrition, anesthesia, pediatric hematology-oncology, integrated management of childhood illnesses, nephrology, and orthopedics (Multimedia Appendix 3 [1,8,15-17,29-54]).
Figure 2. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram.
Most articles (25/31, 81%) used texting, mobile instant messaging, or SMS text messaging to provide continuing education content either as a stand-alone intervention or in addition to other digital learning tools and blended learning formats (eg, coupling SMS text messaging with traditional face-to-face learning) [8,15-17,30-38,40,41,43,45,46, 48-52,55,56]. WhatsApp was the most commonly used platform among the studies that used messaging services (17/31, 55%) [8,15,30-34,36,37,43,46,48,50-52,55,56]. Telephone calls were included in 16% (5/31) of the studies and were primarily used between students and mentors to discuss and reinforce learning content and for students to obtain feedback from mentors [16,41,45,46,53]. Web-based courses that facilitated web-based interactive discussions and commentary were used in 19% (6/31) of the studies [1,42-46]. Of these 6 studies, 3 (50%) coupled web-based courses with social media platforms such as Facebook, Twitter, and Google groups, which served as an adjunct to the course in facilitating learning and peer interaction and engagement [1,43,44]. A total of 3% (1/31) of the studies used Facebook as the sole platform in both providing educational content and facilitating discussions between peers and mentors [39] (Multimedia Appendix 3).
Acceptability
Across the studies that assessed student acceptability and student satisfaction with the mobile-social interventions (16/31, 52%), most participants strongly endorsed using mobile-social learning for continuing education and were highly satisfied with the platform [1,8,15,32,36-42,46,49,51,52,54,55]. Students regarded the learning platforms as easily accessible, informative, and user-friendly, with the social components improving communication and knowledge sharing and fostering real-time feedback. Students in a number of studies (12/16, 75%) specifically highlighted the ability to receive real-time feedback from peers or mentors as beneficial to clinical practice, knowledge gains, and team building [8,15,31, 34-37,39,40,50,52,53].
Articles that measured student engagement (16/31, 52%) within the mobile-social learning platforms reported high levels of use among students [1,15,31,33,36-39,43-45,48,50-52,55]. However, the association between levels of engagement and learning outcomes varied among the studies. Woods et al [31] noted that students who regularly followed the WhatsApp learning group had a clinically significant increase in the odds of having higher confidence in managing their patients (odds ratio 8.44, 95% CI 2.33-35.23; P<.05). Abiodun et al [37] noted that, although students were highly engaged within WhatsApp groups, there were no significant associations between the frequency of reading messages and social-professional outcome measures. Among the studies that coupled web-based learning modules with social media interaction and discussions through Facebook and WhatsApp, module completion rates were significantly higher compared with standard massive open web-based course completion [1,30,43,44].
Interaction With Peers
High levels of peer engagement and interaction were reported among the included studies (19/31, 61%) [1,15,30,32,34,38-40,42-44,46,49-52,54,57]. A dominant theme that arose among the studies that assessed peer interaction was the ability to engage in active knowledge sharing. Interventions that fostered peer engagement and interaction through messaging and discussion forums found that participants viewed the interactive component and commentary as beneficial [1,15,30,32,34,38-40,42-44,46,49-52,54,57]. CPD programs that were augmented with social media found that peer support was facilitated through social media platforms, which allowed for real-time interactions and peer feedback and greater understanding of course material [1,30,43,44]. The inclusion of a peer support network was suggested by students in a study that solely focused on virtual mentorship for cervical cancer screening among nurses and did not include a virtual peer-to-peer interaction component [40]. Students in this study stated that, although they were actively engaged with mentors virtually, they strongly believed that including a peer support network or chat room to actively discuss clinical cases and medical imaging in real time would be beneficial [40].
Interaction With Mentors
Mentorship occurred at varying degrees (eg, pairing a student with a master mentor, assigning groups of students to a mentor, and facilitators providing feedback to students in discussion groups). Among the studies that included virtual mentorship (24/31, 77%), students reported positive interactions with mentors [1,8,15-17,34,35,38-41,43-54]. Mentorship occurred through phone calls, texting, and video calls in which mentors were able to provide remote support, real-time feedback, and guidance to students along with reinforcement of key learning messages and skills gained from educational modules and training sessions. In studies where a blended training approach was used, students emphasized the importance of having virtual access to an expert for further questions and case discussions after the initial on-site training [40,45]. Asiedu et al [37] noted that, despite receiving positive feedback on the mobile mentoring component from students, several students and mentors voiced concerns that mobile mentoring on its own was insufficient for posttraining follow-up and support. A few mentors noted that it was difficult to sustain the process of repeated telephone calls to students and that certain students were not being honest about progress [37]. The intervention implemented by Feldacker et al [42] did not contain a virtual mentorship component; however, students highly suggested the inclusion of virtual mentoring opportunities to supplement learning. Similarly, an intervention in Kenya that used WhatsApp mobile messaging for family planning learning did not include a mentorship component; however, students voiced the need for more mentorship support [55].
Students who used mobile-social platforms reported positive learning outcomes in most of the included articles (27/31, 87%) [1,8,15,17,30-39,41-48,50,52,54,55,58]. Learning outcomes included knowledge gains, improved clinical skills, positive influences on clinical practice, and improved quality of service delivery. Students emphasized the educational benefits of having live case discussions with peers or mentors via the mobile-social learning platforms, in which patient-related questions could be addressed in real time along with consulting with peers or mentors about complex clinical cases [8,15, 30,36,38,46,50,52,54]. Across the studies that combined face-to-face learning with mobile-social learning (8/31, 26%), digital platforms that supported mobile-social learning were found to be instrumental in bridging the periods between face-to-face meetings through the ability of the participants to engage in continuous communication and feedback [52]. In 13% (4/31) of the studies where mobile messaging through peer groups was used, participants stated that previous case discussions with peers were used as a resource to which they referred when presented with a complicated clinical case in their practice. In addition, students cited using old case discussions saved in group chats for self-study [31,34,38,41].
Of the 31 studies, 3 (10%) [16,17,49] compared mobile-social learning platforms with traditional face-to-face interventions, but these studies yielded varied results regarding learning outcomes. Yigzaw et al [16] and Muhe et al [49] found no significant differences between groups in the gains in knowledge scores, whereas Ugwa et al [17] reported that the virtual learning arm, which included mobile mentoring, led to better skill performance at all assessment points compared with the traditional arm, with the virtual arm performing better in all competencies at 3 and 12 months after training.
Social Capital and Professional Integration
Social capital characterizes the relationships and interactions between members of a social group [59]. Social capital encompasses a culture of trust and tolerance in which extensive networks of voluntary associations emerge that facilitate coordination and cooperation for mutual benefit [60,61]. In medicine, social capital has been tied to the realization of lifelong learning opportunities, with digital engagement contributing to the development and maintenance of social capital [51,52]. Social capital typologies among the included articles included emotional support, the formation of deeper social connections with peers and colleagues, networking, and non–work-related communication [8,15,30,33,37,39,42,51,52]. Students in the studies that measured social capital (9/31, 29%) cited that virtual interaction with peers or mentors reduced feelings of isolation. Participants stated that interactions helped them maintain existing relationships while also developing and strengthening new social ties, thus promoting professional integration and improving team dynamics [33,34,37,51]. Pimmer et al [33] and Abiodun et al [37] noted that participants with higher levels of active engagement also felt less isolated professionally and had higher levels of social capital.
Challenges and Success Factors
Although positive feedback was elicited from students regarding mobile-social learning, there were several challenges in the implementation and use of the learning modality. Resource challenges related to power cuts and maintenance of uninterrupted internet access were primary barriers to the use of the mobile-social learning platforms in several studies (14/31, 45%) [8,15,31,32,38,40,42-46,50,52,54]. Ugwa et al [17] cited additional resource challenges pertaining to the unavailability of equipment for students to translate what they learned on the web into practice. The lack of time to participate in learning programs because of conflicts with clinical schedules was a challenge noted in 13% (4/31) of the studies [8,17,42,44]. However, 19% (6/31) of the studies highlighted that mobile-social programs allowed for increased flexibility of learning that could easily fit into students' schedules and reduce the need for travel to access face-to-face continuing education programs, which could be challenging for health care providers located in rural areas [1,32,42,43,49,54]. The costs of data bundles and messaging services to support the programs were cited as barriers in 10% (3/31) of the studies [41,49,52]. However, a few studies (6/31, 19%), including those that mentioned cost as a barrier, stated that, over the long term, distance learning approaches were more cost-effective compared with traditional face-to-face programs [8,16,41,43,48,49]. Sociobehavioral challenges were also noted, such as certain users engaging in inappropriate non–work-related discussions on the learning platforms, low levels of active participation, and low digital literacy [15,38,45,50]. In addition, hesitancy among students to interact on platforms because of fear, embarrassment, or lack of knowledge or awareness was cited as a barrier [38,40]. Success factors that were noted among the interventions included tailor-made content to meet the needs of the participants, the flexibility of being able to access learning content anytime and anywhere, and features that promoted ongoing engagement and personal interactivity with peers and mentors [1,8,15,17,30,32-35,37-39,42-47,49,51,52,54]. Peer and mentor interaction allowed for direct personalized feedback, the application of educational content from theory to clinical practice by the students, self-direction for learning, and active learning. Interaction with peers and mentors heightened confidence and promoted empowerment among students, thus leading to increased motivation to maintain newly acquired knowledge and skills [31,40,41].
The use of a wide variety of mobile platforms has become a common adjunct to traditional classroom-based pedagogy and, in many cases, is the default strategy for curriculum dissemination in many countries. However, even in the era of increased uptake of mobile platforms for learning, multifaceted approaches are needed for the diversity of learning needs and preferences [42,62-64]. This integrative review demonstrates that mobile platforms that foster mobile-social learning can serve as an innovative method for providing health care workers and preprofessional students with skill training and education along with virtual interactive components. A major advantage of these strategies is the ability to reach a widely dispersed learner population residing in diverse geographic locations [15,30,40,54]. Access to learning can be independent of time specificity and open to the availability of repetitive exposure to content in support of mastery learning. This evidence synthesis demonstrates the added value of social learning networks as interventions that enhance the utility and effectiveness of internet-based learning platforms whether as independent dissemination strategies or as part of blended learning (hybrid) teaching and learning approaches. Social networks serve as the interface between teachers, mentors, independent learners, and the network of learners engaged in the exploration of any single topic [65,66]. Social networks through mobile platforms can be used to facilitate mobile-social learning as a means of deeper exploration of the understanding of content through peer engagement and interactive discussion and the giving and receiving of feedback [66,67]. In addition, this review highlighted the impact of mobile-social learning on reducing feelings of professional isolation and increasing social capital among health care workers. Increased social connectedness and social presence can play a key role in team building and increasing health care worker motivation and confidence [68]. Improved health care worker motivation may serve as a critical component in reducing attrition in LMICs, thus improving workforce capacity within health systems.
The studies included in this review offered evidence for the acceptability of the use of mobile platforms as an instructional modality, viewing them as accessible and user-friendly. Learners recognized and valued the addition of social interaction strategies via these mobile platforms as measures to receive affirmation of learning. This reinforcement offered by peers and mentors affected the confidence of students when translating learning into clinical practice. The interface of mobile learning with social engagement in the learning process offered the opportunity for meaningful interaction with a wider network of learners and health workers. The ability to engage in real-time discussion of clinical topics and resolution of clinical challenges diminished feelings of isolation, extended the professional network for collaboration when the next need might arise, and expanded the opportunity to remain current with emerging evidence underpinning clinical practice, thus affecting the quality of service delivery.
The evidence synthesis also highlighted the challenges that are inherent in the use of mobile-social learning platforms—infrastructure challenges that are often more complex in lower-resource settings. These include the tangible costs associated with hardware, software, and network connections. The intangible costs of the learning curve that must be faced by each participant must also be considered in the implementation of mobile-social learning programs as some platforms are inherently more complex and less user-friendly than others.
Implications for Future Research and Practice
Several key areas of digital health research are needed to support the efficacy of mobile-social learning. The use of digital platforms is well-suited to measuring the utility of the approach given that the platforms allow for the tracking of time and frequency of use by individual learners, including the degree to which these learners take advantage of the opportunities for social interaction as an enhancement of learning. These data are critical for the evaluation of the effectiveness of the mobile-social teaching and learning strategy. In addition, although mobile-social learning offers various advantages and benefits, certain studies in our review (3/31, 10%) did not yield significant learning outcomes among participants, with participants in some studies citing that they preferred face-to-face learning [16,17,49]. Thus, this underscores the importance of providing multifaceted options in CPD to meet the diversity of learning needs and preferences. Although most studies that included virtual mentorship noted positive results and favorability among participants, the health care infrastructure and human resource constraints in many LMICs may limit access and availability of mentors [69]. Thus, further research is needed to assess how mentorship can be provided without being an additional burden on health care systems and personnel. More research is also needed on developing mobile-social learning programs designed to fit local contexts. Future studies should evaluate the use of recent technological innovations such as augmented reality and virtual reality for mobile-social learning. The included studies did not evaluate the use of these platforms; however, these interventions are gaining traction for the training of health care professionals and preclinical students in high-income countries [70]. As technology advances at a rapid pace, there is a need to explore how such technological innovations can be accessible for health care providers and students in lower-resource settings. Although none of our included studies applied a gender lens to the observed outcomes, it is generally acknowledged as a moderating influence in health and education and, thus, should be considered in the implementation of programs [64,71]. More evidence generated through studies that are methodologically rigorous while simultaneously allowing for lean, iterative, and rapid-paced development and evaluation is needed to thoroughly assess the benefits of mobile-social learning in comparison with traditional learning modalities [72].
Central to the success of digital health interventions is the knowledge of health informatics challenges that may be experienced, particularly in environments where instability in the digital and health infrastructure is common [73]. Developing interventions that are designed to meet learning needs and preferences will entail more representation of individuals from LMICs in the technology development sector to inform the development of digital tools that fit local country contexts [74,75]. Although the included studies discussed challenges in internet access as a barrier to accessing mobile-social learning programs, there was limited discussion on the digital environment in which these studies were implemented. When developing, implementing, and expanding the use of digital health programs that focus on mobile-social learning in LMICs, it is essential to foster strong digital health ecosystems by building and promoting partnerships between the relevant public and private sectors [10,76,77]. Communication channels such as WhatsApp are increasingly being used as a simple, low-cost, and effective means of learning and communication within the clinical health sector. However, more attention must be paid to confidentiality, consent, and data security if individual client data are being shared through these channels [78]. The roles and responsibilities of medical professionals when using digital platforms for mobile-social learning must be outlined along with the development of guidelines and protocols to facilitate the integration of mobile-social learning within digital and health care infrastructures [78]. Thus, the standardization of policies in the exchange and use of information between systems will be critical in ensuring the usability and sustainability of mobile-social learning programs [73,78,79].
This study is not without limitations. Although we used a comprehensive search strategy, we cannot guarantee that it identified all relevant studies. However, the incorporation of gray literature in our review reduced publication bias and denoted experiential evidence that supported mobile-social learning. Our search yielded studies that were predominantly focused in sub-Saharan Africa (28/31, 90%), with only a few studies (3/31, 10%) being conducted outside of that global region. Thus, the findings we report cannot be generalized to all LMIC settings given that sociocultural contexts, subjective norms, health system contexts, and digital environments may vary in different country settings. Finally, we only included articles that were published in English; therefore, we could have missed relevant articles published in other languages.
Mobile-social learning is a particularly useful modality for curriculum dissemination and skill training, and the interface of mobile and social learning offers an interaction effect that can serve as a catalyst for improved learning outcomes coupled with increased social capital. The mobile-social approach is by its nature conducive to the dissemination of shorter segments of key content packed in social platform formats that allow for peer and mentor engagement and interactivity. The concurrent enhancement of mobile curriculum dissemination apps, embedding of proven social interaction strategies into those apps, and development of more and newer user-friendly digital learning opportunities will lead to greater opportunities for learning and peer and mentor support in the interest of improving the quality of health services. As more countries turn to digital modalities of learning, it will be imperative for programs to be adapted for both the technological ecosystem and the local and national health care systems.
This study was supported by Jhpiego, a Johns Hopkins University affiliate.
Search strategy.
Design and level of evidence of included studies.
Summary of included articles.
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CPD: continuing professional development
LMIC: low- and middle-income country
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Edited by T Leung; submitted 03.08.21; peer-reviewed by L Suppan, R Kyabaggu, D Davies, JM Ocampo; comments to author 15.01.22; revised version received 26.01.22; accepted 26.04.22; published 07.06.22
©Dominique Guillaume, Erica Troncoso, Brenice Duroseau, Julia Bluestone, Judith Fullerton. Originally published in JMIR Medical Education (https://mededu.jmir.org), 07.06.2022.
Guillaume D, Troncoso E, Duroseau B, Bluestone J, Fullerton J


We aim to hold an exhibition of work every two years and try to locate the exhibition in different venues around East Berkshire.
The Threads on the Wing exhibition ran in April 2016 in Dinton Pastures Park.
Guild members all share a passion for fibre – from wool to silk, flax (linen) to crab or banana! These are spun, woven, dyed, knitted, felted, crocheted into many different textiles. The skills involved have often taken many years to learn and the crafted items many months to make. You may find a few items for sale in amongst these treasures.
Visit the demonstration area and watch craftswomen (and men) spinning and weaving, and have a go yourself. There are also taster workshops in spinning, weaving, knitting and felting. Please visit our website www.bswd.org.uk for further details.
Photos from our in 2016 exhibition in Dinton Pastures.


FX won't be ordering more episodes of Brand X With Russell Brand, FX Networks CEO John Landgraf said at a press conference today. The network will stay in business with the actor, picking up a scripted live-action comedy pilot starring Brand, which will be based loosely on his life in the vein of HBO's Curb Your Enthusiasm. A search is underway for a writer. In the end, "W. Kamau Bell and (executive producer) Chris Rock were more ready to convert to a daily show," Landgraf said. Totally Biased With W. Kamau Bell, which just logged a series high, will switch to a nightly format when it moves to FXX in September. "We saw more potential and upside in audience's reaction." Brand X started off as a taped weekly show and moved to a live production for the second batch of episodes. The series aired 26 episodes in total.


text:
Siim Roops (* 4. März 1986 in Tartu) ist ein estnischer Fußballspieler.

Karriere
Siim Roops begann seine Karriere in der Jugend des JK Tammeka Tartu. Im Jahr 2002 wurde der Abwehrspieler erstmals in der Meistriliiga eingesetzt. In der Folgezeit konnte sich Roops einen Stammplatz erkämpfen. Nach fünf Spielzeiten in Tartu wechselte dieser 2007 zum estnischen Rekordmeister Flora Tallinn. In Tallinn konnte er an den Leistungen, die er zuvor bei Tammeka gezeigt hatte, nicht anknüpfen, da er unter Pasi Rautiainen in zwei Saisons kaum zu Spielminuten kam. Gleichwohl gewann Roops mit Flora den Estnischen Pokal. Auch eine viermonatige Ausleihe zum Viertligisten Valdres FK nach Norwegen fiel in diese Zeit. Am Saisonende 2008 wechselte er zum JK Tulevik Viljandi wo er für zwei Spielzeiten unter Vertrag stand. Im Jahr 2010 kam er zum Stammverein aus Tartu zurück und konnte sich dort in zwei Jahren die er dort spielte in der ersten Elf etablieren. Mit Ende der Saison 2011 unterschrieb Siim Roops einen Vertrag bei FK Jerv aus Norwegens 2. Divisjon. Mit der Mannschaft aus Grimstad stieg er am Saisonende 2012 aus der 3. in die 4. Liga ab. 2014 ging er dann weiter zum estnischen Drittligisten FC Santos Tartu und stieg mit dem Verein sofort in die zweite Liga auf. In den Spielzeiten 2017 und 2018 war er vereinslos, schloss sich dann aber Anfang 2019 dem Amateurklub FC Otepää an.

Nationalmannschaft
Siim Roops absolvierte am 3. Februar 2007 seine einzige Partie für die estnische A-Nationalmannschaft. Unter dem niederländischen Nationaltrainer Jelle Goes wurde Roops bei der 0:4-Testspielniederlage gegen Polen, welche im spanischen Jerez de la Frontera ausgetragen wurde, 66 Minuten lang eingesetzt. Mit diesem Einsatz war Roops der 200. Nationalspieler in der Länderspielgeschichte des Baltischen Staates.

Erfolge
 Estnischer Pokalsieger: 2008

Einzelnachweise

Weblinks
 Spielerprofil beim FK Jerv
 Statistiken beim Estnischen Fußballverband

Fußballnationalspieler (Estland)
Fußballspieler (FK Jerv)
Fußballspieler (JK Tammeka Tartu)
Fußballspieler (FC Flora Tallinn)
Fußballspieler (JK Tulevik Viljandi)
Fußballspieler (FC Otepää)
Este
Geboren 1986
Mann

redpajama_set_name: RedPajamaWikipedia


Have you ever come home from a bad day only to have your stress melted away by your faithful canine companion? Dogs tend to have that special quality about them, and a new study suggests that it could be beneficial for your children.
Researchers at the University of Florida say that dogs have what they call a "stress-buffering" effect that can help kids cope with the world around them.
"How we learn to deal with stress as children has lifelong consequences for how we cope with stress as adults. . . Our research shows that having a pet dog present when a child is undergoing a stressful experience lowers how much children feel stressed out," Kertes said. "Children who had their pet dog with them reported feeling less stressed compared to having a parent for social support or having no social support," said researcher Darlene Kertes.
Kertes and her colleagues conducted a randomized controlled study in which 100 pet-owning families visited their laboratory with their dogs. Children in the families were asked to take part in a public speaking task and mental arithmetic in order to stimulate feelings of stress and had either their dog, a parent, or no social support present depending on their group assignment.
To objectively measure stress levels, researchers took saliva samples from children before and after the tasks to see how much cortisol was present; high amounts of the hormone would indicate higher levels of stress.
The findings showed that children who had their dogs present for support and actively engaged them had less cortisol in their saliva. "Children who actively solicited their dogs to come and be pet or stroked had lower cortisol levels compared to children who engaged their dogs less," said Kertes.
The results show that children who have a pet dog may benefit from their stress-buffering capacity, especially if they're at a time in their life when they're learning how to cope with anxiety.
"Middle childhood is a time when children's social support figures are expanding beyond their parents, but their emotional and biological capacities to deal with stress are still maturing. Because we know that learning to deal with stress in childhood has lifelong consequences for emotional health and well-being, we need to better understand what works to buffer those stress responses early in life," said Kertes.


Known for its exceptional appearance, this Tiger Hardwood Flooring as exotic hardwood is a great choice - as the name suggests, is a species which exhibits a wide range of colour/striping. The striping can vary from fine lines to bold. The background colour can range from light tans to darker orange browns within the Tiger Hardwood Flooring range.


The use of Wi-fi has increased rapidly in recent years. Through the use of this technology, electronic devices are connected to a computer network wirelessly using radio waves, or radiofrequency (RF) electromagnetic energy (EME), thereby eliminating or reducing the need for network cables. A common example is a laptop connected to the internet using a wi-fi modem at home. Wi-fi access points can also be found in schools and many public areas. People in a wi-fi enabled environment will be exposed to low level RF EME from time to time when using the network on computers and also from the access points. There is some public concern about potential health effects associated with RF EME emissions from wi-fi in homes, schools and other places.
In 2015, scientists from around the world united for the International EMF Scientist Appeal based on the results of over 2,000 research papers. The appeal is the collective voice of 190 scientists from 39 different countries. They are calling for tighter regulations and more security measures when dealing with electromagnetic field exposures generally, and WiFi in particular.
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If you're thinking of buying a phone case with 'radiation blocking material' believing it will reduce radiation, you should know this: Phones have automatic power control, such cases act as shields and make the phone work harder, transmitting more power, increasing heat and reducing battery life, The incoming signal to the phone will also be reduced so your phone may not work in areas of poor signal.
In those cases, however, there are two important things to note. The person exposed to the non-ionizing microwave radiation would be exposed to a very high power dose at a very close range. The magnetron in your average consumer microwave produces about 700 watts of microwave energy, and that microwave discharge is safely contained within the body of the microwave thanks to proper shielding. Even if the microwave was malfunctioning and the shielding was beginning to fail, you wouldn't even feel anything standing in the same room as the device.
Feelsafe Wireless provides qualified customers with a free lifeline government phone and Free Monthly Phone Service. How do you qualify for a free phone? Start by entering your zip code into the text box at the top of the page. You will then be directed to information pertaining to your area. A paper application must be filled out and mailed or faxed in for evaluation. Qualified applicants for a free lifeline government cell phone will will need to participate in a qualifying government assistance program or have a household income level will have a household income that meets the income requirements. Applications can be filled out as tribal or non-tribal households. Once qualified, certification is good for up to one year from the date of account activation with Feelsafe Wireless. Certification must be updated annually to avoid program termination.
Most phones have a GPS that can pinpoint your general or exact location. With this capability, many applications may collect and share your location information. However, many smartphones give you the option of managing your location sharing under the "settings." You can pick and choose which applications may access your location or you can opt to turn off the location setting altogether. Minimizing the location access can also help increase the battery life on your phone. If your phone doesn't offer specific location-sharing settings, choose carefully when downloading new apps so you're not sharing your location unknowingly.
Safety standards do exist for radio frequency radiation emissions, but these standards are only based on thermal heating effects. That is to say they only consider these exposures to be harmful if they heat tissue. But these safety standards do not protect us from adverse biological effects which are thought to be the precursor to serious diseases. Scientists have already raised the alarm regarding this issue.
If you've bought a computer any time in the last 5 years, there is almost a certainty that it has wifi built in. We're far past the days of getting separate wifi cards or adapters for our computers. The problem is, Wifi does emit RF radiation, a type of EMF radiation that is very harmful. Whether you have a desktop computer or a laptop that you use, it likely uses Wifi, so let's take care of that.
Infertility is a common disorder that affects 15% of couples and nearly half of the cases are due to male infertility. As mentioned above, RF-EMR affects many organs including the testes by a direct or a thermal effect . In one study, detrimental effects of RF-EMR on Leydig cells, seminiferous tubules, and especially the spermatozoa were clearly defined . Although RF-EMR reduces testosterone levels, impairs spermatogenesis, and causes sperm DNA damage , the relationship between RF-EMR devices and male infertility is still controversial.
I have noticed that whenever I set the location settings so the apps can access my location, I get a fuzzy feeling in my head. This is followed by feelings of confusion for however long the setting is enabled and often continues for a while even after I switch the settings off. I have also noticed that the effect is magnified by bringing the phone closer to my head. At arms length, the effect is negilable but up close the effect is more dramatic- a space at the back of my eyes start to itch and I find it difficult to concentrate. Anyone else feel anything like this?
Exposure to electromagnetic radiation (EMR) is rapidly increasing in everyday environment, consequently conferring potential health effects. Oxidative stress is emerging as a mechanism implicated in pathophysiology and progression of various diseases. To our knowledge, no report has been made on the status of antioxidant redox systems after continuous exposure to radiofrequency radiation emitted from a Wi-Fi access point in animal model so far. Therefore, we aimed to continuously subject rats in the experimental group to radiofrequency (RF) radiation emitted from a commercially available Wi-Fi device. Male Wister rats were exposed to 2.45 GHz RF radiation emitted from a Wi-Fi for 24 h/day for 10 consecutive weeks. In order to assess the change in antioxidant redox system of plasma after continuous exposure to a Wi-Fi device, the total antioxidant capacity of plasma, level of thiobarbituric acid reactive substances, concentration of reduced glutathione (GSH), and activity of different enzymatic antioxidants, e.g., superoxide dismutase [SOD], catalase [CAT], glutathione peroxidase [GSH-Px], and glutathione S-transferase [GST], were measured. In the Wi-Fi exposed group, a significant decrease was detected in total antioxidant capacity of plasma and the activities of several antioxidant enzymes, including CAT, GSH-Px, and SOD (P < 0.05). Meanwhile, the GST activity was significantly increased in this group (P < 0.05). However, no significant changes were found in GSH and TBARS levels following exposure to RF radiation. According to the results, oxidative defense system in rats exposed to Wi-Fi signal was significantly affected compared to the control group. Further studies are needed to better understand the possible biological mechanisms of EMR emitted from Wi-Fi device and relevant outcomes.


Alaska Sonata is a vintage secret set during the Nome, Alaska gold rush.
Before the S.S. Victoria completes her spring run to Nome. Stumpy, Andrew Macfarlane, ex wrestler, ship's detective, and pianist on "Old Vic" needs to peel away layers of bewilderment and fake ends up in carry the assassin to the captain.
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"How can a useless guy be killed?" As he walks the seashore of the indian village, Hoonah, Alaska, this query is floated towards Stumpy via a lady shaman. most unlikely? Or is it? "You recognize, or will know," the shaman keeps, leaving Stumpy scratching his head, really his toupee--"time isn't a line, yet quite a circle." This complicated enigma is just one of many impossibilities Stumpy faces as ship's detective aboard the S.S. Victoria as he makes an attempt to plow through the flotsam of lies obscuring the 1st homicide. Then there are more.
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For aid, Stumpy depends Victoria's team: Bobby Burns, purser, alcoholic and scared of the water; First Mate Smith, a pompous ingratiating boot licker; Matty, ship's nurse who has 'seen it all'. She is in love with Stumpy and may do whatever to assist him; As his eyes and ears, Stumpy depends the boys from steering who're touring to the gold fields of Nome. As excessive in personality as they're low in station they arrive to Stumpy's rescue.
The Victoria, racing to be the 1st send of the season into Nome, is stopped useless within the water. Captain Lundstrom fumes while delays compound delays and strength detours. He desires to provide his detective a few slack, yet cannot.
Iciness 1955, das Dorf auf der schwäbischen Alb versinkt im Schnee. Der wirtschaftliche Neuanfang ist auch in Dornstetten zu spüren, der Aufschwung der neuen Zeit wird erwartet. Aber die alte Zeit, der Krieg, das deutsche Reich lässt die Bewohner nicht los. Sie ist verschüttet und eingeschrieben in den Erinnerungen und Gefühlen der Bewohner.
En 1989, une équipe de coureurs français, sponsorisée par l'épicerie et l. a. brasserie du coin, s'apprête à effectuer une direction sans précédent de Béziers à Moscou pour célébrer le bicentenaire de l. a. Révolution. Son lengthy trajet à travers l'Europe sera ponctué de drames amoureux et de rencontres saugrenues qui prendront peu à peu le pas sur l'exploit sportif à proprement parler.
Fronte russo, 1943. Una nuova indagine sulla linea del fuoco according to Martin Bora. Il romanzo più potente e visionario di Ben Pastor.
The opera Aida, deeply encouraged by way of Egypt, was once written by means of Giuseppe Verdi for functionality at Cairo's Khedivial Opera condo. This opera has consistently been entwined with the background and tradition of the town and its citizens. The 12 months is 1971. Cairo resident Kismet believes the spirit of Aida, the opera's name personality, has touched her and will be speaking together with her via her goals.


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text:
472. Robert Southey to Samuel Taylor Coleridge, [started before and continued on] 1 January 1800
472. Robert Southey to Samuel Taylor Coleridge, [started before and continued on] 1 January 1800 *
I will transcribe the books of Thalaba & send them up. [1] to trust the single copy to stage coach risque would not be wise – moreover transcribed they must be for correction & for the press. – A History of the Levelling Principles [2] – or Jacobinism – if it be a prettier title – I am able & willing to undertake, – if a publisher chuses to engage me. I have no objection so to colour the dose or flavour it as to disguise its medicinal virtue from sight & taste. my name I would not affix – nor would a wise bookseller require it – the indelible epithet character of republicanism sticks to it. The history should commence with the agrarian governments – & conclude with the death of the principle in France – where it now lies with little hope of a joyful resurrection. [3] One might make a grave & good chapter in examining the principle & confuting it only upon the ground of original sin.
You have not understood my travelling plans. certainly to settle somewhere – probably at Trieste, but from thence, if I had a companion to make occasional excursions of some length, certainly once thro Hungary to Constantinople.
I like your Carol much – & the ode – tho the why of the latter is not quite so palpable as it should be. [4] if my memory play me not false, the Austrian did not fall beneath the shaft of Tell [5] – supposing the tale to be true which assuredly it is not. howbeit let that pass. tis a good story & fit 'to make a song of.' [6] my correspondents increase. the Anthology [7] is a very favourite scheme of its mine & very disinterestedly. it cannot bring me in more than twenty pounds a volume – but it is a sort of focus – a something on which so many of those whom I have <some> regard for feel an interest that I should be loth to have it drop.
I have found Jeremy Taylors sermons at an old shop here – they contain incomparably finer passages than any I remember in his Holy Living. [8] the Ductor Dubitantum is not a book of powerful eloquence – it does not admit of it – but the sermons have more poetry than 12 of the great volumes of Andersons 13. [9] Did I tell you that Mackintosh every where praises the old Bishop? [10] I strongly suspect that he talks after you. Mackintosh is here – I have no inclination to see him – by the by you should not abuse him Scot as he is, in common company – people bottle up your sayings & retail them, & God knows there is no occasion for making an enemy.
How like you Gobwins novel? [11] it is at times powerfully written – but it is dilated or diluted. St Leon always acts so like a fool that his conduct is the most unbelievable part of the volume & Gobwin is always exposing himself in a posture which says 'come kick me.' the passage in the first volume about voluptuousness, which recommends a course of brothel studies, is very exceptionable, & Gobwin ought to have recollected what allusion his enemies would immediately make. [12] I was quite paind & irritated at the mans folly.
The Baptist Library [13] here – I have got access to, & the privilege of carrying home its books. this is of importance to me. the books relating to Oriental matters are many & good. Do you know that they have missionaries in the East Indies? Ryland [14] showed me a little God whom they had just sent over – the primitial spoils I suppose. twas an ugly brass epicene-looking God sitting cross-legged upon a peacock. Should not you like to hear a controversy between a Baptist & a Bramin?
Jany. 1. 1800. I have made some progress in transcribing Thalaba. the notes need not be sent. suffice it that they will be numerous, & explanatory of every out-of-the-way word or allusion in the text.
The Gentlemen of the Literary Fund [15] are about to commence a review I hear – now these Gentlemen write books themselves – & when one Gentleman reviews another Gentlemans poetry – what pretty gentlemanlike criticism we shall have! [16] there is Boscawen who did Horace into English [17] – as probably his bookseller has most reason to remember. & W. J. Fitzgerald who wrote rhymes upon Marie Antoinette – a dying speech & confession poet. [18] & Mister Pye who makes his country ashamed of Naval Dominion, & who also has fallen foul upon Alfred! [19] God have mercy on his soul – Blackmore [20] first – & then Henry James Pye – & twenty four books besides! [21] – but these Gentlemen Critics who will be so civil to one another must vary their review by a little severity – & that must fall upon the poor writers who are not Gentlemen.
Estlin is coming to London. I supped there on Monday – they produced Cartwrights Armine & Elvira [22] for me to read aloud, after some half hours superlative praises upon its merit. I read a little on the hand gallop – for an easier pace would have put me to sleep – & when I had done you never witnessed such a dead flatness as ensued. Danvers cried out – & I gave such a conscientious half-scruple of praise – that the next day they laid all the poor poems failure upon my bad reading – I murdered it – which would have been like killing dead small beer.
Davy is expecting to hear from you. George is on trial at Savarys. [23] Poole has sent me some Laver, & I have a thought for a poem on its origin. [24]
God bless you –
yrs Robert Southey.
* Address: To/ Mr Coleridge/ 21. Buckingham Street/ Strand/ London./ Single
Postmarks: BRISTOL/ JAN. 1800; B/ JAN 2/ 1800
Watermark: [obscured]
Endorsement: 45=974
MS: Bodleian Library, MS Eng. Lett. d. 122. ALS; 4p.
Previously published: National Review, 19 (1892), 704–706; Kenneth Curry (ed.), New Letters of Robert Southey, 2 vols (London and New York, 1965), I, pp. 212–214. BACK
[1] Coleridge had offered to treat with the publishers Longmans on Southey's behalf and see what terms he could secure for the publication of Thalaba the Destroyer (1801) (Coleridge to Southey, 28 December 1799, E.L. Griggs (ed.), The Collected Letters of Samuel Taylor Coleridge, 6 vols (Oxford, 1956–1971), I, p. 553). BACK
[2] Coleridge had suggested this project in his letter to Southey, 28 December 1799, E.L. Griggs (ed.), The Collected Letters of Samuel Taylor Coleridge, 6 vols (Oxford, 1956–1971), I, p. 554. BACK
[3] France had adopted the Constitution of the Year VIII on 24 December 1799. It concentrated power in the hands of three Consuls and limited popular participation in government. BACK
[4] In his letter to Southey of 28 December 1799, Coleridge had enclosed copies of his 'Christmas Carol', Morning Post, 25 December 1799, and 'Ode to Georgiana, Duchess of Devonshire', Morning Post, 24 December 1799. Both were included in Annual Anthology (Bristol, 1800), pp. 79–82, 212–216. BACK
[5] A refrain within Coleridge's 'Ode to Georgiana, Duchess of Devonshire'. William Tell was a legendary fourteenth century hero in the struggle for Swiss independence. Southey, though, was incorrect. In most versions of the Tell legend he did kill Hermann (or Albrecht) Gessler, the Bailiff of Altdorf and local representative of Austria. BACK
[6] Unidentified. BACK
[7] Annual Anthology (1799) and Annual Anthology (1800). Further volumes were planned, but never appeared. BACK
[8] Jeremy Taylor (1613–1667; DNB), Anglican theologian. The book may well have been XXVIII Sermons Preached at Golden Grove (1654), no. 2783 in the sale catalogue of Southey's library. Southey versified part of Sermon XXV 'The Miracles of Divine Mercy' in Thalaba the Destroyer (1801), Book 8, lines 226–237. He openly preferred the Sermons to Taylor's more famous The Rule and Exercises of Holy Living (1650) and Doctor Dubitantum, or the Rule of Conscience (1660). BACK
[9] Robert Anderson (1749–1830; DNB), A Complete Edition of the Poets of Great Britain, published in thirteen volumes between 1792 and 1795; a fourteenth volume was added in 1807. BACK
[10] William Taylor to Southey, 18 October 1799 (J.W. Robberds (ed.), A Memoir of the Life and Writings of the Late William Taylor of Norwich, 2 vols (London, 1843), I, p. 298) revealed that James Mackintosh (1765–1832; DNB), author of Vindiciæ Gallicæ: A Defence of the French Revolution and its English Admirers (1791,) had enthusiastically praised the works of Jeremy Taylor during his visit to Norwich. BACK
[11] William Godwin, nicknamed 'Gobwin' by Southey, had just published his new novel, St Leon (1799). BACK
[12] William Godwin, St Leon, 4 vols (London, 1799), I, pp. 81–82; Godwin's An Enquiry Concerning Political Justice (1793) had condemned marriage as a form of legalised prostitution. Moreover, Southey is probably also recalling the controversy over Godwin's portrayal of Mary Wollstonecraft in Memoirs of the Author of a 'Vindication of the Rights of Woman' (1798). BACK
[13] The Library at Bristol Baptist College, which trained Baptist Ministers and could trace its history back to 1679. The Baptist Missionary Society, founded in 1792, which promoted missions abroad, was closely connected to the College. BACK
[14] John Ryland (1753–1825; DNB), leading Baptist and President of Bristol Baptist College, 1793–1825. BACK
[15] The Royal Literary Fund, founded in 1790 to help writers in financial difficulty. BACK
[16] The reference is obscure. It could relate to the proposed involvement of David Williams (1738–1816; DNB) in a projected loyalist periodical, the Imperial Gazette. It might also relate to the Royal Literary Fund's decision, announced later in 1800, to produce a history of its actitivities, eventually published as the Claims of Literature (1802). BACK
[17] William Boscawen (1752–1811; DNB), translator of The Odes, Epodes, and Carmen Secularae of Horace (1793) and The Satires, Epistles and Art of Poetry of Horace (1797). His unfortunate bookseller was John Stockdale (1750–1814; DNB). BACK
[18] William Thomas Fitzgerald (1759–1829; DNB), author of numerous patriotic verses, including The Tribute of an Humble Muse to an Unfortunate Captive Queen, the Widowed Mourner of a Murdered King (1793), about Marie Antoinette (1755–1793; Queen Consort of France 1774–1792). BACK
[19] The Poet Laureate, Henry James Pye ( 1745–1813; DNB), Naucratia, or Naval Dominion (1798) and Alfred, an Epic Poem in Six Books (1801). BACK
[20] Richard Blackmore (1654–1729; DNB), author of Alfred, an Epick Poem. In Twelve Books (1723). BACK
[21] Joseph Cottle's Alfred (1800) outdid Blackmore and Pye by taking up 24 Books. BACK
[22] Edmund Cartwright (1743–1823; DNB), clergyman, inventor of the power loom and author of Armine and Elvira – a Legendary Poem (1770). BACK
[23] George Fricker had been placed in the Bristol bank of John Savary (d. 1831) after efforts on his behalf by Southey and Coleridge. BACK
[24] Laver is a type of edible seaweed. Southey did not write a poem on its origin, but see Common-Place Book, ed. John Wood Warter, 4 series (London, 1849–1850), IV, p. 21 for his note on the possibility of a poem on 'Laver; how it was ambrosia'. BACK
Coleridge, Samuel Taylor (1772–1834)
Godwin, William (1756–1836) (mentioned 3 times)
Fricker, George (1785–1813) (mentioned 2 times)
Wollstonecraft, Mary (1759–1797) (mentioned 1 time)
Poole, Thomas (1766–1837) (mentioned 1 time)
Estlin, Susanna Bishop (d. 1842) (mentioned 1 time)
Danvers, Charles (c. 1764–1814) (mentioned 1 time)
Davy, Humphry (1778–1829) (mentioned 1 time)

redpajama_set_name: RedPajamaCommonCrawl


text:
Gorovje Pamir leži na stičišču gorovij Tian Shan v Kirgizistanu, Karakorum v Pakistanu, Kunlun Shan na Kitajskem in Hindukuš v Afganistanu. Večina pogorja leži v Tadžikistanu. Manjši deli pa se nahajajo tudi v naslednjih državah: Kirgizistan, Afganistan in Pakistan.

Geografija

Najvišji vrh je Ismoil Somoni (od leta 1932 - 1962 imenovan Stalinov vrh, od leta 1962 - 1998 imenovan Vrh komunizma) z višino 7.495 m. Sledi Ibn Sina (znan kot Pik Lenin) s 7134 m in Pik Korženevske (rusko: Пик Корженевской, Pik Korženevskoi) s 7105 m.

V gorovju leži veliko ledenikov, med drugim tudi 72 km dolg ledenik Fedčenko, največji ledenik v nekdanji Sovjetski zvezi in največji izven polarne regije.

V Pamirju leži v bližini meje s Kirgizistanom tudi veliko jezero Karakul, poleg tega pa še mnogo manjših visokogorskih jezer. Iz jezera Zorkal izteka tudi reka Pamir. ki se po sotočju z reko Vahan imenuje Pjandž, ki na zahodu obkroža pogorje in ga loči od Hindukuša. Večina ostalih rek odteka v Pjandž.

Podnebje
Pamir je celo leto pokrit s snegom. Ima dolge in ostre zime in kratka ter hladna poletja.

Ekonomija
Na zahodnem delu se nahaja rudnik premoga, sicer pa se ljudje večinoma preživljajo z živinorejo.

Dostopnost
Na jugovzhodnem delu regije Pamir na Kitajskem visokogorska cesta imenovana tudi Karakorumska avtocesta (Karakoram Highway – KKH) povezuje Pakistan in Kitajsko preko 4934 m visokega mejnega prelaza Hundžirab. Visokogorska cesta Pamir (M41) je druga najvišje ležeča cesta, ki preko 4280 m visokega prelaza Kyzyl Art povezuje Karakul v Tadžikistanu in Oš v Kirgizistanu čez avtonomno regijo Guorno-Badakhshan.

Viri
 Atlantika, veliki satelitski atlas sveta, Mladinska knjiga 2007, ISBN 978-86-11-17783-0

Zunanje povezave
 Informacije in fotografije
 The Pamirs. 1:500.000 - Turistična karta Gorno-Badkshan-Tadžikistana in informacije o regiji. Verlag "Gecko-Maps", Switzerland 2004 (ISBN 3-906593-35-5)
 Turistični urad v Khorogu (Tadžikistan) Pamirs Tourism Association

Gorovja v Aziji
Geografija Tadžikistana
Geografija Pakistana
Geografija Afganistana
Geografija Kirgizistana