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This paper proposes and describes a context- and subject-specific professional digital competence (PDC) framework for beginning English language teachers in Hong Kong. Taking a localised approach, the framework was developed through a four-stage data collection process, (1) Literature review of empirical studies conducted in Hong Kong of English language teachers' technology use, (2) Review of local government curriculum documents; (3) An online survey of English language teachers' technology use (n = 83); (4) follow-up individual interviews (n = 22). The study revealed that the local subject-specific PDC of teachers includes five aspects; Technological proficiency; Pedagogical compatibility; Preparing students for the digital world; Risk, well-being and ethical awareness and Professional work. Each aspect includes ability statements. The framework can be used to evaluate existing teacher education programmes, support the development of pre-service English-language teachers and facilitate self-, peer- and teacher assessment. The elements of PDC can be converted into programme- and course-level learning outcomes or incorporated into assessment rubrics. In addition, the methods used to develop the framework can be used by scholars in other contexts and subject areas to develop localised subject-specific PDC frameworks.

Purposeful and strategic use of L1 can help with L2 learning. However, in many contexts, monolingual immersion approaches dominate, leading language teachers to refrain from using L1. It can also mean that teachers are not professionally prepared to implement evidence-informed uses of L1. In this article, we share the findings of an intervention study that aimed to raise preservice English language teachers' awareness of purposeful L1 use while co-exploring ways generative artificial intelligence (AI) tools (e.g. ChatGPT) can aid teachers' knowledge development and strategic utilization of L1 in L2 classrooms. Data were collected from fifty-six preservice language teachers in Hong Kong through a pre- and post-intervention mixed-method survey and follow-up group interviews. The findings show that explicit instruction on the use of L1 in L2 classrooms can increase preservice teachers' intention to use L1 as well as their knowledge about the evidence-informed use of L1 and the ways in which generative AI tools can assist their implementation of L1.

Heather Moffatt,1 Paige Moorhouse,1,2 Laurie Mallery,1,2 David Landry,1 Karthik Tennankore2 1Nova Scotia Health Authority, Halifax, NS, Canada; 2Dalhousie University, Halifax, NS, CanadaPurpose: Recent evidence supports the prognostic significance of frailty for functional decline and poor health outcomes in patients with chronic kidney disease. Yet, despite the development of clinical tools to screen for frailty, little is known about the experiential impact of screening for frailty in this setting. The Frailty Assessment for Care Planning Tool (FACT) evaluates frailty across 4 domains: mobility, function, social circumstances, and cognition. The purpose of this qualitative study was as follows: 1) explore the nurse experience of screening for frailty using the FACT tool in a specialized outpatient renal clinic; 2) determine how, if at all, provider perceptions of frailty changed after implementation of the frailty screening tool; and 3) determine the perceived factors that influence uptake and administration of the FACT screening tool in a specialized clinical setting.Methods: A semi-structured interview of 5 nurses from the Nova Scotia Health Authority, Central Zone Renal Clinic was conducted. A grounded theory approach was used to generate thematic categories and analysis models.Results: Four primary themes emerged in the data analysis: “we were skeptical”, “we made it work”, “we learned how”, and “we understand”. As the renal nurses gained a sense of confidence in their ability to implement the FACT tool, initial barriers to implementation were attenuated. Implementation factors – such as realistic goals, clear guidelines, and ongoing training – were important factors for successful uptake of the frailty screening initiative.Conclusion: Nurse participants reported an overall positive experience using the FACT method to screen for frailty and indicated that their understanding of the multiple dimensions and subtleties of “frailty” were enhanced. Future nurse-led FACT screening initiatives should incorporate those factors identified as being integral to program success: realistic goals, clear guidelines, and ongoing training. Adopting the evaluation of frailty as a priority within clinical departments will encourage sustainability.Keywords: frailty, screening, feasibility, qualitative, end stage renal disease, decision making

Technostress is a phenomenon in which rapid technological advancement affects teachers' psychological well-being. It is an emerging concern in English language education, which may be exacerbated by the advent of generative artificial intelligence (GenAI) tools such as ChatGPT. This study explores the factors that influence technostress among English language teachers using GenAI tools and strategies that can alleviate it. Based on the analysis of qualitative data from semi-structured interviews with 16 instructors at higher education institutions in Hong Kong, the study identifies the rapid advancement of AI technology, inadequate training and lack of experience as contributors to technostress. It also names mitigating strategies including targeted professional development, online engagement and gradual integration. These techniques can foster Technological Pedagogical Content Knowledge (TPACK) and reduce the challenges of incorporating GenAI into English teaching. The findings align with existing literature on the impact of technostress and the role of TPACK. The practical implications include the need for comprehensive training, supportive communities and a balanced approach to AI integration. This investigation also expands the theoretical understanding of technostress in English language teaching and the use of GenAI tools, providing empirical support for existing frameworks. It also suggests directions for future research, which could investigate teacher well-being, effective AI integration and the impact of TPACK.

As Artificial Intelligence (AI) advances technologically, it will inevitably bring many changes to classroom practices. However, research on AI in education reflects a weak connection to pedagogical perspectives or instructional approaches, particularly in K-12 education. AI technologies may benefit motivated and advanced students. Understanding the teacher's role of student motivation in mediating and supporting learning with AI technologies in the classroom is needed. This study used self-determination theory as the undergirding framework to investigate how teacher support moderates the effects of student expertise on needs satisfactions and intrinsic motivation to learn with AI technologies. This experimental study involved 123 Grade 10 students, and used chatbots as AI-based technologies in the experiment. The analyses revealed that intrinsic motivation and competence to learn with the chatbot depended on both teacher support and student expertise (i.e. self-regulated learning and digital literacy), and the teacher support better satisfied the need for relatedness, and it less satisfied the need for autonomy. The findings refined our understanding about the application of self-determination theory and expand the pedagogical and design considerations of AI application and instructional practices.

Beginning teaching is challenging during normal circumstances. Yet, in the summer of 2020, the newly qualified teachers (NQTs) from initial teacher education (ITE) programmes in Hong Kong, as well as many other global contexts, entered schools that were severely disrupted by COVID-19. This qualitative study, through the use of a qualitative online survey, explored the sense of preparedness and first-semester experiences of one cohort of NQTs who graduated from an ITE programme in Hong Kong in the summer of 2020. Findings suggest that the disruptions to their programme and teaching role fundamentally affected their sense of preparedness and defined their first-year experience. Specifically, the NQTs did not feel practically or psychologically prepared to teach online using digital technologies. However, some NQTs reported positive school-based practices that aided their transition. Based on the study's findings, professional digital competence beginning teachers require for online teaching environments, as well as recommendations for ways ITE programmes can help develop this competence, are provided.

In-person teaching abroad experiences, where pre-service teachers spend a defined period teaching in schools in a foreign country, have received considerable research attention in recent years. However, virtual alternatives have yet to be explored. This exploratory study sought to understand the effects a virtual teaching abroad experience had on pre-service teachers' professional learning. Data included teaching logs and reflective writings of two groups of pre-service teachers from Hong Kong who participated in a virtual teaching abroad experience hosted by a university in the United Kingdom and interviews with their course coordinators. The findings suggest that the PSTs found the virtual teaching abroad experience novel and unique, contributing to professional learning. Specifically, the experience (a) increased the PSTs' confidence and flexibility; (b) improved their synchronous online teaching skills; (c) gave them greater awareness of learner differences and needs; and (d) exposed them to innovative pedagogical approaches. The study suggests that virtual teaching abroad experiences could have a place within initial teacher education, especially as the financial costs associated with them are lower than in-person experiences. However, they do not seem adequate to replace a sustained period immersed in an overseas school context.

Technology reviews are a specific article genre published in several language teaching and learning journals. Their emergence is likely due to the proliferation of technology that facilitates and supports language acquisition. These reviews aim to increase teachers' and learners' awareness of the forms of technology available and succinctly describe their benefits and limitations for language teaching and learning. As education enters a new digital age, accelerated by the COVID-19 pandemic, it is essential to determine which forms of technology support teachers' professional learning and how they can be utilized. This article presents a systematic review of technology reviews published between 2017 and 2022 in five Q1 SCOPUS-indexed language teaching and learning journals: "RELC Journal," "TESOL Journal," "CALICO Journal," "Language Learning and Technology" and "Teaching English as a Second Language Electronic Journal" (TESL-EJ). These five journals were the only Q1 language teaching and learning journals we identified that publish technology reviews. All 73 technology reviews published in the 5-year period in the 5 journals were reviewed. Using professional digital competence as a framework, we explore what the articles reveal about how technology is used, as well as the knowledge gaps that remain. We examine the types and features of the technology described in the reviews, the language skills and educational levels of the learners, and the pedagogical implications of technology use. We found that the technology reviews mainly introduced the technological features and functions of the reviewed technologies with less emphasis placed on their pedagogical utilities and social aspects of their use for language teaching. The article concludes with recommendations for authors and journal editors regarding the content that should be included in a technology review to ensure that it is helpful to the profession. We also offer advice to practitioners on how to benefit from technology reviews.

In this technology review, we explore the affordances of the generative AI chatbot ChatGPT for language teaching and learning. In addition to this, we also present debates and drawbacks of ChatGPT. Finally, we present the digital competencies teachers and learners require to use this chatbot ethically and effectively to support language learning.

Interaction is seen by many English language teachers and scholars as an essential part of face-to-face English language classrooms. Teachers require specific competencies to effectively use interaction as a tool for mediating and assisting learning. These can be referred to as classroom interactional competence (CIC). However, the situation created by the ongoing global COVID-19 pandemic which began in early 2020, and the recent advancement in technologies have led to teachers conducting synchronous online lessons through video-conferencing software. The online environment is distinctly different from the face-to-face classroom and teachers require new and additional skills to effectively utilise interaction online in real time. This exploratory study used an online mixed-method survey of 75 university level English language teachers who had engaged in synchronous online teaching due to COVID-19, to explore the competencies that teachers need to use interaction as a tool to mediate and assist language learning in synchronous online lessons. Teachers were found to require three competencies, in addition to their CIC -- technological competencies, online environment management competencies, and online teacher interactional competencies -- which together constitute e-CIC. The findings provide greater insights into the needs of teachers required to teach synchronously online and will be of interest to teachers and teacher educators.

Synchronous online teaching through video-conferencing software (VCS) has become a common mode of instruction during the COVID-19 pandemic. This mode brings unique challenges for teachers that require specific professional digital competences. One such challenge is conducting formative assessment. Through the use of in-depth interviews with nine Hong Kong university teachers who had taught synchronously online for one semester, this exploratory study explored the challenges of conducting formative assessment during synchronous online lessons and the strategies teachers deploy to conduct formative assessment. The findings indicate that the key difficulties include gathering information on students' needs, checking students' understanding, giving individual feedback, and building relationships with students. To address these challenges, the teachers suggested four pedagogical strategies: (1) Combine synchronous with asynchronous approaches; (2) Utilise breakout rooms; (3) Utilise poll functions of the VCS and combine it with other online platforms; and (4) Provide time before or after lessons for informal conversations. The findings suggest that teachers need to develop specific pedagogical strategies to conduct formative assessment. This provides an initial conceptualisation of one important dimension of Professional Digital Competence, teaching using digital technologies, and one aspect of that dimension, how teachers use digital tools and strategies to conduct formative assessment.

This article reports on a study that investigated primary-school English-language teachers' use of digital technologies in their in-person classrooms after a period of online teaching necessitated by the COVID-19 pandemic. It also explored the perceived effects the period of online teaching had on the teachers' practices. Data were collected through in-depth interviews with sixteen experienced Hong Kong primary-school English-language teachers approximately one year after they returned to in-person teaching. The findings suggest that the period of online teaching has led to a greater utilization of technology for teaching. In addition, they suggest digital technologies are now embedded in teachers' regular teaching practices, with the digital technologies adopted primarily those that enhance existing practices. Common digital technologies include: (1) learning management systems; (2) digital noticeboards; (3) interactive digital worksheets and quizzes; and (4) interactive presentation software. Examples of how teachers use digital technologies, and considerations for their use, are provided.

A set of core concepts ("big ideas") integral to the discipline of physiology are important for students to understand and demonstrate their capacity to apply. We found poor alignment of learning outcomes in programs with physiology majors (or equivalent) from 17 Australian universities and the 15 core concepts developed by a team in the United States. The objective of this project was to reach Australia-wide consensus on a set of core concepts for physiology, which can be embedded in curricula across Australian universities. A four-phase Delphi method was employed, starting with the assembling of a Task Force of physiology educators with extensive teaching and curriculum development expertise from 25 Australian universities. After two online meetings and a survey, the Task Force reached agreement on seven core concepts of physiology and their descriptors, which were then sent out to the physiology educator community across Australia for agreement. The seven core concepts and their associated descriptions were endorsed through this process (n = 138). In addition, embedding the core concepts across the curriculum was supported by both Task Force members (85.7%) and educators (82.1%). The seven adopted core concepts of human physiology were Cell Membrane, Cell-Cell Communication, Movement of Substances, Structure and Function, Homeostasis, Integration, and Physiological Adaptation. The core concepts were subsequently unpacked into themes and subthemes. If adopted, these core concepts will result in consistency across curricula in undergraduate physiology programs and allow for future benchmarking.

A task force of physiology educators from 25 Australian universities generated an Australia-wide consensus on seven core concepts for physiology curricula. One adopted core concept was "cell membrane," defined as "Cell membranes determine what substances enter or leave the cell and its organelles. They are essential for cell signaling, transport, and other cellular functions." This concept was unpacked by a team of 3 Australian physiology educators into 4 themes and 33 subthemes arranged in a hierarchical structure up to 5 levels deep. The four themes related to defining the cell membrane, cell membrane structure, transport across cell membranes, and cell membrane potentials. Subsequently, 22 physiology educators with a broad range of teaching experience reviewed and assessed the 37 themes and subthemes for importance for students to understand and the level of difficulty for students on a 5-point Likert scale. The majority (28) of items evaluated were rated as either Essential or Important. "Theme 2: cell membrane structure" was rated as less important than the other three themes. "Theme 4: membrane potential" was rated most difficult, while "theme 1: defining cell membranes" was rated as the easiest. The importance of cell membranes as a key aspect of biomedical education received strong support from Australian educators. The unpacking of the themes and subthemes within the cell membrane core concept provides guidance in the development of curricula and should facilitate better identification of the more challenging aspects within this core concept and help inform the time and resources required to support student learning. [This article was written with Task Force.]

Sexual violence is a global phenomenon needing sustainable interventions. The article extends findings from media literacy scholars by exploring ways that critical media literacy (CML) pedagogies can be used to teach affirmative consent education for the purposes of violence prevention. The article is not a curriculum blue-print, as the pedagogies are still being piloted for adolescents in Ontario. However, the rationales for bridging consent education and critical media literacy apply transnationally. Engaging educators and students with critical analysis of media and creative media production is key to transformative learning about consent, within and beyond the classroom. The article ends by outlining methods that will be used to test the hypothesis that a CML approach rooted in social justice frameworks and best practices in violence prevention will improve the way affirmative consent is taught to adolescents.

Technology is increasingly being used to foster engagement, enhance classroom dynamics, promote autonomy and improve the student learning experience in language learning environments. Many teachers have begun to employ digital apps and tools (e.g. Mentimeter and GoSoapBox) as a more interactive alternative to traditional activities. One product that has been particularly popular due to its user-friendly interface and focus on motivation, enjoyment and competition is Kahoot! (https://kahoot.com) -- a game-based student response system in which the teacher takes on the role of a game show host with the students as contenders. Kahoot! can enhance the language classroom by making the introduction of new content (e.g. definitions, tenses or collocations) and the consolidation of knowledge more interactive and visible, helping learners reach mastery of the language content. Although Kahoot! has been a popular platform since its launch in 2013, its utility in the language classroom has yet to be fully explored. Furthermore, to be used effectively, teachers need a clear understanding of its subject-specific affordance and limitations. Therefore, this review explores how language teachers can use Kahoot! to improve student engagement -- and potentially academic performance -- by gamifying learning. Notably, only the free version of Kahoot! is examined.

The kākāpō is a flightless parrot endemic to New Zealand. Once common in the archipelago, only 201 individuals remain today, most of them descending from an isolated island population. We report the first genome-wide analyses of the species, including a high-quality genome assembly for kākāpō, one of the first chromosome-level reference genomes sequenced by the Vertebrate Genomes Project (VGP). We also sequenced and analyzed 35 modern genomes from the sole surviving island population and 14 genomes from the extinct mainland population. While theory suggests that such a small population is likely to have accumulated deleterious mutations through genetic drift, our analyses on the impact of the long-term small population size in kākāpō indicate that present-day island kākāpō have a reduced number of harmful mutations compared to mainland individuals. We hypothesize that this reduced mutational load is due to the island population having been subjected to a combination of genetic drift and purging of deleterious mutations, through increased inbreeding and purifying selection, since its isolation from the mainland ∼10,000 years ago. Our results provide evidence that small populations can survive even when isolated for hundreds of generations. This work provides key insights into kākāpō breeding and recovery and more generally into the application of genetic tools in conservation efforts for endangered species.

Synchronous online language lessons (SOLLs) are distinctly different from in-person lessons. Although digital tools, specifically, videoconferencing software, make doing SOLLs possible, these tools have specific affordances and constraints pertaining to how we engage, interact, and relate -- creating new literacy practices. This study reports on a project which explored how five Hong Kong university English language teachers engaged in teaching SOLLs over a 13-week semester. The aim of the project was to understand and conceptualize the professional practices of synchronous online language teachers; specifically, our goal was to explore the relationship between identified practices and the competences needed to use digital tools during SOLLs to facilitate classroom interaction and therefore create appropriate conditions for language learning. The study expands our understanding of the professional practices teachers are engaged in when doing SOLLs. Furthermore, our data exemplify the context-specific teaching strategies and related competences needed to assist and mediate interaction in SOLLs. We propose that by improving synchronous online language teachers' interactional competence, they will be well-placed to help language learners achieve their learning goals. The findings have implications for the preparation and professional learning of online English language teachers.

The COVID-19 pandemic has had a profound effect on schools around the world with many forced to suspend in-person classes. This has meant teachers have been required to find ways to continue teaching remotely. Remote teaching requires specific and extended skills and knowledge from those required in the in-person classroom. This two-stage qualitative-dominant sequential mixed-method study, using a survey of Hong Kong primary and secondary school English language teachers (N = 73) and follow-up interviews (N = 10), collectively explores teachers' readiness for using digital technologies before the pandemic, how they have innovated and professionally developed throughout the pandemic, and what impact the pandemic has had on their pedagogical and technological development. The findings indicate that the COVID-19 pandemic has been a catalyst for teacher innovation and development. Teachers went through a three-phase period of innovation as they responded to the school closures and adjusted to the new digital environment. To support their innovation, teachers engaged in both school and teacher-initiated professional development. The findings have theoretical implications, proposing a model to explore innovation during times of crisis, "Phases of Innovation in Response to Crisis Process". They also have practical implications, providing examples of innovations adopted by teachers during this period of radical change.

Opportunities for pre-service teachers to participate during their initial teacher education (ITE) in teaching-abroad experiences, where they spend time teaching in a foreign country, have become increasingly popular. However, studies to date have collected data during or soon after the participant's return. Little is known about how recently qualified teachers (RQTs) who participated in such experiences during the ITE perceive their benefits. By collecting and analysing reflective writings of ten RQTs in Hong Kong, who participated in a teaching-abroad experience in China, this small-scale study sought to explore its impact on their perceived preparedness for their current roles in their home context. The findings suggest that the teachers feel that the experience added to their preparedness, in areas such as lesson preparation and planning, teaching confidence and flexibility and professional collaborations. The RQTs attributed these benefits to the unfamiliar teaching context and the additional teaching practice that the experience provided, as well as the opportunity to work closely with peers, course tutors and teachers in China. The study adds to the growing teaching-abroad literature by including the perspectives of RQTs, providing further justification for including such experiences in ITE programme curriculums.

The global pandemic caused by the COVID-19 virus has had a disruptive and profound impact on English-language teaching. To reduce the spread of the virus, teachers and learners had to suspend in-person teaching and learning. This led to the widespread adoption of synchronous and asynchronous online teaching. Obviously, this period has led to immense challenges for teachers and students alike, but it has also provided a unique opportunity to understand the potential affordances of online teaching in English-language teaching. This study, a systematic thematic review of empirical studies pertaining to English-language teaching and the COVID-19 pandemic, identifies and analyses the key knowledge generated by the English-language-teaching community during the pandemic. It ends with a discussion of the lessons learned from the pandemic and suggests potential areas for further research.

This article reports on a small-scale exploratory study that examined how native-speaking English teachers (NETs) working in the Primary Native-speaking English Teacher (PNET) Scheme construct their professional identity(ies) and explored the barriers to their professionalism that exist within their role and context. Data were collected using questionnaires and a group interview with qualified NETs. The findings of the study show that NETs' identities are complex with NETs having to negotiate their professional identities to fit into "their" role and local context. Although other stakeholders endorse this modification, it does not come without cost. NETs sacrifice their authentic selves while facing barriers to their own personal beliefs of good teaching and professionalism. The author suggests that if these barriers are not addressed, NETs may feel marginalised and be unable to be their professional selves. A number of suggestions are made for NETs, teachers, school administrators and policy-makers on how to better support NETs' professionalism.

BACKGROUND:Uptake of antiretroviral treatment (ART) is expanding rapidly in low- and middle-income countries (LMIC). Monitoring of virological suppression is recommended at 6 months of treatment and annually thereafter. In case of confirmed virological failure, a switch to second-line ART is indicated. There is a paucity of data on virological suppression and clinical management of patients experiencing viremia in clinical practice in LMIC. We report a large-scale multicenter assessment of virological suppression over time and management of viremia under programmatic conditions. METHODS AND FINDINGS:Linked medical record and laboratory source data from adult patients on first-line ART at 52 South African centers between 1 January 2007 and 1 May 2018 were studied. Virological suppression, switch to second-line ART, death, and loss to follow-up were analyzed. Multistate models and Cox proportional hazard models were used to assess suppression over time and predictors of treatment outcomes. A total of 104,719 patients were included. Patients were predominantly female (67.6%). Median age was 35.7 years (interquartile range [IQR]: 29.9-43.0). In on-treatment analysis, suppression below 1,000 copies/mL was 89.0% at month 12 and 90.4% at month 72. Suppression below 50 copies/mL was 73.1% at month 12 and 77.5% at month 72. Intention-to-treat suppression was 75.0% and 64.3% below 1,000 and 50 copies/mL at month 72, respectively. Viremia occurred in 19.8% (20,766/104,719) of patients during a median follow-up of 152 (IQR: 61-265) weeks. Being male and below 35 years of age and having a CD4 count below 200 cells/μL prior to start of ART were risk factors for viremia. After detection of viremia, confirmatory testing took 29 weeks (IQR: 16-54). Viral resuppression to below 1,000 copies/mL without switch of ART occurred frequently (45.6%; 6,030/13,210) but was associated with renewed viral rebound and switch. Of patients with confirmed failure who remained in care, only 41.5% (1,872/4,510) were switched. The median time to switch was 68 weeks (IQR: 35-127), resulting in 12,325 person-years spent with a viral load above 1,000 copies/mL. Limitations of this study include potential missing data, which is in part addressed by the use of cross-matched laboratory source data, and the possibility of unmeasured confounding. CONCLUSIONS:In this study, 90% virological suppression below the threshold of 1,000 copies/mL was observed in on-treatment analysis. However, this target was not met at the 50-copies/mL threshold or in intention-to-treat analysis. Clinical management in response to viremia was profoundly delayed, prolonging the duration of viremia and potential for transmission. Diagnostic tools to establish the cause of viremia are urgently needed to accelerate clinical decision-making.

COVID-19 has forced universities around the world to suspend in-person teaching and adopt emergency remote teaching (ERT). To compensate for the suspension of in-person teaching, many universities mandated that teachers utilise video-conferencing software (VCS) to deliver synchronous online lessons conducted through VCS. This study explored the impact of ERT and the requirement to teach synchronously online through VCS on the motivation of university teachers at a major university in Hong Kong. In-depth interviews were conducted with nine teachers who had completed a full semester of ERT. The findings suggest that the teachers fell into two distinct groups. Teachers in one group (n = 5) seemed to thrive, reporting mainly positive effects of ERT on their motivation, while the others (n = 4) seemed to be just surviving, reported mainly negative effects. For members of the "thriving" group, the semester reinvigorated their teaching and provided them with new skills; members of the "surviving" group, by contrast, questioned their ability to teach, found it hard to build a rapport with learners, felt isolated, and struggled to find job satisfaction. The study concludes with a discussion of measures that could help university teachers to maintain their motivation during online instruction.

This small-scale exploratory study explores the practices and experiences of two experienced Hong Kong Education Bureau Advisory Teachers (ATs) engaged in school-based professional support (SBPS) of teachers during school closure caused the COVID-19 pandemic. It documents the ATs usual practices, conditions for effective SBPS, the effect the pandemic had on their practices, and the specific support they provided remotely during the pandemic. Key findings indicate that effective SBPS requires clear role expectations, a collaborative support approach, building strong relationships and durability. The SBPS model is resilient and allows ATs and teachers to adjust to the evolving situation. ATs have continued to provide support throughout the school closures, something that would not have been possible without the existing SBPS model, relationship cultivated over an extended period of support and available technology. The authors recommend that Education Bureaus explore SBPS as a way to continue supporting teachers during school closures.

This article reports on a collaborative self-study conducted by the authors (two teacher educators) as we attempted to implement a pedagogy of care during the disruptions to teacher education caused by COVID-19. Due to the pandemic, we were required to conduct our teacher education courses synchronously online through video-conferencing software. Although this mode of instruction allowed us to continue teaching despite the restrictions necessitated by COVID-19, the relational aspect of teaching and the role of care seemed to be limited and became an important concern for us. Through self-study, we aimed to improve our online teaching practices by enacting a pedagogy of care during one full semester. We detail our attempts to conceptualise a pedagogy of care for the online classroom, begin our courses from a position of care and prioritize and maintain care throughout the semester. We also present the ongoing challenges we experienced in implementing a pedagogy of care online. While recognising that everyone has been affected by COVID-19 in different ways, we hope through sharing our experiences, others can learn from them and conceptualise and implement a pedagogy of care in their contexts.

This study explores the professional learning of ten pre-service teachers from Hong Kong and ten host teachers in a school in China who participated in a teaching abroad project. The participants' professional learning during the project is conceptualised within five knowledge domains of quality teaching for the twenty-first century: personal, contextual, pedagogical, sociological and social. The findings suggest that by immersing pre-service teachers in an unfamiliar teaching environment, they can learn professional knowledge for teaching in an increasingly complex world. This complements the knowledge they are acquiring in their domestic courses and practicums. Furthermore, through the pedagogical exchange of ideas, the host teachers are also found to benefit. We recommend that teaching abroad opportunities be included in initial teacher education (ITE) programmes and that host teachers' professional learning are considered in their development.

COVID-19 has led to dramatic changes in the way teachers teach and students engage in higher education (HE). To cater for social distancing and learners' diverse needs, including being in different geographical locations from their HE instruction, different modes of teaching and learning have been adopted. One such mode is HyFlex. HyFlex sees teachers teaching students at the same time in a physical classroom and synchronously online through video-conferencing software. This small-scale exploratory study considers the experiences and perceptions of nine post-graduate students who attended a six-week course delivered through HyFlex. Findings suggest that while there were communication challenges between students who attended through different modes, participants did appreciate the flexibility it afforded. The utilisation of various features of the video-conferencing software and other digital tools were seen as essential to the effectiveness of HyFlex.

Involving parents in their children's school-based English language learning is beneficial to learners' academic achievement as well as their language and literacy development. However, involving parents can be challenging. This study reports on one teacher's use of a digital learning platform, Seesaw, with his third-grade (7 to 8 year-olds) English language writing class in Hong Kong to address the lack of parental involvement. The platform became a space for parents to be involved in their child's school-based writing. It enabled them to view, like and comment in response to their child and other children's English work. Although parents were seen to be involved on the platform, it was observed they mainly viewed and liked rather than commented. Future pedagogical directions will be discussed with suggestions provided on how parents can be encouraged to take a more active role on such platforms.

The affordances and pedagogical benefits of technology in the English for Specific Purposes (ESP) and English for Academic Purposes (EAP) classrooms are widely acknowledged. One potential use of technology is in eliciting and managing students' responses, which is an area where EAP/ESP teachers often report difficulties. Traditionally, teachers either nominate students to respond or rely on students volunteering to answer questions. In practice, this condition tends to mean that the more confident students respond, or students are 'put on the spot' by being nominated to speak by a teacher. One way to address this issue is through response cards. Students can respond in unison with a card or whiteboard displaying the answer. Response cards are effective at all levels of education. They increase active responses, improve test scores, and motivate learners. There are now digital alternatives to response cards called 'student response systems' (SRS). These systems provide a flexible and diverse way for students to respond using their mobile devices. SRS include Mentimeter, Kahoot, Plickers, GoSoapBox, and Poll Everywhere. Due to its versatility and unlimited number of participants, we believe Mentimeter has greater potential in the EAP/ESP classroom. This tech review will provide an overview of Mentimeter's features and potential uses.

Globally, the number of drug prescriptions is increasing causing more adverse drug events, which is now a significant cause of mortality, morbidity, and disability that has reached epidemic proportions. The risk of adverse drug events is correlated to very old age, multiple co-morbidities, dementia, frailty, and limited life expectancy, with the major contributor being polypharmacy. Each characteristic alters the risk-benefit balance of medications, typically reducing anticipated benefits and amplifying risk. Current clinical guidelines are based on evidence proven in younger/healthier adult populations using a single disease model and their application to older adults with multimorbidity, in whom testing has not been conducted, yields a different risk-benefit prospect and makes inappropriate medication use and polypharmacy inevitable. Applying inappropriate clinical practice guidelines to older adults is antithetical to good healthcare, is likely to increase health inequity, and is associated with substantial negative clinical, economic, and social implications for health systems. The casualties are on the scale of a war or epidemic, yet are usually invisible in measures of healthcare quality and formal recommendations. Radical and rapid action is required to achieve a better quality of life for older populations and to remain true to the principles of medical professionalism and evidence-based medicine that place patients' interests and autonomy at the fore. This first International Group for Reducing Inappropriate Medication Use & Polypharmacy position statement briefly details the causes, consequences, and extent of inappropriate medication use and polypharmacy. This article outlines current strategies to reduce inappropriate medication use, provides evidence for their effect, and then proposes recommendations for moving forward with 10 recommendations for action and 12 recommendations for research. We conclude that an urgent integrated effort to reduce inappropriate medication use and polypharmacy should be a leading global target of the highest priority. The cornerstone of this position statement from the International Group for Reducing Inappropriate Medication Use & Polypharmacy is the understanding that without evidence of definite relevant benefit, when it comes to prescribing, for many older patients 'less is more'. This approach differs from most other current recommendations and guidance in medical care, as the focus is on what, when, and how to stop, rather than on when to start medications/interventions. Disrupting the framework that indiscriminately applies standard guidelines to older adults requires a new approach that better serves patients with multimorbidity. This transition requires a shift in medical education, research, and diagnostic frameworks, and re-examination of the measures used as quality indicators. In achieving this objective, we promote a return to some of the original concepts of evidence-based medicine: which considers scientific data (where it exists), clinical judgment, patient/family preference, and context. A shift is needed: from the current model that focuses on single conditions to one that simultaneously considers multiple conditions and patient priorities. This approach reframes the clinician's role as a professional providing care, rather than a disease technician.

BACKGROUND:Antiretroviral therapy (ART) that enables suppression of HIV replication has been successfully rolled out at large scale to HIV-positive patients in low-income and middle-income countries. WHO guidelines for these regions define failure of ART with a lenient threshold of viraemia (HIV RNA viral load ≥1000 copies per mL). We investigated the occurrence of detectable viraemia during ART below this threshold and its effect on treatment outcomes in a large South African cohort. METHODS:In this observational cohort study, we included HIV-positive adults registered between Jan 1, 2007, and May 1, 2016, at 57 clinical sites in South Africa, who were receiving WHO-recommended ART regimens and viral load monitoring. Low-level viraemia was defined as the occurrence of at least one viral load measurement of 51-999 copies per mL during ART. Outcomes were WHO-defined virological failure (one or more viral load measurement of ≥1000 copies per mL) and switch to second-line ART. Risks were estimated with Cox proportional hazard models. FINDINGS:70 930 patients were included in the analysis, of whom 67 644 received first-line ART, 1476 received second-line ART, and 1810 received both. Median duration of follow-up was 124 weeks (IQR 56-221) for patients on first-line ART and 101 weeks (IQR 51-178) for patients on second-line ART. Low-level viraemia occurred in 16 013 (23%) of 69 454 patients, with an incidence of 11·5 per 100 person-years of follow-up (95% CI 11·4-11·7), during first-line ART. Virological failure during follow-up occurred in 14 380 (22%) of 69 454 patients on first-line ART. Low-level viraemia was associated with increased hazards of virological failure (hazard ratio [HR] 2·6, 95% CI 2·5-2·8; p